scholarly journals Optimized Procedure to Schedule Physicians in an Intensive Care Unit: A Case Study

Mathematics ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 1976
Author(s):  
Lotfi Hidri ◽  
Achraf Gazdar ◽  
Mohammed M. Mabkhot
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Minimization ◽  
Optimal Schedule ◽  
Real Life ◽  
Real Data ◽  
Experimental Tests ◽  
Operating Costs ◽  
Healthcare Personnel ◽  
Total Cost

Hospitals are facing an important financial pressure due to the increasing of the operating costs. Indeed, the growth for the hospitals’ services demand causes a rising in the number of required qualified personnel. Enlarging the personnel number increases dramatically the fixed total cost. Based on some studies, 50% of operating costs in US hospitals are allocated to healthcare personnel. Therefore, reducing these types of costs without damaging the service quality becomes a priority and an obligation. In this context, several studies focused on minimizing the total cost by producing optimal or near optimal schedules for nurses and physicians. In this paper, a real-life physicians scheduling problem with cost minimization is addressed. This problem is encountered in an Intensive Care Unit (ICU) where the current schedule is manually produced. The manual schedule is generating a highly unbalanced load within physicians in addition to a high cost overtime. The manual schedule preparation is a time consuming procedure. The main objective of this work is to propose a procedure that systematically produces an optimal schedule. This optimal schedule minimizes the total overtime within a short time and should satisfies the faced constraints. The studied problem is mathematically formulated as an integer linear program. The constraints are real, hard, and some of them are non-classical ones (compared to the existing literature). The obtained mathematical model is solved using a state-of-the-art software. Experimental tests on real data have shown the performance of the proposed procedure. Indeed, the new optimal schedules reduce the total overtime by up to 69%. In addition, a more balanced workload for physicians is obtained and several physician preferences are now satisfied.

Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

2013 ◽  
Vol 34 (7) ◽  
pp. 723-729 ◽  
Author(s):  
Kayla L. Fricke ◽  
Mariella M. Gastañaduy ◽  
Renee Klos ◽  
Rodolfo E. Bégué
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Patient Contact ◽  
Hospital Type ◽  
Vaccination Rates ◽  
Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

scholarly journals Empirical use of antibiotics in adult intensive care unit: a real-life approach

2019 ◽  
Vol 6 (1) ◽  
pp. 738-746
Author(s):  
Dragana Protić ◽  
Maja Stojković ◽  
Ljiljana Marković-Denić ◽  
Borislav Tošković ◽  
Siniša Djurašević ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Real Life ◽  
Adult Intensive Care Unit

scholarly journals Criteria for referral of pediatric SARS-CoV-2 infection: a real-life experience in the pandemic era

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Carlotta Montagnani ◽  
Elisabetta Venturini ◽  
Manuela L’Erario ◽  
Chiara Tersigni ◽  
Barbara Bortone ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Experience ◽  
Tertiary Care ◽  
Real Life ◽  
Pediatric Intensive Care ◽  
University Hospital ◽  
Children At Risk ◽  
Referral Criteria ◽  
Practical Guidance

AbstractA practical guidance on the management of children with COVID-19 to insure homogeneous criteria for referral to a higher-level facility, according to the disease severity, is pivotal in the pandemic era. A panel of experts in pediatric infectious diseases and intensive care at the tertiary-care Meyer Children’s University Hospital, Florence, Italy, issued a practical document shared with Tuscany hospitals. The rationale was to target the referral for those children at risk of requiring an intensive support, since the above mentioned hospital has the pediatric intensive care unit. Overall, 378 patients between 0 and 19 years of age were diagnosed with COVID-19 infection in the Tuscany region with 24 (6.3%) hospitalizations. Only three children were centralized to Meyer Children’s University Hospital according to reported criteria. Considering that appropriate referral criteria have been associated with reduced mortality in other conditions, our document might be useful to improve outcomes of children with COVID-19.

scholarly journals Improving physical distancing among healthcare workers in a pediatric intensive care unit

2021 ◽  
pp. 1-21
Author(s):  
Anna C. Sick-Samuels ◽  
Sara Cosgrove ◽  
Clare Rock ◽  
Alejandra Salinas ◽  
Opeyemi Oladapo-Shittu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Healthcare Workers ◽  
Real Life ◽  
Pediatric Intensive Care ◽  
Study Objective ◽  
Before And After ◽  
Small Decline ◽  
The Impact

Abstract Background: Healthcare workers (HCWs) not adhering to physical distancing recommendations is a risk factor for acquisition of severe acute respiratory coronavirus virus 2 (SARS-CoV-2). The study objective was to assess the impact of interventions to improve HCW physical distancing on actual distance between HCWs in a real-life setting. Methods: HCWs voluntarily wore proximity beacons to measure the number and intensity of physical distancing interactions between each other in a pediatric intensive care unit. We compared interactions before and after implementing a bundle of interventions including changes to the layout of workstations, cognitive aids, and individual feedback from wearable proximity beacons. Results: Overall, we recorded 10,788 interactions within 6 feet (∼2 m) and lasting >5 seconds. The number of HCWs wearing beacons fluctuated daily and increased over the study period. On average, 13 beacons were worn daily (32% of possible staff; range, 2–32 per day). We recorded 3,218 interactions before the interventions and 7,570 interactions after the interventions began. Using regression analysis accounting for the maximum number of potential interactions if all staff had worn beacons on a given day, there was a 1% decline in the number of interactions per possible interactions in the postintervention period (incident rate ratio, 0.99; 95% confidence interval, 0.98–1.00; P = .02) with fewer interactions occurring at nursing stations, in workrooms and during morning rounds. Conclusions: Using quantitative data from wearable proximity beacons, we found an overall small decline in interactions within 6 feet between HCWs in a busy intensive care unit after a multifaceted bundle of interventions was implemented to improve physical distancing.

A cost-minimization analysis of dexmedetomidine compared with midazolam for long-term sedation in the intensive care unit*

2010 ◽  
Vol 38 (2) ◽  
pp. 497-503 ◽  
Author(s):  
Joseph F. Dasta ◽  
Sandra L. Kane-Gill ◽  
Michael Pencina ◽  
Yahya Shehabi ◽  
Paula M. Bokesch ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Minimization ◽  
Cost Minimization Analysis
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