Medical dispatchers’ perception of the interaction with the caller during emergency calls - a qualitative study

Background Medical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. Whilst emergency medical dispatchers play a key role in the process, their perception of the process is rarely reported. We explored medical dispatchers’ perception of the interaction with the caller during emergency calls. Secondly, we aimed to develop a model for emergency call handling based on these findings. Methods To provide an in-depth understanding of the dispatching process, an explorative qualitative interview study was designed. A grounded theory design and thematic analysis were applied. Results A total of 5 paramedics and 6 registered nurses were interviewed. The emerging themes derived from dispatchers’ perception of the emergency call process were related to both the callers and the medical dispatchers themselves, from which four and three themes were identified, respectively. Dispatchers reported that for callers, the motive for calling, the situation, the perception and presentation of the problem was influencing factors. For the dispatchers the expertise, teamwork and organization influenced the process. Based on the medical dispatchers´ perception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher. Conclusions According to medical dispatchers, the callers seem to lack knowledge about best utilization of the emergency number and the medical dispatching process, which can be improved by public awareness campaigns and incorporating information into first aid courses. For medical dispatchers the most potent modifiable factors were based upon the continuous professional development of the medical dispatchers and the system that supports them. The model of call handling underlines the complexity of medical dispatching that embraces the context of the call beyond clinical presentation of the problem.

Sharp as a Fox: Are foxnews.com Visitors Less Politically Knowledgeable?

In 2012, a survey research was publicized suggesting that Fox News viewers were not only less informed than consumers of other news media but also less informed than people abstaining from news media entirely. Many have taken this to be unequivocally true and the study remains popular among political discussants to this day. However, virtually all of the investigations used to advance the argument focus on current events type knowledge and neglect important controls that could influence both political knowledge and Fox News consumption. Furthermore, no research to date has investigated any effects stemming from consuming the network’s online content (i.e., from foxnews.com ). This article aims to contribute these gaps. Using the 2016 American National Election Survey (ANES), I investigate whether consuming content from foxnews.com is associated with decreased political knowledge. I find no differences in knowledge concerning how the U.S. political system works (what I call process-related knowledge) but do find a significant, negative relationship between visiting foxnews.com and facts about society writ large (what I call society-oriented knowledge). These effects persist even when controlling for party, ideology, and conservative-group affinity and in the preponderance of matching procedures employed to reduce concerns of self-selection. Implications and avenues of future research are also discussed.

SPEAKers at the National Society of Hospital Medicine Meeting: A Follow-UP Study of Gender Equity for Conference Speakers from 2015 to 2019. The SPEAK UP Study

Women continue to be underrepresented as speakers at national conferences, and research has shown similar trends in hospital medicine. The Society of Hospital Medicine (SHM) Annual Meeting has historically had an open call peer review process for workshop speakers and, in 2019, expanded the process for didactic speakers. We aimed to assess the overall conference trends for women speakers and whether the systematic processes in recruitment procedures (ie, open call) resulted in improved representation of women speakers. We also sought to understand how the proportion of women speakers might affect overall scores of the conference. From 2015 to 2019, the overall representation of women speakers increased, as did evaluation scores during the same time period. When selection processes included the open call peer review process, there were higher proportions of women speakers. An open call process with peer review for speakers may be a systematic process that national meetings could replicate to reduce gender inequities.

CBME framework to promote transition to senior

Residency programs across Canada are transitioning to Competence by Design (CBD). Our innovative framework improves the traditional transition to independent senior overnight call process by adding workplace-based (WBA) assessments. Our process ensures that faculty and residents have a shared understanding of what competencies need to be demonstrated before residents can work independently as the in-house senior resident overnight. This protocol is worth exploring; initial perceptions suggest an increase in resident confidence while on call and improved faculty comfort when paired with these senior residents. We believe that this in turn will be reflected in enhanced patient care.

Port-2-Port Communication Enhancing Short Sea Shipping Performance: The Case Study of Cyprus and the Eastern Mediterranean

The sustainability of Short Sea Shipping (SSS) is central to a clean, safe, and efficient European Union (EU) transport system. We report on key challenges for advancing reliability, quality, and safety, and removing unnecessary costs and delays at SSS hubs, with a particular focus on Cyprus and the Eastern Mediterranean. Specifically, we consider the effect of port-2-port (P2P) communication on port efficiency by investigating the factors influencing the various waiting times at the Port of Limassol, both from a qualitative and a quantitative perspective. The qualitative results are based on the views of key stakeholders involved in the port call process. The quantitative analysis relies on data from over 8000 port calls during 2017–2018, which are analyzed with respect to ship type, port of origin, and shipping agent. The calculated Key Performance Indicators (KPIs) include arrival punctuality, berth waiting, and berth utilization. The analysis clearly reveals considerable variation in agent performance regarding the KPIs, suggesting a lack of attention to the social aspect of a port’s socio-technical system. We propose measures for improving agent performance based on the principles of Port Collaborative Decision Making (PortCDM), including P2P communication, data sharing and transparency among all involved in a port call process including the agents, and open dissemination of agent-specific KPIs.

