Quality Of Health Care Delivery Research Articles

Availability, pricing, and affordability of essential medicines for pediatric population in Malawi.

Lack of access to essential medicines negatively impacts on the quality of healthcare delivery and increases morbidity and mortality, especially to the vulnerable pediatric population. We assessed the availability, pricing, and affordability of pediatric formulations in Malawi. The study was conducted in 76 health facilities (public, faith-based and private pharmacies, and clinics) from the northern and southern regions of Malawi from March to May 2023. We adapted the WHO/HAI method for the assessment of both availability and pricing of medicines. Data on availability were collected from stock card records using a WHO/HAI template and medicine prices were provided by the pharmacy personnel who were managing the facilities. Availability of medicines was calculated as the percentage of facilities which had a stock of the respective medicine at the time of data collection while medicine prices was assessed by calculating the median prices of each medicine. To assess the affordability of the medicines, we calculated the number of days it takes for a person who is receiving the government-set minimum wage to work to pay for a treatment course of common indications. The study was approved by the KUHES ethics committee under the numbers U.12/22/3900 and U.12/22/3903. The overall availability of pediatric medicines was 38.1% for public health facilities, 53.7% for private retail pharmacies and drug stores, 49.5% for private clinics and 48.3% for Christian Health Association of Malawi (CHAM) facilities. We found the illegal availability of prescription-only medicines of up to 54% in medicine stores. Medicine median prices were higher in the private clinics followed by retail pharmacies and drugs stores. CHAM had the lowest median prices for medicines of all the sectors. More than 50% of medicines were found to be affordable as less than a day's wage was required to purchase the treatment. We found poor availability of pediatric formulation among public, CHAM, and private sectors in Malawi. This may affect the quality of care among pediatric patients and therefore contribute to morbidity and mortality in Malawi. The supply of medicines and health commodities needs to consider needs of special populations such as children to achieve universal health coverage.

Prevalence and predictors of workplace sexual harassment of nurses in the Central Region of Ghana: a cross-sectional online survey

ObjectiveWe investigated the prevalence and predictors of workplace sexual harassment against nurses in the Central Region of Ghana.DesignA cross-sectional online survey.SettingCentral Region of Ghana.ParticipantsA total of 1494 male and female...

Public-Private engagement and health systems resilience in times of health worker strikes: a Ghanaian case study.

In low and middle-income countries like Ghana, private providers, particularly the grouping of faith-based non-profit health providers networked by the Christian Health Association of Ghana (CHAG), play a crucial role in maintaining service continuity during health worker strikes. Poor engagement with the private sector during such strikes could compromise care quality and impose financial hardships on populations, especially the impoverished. This study delves into the engagement between CHAG and the Government of Ghana (GoG) during health worker strikes from 2010 to 2016, employing a qualitative descriptive and exploratory case study approach. By analysing evidence from peer-reviewed literature, media archives, grey literature and interview transcripts from a related study using a qualitative thematic analysis approach, this study identifies health worker strikes as a persistent chronic stressor in Ghana. Findings highlight some system-level interactions between CHAG and GoG, fostering adaptive and absorptive resilience strategies, influenced by CHAG's non-striking ethos, unique secondment policy between the two actors and the presence of a National Health Insurance System. However, limited support from the government to CHAG member facilities during strikes and systemic challenges with the National Health Insurance System pose threats to CHAG's ability to provide quality, affordable care. This study underscores private providers' pivotal role in enhancing health system resilience during strikes in Ghana, advocating for proactive governmental partnerships with private providers and joint efforts to address human-resource-related challenges ahead of strikes. It also recommends further research to devise and evaluate effective strategies for nations to respond to strikes, ensuring preparedness and sustained quality healthcare delivery during such crises.

