Demand For Staff Research Articles

Exploring the Causes and Policy Explanations for the Imbalance between Supply and Demand of Professional Healthcare Personnel in Grassroots Elderly Care Institutions in Qingdao

Current pension agency for with the deepening of aging degree and “combining medical and nursing care” policy response has many problems, widespread phenomenon is professional staff pension agency imbalance between supply and demand. In this study, the causes of this problem and its policy explanation are analyzed by using the in-depth interview method of qualitative research. Through the interviews with nurses, medical staff and management personnel in the local pension institutions in Qingdao, it is found that the causes of the imbalance between the supply and demand of professional medical staff mainly include insufficient number of medical staff, inconsistency between workload and income, tension between doctors and patients, and operation difficulties of pension institutions. The key to solving the problem is to promote cooperation between enterprises and schools, set up unified posts, improve the recruitment system, increase government subsidies and support, and formulate and implement targeted policies and measures to form a reasonable and efficient medical and nursing combination system.

Application of BIM and Virtual Reality of System Integration Design and Development in Medical Building Projects: A Case Study in China

Design outcomes in the Medical Building Projects (MBPs) must satisfy the demand of the medical staff and stakeholders. However, they often do not have the relevant engineering expertise, so the design team is prone to misunderstandings when communicating with them using traditional two-dimensional (2D) Computer-Aided Design (CAD) drawings. The medical staff may not readily visualize and understand the design and then provide feedback to the designer through professional medical requirements or advice, which results in the need to redesign and carry out additional work during the design phase, thus delaying the progress of the MBPs. To address these challenges, this study aims to develop an integrated system based on BIM, advanced rendering engines, and VR technology for use in non-immersive and immersive VR environments. Moreover, in this study, the integrated system was applied to the infection-building project of the People's Hospital of Qingbaijiang District, Chengdu City, and semi-structured interviews were distributed to 16 engineers, designers, contractors, and medical staff who had been involved in the whole project to validate the practicality and effectiveness of the integrated system. The results indicate that this system integration is an efficient visual communication and simulation tool in medical design. Key advantages include enhanced communication efficiency between the design team and medical stakeholders, improved visual interaction, and streamlined decision-making processes within a 3D VR/BIM environment. The successful implementation of this integrated system is expected to significantly aid design teams and stakeholders in effectively managing medical design tasks in future projects.

Obstacles and Challenges Affecting Quality Indicators in a Complex Tertiary Emergency Center.

Hospital performance is significantly affected by external factors (political and economic) rather than internal factors (effectiveness and efficiency). Emergency department (ED) overcrowding is a significant issue for emergency care services globally, characterized by a rising number of visits and persistent unsolved issues, resulting in increased challenges faced by ED staff and decreased patient satisfaction. This study aimed to explore the obstacles and challenges that cause variation in ED quality indicators (QIs) based on five domains: infrastructure, population, workflow, workforce, and administration. A tertiary emergency center in Saudi Arabia administered a questionnaire with standardized measures to 180 nurses, using a cross-sectional descriptive design. Most nurses (75.5%) believed that crowded waiting rooms in the ED were the most influential factor affecting QIs. Many other challenges were identified, including bed capacity, triage area/workflow, increased volume during peak periods, demand for nonemergency visits, staff and shortages. Significant differences in nurses' responses were found on the basis of education level (for infrastructure only, p = 0.004), specialty (for nursing administration only, p = 0.052), and ED experience (for all variables, p = 0.008-0.039). The analysis uncovered various critical aspects of infrastructure, workflow, population, workforce, and nursing administration that have a major effect on patient flow in the ED. Comprehending these aspects will greatly affect the quality measures of ED performance and assist policymakers in formulating strategic plans to enhance ED performance. Therefore, successful implementation and optimization of ED resources depend greatly on considering the right decision variables and resource restrictions.

Personnel shortages in the healthcare sector-will de-economization solve or exacerbate the problem?

