scholarly journals 21st Century Approach: Using data and novel technologies to address the opioid crisis

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Eric Yazel ◽  
Crystal Henderson ◽  
Jessica B. Dennison
Keyword(s):  
Population Distribution ◽  
Response Times ◽  
Health Department ◽  
Rapid Response ◽  
Community Based ◽  
Notification System ◽  
Novel Technologies ◽  
Clark County ◽  
Scott County ◽  
Overdose Patient

ObjectiveTo use novel technologies to develop a rapid response framework to reach opioid overdose patients in an area which is challenging from both a geography and population distribution standpoint.IntroductionClark County, Indiana is geographically located in between the urban area of Louisville, Kentucky and Scott County, Indiana. Scott County is the site for the largest HIV outbreak in the history of the United States, directly related to high rates of IV drug abuse. The unique geographic location of Clark County in combination with the recent HIV and Hepatitis C outbreaks in Clark and neighboring counties has greatly informed the development of an effective response to overdoses and the opioid epidemic in general. Furthermore, Clark County has a unique population distribution, with a population of over 125,000 and a land area of over 300 square miles. Despite this large area, over 80% of the population lives within 9 miles of the southern border of the county. This leads to a mix of both urban and rural challenges. There are several areas of the county that have greater than 15 minute emergency response times, which is often the difference between life and death in an overdose situation. These factors led to the development of the Clark County Rapid Response Project. The rapid response project is a community-based, multidisciplinary framework to address the opioid addicted patient, from initial use to successful recovery. The project uses data driven technology to initiate the care of opiate overdose patients and administer lifesaving interventions.MethodsClark County has partnered with the Indiana State Department of Health utilizing the early notification system that monitors statewide overdose activity. Once an alert is sent out, the response involves the use of two early notification systems. Everbridge is a one touch notification system that allows rapid dissemination of information to various community partners to allow them to initiate the appropriate response. Pulse Point is a smart phone application that allows CPR and trained community laypeople to respond to a cardiac arrest or overdose patient in a public place. It provides directions to the patient as well as to the nearest AED. Clark County has also simultaneously instituted a county-wide CPR training initiative and offered Narcan training as well. This is a major paradigm shift, as prior methods of deployment of trained laypeople essentially relied on the chance that an overdose will be reached by a first responder.ResultsEverbridge has allowed for the rapid notification of county entities and deployment of resources to overdose ‘hot spot’ areas. The Pulse Point initiative has dramatically increased the number of CPR and Narcan trained responders and provided means of delivering them to the appropriate patient population in a timely manner. Both these technologies have dramatically increased the delivery of resources to the overdose patient and decreased response times to the delivery of care.ConclusionsUsing data driven technology to inform how Clark County Health Department and first responders collectively address the opioid crisis is a novel approach. Since January 2018, Clark County Health Department has used ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics) to determine where and when an increase of drug overdose activity is occurring throughout the county. This affords county health officials the ability to inform in “near real-time” first responders, the emergency department and other community stakeholders, relevant information thus allowing for the rapid deployment of county resources to the areas most affected. Our collective efforts to save lives is further enhanced by the county using of novel technologies like Pulse Point which is used to deploy both CPR and Narcan trained laypersons directly to sites in the community where overdoses are occurring. In a community, which is in large part considered rural and, in many places, has a greater than 15 minute emergency response time, using Pulse Point and Everbridge technologies has uniquely positioned Clark County to be on the cutting edge of saving lives as we leverage data and technology to address the opioid epidemic in our communities. This has markedly improved access to treatment and response times to overdose patients in Clark County, Indiana.

scholarly journals Volunteer First Responders for Optimizing Management of Mass Casualty Incidents

2018 ◽  
Vol 13 (02) ◽  
pp. 287-294 ◽  
Author(s):  
Eli Yafe ◽  
Blake Byron Walker ◽  
Ofer Amram ◽  
Nadine Schuurman ◽  
Ellen Randall ◽  
...  
Keyword(s):  
Population Distribution ◽  
Response Times ◽  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Rapid Response ◽  
First Response ◽  
Life Saving ◽  
Rural Settings ◽  
Trauma Mortality