Teknologi Aplikasi Nurse Call berbasis Client Server Pada Rumah Sakit

The credibility of a hospital has the effect of the services provided by the hospital. One of the services in the hospital is inpatient services and the role of nurses who have an important role in serving patients. Some problems in hospitalization services that occur such as manual nurse calls are done by visiting the treatment room and proposing the desired service. This method is less effective because it will require a long process in service. The application of nurse calls is done to improve services so that nurses can provide the best service and patient health can be monitored properly. The calling system for nurses is based on client-server and additional features such as heart detection, temperature detection, and emergency buttons that have the role to call nurses. The advantage of the nurse call application is that it can monitor patient health from several detection devices that will automatically call through the application. In addition to handling patients will be monitored by the hospital, the nurse's performance will also be detected. The results of this study are that the nurse call process will be automatically carried out by a detection device so that the nurse will detect the patient's condition quickly, the patient handling data will be stored on the server, therefore the history of heart rate and temperature records is more complete and can be used for doctors to handle patients.

Analisis Perbandingan Mean Opinion Score Aplikasi VoIP Facebook Messenger dan Google Hangouts menggunakan Metode E-Model pada Jaringan LTE

ABSTRAKPenelitian ini membahas mengenai perbandingan kualitas layanan dua aplikasi VoIP yaitu Facebook Messenger dan Google Hangouts pada jaringan LTE. Kualitas layanan dua aplikasi tersebut ditinjau menggunakan Mean Opinion Score dengan metode objektif yaitu, E-Model. Nilai MOS kedua aplikasi didapatkan dengan menjalankan simulasi menggunakan GNS3 yang berfungsi untuk mensimulasikan topologi jaringan dengan menggunakan router MikroTik. Setelah itu, dilakukan pengukuran parameter QoS yaitu, delay dan packet loss yang terjadi pada saat melakukan panggilan yang berlangsung selama satu jam. Dari hasil pengujian, diperoleh bahwa nilai MOS pada Google Hangouts lebih besar dibandingkan dengan Facebook Messenger, yaitu 4.0. Sedangkan pada Facebook Messenger hanya sebesar 3.6. Jika dikorelasikan ke tingkat kepuasan pengguna untuk mendapatkan nilai MOS, Google Hangouts dikategorikan "baik" dan Facebook Messenger dikategorikan "cukup baik".Kata kunci: MOS, LTE, VoIP, E-Model, GNS3 ABSTRACTThis study discusses the comparison of the quality of service of two VoIP applications, Facebook Messenger and Google Hangouts on LTE networks. The service quality of the two applications is reviewed using the Mean Opinion Score with an objective method namely, E-Model. MOS values from both applications are obtained by running simulations using GNS3 which can simulate network topology using a MikroTik router. After that, QoS parameters are measured, which are delay and packet loss during the call process which lasts one hour. From the test results, it was found that the MOS value on Google Hangouts was greater than Facebook Messenger, that is 4.0 while on Facebook Messenger only 3.6. If correlated with the level of user satisfaction to get MOS value, Google Hangouts is categorized as "good" and Facebook Messenger is categorized as "good enough".Keywords: MOS, LTE, VoIP, E-Model, GNS3

Abstract TP198: Reducing Stroke Readmissions

Background and Purpose: Hospital readmissions have become a priority focus for healthcare organizations. According to the Centers for Medicare and Medicaid, 20% of all patients who are discharged from a hospital will be readmitted within thirty days (CMS, 2015). This not only has a negative impact for the patient, but also imposes a financial impact on the healthcare organization. Baseline data from 2014 at Lake Cumberland Regional Hospital (LCRH) showed a stroke readmission rate of 9.6%. The purpose was to decrease stroke readmissions through development of a discharge call process that targets risk factors for readmission and ensures transition from hospital care to post-discharge follow-up. Methods: The discharge call process was implemented in June 2014. Calls were conducted by the facility’s stroke educator. All stroke program participants excluding discharges to nursing homes, rehabilitation center, or hospice were included in the discharge call process. Minimally, 3 attempts per patient were made to conduct the phone call within 3 days of discharge. In addition, the Lake Cumberland Area Stroke Support Group was established in May 2016 for stroke survivors and their caregivers. Results: Stroke readmission rates at LCRH decreased to 7.9% in 2015 and further declined to 1.6% as of 2nd quarter 2016. Interventions completed as a result of the discharge phone call process include: expediting follow-up appointments, collaborating with primary care practitioner for needed prescriptions, clarifying discharge instructions, reinforcing stroke education, and scheduling additional follow-up calls to provide assistance when needed. Conclusions: Stroke readmission rates decreased from 9.6% in 2014 to 1.6% through second quarter of 2016. Multiple opportunities were discovered to close the communication gap between hospital care and primary care follow-up. Maintaining contact post-discharge is needed to transition from the hospital to home care.