Burn-out among practitioners managing abdominal surgical emergencies in Senegal

IntroductionSurgery represents a distinct medical specialization that necessitates direct interaction with patients and the ability to manage complications. Burn-out is defined as a syndrome arising from persistent workplace stress that has not been effectively addressed. The objective of this work was to assess the prevalence and factors associated with burn-out among practitioners managing abdominal surgical emergencies in Senegal. A descriptive and analytical cross-sectional study was conducted; the study included healthcare professionals (general practitioners, general surgeons, anesthesiologists, nurses) involved in the management of surgical emergencies across all hospitals in Senegal. A standardized assessment of perceived stress was conducted using the Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion, depersonalization, and personal accomplishment. A multiple linear regression model was used to estimate the determinants of burn-out on the three subscales. A total of 186 observations were included in the study, for a response rate of 90.7%. The majority of participants were from the capital region of Dakar (44. 6%). There were 46 women (24. 7%) and 140 men (75. 3%). The mean age was 34 years 9 ±6.7 years, with a range of 24–59 years. The majority of participants were married (71%), followed by single individuals (26. 3%), divorced (2. 2%), and widowed (0. 5%). The majority of participants were physicians (80. 6%), followed by nurses (19. 4%). The most common medical specializations were general surgery (58.7%), anesthesia and resuscitation (22. 7%), and general medicine (18. 7%). Additionally, 46% of participants were in training (residency program). The predominant motivations included passion for the profession (75.3%), patient satisfaction (69. 9%), stimulating challenges (21%), and salary considerations (11. 8%). The overall prevalence of high burn-out (at least in one dimension) was 46.2%. A multiple linear regression model showed that the risk factors contributing to high burn-out were divorce status, being in training, and being motivated by stimulating challenges, salary considerations or passion for the profession. The protective factors were a positive perception of one's salary, a favorable physical work environment, and high-quality training. This study revealed an alarming prevalence of burn-out among surgical teams dealing with abdominal emergencies in Senegal. These findings call for immediate action to ensure the well-being of surgical teams and, by extension, the quality of healthcare delivery.

Communication in Healthcare Discourse: A Cultural and Linguistic Exploration of Exchanges between Healthcare Practitioners and Patients among Jukuns of Nigeria

This paper explored the cultural and linguistic aspects of health exchanges between healthcare practitioners and patients among the Jukuns of Wukari in Nigeria, within the health centres in the town. It focused on patient-healthcare-provider dynamics and found out how language and culture influenced healthcare communication within formal settings. Integrating ethnographic, sociolinguistic, and anthropological approaches, the study unveiled how language and culture impacted interactions and health-seeking behaviours in these centres. It revealed the roles of language and culture in understanding health information, healthcare provider-patient exchanges, and treatment adherence within the distinct sociolinguistic context of the Jukun. Using such qualitative techniques as interviews and observations in the health centres, the study captured the intricate verbal and nonverbal communication, specific cultural discourse patterns, and communication strategies used by patients and healthcare practitioners. Findings highlighted diverse cultural and linguistic methods employed by Jukuns, such as using proverbs, ironies, metaphors, and nonverbal cues, to express themselves in healthcare settings. The research showed that these methods could facilitate communication with familiar practitioners but might complicate interactions with those from different ethnic backgrounds. Ultimately, it offered crucial perspectives for refining healthcare provision, aligning with the precise linguistic and cultural contexts of the Jukun community within formal healthcare settings in Wukari and other parts of Jukunland. Based on the foregoing, the researchers recommended that health practitioners should make use of interpreters and familiarise themselves with the cultural and linguistic norms of their immediate communities for effective health discourse that would enhance quality healthcare delivery.

The Influencing factors of quality Health Care delivery and nhis Accessibility: A Fresh Empirical Evidence from the Greater Accra Metropolis, Ghana

In low-income economy such as Ghana, most citizens have poor access to quality health delivery (QHD). Healthcare system in Ghana suffers from numerous challenges that affect people accessibility to quality health care. This research investigates the comprehensive dynamics influencing the quality of healthcare in Ghana, focusing on the interplay between government funding (GF), human resource management (HRM), demoralization of health workers (DHW), healthcare infrastructure (HCI), and work attitude and ethics (WAE). Anchored in Andersen's Health Behavior Model and the WHO Health System Framework, the study aims to discern the intricate relationships among these variables. The research objectives involve assessing the individual and collective impacts of GF, HRM, DHW, HCI, and WAE on the quality of healthcare. The research further explored the moderation effect of health care professional behavior on the connection between WAE and QHD in Ghana. A sample size of 300 respondents is surveyed using the Partial Least Squares Structural Equation Model (PLS-SEM) method, allowing for a robust examination of the complex relationships within the proposed model. The outcome of the study indicated that all the variables were reliable and valid. The main findings of the present study indicated government funding, human resource management, demoralization of health workers, health care infrastructure and work attitude and ethics have a significant influence on QHD in Ghana. In addition, the study empirical outcome revealed that health workers professional behavior moderates the interaction between work attitude and ethics and QHD. Furthermore, this study provides valuable insights for policymakers, healthcare practitioners, and researchers alike, offering a holistic understanding of the factors shaping the healthcare landscape in Ghana and providing a foundation for informed interventions and policy development.