ABSTRACTObjectiveRapid response to a trauma incident is vital for saving lives. However, in a mass casualty incident (MCI), there may not be enough resources (first responders and equipment) to adequately triage, prepare, and evacuate every injured person. To address this deficit, a Volunteer First Responder (VFR) program was established.MethodsThis paper describes the organizational structure and roles of the VFR program, outlines the geographical distribution of volunteers, and evaluates response times to 3 MCIs for both ambulance services and VFRs in 2000 and 2016.ResultsWhen mapped, the spatial distribution of VFRs and ambulance stations closely and deliberately reflects the population distribution of Israel. We found that VFRs were consistently first to arrive at the scene of an MCI and greatly increased the number of personnel available to assist with MCI management in urban, suburban, and rural settings.ConclusionsThe VFR program provides an important and effective life-saving resource to supplement emergency first response. Given the known importance of rapid response to trauma, VFRs likely contribute to reduced trauma mortality, although further research is needed in order to examine this question specifically. (Disaster Med Public Health Preparedness. 2019;13:287–294)

scholarly journals Underreporting of communicable diseases in the prefecture of Achaia, western Greece, 1999-2004 – missed opportunities for early intervention

2010 ◽  
Vol 15 (21) ◽  
Author(s):  
E Jelastopulu ◽  
G Merekoulias ◽  
E C Alexopoulos
Keyword(s):  
Infectious Diseases ◽  
Control Strategies ◽  
Health Centre ◽  
Health Resources ◽  
Health Department ◽  
Public Health Department ◽  
Missed Opportunities ◽  
Notification System ◽  
And Control ◽  
Western Greece

This study investigates the completeness of the reporting of infectious diseases in the prefecture of Achaia, western Greece in the period of 1999-2004. We collected hospital records relating to infectious diseases retrospectively from three major hospitals in the region and compared the records to corresponding records at the prefectural public health department (PHD). After record-linkage and cross-validation a total of 1,143 notifiable cases were identified in the three hospitals, of which 707 were reported to the PHD of Achaia, resulting in an observed underreporting of infectious diseases of 38% during the study period. At prefecture level, a further 259 cases were notified by other sources, mainly by the fourth hospital of the region not included in our study, resulting in a total of 966 cases reported to the PHD; 73% of these were reported from the three hospitals included in our study, 27% were notified by the fourth hospital not included in our study and less then 0,3% by physicians working in a private practice or health centre. Meningitis (51%), tuberculosis (12%) and salmonellosis (8%) were the most frequently reported diseases followed by hospitalised cases of varicella (7%), brucellosis (6%) and hepatitis (6%). During the study period, clustering of specific diseases like brucellosis, meningitis, mumps, and salmonellosis was observed, indicating possible outbreaks. Our results show that notification system needs to be improved, in order to ensure proper health resources allocation and implementation of focused prevention and control strategies.

The Role of EMS Systems in Public Health Emergencies

1997 ◽  
Vol 12 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Barbara A. McIntosh ◽  
Patricia Hinds ◽  
Lorraine M. Giordano
Keyword(s):  
Public Health ◽  
Health Department ◽  
Definitive Treatment ◽  
Local Health ◽  
Public Health Response ◽  
Pneumonic Plague ◽  
Notification System ◽  
The Public ◽  
Public Health Emergencies ◽  
Isolation Facilities

AbstractIntroduction:Until now, the public health response to the threat of an epidemic has involved coordination of efforts between federal agencies, local health departments, and individual hospitals, with no defined role for prehospital emergency medical services (EMS) providers.Methods:Representatives from the local health department, hospital consortium, and prehospital EMS providers developed an interim plan for dealing with an epidemic alert. The plan allowed for the prehospital use of appropriate isolation procedures, prophylaxis of personnel, and predesignation of receiving hospitals for patients suspected of having infection. Additionally, a dual notification system utilizing an EMS physician and a representative from the Office of Infectious Diseases from the hospital group was implemented to ensure that all potential cases were captured. Initially, the plan was employed only for those cases arising from the Centers for Disease Control and Prevention (CDCJ/Public Health Service (PHS) quarantine unit at the airport, but its use later was expanded to include all potential cases within the 9–1–1 system.Results:In the two test situations in which it was employed, the plan incorporating the prehospital EMS sector worked well and extended the “surveillance net” further into the community. During the Pneumonic Plague alert, EMS responded to the quarantine facilities at the airport five times and transported two patients to isolation facilities. Two additional patients were identified and transported to isolation facilities from calls within the 9–1–1 system. In all four isolated cases, Pneumonic Plague was ruled out. During the Ebola alert, no potential cases were identified.Conclusion:The incorporation of the prehospital sector into an already existing framework for public health emergencies (i.e., epidemics), enhances the reach of the public safety surveillance net and ensure that proper isolation is continued from identification of a possible case to arrival at a definitive treatment facility.