The healthcare industry has long complained about an acute shortage of skilled workers. Vacancies can often only be filled by skilled workers from abroad. While rural areas are increasingly experiencing a shortage of personnel, many urban centers continue to have an oversupply and a sufficient number of young doctors. Hospitals do not expect the situation to improve in the future. Hospitals are trying to counteract the negative development of the job situation in nursing staff. Government intervention can limit the economically motivated adjustment of resource utilization. The demand for staff will not fall as a result of de-economization.

Better operating room efficiency and reduced staff demand: Individualised versus off-the-shelf total knee arthroplasty.

The purpose of this pilot cross-sectional study was to compare the operating room (OR) efficiency and intraoperative staff task load when performing individualised versus off-the-shelf (OTS) total knee arthroplasty (TKA). A consecutive series of 28 patients randomised (1:1) to receive either OTS TKA or individualised TKA were included. The OR staff workload was assessed with the NASA Task Load Index (TLX), a subjective grading system assessing mental demand, physical demand, temporal demand, performance, effort and frustration on a scale from 0 (very low) to 20 (very high). The time for patient preparation, surgical time, closureand total OR time was recorded to assess OR efficiency. Effect sizes of differences between OTS and individualised TKA were expressed as mean differences (MDs) with 95% confidence intervals (CIs). Patients in both cohorts were similar in age (OTS vs. individualised TKA (median [IQR]), 67 [63-76] vs. 71 [68-79]; p = 0.207) and body mass index (BMI) (29 [24-33] vs. 29 [26-31]; p = 0.807), and there were no significant differences in other preoperative characteristics. The OR staff perceived individualised TKA as less demanding than OTS TKA: Individualised TKA was rated significantly better across the six domains of the NASA TLX: mental demand by 5.6 points, physical demand by 6.3 points, temporal demand by 5.3 points, performance by 3.6 points, effort by 5.9 pointsand frustration by 5.8 points. Individualised TKA resulted in statistically significantly shorter mean total OR time (MD, 10 min; p = 0.018). The staff in the OR found that individualised TKA is less mentally, physicallyand temporally demanding than OTS TKA. The average total time spent in the OR during individualised TKA is 10 minless than during OTS TKA. This study constitutes a part of a larger registered randomised controlled trial comparing patient satisfaction following OTS versus individualised TKA (NCT04460989). Level III.

Exploring Trends and Challenges in Professional Development of Adult Educators across European Member States: Insights and Recommendations for Improvements

This article provides an overview of professional development trends in European Member States, encompassing training and qualification requirements, as well as the supply and demand for adult teaching staff, including specialized training in andragogical studies. The study investigates actions and policies related to professional development in selected European Member States through thematic analysis of a supportive document for National Coordinators of Adult Learning, who participated in an online Peer Learning Activity (PLA) in May 2021. Additionally, relevant information from Eurydice, European policy documents, scholarly articles, and research papers is incorporated. This overview sets the stage for a discussion on prevailing trends in the professional development of adult educators across European Member States and explores how these trends impact professional development. Overall, the discussion underscores the need for a more systematic and sustained approach to professional development and professionalization in the field of adult education. This includes addressing the diverse needs of adult educators and advocating for greater recognition and regulation of the profession across European countries.

E043 Fast track giant cell arteritis service in a district general hospital using ultrasound doppler imaging