A Nationwide Chronic Disease Management Solution via Clinical Decision Support Services: Software Development and Real-Life Implementation Report.

The increasing population of older adults has led to a rise in the demand for health care services, with chronic diseases being a major burden. Person-centered integrated care is required to address these challenges; hence, the Turkish Ministry of Health has initiated strategies to implement an integrated health care model for chronic disease management. We aim to present the design, development, nationwide implementation, and initial performance results of the national Disease Management Platform (DMP). This paper's objective is to present the design decisions taken and technical solutions provided to ensure successful nationwide implementation by addressing several challenges, including interoperability with existing IT systems, integration with clinical workflow, enabling transition of care, ease of use by health care professionals, scalability, high performance, and adaptability. The DMP is implemented as an integrated care solution that heavily uses clinical decision support services to coordinate effective screening and management of chronic diseases in adherence to evidence-based clinical guidelines and, hence, to increase the quality of health care delivery. The DMP is designed and implemented to be easily integrated with the existing regional and national health IT systems via conformance to international health IT standards, such as Health Level Seven Fast Healthcare Interoperability Resources. A repeatable cocreation strategy has been used to design and develop new disease modules to ensure extensibility while ensuring ease of use and seamless integration into the regular clinical workflow during patient encounters. The DMP is horizontally scalable in case of high load to ensure high performance. As of September 2023, the DMP has been used by 25,568 health professionals to perform 73,715,269 encounters for 16,058,904 unique citizens. It has been used to screen and monitor chronic diseases such as obesity, cardiovascular risk, diabetes, and hypertension, resulting in the diagnosis of 3,545,573 patients with obesity, 534,423 patients with high cardiovascular risk, 490,346 patients with diabetes, and 144,768 patients with hypertension. It has been demonstrated that the platform can scale horizontally and efficiently provides services to thousands of family medicine practitioners without performance problems. The system seamlessly interoperates with existing health IT solutions and runs as a part of the clinical workflow of physicians at the point of care. By automatically accessing and processing patient data from various sources to provide personalized care plan guidance, it maximizes the effect of evidence-based decision support services by seamless integration with point-of-care electronic health record systems. As the system is built on international code systems and standards, adaptation and deployment to additional regional and national settings become easily possible. The nationwide DMP as an integrated care solution has been operational since January 2020, coordinating effective screening and management of chronic diseases in adherence to evidence-based clinical guidelines.

Assessing the Medico-legal Knowledge of Health Care Professionals: The Case of Konongo Odumasi Government Hospital

Introduction: There is growing public awareness regarding the ethical conduct of medical practitioners. Hence knowledge about medico-legal issues is as important to the practice of medicine as clinical skills. Method: A survey was conducted among some health care professionals at Konongo Odumasi Government Hospital, Ghana. A self-administered questionnaire was used to elicit information on informed consent, confidentiality and medico-legal issues. Data collected was analysed using SPSS version 20. Results: A total of 100 health care workers were enrolled on the study representing 100% response rate. The study revealed that 96% had knowledge or were aware of medico-legal issues; and 26% of the respondents indicated that disclosing a patient's medical information to someone else cannot lead to a medico-legal case. About 28% of the health care professionals had inadequate knowledge on physician-assisted suicide. 89% of the respondents indicated that taking precautions is very good as it can prevent a charge of malpractice and 80% of the health care professionals indicated that lacking medico-legal knowledge can affect you in your profession. Conclusion: Knowledge of health care professionals on informed consent, confidentiality and medico-legal issues is high and their perceptions are positive. However, regular training to update their knowledge will be necessary in order to ensure continuous improvement of the quality of health care delivery.

