scholarly journals The Effect of Technology Investments on Hospital Budget and Patient Safety: A Simulation for Emergency Department

2019 ◽  
Vol 8 (6) ◽  
pp. 4650-4656
Keyword(s):  
Patient Safety ◽  
Waiting Times ◽  
Investment Decisions ◽  
Resource Planning ◽  
Rfid Technology ◽  
Hospital Budget ◽  
Hospital Managers ◽  
Advanced Technologies ◽  
Long Time ◽  
The Impact

One of the most important problems for hospital management is long waiting times. Especially in Emergency Departments, which are very crowded in terms of the number of applicants, patients wait for a long time without any treatment. Long waiting times between stations affect the total length of stay of the patients in this department. In this case, it directly affects patient safety. Furthermore, patients can leave from hospitals because of not to take effective and rapid treatment or lack of resource. Patient satisfaction is negatively affected and the brand value of these hospitals may decrease. All these events trigger hospital budget also. Hospital managers who faced these problems before, should first review all their existing processes, identify roadmaps and plan improvements. They are able to make use of advanced technologies and make investment decisions for improvement processes. However, investment decisions can be quite costly and can effect of hospital budget economically. Therefore, the use of simulations to compare the results of investment decisions can provide much more accurate decisions. The purpose of this study is to support hospital managers in making decisions by monitoring the impact of investment decisions (technology or resource investment) on the hospital budget. Both investment decisions will be simulated comparatively, patient processes and resource planning will be improved by creating a sustainable management model with RFID Technology

scholarly journals 805 A Dangerous Wait: The Impact of Prolonged Waiting Times in Endocrine Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Shuttleworth ◽  
F Eatock
Keyword(s):  
Patient Safety ◽  
Northern Ireland ◽  
Waiting Time ◽  
Safety Concern ◽  
Waiting Times ◽  
Waiting List ◽  
Endocrine Surgery ◽  
Day Case ◽  
Average Waiting Time ◽  
The Impact

Abstract Aim In Northern Ireland on 31/12/19 90,514 patients were awaiting admission/day case procedure. The 2019/2020 Ministerial waiting time target states that by March 2020, 55% of patients should not wait longer than 13 weeks for inpatient/day case treatment, and no patient should wait longer than 52 weeks. This audit investigates the impact of long waiting times in endocrine surgery and how they impact patient safety. Method Data was collected from the endocrine surgery waiting list in the Royal Victoria Hospital, Belfast, up to 6/2/20. Number of days spent on the waiting list, disease complications and the number of days before they occurred were collated. Results 118 patients were awaiting endocrine surgery. The average waiting time was 533 days. 21 patients experience 27 complications related to their endocrine disease whilst waiting for surgery. The average duration before complications was 490 days; 4 required admission, 11 required medical intervention and 3 required a surgical intervention. Conclusions The average waiting time for endocrine surgery is greater than 52 weeks. In Northern Ireland no one should be waiting more than 52 weeks. The length of the waiting list has resulted in 1 in 5 experiencing complications and prolonged suffering from under-treated disease. This is a significant patient safety concern. Urgent action to address waiting lists is required and the disruption caused by COVID-19 should be used as a catalyst for reform.

Euratom and Brexit: Could the United Kingdom Maintain One Foot in the European Union? Current Scenarios and Future Prospects of British withdrawal from the EAEC

2018 ◽  
Vol 18 (2) ◽  
pp. 134-151
Author(s):  
Andrea Circolo ◽  
Ondrej Hamuľák
Keyword(s):  
European Union ◽  
United Kingdom ◽  
Independent Solution ◽  
Legal Regulation ◽  
The European Union ◽  
The United Kingdom ◽  
The Status ◽  
Long Time ◽  
Energy Community ◽  
The Impact

Abstract The paper focuses on the very topical issue of conclusion of the membership of the State, namely the United Kingdom, in European integration structures. The ques­tion of termination of membership in European Communities and European Union has not been tackled for a long time in the sources of European law. With the adop­tion of the Treaty of Lisbon (2009), the institute of 'unilateral' withdrawal was intro­duced. It´s worth to say that exit clause was intended as symbolic in its nature, in fact underlining the status of Member States as sovereign entities. That is why this institute is very general and the legal regulation of the exercise of withdrawal contains many gaps. One of them is a question of absolute or relative nature of exiting from integration structures. Today’s “exit clause” (Art. 50 of Treaty on European Union) regulates only the termination of membership in the European Union and is silent on the impact of such a step on membership in the European Atomic Energy Community. The presented paper offers an analysis of different variations of the interpretation and solution of the problem. It´s based on the independent solution thesis and therefore rejects an automa­tism approach. The paper and topic is important and original especially because in the multitude of scholarly writings devoted to Brexit questions, vast majority of them deals with institutional questions, the interpretation of Art. 50 of Treaty on European Union; the constitutional matters at national UK level; future relation between EU and UK and political bargaining behind such as all that. The question of impact on withdrawal on Euratom membership is somehow underrepresented. Present paper attempts to fill this gap and accelerate the scholarly debate on this matter globally, because all consequences of Brexit already have and will definitely give rise to more world-wide effects.