Abstract Background/Aims Giant cell arteritis (GCA) is the commonest large and medium artery vasculitis, a multisystem condition that results in significant comorbidity and mortality. Corticosteroids are pivotal in remission induction and maintenance therapy, but complications can arise either due to delayed treatment, or unnecessary treatment of GCA mimics. This renders quick diagnosis of GCA vital. Temporal artery biopsy (TAB) has traditionally been the golden standard diagnostic modality, but it requires a surgical setting, resulting in delays. Temporal artery ultrasound doppler scanning (TA UDS), however, has now been incorporated by both BSR and EULAR in their recommendations, offering a diagnostic tool with high specificity and sensitivity. Aims 1. To set up a fast track GCA diagnostic service in an one-stop-shop outpatient clinical setting with inhouse ultrasound; 2. To limit dependence of GCA diagnosis on TAB Methods We set up a dedicated GCA clinic at Eastbourne District General Hospital aiming to see patients within five days of referral. In the clinic, patients were categorised to low, moderate or high GCA risk via a pre-test probability score, and had TA UDS by an expert rheumatologist. We collected data on number of UDS performed, scan outcomes, and TAB requests over a 17-month period. Results Total number of referrals with suspected GCA was 147, mainly via general practice and ophthalmology, with 117 already having been started on corticosteroids by the referrer. Overall, 93% of patients were seen within five days of initial referral, with 32% within 72 hours of steroid commencement. We scanned 138 patients (94%) and diagnosed GCA in 41 (30%) of them. Of the nine we did not scan, six had very low probability score and were given alternative diagnoses; two were out of the window for diagnostics and GCA was diagnosed clinically; and one could not be scanned due to technical reasons, so a TAB was requested. Crucially, this was the only TAB requested during this period. Conclusion Our fast track service has facilitated prompt review of GCA referrals with the use of ultrasound, limiting the need for a TAB. The pathway enables both prompt commencement of appropriate steroid-weaning regimens in confirmed GCA, but also facilitates timely discontinuation of corticosteroids in patients with excluded GCA, thus minimising future complications either way. Typically, it takes more than three weeks to arrange a TAB. Moreover, ultrasound use avoids an invasive procedure with potential for surgical complications. From a healthcare system point of view, there are certain cost-saving implications in using ultrasound for GCA diagnosis. These can range from reduced demand for outpatient clinics, theatre slots and theatre staff, to minimisation of any future complications be it post-op, disease- or steroid- related. Finally, a service user survey, aiming to improve our pathway, documented improved patient satisfaction. Disclosure P. Kamperidis: None. A. Hall: None. H. Perera: None. S. Panthakalam: None.

The Integration of Physical Therapists and Occupational Therapists into Burn Wound Care Increases Therapist Productivity, Job Satisfaction, and Multidisciplinary Collaboration.

When attempting to deliver specialized rehabilitation therapy interventions, physical therapists (PTs) and occupational therapists (OTs) must account for dynamic and logistical patient factors such as daily wound care, pain, difficulty progressing range of motion with dressings donned, and ongoing surgical interventions. Additionally, they must attain institution-specific productivity standards. Given burn patients often require considerable multidisciplinary interventions, efficiently planning and delivering rehabilitation therapy interventions within productivity expectations may prove difficult. The purpose of this study was to assess the feasibility of integrating rehabilitation therapists, PTs and OTs, into daily burn wound care by investigating therapist productivity and multidisciplinary perceptions of this practice change. The quality improvement project involved 6 rehabilitation therapists (3 PTs and 3 OTs) practicing exclusively in the burn unit within an American Burn Association (ABA)-verified burn center at an urban, tertiary care academic medical center. One rehabilitation therapist was responsible for providing interventions within the burn wound care team 5 days a week. General duties included wound assessment, functional wound dressings, and skilled therapeutic interventions such as manual therapy, therapeutic exercise, and compression interventions. The primary outcome was changes in group productivity and individual therapist productivity, as measured by total billed Current Procedural Terminology (CPT) codes per hour worked, which were tracked 22 weeks preimplementation and 28 weeks postimplementation. Program feasibility and general perceptions were assessed by a qualitative questionnaire. For both the entire group of therapists and each individual rehabilitation therapist, billed CPT codes per hour increased postimplementation, 1.81 vs 1.54 (P = .005) and a matched increase of 0.27/h (P = .003). Of the 23 survey respondents, 96% had a favorable impression of the program and reported it eased staffing demands. All respondents reported improved unit workflow and multidisciplinary communication. The majority of multidisciplinary burn team members actively supported the pilot program and commented on improvements in patient care. Full-time rehabilitation therapy participation in wound care increases therapist productivity and job satisfaction. Future efforts, however, should focus on measuring specific patient outcomes and costs as a result of therapist integration into daily wound care practice.

COVID-19 and the Impact on Delirium Care of Hospitalized Older Adults: A Qualitative Study.