Study on Causal Effects of Occupational Stress on Healthcare Workers at a selected Healthcare Facility in Oman

Introduction: Occupational stress (OS) can be described as any physical or psychological change in an individual due to immediate or long-term reactions to workplace conditions that pose perceived threats or challenges to that employee. Typically, since work environments differ worldwide, scientists posit that the nature, sources, and causes of OS and the solutions proffered to address its impacts among healthcare workers (HCWs), differ markedly. The study aims to identify and examine the causal effects of OS on HCWs at the selected health facility in Oman. Methods: The study adopted a quantitative design that utilized questionnaires to examine the causes and effects of OS on selected health workers. Data was collected from December 2021 to January 2022 from 150 health facility employees to obtain their opinions on the causes and effects of OS on their health, work life, and productivity. Results: Findings revealed that 47% of the respondents were male and 53% were female. Further, the results also revealed that HCWs at the selected health facility have experienced a high prevalence of OS due to various factors ranging from staff shortages, as revealed by 56.2% of the participants, to work duration and loads, as revealed by 69.0% of the participants, and staff working conditions. Conclusion: As a panacea, recommend management of healthcare facilities engage more highly qualified staff and create highly conducive work environments and training. Likewise, the management can provide modern-day facilities and amenities. It is envisaged that such measures will also reduce workloads, which will help the HCWs to rest, resuscitate, re-energize, and nurture effective stress. Furthermore, the measures will help create a stress-free, healthy, and conducive environment for the HCWs and greatly improve quality healthcare delivery services.

Effect of integrated supportive supervision on availability of resources for health care service delivery and uptake of services in Ekiti State, Southwest Nigeria, evidence from the Saving One Million Lives program for result supported facilities.

a world bank performance-based financing program. The Saving One Million Lives program for results supported integrated supportive supervision (ISS) in selected primary health facilities (PHF) in Ekiti State, Nigeria. The study assessed the impact of ISS on health service outputs and outcomes such as infrastructure, basic equipment, human resources for health (HRH), essential drugs, number of children receiving immunization, number of mothers who gave birth in the facility, number of new and continuing users of modern family planning and the number of pregnant women screened for HIV (human immunodeficiency virus). a cross-sectional survey of 70 SOME-supported facilities was used for the study. Parametric and non-parametric method of analysis was employed to compare the mean values of study indicators gathered over the 4 rounds of ISS visits from January 2018 to August 2020. the study demonstrated that ISS approach has a positive effect on PHC service outputs and outcomes such as infrastructure, basic equipment, health human resources (HRH), essential drugs, contraceptives prevalence rate, skilled birth attendant as well as postnatal care. However, there was no significant impact on HIV screening for pregnant women. integrated supportive supervision approach has a positive effect on the quality of health care delivery in PHCs in Ekiti State, Nigeria. It is therefore recommended that periodic ISS visits should be routinely carried out in all PHCs across the State in the country and can be further extended to secondary and tertiary facilities.

Putting Patient Experience Data into Action! A Workshop to Explore the Collection and Use of Patient Experience Data in Practice

Health systems globally are in pursuit of the quintuple aim – better population health, improved patient and caregiver experiences, improved clinician experiences, sustainable per capita costs1 and greater health equity. Patients and their care partners (family and friends who provide care) have unique insights on the quality of healthcare delivery, yet, few organizations are poised to meaningfully integrate these voices into care delivery transformation efforts. Patient experience (PE) data comes in many forms including (and not limited to) structured and unstructured survey data, narratives of patient and family complaints or accolades, adverse event reporting, or qualitative interviews and focus groups. These data are often temporally lagging the patient’s interaction with the health system, rarely includes the voices of equity deserving groups (i.e, individuals who have been historically marginalized and underrepresented in research) and are seldom used for improving care.
 To meet the expectations of patients and care partners, we require a comprehensive, systematic, and sustainable approach to integrating patient and care partner voices into how we reform, design and deliver care.
 Through a scoping review and stakeholder engagements we have highlighted that methods for the collection and implementation of PE data should be multidimensional and have identified four components of a PE Tool-kit (PET) to move from knowledge to action: 1) engage the community meaningfully; 2) identify and curate multiple forms of PE data; 3) aggregate and synthesize PE data; and 4) integrate PE data into quality improvement efforts.
 We are conducting this workshop to further explore domains within our proposed Patient Experience Tool-Kit that resonates with an international audience and identify gaps and implementation considerations.
 The workshop will be grounded by a brief theory burst about the challenges the PET and its components aim to address followed by interactive sessions in small groups to address the following questions:
 1)How will the proposed components support the link between the collection and use of PE data into health system improvement efforts? What tool-kit components are missing?
 2)What are the barriers and facilitators to implementing the PE Tool-Kit?
 Note: we will direct participants to use a sociotechnical systems approach when identifying barriers and facilitators which consists of: people, environment (macro/micro), tools (i.e., technology), and tasks (i.e., process).
 3)What are the considerations/adaptations to consider that will support the Tool-Kit’s adoption across different sectors of the integrated care system?
 