Abstract P833: Standardized Protocols Reduce Response Times for LVO Strokes

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Vanesa K Vanderhye ◽  
Lynda Christel ◽  
Ali Turkmani ◽  
Kara A Sands
Keyword(s):  
Response Times ◽  
Vessel Occlusion ◽  
Early Reperfusion ◽  
Notification System ◽  
Stroke Treatment ◽  
Phone Calls ◽  
Data Points ◽  
Stroke Center ◽  
High Level ◽  
Cerebral Reperfusion

Introduction: Acute ischemic stroke treatment is time sensitive especially for large vessel occlusion (LVO) strokes with the goal to achieve early cerebral reperfusion. Research suggests standardized protocols incorporate early notification to reduce time from arrival to mechanical thrombectomy (MT). The MT workflow at a certified stroke center required multiple phone calls to mobilize staff and resources resulting in treatment delays. The average time from neurosurgery notification (NN) to case start (CST) was 60.4 minutes (min) resulting in average door-to-puncture (DTP) time of 124.8 min further delaying early reperfusion. Purpose: Standardize MT workflows and incorporate a 1-step notification system to reduce average NN to CST by 20% to 45 min to achieve 90 min average DTP time by 90 days post implementation. Methods: Baseline data for MT cases admitted 1/1/18 - 9/2/19 arriving in the emergency room (ER) and occurring inpatient were abstracted from stroke alert logs and the electronic health record. MT transfers were excluded. A multidisciplinary group of key stakeholders completed both high level process and workflow analysis maps and mock simulations to identify gaps. Both an analysis of variance and Tukey-Kramer’s T Test were performed revealing NN to CST was most statistically significant (p<.0001) and largest root cause for overall increased DTP times. New service-specific workflows were developed including 1-step notification activated via an existing group paging system used for other purposes. Activation notified on call staff of the MT case and patient location. Data points collected were NN to CST (ED and inpatient) and DTP (ED only). Results: Average NN to CST time was 26.7 min (33.3 min decrease or 55.1%; p<.0001, n=12) resulting in DTP average of 83.4 min (41.4 min decrease or 35.3%, n=10) 90 days post-implementation. The paging system was cost-neutral due to existing licensing agreements. Conclusion: In conclusion, streamlined workflows incorporating 1-step notification reduced time from notification to staff response so MT procedures could start sooner. A multidisciplinary approach along with key stakeholder buy-in was instrumental in successful project implementation.

Photovoice as a Social Transformative Tool: Unpacking the Experiences of Immigrants and Refugees Living with HIV in Canada

2021 ◽  
Vol 12 (1) ◽  
pp. 97-97
Author(s):  
Dr. Rita Dhungel
Keyword(s):  
Mental Health ◽  
Service Providers ◽  
Rapid Response ◽  
Health Coverage ◽  
Hiv Status ◽  
Mental Health Needs ◽  
Community Based ◽  
Immigrants And Refugees ◽  
Financial Difficulties ◽  
Living With Hiv

1026 immigrants and refugees tested positive for HIV (IRLWH) in Canada in 2018 (Haddad, et al, 2019). IRLWH experience discriminatory behaviors because of because of the immigration and HIV status; culturally appropriate supports and resources for IRLWH are lacking. Financial difficulties are experienced by many new immigrants, they may be unable to meet their health care or mental health needs, particularly if they are IRLWH (Chen et al., 2015). Language barriers, loss of social support and a lack of health coverage can impact the ability for IRLWH to access care (Rapid Response Service, 2014). There can be stigma surrounding HIV within the cultural community, impacting the level of support for IRLWH (Rapid Response Service, 2014). IRLWH experience mistreatment by service providers, lack of culturally and linguistically appropriate services, lack of awareness of local programs, unemployment and housing issues in Canada (Chen et al., 2015; Gatteri et al., 2020). To augment the limited extant knowledge on the challenges of IRLWH and based on the implications of a study that claimed the need for a further research exploring the voices of IRLWH using photovoice (Getteri, et.al., 2020), this community based photovoice study was designed with an aim to understand intersectional oppressions experienced by IRLWH across Alberta in general, with a focus on the COVID-19 pandemic in particular from determinants of health perspectives. Keywords: Immigrants and Refugees; HIV, Photovoice, Intersectional Violence, Mental Health