Older adult patients with COVID-19 and delirium experience higher rates of adverse outcomes. Early recognition of at-risk patients and implementation of management strategies improve outcomes, though understanding barriers to acute care nurses implementing these strategies is limited. This study's purpose was to understand the experiences of acute care nurses providing care to older adults with COVID-19 and delirium. Experiences explored included assessment, nursing management interventions, and barriers to care. Purposive sampling to recruit nurses for semistructured focus groups was performed, and thematic analysis was generated by 4 members of the research team. Twenty-one nurses participated in focus groups. Thematic analysis revealed themes of increased patient social isolation, barriers to delirium assessment and prevention, increased staff demands, and stressful work environments. Rich findings reveal the profound impact of the pandemic on assessment for delirium and implementation of strategies for prevention and management in older adult patients.

CURRENT STATUS OF SCHOOL LUNCHES RELATED TO FOOD ALLERGY AND UNMET NEEDS OF TEACHERS IN MIYAGI PREFECTURE

The number of students with food allergies is on the increase, while the problems and burdens of school teachers and staff are not yet clear. Our study was designed to identify the unmet needs of school teachers and staff dealing with food allergy in school lunches. A written questionnaire was sent by mail to 600 elementary and junior high schools in Miyagi Prefecture. Responses were received from 169 schools. The prevalence of food allergy was 5.6% and the EpiPen possession rate was 0.36%. The most common problems perceived by teachers and staff were the "increase in the number of students with food allergies" and the "diversification of causative foods". Other problems included "uncertainty of foods to be removed" and "insufficient collaboration among teachers, guardians, and doctors," which could be improved by the medical providers. In the free descriptions, many respondents complained of an excessive workload and the mental burden of never making a mistake or missing anything. Our survey revealed that while there is a public demand for safe school lunches, the teachers and staff dealing with this demand are under considerable strain. It is necessary to consider reducing the burden, and a sustainable system needs to be established.

Factors that influence locum practice in public and faith-based hospitals in Malawi.

Locum practice is a non-standard form of employment used to address the shortage of healthcare workers in hospitals. In Malawi, the locum practice is used to improvre the availability of healthcare workers and promote continuity of care. Despite this, little attention has been paid to the effective and efficient use of locum practice. To explore the factors influencing locum practices in public and faith-based hospitals in Malawi. Six public and faith-based hospitals in Malawi. An exploratory descriptive design was used in the qualitative strand of this larger mixed-methods study. Data were collected through in-depth interviews with hospital managers (n = 15) and focus group discussions (FGD) with nurses, medical officers, and clinical officers (n = 29). All the interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. Locum practice was characterised by challenges related to healthcare workers working beyond the prescribed hours, a lack of orientation for locu staff, inconsistent locum rates, and delayed payments. The consequences of these challenges are compromised quality and safety of patient care. Locum practice is associated with numerous challenges in both public and faith-based hospitals in resource-limited settings. This could be attributed to the lack of regulation, supervision and monitoring of locum practice. The findings suggest the need for the development and adherence to guidelines and policies for managing locum practice. Further studies could explore measures to retain permanent staff as a way of reducing the demand for locum staff.

The Impacts of the COVID-19 Traffic Light System on Staff in Tertiary Education in New Zealand

The global impact of the COVID-19 pandemic demanded a swift transition in the usual educational mode of delivery from face to face to online. New Zealand established “a traffic light system” after initial COVID-19 lockdowns, and educational delivery adapted accordingly at a tertiary education provider in Te Pūkenga, Eastern Institute of Technology. This study investigates the ramifications of the traffic light system on this institute’s staff, employing semi-structured interviews and an inductive semantic thematic analysis. The findings reveal a universal impact on staff, characterized by an augmented workload attributed to students’ absences and illnesses. This led to increased support demands of staff for their students’ academic progression. Anxiety, stress, and guilt emerged as prevalent emotions linked to student support. Despite the staff adapting to the mandates, a notable challenge arose from the discord between educational and industry directives, causing confusion among the students. While the study indicates staff resilience in navigating the traffic light changes, it underscores the imperative of recognizing the toll on their wellbeing. The research calls for a proactive consideration of future challenges, emphasizing the importance of safeguarding the mental and emotional health of tertiary education staff amidst potential uncertainties in educational delivery.