 Introduction to Workshop/ Overview of Activities – 5 mins
 Presentation of Patient Experience Tool-Kit Components- 10 mins
 Small group discussions to address the three questions (each table to start with a different question)- 30 mins
 Large group activity to report back and synthesis small group discussion, including the l use Mentimeter to capture core insights). The facilitators will summarize key insights and highlight core themes captures in the discussion at the end of the activity – 20 minutes
 Wrap up to assess interest in developing a community of practice for continued learning and sharing- 5 mins
 

Electronic health record impact on data quality: An integrated review

Few studies have assessed the impact of Electronic Health Record (EHR) on data quality and how it has impacted timeliness, accuracy, availability, integrity, consistency and uniqueness of health data. Assessing the current gaps between electronic health record utilisation in relation to enhancing data quality can help to identify and recommend key measures to improve healthcare delivery. This review examines the impact of electronic health record on data quality, and proposes recommendations desirable to improving healthcare delivery. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Integrative Review Frameworks (IRF) were adapted as a sign post for the study. These frameworks guided literature search, data analysis and presentation of findings. Boolean AND/OR operators were combined with search terms to increase relevant search results. Six (6) electronic databases that were used for literature search are Scopus, Web of Science, Science Direct, PubMed, ProQuest and Google Scholar. Searched articles were between 2012 to 2022, with the exception of two articles on the Technology Acceptance Model (TAM) published in 1986 and 1975. EHR implementation impact key health outcomes and contribute to timely and complete data submission. Implementation of Electronic Health Systems (EHS) embellish consistency, completeness, accuracy and integrity of clinical data significantly through embedded interoperability solutions. By reducing the scope of manual reviews, integrating a technology that automates data integrity and quality checks into EHR may potentially lessen the strain of maintaining data quality. Our findings depict that interoperability of clinical data sources will ensure consistent, timely and available health data when using EHR. The automated data integrity and consistency checks in the EHR improve data quality. The study contributes to advancing the theory of Technology Acceptance Model (TAM) in electronic health records and its impact on data quality in healthcare delivery.

Service Compact (SERVICOM) and Service Delivery in the Nigerian Public Sector: A Study of Alex Ekwueme Federal University Teaching Hospital, Abakaliki

This study was carried out to examine the effect of SERVICOM on service delivery in public institutions in Nigeria with particular reference to Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Specifically, the research among others sought to ascertain the extent to which SERVICOM has enhanced timely response to patients’ complaints in AE-FUTHA; to examine the extent to which SERVICOM has improved quality healthcare delivery in AE-FUTHA. The study was anchored on New Public Management Theory by Hood (1991). A descriptive survey design was adopted with a sample size of 380. Data for the study were obtained from the structured questionnaire, which were presented in frequency distribution tables for purpose of analysis. The findings of the study revealed among others - that there was significant positive relationship between SERVICOM and timely response to patients’ complaints in AE-FUTHA; that there was significant positive relationship between SERVICOM and improved quality healthcare delivery in AE-FUTHA. The implication of the findings is that SERVICOM is very strategic to entrenching efficient service delivery in the health facility. Therefore, the following recommendations among others were proffered: that SERVICOM unit in the health sector should be strengthened to always ensure reduction to delays in addressing the health and other related complaints of patients in the hospital; that there should be regular capacity building of the staff of the SERVICOM unit in the health institution to enable them sustain quality healthcare delivery in the hospital

The Adoption of Information System Technology in Piloting the Current State of Health Institution in Tier Three Nations

This article is a pragmatic approach on the evaluation and implementation of the health information system as directed in assisting medical institutions to store patients’ health record in an electronic based method. In order to manage lots of information, the health information system comes in handy to sort data, processes and people. The system which consists of a set of interrelated components gathers, stores, and disseminates health or organizational related information of individuals working in the same health sector. All around the world the applications of digital health technology have become vital tools of modern information technology which has aided in the smooth and efficient delivery of quality healthcare. Studies have shown that the success of the electronic health information system implementation in developing countries is still low, and various reasons have however been identified as the cause of this poor outcome. This article is a pragmatic approach on the evaluation of information system technology adoption in the Nigerian health sector. The work focuses on factors that will determine the successful implementation of the health information system in health institutions in Nigeria, and how these factors can be enhanced using the Information System Quality Dimensions (Service Quality, System Quality, and Information Quality) as findings from this study show that attention should be on updating and upgrading the Information System quality dimensions (service Quality, Information Quality, and System Quality) since it reveals that there is a high dependence on these dimensions to bridge the research gap; as results show that there is an overall correlation between the analyzed variables.

