Civilian-Military Collaboration before and during COVID-19 Pandemic—A Systematic Review and a Pilot Survey among Practitioners

Due to the similarity in skills and assets, Civilian-Military collaboration has emerged as one of the most reliable partnerships during the disaster and public health emergency management to address all necessary elements of surge capacity, i.e., staff, stuff, structure (space), and systems. This study aimed to evaluate this collaboration before and during the coronavirus 2019 pandemic. The outcomes of the systematic review revealed several published reports on successful civilian-military collaboration and proposed a need for further improvement. One hundred sixty-six individuals from 19 countries responded to nine questions, included in an online survey with the possibility to leave comments if necessary. The questionnaire referred to elements such as command and control, safety, communication, assessment, triage, treatment, and transport, as the crucial components of emergency management. The comprehensive examination of the survey results together with registered comments revealed a possible improvement in collaboration particularly on the strategic levels, i.e., meetings at the command-and-control level, safety, communication, and networking issues. While logistic collaboration seemed to be unchanged, the practical parts of the collaboration, i.e., clinical and non-clinical operational partnership (Triage and Treatment), mutual education, training, and operational understanding of each organization remained unchanged. In conclusion, although the current pandemic may have facilitated a more intense collaboration between civilian and military healthcare organizations, it lacks practical partnership and operative engagement, representing two crucial elements necessary for harmony and compatibility of both systems. Such collaboration may require a political will and perhaps a mutual civilian-military authority.

Safe preoperative regional nerve blocks

BackgroundProcedural time-outs and checklists are proven to be an effective means of improving teamwork and preventing wrong-sided procedures. The main objective of this study was to ensure that all regional nerve blocks being performed in the preoperative area at our hospital were executed with a proper time-out. The goal of this project was to increase integration of a safe preoperative block process including a time-out checklist to ensure; complete consents, correct patient and laterality were marked prior to each procedure. We focused on recognising events that took place before, during and after the nerve block including non-compliance with the checklist and deviations from protocol.MethodsA safe preoperative block process current and future state flowchart, revised time-out checklist and action/implementation plan as part of our Plan–Do–Study–Act model was constructed using a multidisciplinary approach. Pre-implementation and post- implementation data were collected by medical students acting anonymously via direct observation noting the presence of an anaesthesiologist, resident, nurse, time-out for procedure, checklist completed and procedure start and sedation time representing a complete time-out.ResultsThe direct observations in the pre-implementation group showed a 20% (3/15) compliance with a correct time-out. The direct observations in the post implementation group showed 85% (12/14) compliance. This revealed a 65% increase in all portions of the time-out checklist completed. Comparative analysis confirmed decrease in non-compliance and deviations from protocol as displayed by 65% increase in all portions of time-out checklist completed.ConclusionWe aimed to improve safety, communication and compliance for preoperative nerve blocks through development and implementation of a safe preoperative block process using a multidisciplinary model. We conclude that creation of a safe nerve block was achieved by integration of a preoperative nerve block process which included increased compliance to the time-out checklist, verifying patients and laterality with marking of patient prior to each procedure, identifying proper consents were completed and ensuring each regional nerve block was executed with a proper time-out.

Enhancement of safety communication model

A fundamental measure of safety communication is the residual error probability, i. e., the probability of undetected errors. For the detection of data errors, typically a Cyclic Redundancy Check (CRC) is applied, and the resulting residual error probability is determined based on the Binary Symmetric Channel (BSC) model. The use of this model had been questioned since several error types cannot be sufficiently described. Especially the increasing introduction of security algorithms into underlying communication layers requires a more adequate channel model. This paper introduces an enhanced model that extends the list of considered data error types by combining the BSC model with a Uniformly Distributed Segments (UDS) model. Although models beyond BSC are applied, the hitherto method of the calculation of the residual error probability can be maintained.

Development of Standard Operating Procedure (SOP) Training Model Using Disaster Safety Communication Network Based on Public Safety Long Term Evolution (PS-LTE)

This study provides information for developing the domestic standard operating procedure (SOP) to CMMI level 3 or higher by presenting the SOP education and training model development process that systematically utilize the PS-LTE-based disaster safety communication network. The survey was conducted with 113 domestic SOP experts. Results revealed that four strategies can minimize the damage to people's lives and property in a national disaster and develop the domestic SOP level to CMMI level 3 or higher-establishment of governance for the SOPs for disaster safety communication networks; training on SOP once a year; establishment of SOP according to the guidelines; and improvement in the technical field. In the future, if SOP develops to CMMI level 3 or higher, it will contribute to the protection of public safety and property from disasters.