Perceived knowledge, attitudes and practices regarding the medical consortium among medical staff in Sichuan, China: a cross-sectional survey

BackgroundIn China, fragmented and inefficient health care systems are common while quality resources are limited. To promote an organized, efficient system, the government launched a medical consortium policy to vertically integrate health care through the collaboration of different levels of medical care. Logically, medical staff’s knowledge, attitudes and practices (KAP) regarding the consortium are critical for its development. The objective of this study was to explore the KAP regarding the medical consortium among medical staff in a medical consortium in Sichuan Province, China.MethodsA cross-sectional survey was conducted. In total, 690 medical staff members in 3 cities of Sichuan Province, China, were interviewed from November 2018 to December 2018. The questionnaire consisted of 18 items, including 4 items related to perceived knowledge, 4 items related to attitudes and 2 items related to practices, and was rated on a 5-point Likert scale (one = strongly disagree/do not know, five = strongly agree/know).ResultsThe effective response sample was 640 copies of the questionnaire, and most medical staff members (92.50%) knew about the cooperation with other hospitals in the medical consortium. Medical staff scored differently on each item in the questionnaire, with the highest score being the item ‘agreeing with the ward rounds and clinical teaching and training organized by the leading hospital’ (4.54 ± 0.76), and the lowest score being the item ‘frequency in participating in ward rounds and clinical teaching organized by the leading hospital’ (2.83 ± 1.36). In addition, the effect of demographic characteristics on KAP was evaluated by stepwise multiple regression analysis, and a significant positive correlation was found between all the studied variables by Spearman’s correlation (p < 0.05).ConclusionsThis study showed that the attitudes toward and knowledge of the medical consortium significantly contribute to practices, satisfaction with the support work performed by the leading hospital and agreement of improvement after joining the medical consortium. Thus, to improve medical staff’s KAP and satisfaction, publicity and educational programs in medical consortia are necessary, and the leading hospital should attach importance to the informatization construction and demand of different medical staff members.Clinical trial registrationThere are no clinical trials in this study.

Assessing and Preparing Patients for Hematopoietic Stem Cell Transplant in Canada: An Environmental Scan of Psychosocial Care.

HCT programs across Canada were contacted with a list of questions about their psychosocial assessment and preparation process with patients and caregivers. They could respond via email or participate in an interview over the phone. Descriptive qualitative content analysis was conducted, using steps outlined by Vaismoradi and colleagues (2013). Most participants were social workers from hospitals (64%). Four qualitative themes arose: (a) Psychosocial Team Composition. Psychosocial assessment for HCT patients was often provided by social workers, with limited availability of psychologists and psychiatrists. (b) Criteria for assessing select HCT patients. Participants prioritized psychosocial assessments for patients with higher perceived psychosocial needs or risk, and/or according to transplant type. Limited time and high psychosocial staff demands also played into decision-making. (c) Components and Practices of Pre-HCT Psychosocial Assessment. Common components and differences of assessments were identified, as well as a lack of standardized tools. (d) Patient Education Sessions. Many sites provided adjunct patient education sessions, of varying depth. Significant variation exists in the way programs across the country assess their patients' psychosocial pre-transplant needs and assist in preparing patients for the psychosocial aspects of HCT. This environmental scan identified several strategies used in diverse ways. Further in-depth research on program outcomes across Canada could help to identify which strategies are the most successful.

Analysis of the comprehensive needs of primary caregivers of hospitalized colorectal cancer patients and characteristics analysis of high comprehensive needs population.

To identify the care needs of primary caregivers of colorectal cancer (CRC) patients and specify the characteristics of high-needs caregivers. A cross-sectional survey was conducted on the primary caregivers of CRC patients using the Comprehensive Needs Assessment Tool in Cancer Caregivers. The care needs and the characteristics of caregivers with high needs were identified using the Chi-square test and Logistic regression. The results of the survey of 364 primary caregivers of CRC patients showed that the top 2 dimensions of caregiver needs were the healthcare staff and the information dimension. The characteristics of caregivers with high demand for healthcare staff included on-the-job, a family per capita monthly income of <4000 yuan, and the CRC patients they took care of paid medical expenses through self-pay/public expense/rural insurance. The characteristics of caregivers with high information needs included living in the city, on-the-job, a family per capita monthly income of <4000 yuan, and the CRC patients they took care of paid medical expenses through self-pay/public expense/rural insurance. In clinical settings, the information needs of primary caregivers of CRC patients should be given due attention. Particular attention should be paid to the primary caregivers of CRC patients who live in cities, are on-the-job, have a per capita monthly income of <4000 yuan, and pay medical expenses through self-pay/public/rural insurance.