„Arvīd, uz kurieni Tu aizgāji?”: Arvīda Griguļa personības loma Rakstnieku savienības vēsturē

2020 ◽  
pp. 74-84
Author(s):  
Madara Eversone
Keyword(s):  
20Th Century ◽  
Communist Party ◽  
Central Committee ◽  
State Archive ◽  
National Archives ◽  
Literary Heritage ◽  
Literary Process ◽  
Long Time ◽  
The Impact

The article aims to highlight the role of Arvīds Grigulis’ (1906–1989) personality in the Latvian Soviet literary process in the context of the Latvian Soviet Writers’ Union, attempting to discover the contradictions and significance of Arvīds Grigulis’ personality. Arvīds Grigulis was a long-time member of the Writers’ Union, a member of the Soviet nomenklatura, and an authority of the soviet literary process. His evaluations of pre-soviet literary heritage and writings of his contemporaries were often harsh and ruthless, and also influenced the development of the further literary process. The article is based on the documents of the Central Committee of the Latvian Communist Party, the Latvian Soviet Writers’ Union and the Communist Party local organization of the Latvian Soviet Writers’ Union that are available at the Latvian State Archive of the National Archives of Latvia, as well as memories of Grigulis’ contemporaries. It is concluded that the personality of the writer Arvīds Grigulis, although unfolding less in the context of the Writers’ Union, is essential for the exploration of the soviet literary process and events behind the scenes. The article mainly describes events and episodes taking place until 1965, when Arvīds Grigulis’ influence in the Writers’ Union was more remarkable. Individual and further studies should analyse changes and the impact of his decisions in the cultural process of the 70s and 80s of the 20th century.

The Impact of Strategic Relevance and Assurance of Sustainability Indicators on Investors' Decisions

2014 ◽  
Vol 34 (1) ◽  
pp. 131-162 ◽  
Author(s):  
Mandy M. Cheng ◽  
Wendy J. Green ◽  
John Chi Wa Ko
Keyword(s):  
Strategic Alignment ◽  
Investment Decisions ◽  
Company Strategy ◽  
Cost Leadership ◽  
Nonprofessional Investors ◽  
Differentiation Strategy ◽  
Leadership Strategy ◽  
Strategy Versus ◽  
The Impact ◽  
Cost Leadership Strategy

SUMMARY In this study, we report two 2 × 2 between-subjects experiments that investigate the effect of strategic relevance of reported sustainability information and its assurance on nonprofessional investors' investment decisions. The first experiment manipulates strategic relevance of reported environmental, social, and governance (ESG) indicators between “high” and “low” by varying the company strategy (sustainability-based differentiation strategy versus cost leadership strategy unrelated to sustainability). The second experiment manipulates the strategic alignment of the ESG indicators (holding strategy constant). We also manipulate the presence (absence) of assurance in both experiments. Results from both experiments document that investors perceive ESG indicators to be more important, and are more willing to invest in the company if ESG indicators have higher strategic relevance. Experiment one also provides evidence that assurance increases investors' willingness to invest to a greater extent when ESG indicators have high relevance to the company strategy. Our findings suggest that the assurance of ESG indicators has a beneficial signaling role in communicating the importance of this reported information to investors.