Breaking Barriers: How Neural Network Algorithm in AI Revolutionize Healthcare Management to Overcome Key Challenges The key challenges faced by healthcare management.

Healthcare is one of the most important sectors of the economy. Quality healthcare is one of the most important factors determining how individuals perceive the quality of their lives. Further, healthcare has become a major political issue within different countries. Delivery of quality healthcare is, therefore, a major determinant of the national identity. However, healthcare is one of the sectors facing a number of challenges that need to be addressed. All healthcare economies are going through the same issues across the world. Introducing new technologies has further led to more challenges in the healthcare sector. Through AI, data analytics is available which will ensure that solutions to the challenges are found. The disruptive technology introduces more patient power, which has resulted in many issues in the healthcare sector. Therefore, the main concern of the essay is to present some of the challenges facing the healthcare sector. Also, it will address how disruptive technology can play an important role in ensuring that the challenges are being addressed to enhance the quality of care.

A descriptive cross sectional study of job satisfaction among pharmacists in a clinical setting

Background: Job satisfaction has been linked to improved job performance. Pharmacists as key healthcare providers with the ultimate duty of improving and maintaining the quality of life through the responsible provision of drug therapy, are expected to be highly productive. Low performance by Pharmacists can result to loss of lives especially through undetected actual and potential drug therapy problems which have been documented to be associated with high mortality and high rate of hospital admissions. Job satisfaction is the feeling of fulfilment that employees derive from their job which has a significant deal on their productivity. Assessing Pharmacists’ job satisfaction is therefore very paramount. Objective: This study accessed job satisfaction among Pharmacists working in a tertiary hospital and identified factors affecting job satisfaction among the study population Method: The study was a descriptive cross sectional study that employed the use of questionnaires as a research instrument for data collection with 30 participants completing the questionnaires. Simple percentages were used to analyse demographic characteristics and level of satisfaction. Relationship between variables was tested using chi square. Level of significance was measured at 95% confidence interval (p=0.05) Result: There was male participants’ preponderance (76.7%). Majority of the participants had practice years between 11-20 years (56.7%). 63.3% had Masters Degrees, 93.3% were Christians and 80% married. Level of job satisfaction was 33.3% among the participants. Hospital culture (76.7%), work environment (60%), reward system (60%) and remuneration (53.3%) were found to be factors recorded with the highest level of dissatisfaction. The Pharmacists were some-what satisfied with how their contribution were valued and the value placed on them by the organisation (53.3% each). However, satisfaction with their position was moderate (40.0%). Conclusion: Hospital pharmacists are important healthcare professionals that play critical roles in determining the effectiveness, efficiency, and sustainability of health care systems vial the delivery of pharmaceutical services. Showing concerns for Pharmacists welfare is an important factor to enhancing their job satisfaction with resultant improvement in the quality healthcare delivery. It is paramount that Government of Nigeria upgrades the remuneration of Pharmacists and provides conducive work environment as these would enhance productivity and effective pharmaceutical delivery to our teeming patient population.

See, seek, support: a policy framework to uplift first-generation low-income medical professionals.

The First-Generation and/or Low-Income (FGLI) identity is not readily visible, encapsulating those who are the first in their families to complete a 4-year college degree and/or those living near or below the poverty line. In the backdrop of unprecedented levels of socioeconomic inequality in a country where household income predicts educational attainment, we explore the current state of U.S. society regarding socioeconomic status and health care. We describe challenges in diversifying the health care workforce and present a multi-pronged policy approach for visibilizing, recruiting, supporting, and retaining FGLI trainees in medicine, with the promise of improving the quality of health care delivery altogether. Through this work, we aim to render the field of medicine more equitable for trainees, physicians, and patients alike.