Relationship between Racial Diversity in Medical Staff and Hospital Operational Efficiency: An Empirical Study of 3870 U.S. Hospitals.

Demand for foreign nurses and medical staff is rapidly increasing due to the severe labor shortage in U.S. hospitals triggered by the COVID-19 pandemic. However, empirical studies on the effect of the racial diversity of medical staff on hospital operations are still lacking. This research gap is thus investigated based on the foreign medical staff working in 3870 U.S. hospitals. Results show that workforce racial diversity has a significantly positive relationship with hospital operational efficiency regarding occupancy rate, manpower productivity, capacity productivity, and case mix index. Notably, this study empirically supports that increasing the ratio of foreign nurses positively affects the overall operational efficiency of hospitals. In addition, the study results also indicate that the hospital location, size, ownership, and teaching status act as significant control variables for the relationship between racial diversity and hospital efficiency. These results imply that hospitals with these specific operating conditions need to pay more attention to racial diversity in the workplace, as they are structurally more sensitive to the relationship between racial diversity and operational efficiency. In short, the findings of this study suggest that hospital efficiency can be operationally improved by implementing workforce ethnic diversity. For this reason, hospital stakeholders and healthcare policymakers are expected to benefit from this study's findings. Above all, the results of this study imply that if an organization adapts to extreme external environmental changes (e.g., the COVID-19 pandemic) through appropriate organizational restructuring (i.e., expanding the workforce racial diversity by hiring foreign medical staff), the organization can gain a competitive advantage, a claim that is supported by contingency theory. Further, investors are increasingly interested in ESG, especially companies that embody ethical and socially conscious workplaces, including a diverse and inclusive workforce. Thereby, seeking racial diversity in the workforce is now seen as a fundamental benchmark for organizational behavior that predicts successful ESG business practices, a claim that is supported by stakeholder theory. Therefore, in conclusion, the findings of this study suggest that workforce racial diversity is no longer an optional consideration but should be considered as one of the essential determinants of competitive advantage in organizations, particularly in the healthcare sector.

Development of dissolving microneedles for intradermal delivery of the long-acting antiretroviral drug bictegravir

Oral administration and intramuscular (IM) injection are commonly recommended options for human immunodeficiency virus (HIV) treatment. However, poor patient compliance due to daily oral dosing, pain at injection sites and the demand for trained healthcare staff for injections limit the success of these administration routes, especially in low-resource settings. To overcome these limitations, for the first time, we propose novel bilayer dissolving microneedles (MNs) for the intradermal delivery of long-acting nanosuspensions of the antiretroviral (ARV) drug bictegravir (BIC) for potential HIV treatment and prevention. The BIC nanosuspensions were prepared using a wet media milling technique on a laboratory scale with a particle size of 358.99 ± 18.53 nm. The drug loading of nanosuspension-loaded MNs and BIC powder-loaded MNs were 1.87 mg/0.5 cm2 and 2.16 mg/0.5 cm2, respectively. Both dissolving MNs exhibited favorable mechanical and insertion ability in the human skin simulant Parafilm® M and excised neonatal porcine skin. Importantly, the pharmacokinetic profiles of Sprague Dawley rats demonstrated that dissolving MNs were able to intradermally deliver 31% of drug loading from nanosuspension-loaded MNs in the form of drug depots. After a single application, both coarse BIC and BIC nanosuspensions achieved sustained release, maintaining plasma concentrations above human therapeutic levels (162 ng/mL) in rats for 4 weeks. These minimally invasive and potentially self-administered MNs could improve patient compliance, providing a promising platform for the delivery of nanoformulated ARVs and resulting in prolonged drug release, particularly for patients in low-resource settings.