The impact of craniotomy for brain tumor case volume on patient safety indicators and in-hospital mortality

2020 ◽  
Vol 196 ◽  
pp. 106043
Author(s):  
Paul R. Clark ◽  
Robert J. Dambrino ◽  
Sean M. Himel ◽  
Zachary S. Smalley ◽  
Wondwosen K. Yimer ◽  
...  
Keyword(s):  
Patient Safety ◽  
Brain Tumor ◽  
Hospital Mortality ◽  
Case Volume ◽  
Patient Safety Indicators ◽  
The Impact

Quality and Patient Safety in a Pathology Residency Training Program

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S95-S96
Author(s):  
R Demkowicz ◽  
S Sapatnekar ◽  
D Chute
Keyword(s):  
Patient Safety ◽  
Residency Training ◽  
Chief Resident ◽  
Residency Training Program ◽  
Basic Structure ◽  
Learning Activities ◽  
Before And After ◽  
Quality And Patient Safety ◽  
The Impact ◽  
Quiz Scores

Abstract Introduction/Objective Since the start of the new millennium, optimization of Quality and Patient Safety (QPS) has taken a renewed focus in the healthcare industry. Consequently, the Accreditation Council for Graduate Medical Education has mandated that QPS be a part of residency training. We have previously presented our curriculum designed to meet the specific needs of Pathology training programs, and covering four content areas: Handoffs, Error Management, Laboratory Administration, and Process Improvement. We are now presenting implementation. Methods To implement this curriculum, we 1) created online modules for self-directed learning on basic topics (using courses developed by IHI and CAP, and assigned articles), and paired these with faculty-facilitated interactive learning activities on more complex topics, including proficiency testing, root cause analysis and test utilization, 2) assigned every resident to a QPS project that was aligned with departmental priorities, led by a faculty advisor, and ran over 8- 10 months, and 3) appointed a QPS Chief Resident to coordinate and support the residents’ QPS activities. We measured the impact of the curriculum by comparing RISE laboratory accreditation percentiles and QPS curriculum quiz scores before and after curriculum implementation. Results After its implementation, RISE percentiles increased by at least 25 for every PGY, and QPS quiz scores increased by at least 10% for 3 of 4 PGY. Every QPS project was presented at Grand Rounds, and 4 were presented externally, including 2 at national conferences. Conclusion Our curriculum was successful in improving residents’ knowledge and competence in QPS. Challenges included designing appropriate learning activities, tracking completion of activities, coordinating faculty schedules and maintaining resident buy-in to the curriculum. We believe that the basic structure of our curriculum offers a solid foundation to which revisions can be made as QPS priorities evolve, and which can be readily adapted to other programs and locations.

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

scholarly journals Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data

2021 ◽  
Vol 10 (8) ◽  
pp. 1782
Author(s):  
Ignacio Ricci-Cabello ◽  
Aina María Yañez-Juan ◽  
Maria A. Fiol-deRoque ◽  
Alfonso Leiva ◽  
Joan Llobera Canaves ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Cross Sectional ◽  
Morbidity Burden ◽  
Patient Reported ◽  
Patient Complexity ◽  
Complex Relationships ◽  
The Impact

We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men.

scholarly journals More than just contraception: the impact of the levonorgestrel-releasing intrauterine system on public health over 30 years

2021 ◽  
pp. bmjsrh-2020-200962
Author(s):  
Kristina Gemzell-Danielsson ◽  
Ali Kubba ◽  
Cecilia Caetano ◽  
Thomas Faustmann ◽  
Eeva Lukkari-Lax ◽  
...  
Keyword(s):  
Unplanned Pregnancy ◽  
Universal Access ◽  
Waiting Times ◽  
Hospital Environment ◽  
Future Research ◽  
Reproductive Health Services ◽  
Therapeutic Benefits ◽  
Cost Efficacy ◽  
Long Acting ◽  
The Impact

Universal access to sexual and reproductive health services is essential to facilitate the empowerment of women and achievement of gender equality. Increasing access to modern methods of contraception can reduce the incidence of unplanned pregnancy and decrease maternal mortality. Long-acting reversible contraceptives (LARCs) offer high contraceptive efficacy as well as cost-efficacy, providing benefits for both women and healthcare systems. The levonorgestrel-releasing intrauterine system (LNG-IUS) first became available in 1990 with the introduction of Mirena (LNG-IUS 20), a highly effective contraceptive which can reduce menstrual blood loss and provide other therapeutic benefits. The impact of the LNG-IUS on society has been wide ranging, including decreasing the need for abortion, reducing the number of surgical sterilisation procedures performed, as well as reducing the number of hysterectomies carried out for issues such as heavy menstrual bleeding (HMB). In the context of the COVID-19 pandemic, Mirena can provide a treatment option for women with gynaecological issues such as HMB without organic pathology, minimising exposure to the hospital environment and reducing waiting times for surgical appointments. Looking to the future, research and development in the field of the LNG-IUS continues to expand our understanding of these contraceptives in clinical practice and offers the potential to further expand the choices available to women, allowing them to select the option that best meets their needs.

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