A new conceptual model to investigate the role of hospital's capabilities on sustainable learning

The health-care industry is in a state of constant flux, with new challenges and opportunities emerging regularly. Hospitals, as the cornerstone of health-care delivery, must adapt and embrace change to provide optimal patient care. One crucial aspect that plays a significant role in the success of hospitals is sustainable learning. Sustainable learning refers to acquiring knowledge, skills, and competencies that enable health-care professionals to adapt to changes, implement best practices, and deliver high-quality care. Sustainable learning, a concept gaining prominence, emphasizes the ability of hospitals to learn from experiences and adapt to changing circumstances while maintaining quality health-care delivery. This article aims to investigate the role of hospital capabilities in sustainable learning and explore how hospitals can foster an environment that promotes continuous learning and development. Another goal of the paper is to test the relationships between cultural capabilities, structural capabilities, knowledge management capabilities, Information Technology (IT) infrastructure, top management support, application capabilities, and sustainable learning. The Partial Least-Squares (PLS) algorithm was performed using SmartPLS 3.0 to attain this goal. The results successfully support the study goals. This study verified that cultural capability, structural capabilities, knowledge management capabilities, IT infrastructure, top management support, and application capabilities positively affected sustainable learning. This investigation contributes to hospital, management, and education research by developing an integrated paradigm for sustainable learning. In conclusion, the new conceptual model presented here provides a robust framework for investigating the role of hospital capabilities in sustainable learning. By understanding and improving their capabilities, hospitals can not only adapt to change but also thrive in an ever-changing health-care landscape.

Development of a knowledge-based healthcare-associated infections surveillance system in China

BackgroundIn the modern era of antibiotics, healthcare-associated infections (HAIs) have emerged as a prominent and concerning health threat worldwide. Implementing an electronic surveillance system for healthcare-associated infections offers the potential to not only alleviate the manual workload of clinical physicians in surveillance and reporting but also enhance patient safety and the overall quality of medical care. Despite the widespread adoption of healthcare-associated infections surveillance systems in numerous hospitals across China, several challenges persist. These encompass incomplete coverage of all infection types in the surveillance, lack of clarity in the alerting results provided by the system, and discrepancies in sensitivity and specificity that fall short of practical expectations.MethodsWe design and develop a knowledge-based healthcare-associated infections surveillance system (KBHAIS) with the primary goal of supporting clinicians in their surveillance of HAIs. The system operates by automatically extracting infection factors from both structured and unstructured electronic health data. Each patient visit is represented as a tuple list, which is then processed by the rule engine within KBHAIS. As a result, the system generates comprehensive warning results, encompassing infection site, infection diagnoses, infection time, and infection probability. These knowledge rules utilized by the rule engine are derived from infection-related clinical guidelines and the collective expertise of domain experts.ResultsWe develop and evaluate our KBHAIS on a dataset of 106,769 samples collected from 84,839 patients at Gansu Provincial Hospital in China. The experimental results reveal that the system achieves a sensitivity rate surpassing 0.83, offering compelling evidence of its effectiveness and reliability.ConclusionsOur healthcare-associated infections surveillance system demonstrates its effectiveness in promptly alerting patients to healthcare-associated infections. Consequently, our system holds the potential to considerably diminish the occurrence of delayed and missed reporting of such infections, thereby bolstering patient safety and elevating the overall quality of healthcare delivery.

Towards Building a Trustworthy Deep Learning Framework for Medical Image Analysis.

Computer vision and deep learning have the potential to improve medical artificial intelligence (AI) by assisting in diagnosis, prediction, and prognosis. However, the application of deep learning to medical image analysis is challenging due to limited data availability and imbalanced data. While model performance is undoubtedly essential for medical image analysis, model trust is equally important. To address these challenges, we propose TRUDLMIA, a trustworthy deep learning framework for medical image analysis, which leverages image features learned through self-supervised learning and utilizes a novel surrogate loss function to build trustworthy models with optimal performance. The framework is validated on three benchmark data sets for detecting pneumonia, COVID-19, and melanoma, and the created models prove to be highly competitive, even outperforming those designed specifically for the tasks. Furthermore, we conduct ablation studies, cross-validation, and result visualization and demonstrate the contribution of proposed modules to both model performance (up to 21%) and model trust (up to 5%). We expect that the proposed framework will support researchers and clinicians in advancing the use of deep learning for dealing with public health crises, improving patient outcomes, increasing diagnostic accuracy, and enhancing the overall quality of healthcare delivery.