Now is the time to fix the clinical research workforce crisis.

The clinical and translational research enterprise is recognized by many as the "evidence generation system." While there have been several calls to revolutionize this enterprise to more effectively deliver the fruits of biomedical science to patients and society, significant issues across the clinical research workforce are pervasive. Perhaps the most visible sign is the widening gap between supply and demand for competent staff. Underpinning this, is a perfect storm of complex issues. Now reaching crisis point, this problem is far bigger than a staffing issue and ultimately jeopardizes the "engine" of drug and device development. With the current perilous state of the workforce, proposed enterprise fixes are likely to languish far out of reach, given that even "business as usual" is under threat. In fact, a glaring disconnect is evident between the visionary discourse on how to revolutionize the clinical research enterprise and the sober recognition that operationalization of any such vision rests on the shoulders of a workforce that's in dire straits. In this article, we provide a brief forensic analysis of the workforce problem and an initial indication of where solutions may lie.

Malaria Detection in Blood Smeared Images Using Convolutional Neural Networks

Abstract: With 200 million cases annually, malaria often claims more lives than crisis and deadly wars. Given the ineffectiveness of efforts to lower mortality rates, insufficient malaria diagnosis is one of the hurdles to a successful and efficient reduction in fatality. Hence, malaria is one of the major causes of deaths and diseases in many developing countries, where young children and prenatal mothers are the most impacted populations. The parasite called Plasmodium is the source for the potentially fatal disease named malaria. Highly trained and experienced microscopists observe minute blood smeared images to look for the parasite. Modern deep learning techniques could automate the completion of the required analysis. With the development of an independent, accurate, and useful model the demand for skilled staff can be significantly decreased. In this study, we offer a totally automated method and approach for the diagnosis and classification of malaria using microscopic blood-smeared pictures based on convolutional neural networks-(CNN).

T4 Integration of PT/OT in Burn Wound Care Increases Therapist Productivity

Abstract Introduction Inpatient physical (PT) and occupational (OT) burn therapists must balance complex patient factors such as daily wound care when attempting skilled therapy sessions, while also attaining specific productivity standards. These factors often lead to inefficient work flow and loss of productivity. The purpose of this study was to assess the productivity and feasibility of therapist integration into daily burn wound care. Methods A quality improvement project was initiated by the burn therapy team at our ABA verified burn center. One full time equivalent (FTE) PT or OT was assigned to the burn wound care team five days a week, involving 6 therapists (3 PTs and 3 OTs). General duties included wound assessment, functional wound dressings, and skilled therapeutic interventions. The primary outcome measure was individual therapist productivity tracked 3 months pre and 3 months post project implementation. Productivity was calculated by taking total billable patient time divided by total workday time, with a goal of 50% productivity. Billed time units were also compared to goal units. The results were analyzed using a paired t-test to measure significance and averaged. The secondary outcome measure was program feasibility, assessed by a qualitative questionnaire taken by burn staff pre and post. Results Overall therapist productivity increased, 49% pre implementation vs 54% post (p=0.0041). The difference of billed vs goal units increased, 5 pre vs 15.9 post (p= 0.00142). Proportion of therapists meeting target productivity increased, 57.1% pre vs 90.5% post (p=0.0052). Prior to program implementation, survey results found that 77% of burn staff (n=23 respondents) were favorable of project implementation, whereas 23% were either hesitant or indifferent. After 3 months post implementation, 95% of burn staff were favorable of therapist participation, 95% indicated ease of staffing burden, and 100% reported improved multidisciplinary communication. Furthermore, 100% of burn staff felt that the unit’s workflow had improved. Conclusions Full time therapy participation in wound care increases therapist productivity and increases the likelihood of meeting target productivity in the future. The majority of burn staff actively supported this pilot program and felt that it eased staffing demands, improved unit workflow, and improved multidisciplinary communication. Future efforts should focus on measuring specific patient outcomes and cost as a result of therapist participation in daily wound care practice. Applicability of Research to Practice All burn units should consider implementing a skilled burn therapist in wound care practice.