The Importance of Tone and Attitude in Email and the Online Classroom

2020 ◽  
pp. 52-67
Author(s):  
Melissa A. Miller
Keyword(s):  
Response Times ◽  
Body Language ◽  
Ease Of Use ◽  
Rapid Response ◽  
Communication Tool ◽  
Online Classroom ◽  
Sensory Stimuli ◽  
Communication Method ◽  
Email Correspondence

In the online classroom, email has emerged as a predominant communication method between students and faculty. Despite many benefits of email, including ease of use, familiarity of the technology, and rapid response times, there are numerous challenges faculty face when sending and receiving email correspondence with students. Mainly, due to the medium and format of email, with its lack of cues such as body language, inflection, and other sensory stimuli, it presents a paramount challenge to faculty. However, appropriate tone and attitude in emails can help mitigate the challenges the medium presents. When written and read effectively and purposefully, email is an effective outreach and communication tool for students and faculty.

scholarly journals Prevalence of Onchocerciasis and Associated Factors among Adults Aged ≥ 15 Years in Semen Bench District, Bench Maji Zone, Southwest Ethiopia: Community Based Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Bedilu Kifle ◽  
Kifle Woldemichael ◽  
Mamo Nigatu
Keyword(s):  
Logistic Regression ◽  
Associated Factors ◽  
Statistical Significance ◽  
Health Department ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Southwest Ethiopia ◽  
Bivariate Logistic Regression

Background. Though onchocerciasis control and elimination through community directed treatment with ivermectin were conducted for the last fifteen years, prevalence of onchocerciasis and factors associated with it in the study area are yet not known. The aim of the current study is to assess prevalence of onchocerciasis and associated factors among adults aged greater than or equal to fifteen years in Semen Bench district, Bench Maji zone, southwest Ethiopia: community based cross-sectional study 2018. Methods. Community based cross-sectional study was conducted on 553 study participants selected by multistage sampling in April 2018. Data were collected using a pretested interviewer-administered questionnaire. Data were entered using EpiData version 3.1 and exported to SPSS version 20 for statistical analysis. Descriptive statistics were done to summarize dependent and independent variables. Bivariate logistic regression was done to select candidate variables. Multivariable logistic regression was performed to identify independent predictors of onchocerciasis infection. Adjusted odds ratios with 95% CI were calculated to assess association and statistical significance, respectively. Confidence interval was used to declare statistical significance. Result. The overall prevalence of onchocerciasis infection in the study area was 6.32%. Age category of 35-44 years (AOR: 13.48, 95%CI: 3.51, 51.76), age of 45 years and above (AOR: 9.41, 95% CI: 2.26, 39.06), male sex (AOR 4.568, 95% C.I: 1.622, 12.861), not being compliant with ivermectin treatment (AOR: 3.804, 95%CI: 1.524, 9.49), and residing at less than 2Km from the river (AOR: 9.15, 95%CI: 3.9, 21.49) were significantly associated with onchocerciasis infection. Conclusion and Recommendation. After more than a decade of treatment with ivermectin, onchocerciasis in the study area is still hypoendemic. Zonal health department and other stakeholders should evaluate therapeutic coverage and community directed treatment with ivermectin in the study area. Zonal health department with other stokeholds should give community based information education communication, giving due attention to older ages, male residents, and those living near the rivers. Further community based study should also be done to identify factors hindering the community compliance with the treatment.

scholarly journals The Predictive Factors for Severe Leptospirosis Cases in Kedah

2020 ◽  
Vol 5 (2) ◽  
pp. 79
Author(s):  
Rakesh Singh Sandhu ◽  
Halim Bin Ismail ◽  
Mohd Hasni Bin Ja’afar ◽  
Sanjay Rampal
Keyword(s):  
Predictive Factors ◽  
Health Department ◽  
Cross Sectional Study ◽  
Severe Form ◽  
Industrialized Countries ◽  
Cross Sectional ◽  
Notification System ◽  
Number Of Patients ◽  
Severe Leptospirosis ◽  
The Cost

Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to leptospirosis requires monitoring, specific treatments, and intensive care admission, thus increasing the cost of treating severe leptospirosis cases. Currently, we have data on incident and mortality rates, but we do not have data on the number of patients with severe form of leptospirosis or how many patients have complications, and whether or not these complications were resolved. Therefore, we carried out this study to determine the predictive factors for severe leptospirosis cases in Kedah. We conducted a cross-sectional study. The data of patients diagnosed with leptospirosis were obtained from the surveillance unit, Kedah Health Department, through the e-notification system. These data were then sorted according to the hospitals where the patients were admitted. The patients’ medical records were collected, and their information was obtained using a checklist. A total of 456 confirmed leptospirosis cases were included in the study, with 199 patients classified as severe cases and 257 patients as mild cases, based on the Malaysian leptospirosis guidelines. Most patients were male (71.5%) with a mean SD age of 36.62 ± 20.75 years. The predictive factors for severe leptospirosis include abnormal lung sounds (OR: 3.07 [CI 1.58–6.00]), hepatomegaly (OR: 7.14 [1.10–45.98]), hypotension (OR: 2.16 [1.08–4.34]), leukocytosis (OR: 2.12 [1.37–3.29]), low hematocrit (OR: 2.33 [1.43–3.81]), and increased alanine aminotransferase (SGPT ALT) (OR: 2.12 [1.36–3.30]). In conclusion, knowing these predictive factors will help clinicians identify severe leptospirosis cases earlier and develop their treatment plans accordingly, to reduce the complications and death from severe leptospirosis.

On-the-Scene Triage with a Rapid Response Vehicle

1985 ◽  
Vol 1 (S1) ◽  
pp. 144-145
Author(s):  
Rodney Dreifuss ◽  
Emil Pascarelli
Keyword(s):  
New York ◽  
New York City ◽  
Emergency Medical Service ◽  
York City ◽  
Medical Service ◽  
Response Times ◽  
Rapid Response ◽  
Ambulance Transport ◽  
Operational Problem ◽  
Life Threatening

Perhaps the greatest operational problem faced by the New York City Emergency Medical Service (EMS) today is the sheer volume of calls entering the system, and the fact that many of those requests for medical aid are not life-threatening emergencies requiring ambulance transport. This creates two situations that New York City is all too familiar with: (l) ambulances are not available for true emergencies; and (2) response times for ambulances to arrive at the scene of an emergency are extended.A four-month pilot “on-scene triage” program was initiated by EMS as a possible solution to these problems. The program ran from May to August of 1980. A marked EMS car was designated as the “Triage Car” and was in operation during those hours when ambulance requests were at their peak (usually two to ten PM).

scholarly journals Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital

2014 ◽  
Vol 6 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Ankur Segon ◽  
Shahryar Ahmad ◽  
Yogita Segon ◽  
Vivek Kumar ◽  
Harvey Friedman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Inpatient Mortality ◽  
Rapid Response Teams ◽  
Community Based ◽  
Code Blue ◽  
Response Team

Abstract Background Rapid response teams have been adopted across hospitals to reduce the rate of inpatient cardiopulmonary arrest. Yet, data are not uniform on their effectiveness across university and community settings. Objective The objective of our study was to determine the impact of rapid response teams on patient outcomes in a community teaching hospital with 24/7 resident coverage. Methods Our retrospective chart review of preintervention-postintervention data included all patients admitted between January 2004 and April 2006. Rapid response teams were initiated in March 2005. The outcomes of interest were inpatient mortality, unexpected transfer to the intensive care unit, code blue (cardiac or pulmonary arrest) per 1000 discharges, and length of stay in the intensive care unit. Results Rapid response teams were activated 213 times during the intervention period. There was no statistically significant difference in inpatient mortality (3.13% preintervention versus 2.91% postintervention), code blue calls (3.09 versus 2.89 per 1000 discharges), or unexpected transfers of patients to the intensive care unit (15.8% versus 15.5%). Conclusions The implementation of a rapid response team did not appear to affect overall mortality and code blue calls in a community-based hospital with 24/7 resident coverage.

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