Esophageal Perforation after Using a Single-Use Disposable Duodenoscope

The Food and Drug Administration (FDA) has recently released a safety communication recommending transition to duodenoscopes with innovative designs that facilitate or eliminate the need for reprocessing. Thus, there has been a significant amount of development into disposable duodenoscope components and single-use duodenoscopes, with variable tactile feedback. We describe a case of esophageal perforation after using a single-use disposable duodenoscope (EXALT Model D; Boston Scientific Corporation, Marlborough, MA, USA). To our knowledge, this is the first reported case of an esophageal perforation since FDA approval of this device in December 2019. ERCP was performed with the EXALT Model D single-use duodenoscope (Boston Scientific Corporation) by an experienced gastroenterologist. During the procedure, gentle force applied through the gastroesophageal junction caused a liner perforation in the distal esophagus. An esophageal stent was placed with satisfactory wound healing and no fistula formation. There have been a few reports in the last 2 years showing promising results using this device; however, the differences in the tactile feedback, navigation, and pushability of the device may make it prone to unintended consequences.

How to Improve Safety Commitment: A Case Study on a Plastic Manufacturer in East Java

Introduction: Every year, work accidents frequently occur at PT. X. The initial survey showed a lack of control and commitment to be the main problems. Commitment is the core of the implementation of Occupational Health and Safety (OHS). This study aims to determine the factors that can increase safety commitment of workers. Method: This study used a quantitative approach with a cross-sectional design. In this study, the independent variables were age, gender, years of service, education level, safety motivation, management of safety commitment, safety communication, and social support. Meanwhile, the dependent variable was the safety commitment. 78 workers were selected using a simple random sampling technique from a population of 395 workers. Questionnaires were used to collect data. Data analysis used a multinomial logistic regression test. Results: 64.1% of workers were aged 41-51 years old, 56.4% were females, 82.0% had >10 years of service, 75.6% had a secondary education level, 56.4% had high safety motivation, 57.7% assessed management commitment to safety as low, 59.0% assessed safety communication as less, 52.6% had high social support, and 37.2% tended to have continuous safety commitment. Characteristics of workers (age, gender, years of service, education level), safety motivation, and social support did not affect safety commitment. Meanwhile, management commitment to safety (p=0.004) and safety communication (p=0.014) affected safety commitment of workers. Conclusion: The way to increase workers' commitment to safety is to increase the company's commitment to OHS and improve safety communication efforts.Keywords: management commitment to safety, safety commitment, safety communication

A review of patient safety communication in multicultural and multilingual healthcare settings with special attention to the U.S. and Canada

Purpose The present work aims to raise awareness of the issue of patient safety communication in multicultural and multilingual healthcare settings and to present strategies on how to overcome emerging cultural and language barriers and enable healthcare providers to reduce the risk of miscommunication, prevent inequalities and disparities, and provide their patients with safe and quality care. It also strives to present the policies and measures the United States and Canada have implemented and the strategies U.S. experts have developed to advance effective communication between provider and patient. Methods The literature review was conducted on academic works and publications by health associations, institutes of health, and government departments in topics such as adverse events in health care and strategies to reduce cross-cultural miscommunications and on guides for hospitals. Results/Discussion Cultural diversity in a patient population, language barriers, and a lack of effective communication can impose an increased threat on an individual's health. In order to radically decrease the incidence of adverse events, policies and systems on how to manage multinational and multilingual medical environments should be created at a national level. Cultural competence is also key to delivering care that meets patients' social and cultural needs; furthermore, developing a language access plan and providing language assistance (interpretation, translation) for those in need can greatly contribute to providing quality care. Conclusions Clear communication is key to quality care and patient safety in multicultural and multilingual healthcare environments, but to significantly reduce the incidence of adverse events, policies and systems should be created at a national level.

Comparative Study of Vaccine Safety Surveillance on Covid-19

Vaccine among people globally preparations must be made within countries for covid-19 vaccine safety surveillance on an urgent basis. Safety surveillance must be capable of investigating adverse event of special interest (AESI) and adverse event following immunization to determine a change in the benefit-risk profile of the vaccine. COVID-19 vaccine is the most important tool to stem the pandemic. WHO emergency use listing, while using regulatory pathway through national regulatory authorities. Vaccine safety communication plan should be developed. Expending the global vaccine safety system to meet the needs of covid-19 and other emergency and routine use vaccine is a priority currently. The protective efficacy and the short term and long-term side effect of the vaccine are of major concern. Various strategies have been designed the covid-19 pandemic. The highly infectious corona virus disease 2019 associate with me pathogenic severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) has spread to become a global pandemic. The development of covid-19 vaccine is crucial for the world to return to pre-pandemic normalcy and the collective global effort has been invested into protective against SARS-CoV2.