Dynamic Healthcare Environment Research Articles

Medical Malpractice Litigation Trends Following Primary Total Hip and Knee Joint Arthroplasty: An Updated Nationwide Analysis

BackgroundTotal joint arthroplasty (TJA) is the most common procedure associated with malpractice claims within orthopaedic surgery. Although prior research has assessed prevalent causes and outcomes of TJA-related lawsuits before 2018, the dynamic healthcare environment demands regular re-evaluations. This study aimed to provide an updated analysis of the predominant causes and outcomes of TJA-related malpractice lawsuits and analyze the outcomes of subsequent appeals following initial jury verdicts. MethodsA legal database was queried for cases between 2018 and 2022 involving primary hip and knee TJA in the United States. Cases were listed as original rulings or appeals and reviewed for the alleged negligence, damages incurred, demographics, and verdicts. Appeals were further assessed for appellant details, preliminary judgment, and outcomes. The findings were compared to previous litigation data using descriptive statistics. ResultsThe final cohort comprised 59 cases: 33 (56%) total knee arthroplasty (TKA) and 26 (44%) total hip arthroplasty (THA). The TKA cases primarily cited pain (24%), while the THA cases cited nerve injuries (31%). Negligence largely stemmed from procedural error (47%), postsurgical error (27%), and failure to inform (14%). Case outcomes were in favor of the defense in 66% of cases. Overall, 90% of primary verdicts led to appeals, with 71% by the plaintiff. Initial rulings were upheld in 87% of plaintiff appeals, whereas 53% of defendant appeals retained the initial judgment. ConclusionsThe primary cause of litigation shifted from infection to ongoing/worsening pain in TKA cases over time. While nerve injury TKA cases have decreased, it remains the most cited damage after THA. Defense verdicts are common, but there is an increasing number of verdicts against defendants. Plaintiffs are more likely to appeal, but are less successful in appellate courts. These findings allow surgeons and policymakers to address emerging litigation trends in TJA to mitigate risks and improve the overall quality of TJA.

The impact of simulation-based learning on the knowledge, attitude and performance of physiotherapy students on practice placement

BackgroundPractice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students’ knowledge, attitude, and performance during practice placements with external providers.MethodsThis study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke’s approach was utilised in this study.ResultsTwelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [1] Working together, [2] Working with Service Users, [3] Professionalism, [4] Profession-specific practical skills and [5] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks.ConclusionsSBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators’ and students’ contact time.

A Hybrid Localization Algorithm for Enhanced Accuracy and Robustness in Healthcare Systems

This paper presents a novel hybrid localization algorithm designed for healthcare systems, integrating Received Signal Strength Indicator (RSSI) and Time of Arrival (ToA) measurements with machine learning techniques. The algorithm aims to enhance the accuracy, robustness, and computational efficiency of sensor localization in dynamic healthcare environments. Experimental results demonstrate that the hybrid algorithm achieves a significantly lower localization error, averaging 0.5 meters, compared to traditional RSSI-only and ToA-only methods. The algorithm's rapid convergence and low computational time make it suitable for real-time applications. Additionally, its robustness to measurement noise, a common challenge in healthcare settings, underscores its reliability. This research underscores the potential of advanced localization technologies to improve patient monitoring, safety, and overall healthcare delivery, with future work poised to further enhance performance and adaptability.

Shaping the New Nurse Leader Generation: Strategies for Effective Leadership Development in the Postpandemic Era

The global pandemic has highlighted the indispensable role of effective leadership in navigating the complexities of healthcare. In response, the New York-Presbyterian Nursing Leadership Academy (NYP NLA) emerges as a transformative initiative, designed to fortify nurse leaders with the necessary competencies to thrive in a dynamic healthcare environment. This manuscript provides an in-depth analysis of the NYP NLA, elucidating its targeted objectives, the adoption of pioneering educational methodologies, and the profound impact it has had on participants. Through a blend of structured mentoring, innovative teaching strategies, and comprehensive leadership development, the NYP NLA has not only positively influenced the professional trajectories of nurse leaders but has also made a notable contribution to enhancing the quality of healthcare delivery. By fostering a cadre of empowered, skilled, and visionary leaders, the NYP NLA is setting a new standard for leadership excellence in healthcare, ensuring readiness for current and future challenges.

Patient-centered perspectives on perioperative care

IntroductionThe collection and evaluation of patient-reported outcomes is essential to the development of patient and family centered care. Current patient surveying techniques are limited by delayed response times and restriction to specific health systems. The use of random-domain intercept technology (RDIT), by Real-Time Interactive World-Wide Intelligence (RIWI, Toronto, ON, Canada) mitigates current barriers by creating a dynamic real-time feedback environment and providing a mass sampling technique.MethodsRDIT was employed to survey a wide sample of respondents across the United States (US). Respondents who self-identified as having had a surgical procedure or cared for someone having a surgical procedure were included in the analysis.Results1,004 participants completed the survey and answered questions regarding demographics, perioperative details, sentiments on postoperative recovery, postoperative clinical endpoints, sentiments on healthcare professionals, and opinions on future surgical care.DiscussionThe results of this cross-sectional study identified areas with potential for improvement in the patient perioperative experience that could improve the patient experience. This novel use of RDIT provided a valuable tool for real-time feedback and mass sampling allowing the creation of a dynamic healthcare environment that fosters timely and targeted improvements to patient experiences and outcomes.

172 Roles and Expectations for Evaluators within a Learning Health System

OBJECTIVES/GOALS: Our objective is to explore the evolving role of evaluators within Learning Health Systems (LHSs) and the implications for evaluation approaches in these dynamic healthcare environments. We aim to disseminate lessons learned to help inform best practices for other CTSA hubs operating under a LHS model. METHODS/STUDY POPULATION: Our investigation builds upon our prior qualitative analysis of the LHS literature and contextualization of unique challenges, and potential remedies, of a LHS in Academic Health Centers. As evaluators, we are particularly interested in understanding how evaluation work is conducted in LHSs and exploring ways to optimize the role of evaluators and their skillset in this context. For this investigation, we examined the competencies necessary for evaluators working in LHS and the specialized evaluation approaches needed to fulfill these requirements. Our approach drew from multi-faceted data and experience. We leveraged insights from our literature review, direct experience within WFUSOM CTSI, and discussions with other evaluators. This combination of data sources provided the foundation for our analysis. RESULTS/ANTICIPATED RESULTS: We expect that as more health systems move toward the LHS model, they will have an increased need for various forms of evaluation, requiring resources well beyond what they are currently dedicating to evaluation. Expectations for evaluators will be enhanced in the following distinct, yet complementary, categories: generating new knowledge and translating research knowledge into practice. Anticipated results include identifying essential competencies for evaluators in LHS, such as data proficiency, clinical understanding, and adaptive skills. We also expect to uncover various evaluation approaches specific to LHS, including quality improvement studies, pragmatic trials, and stakeholder-engaged research. DISCUSSION/SIGNIFICANCE: Understanding the evolving role of evaluators and specialized evaluation approaches in LHS is crucial. It enhances the ability to generate localized evidence, customize interventions, and improve patient care. This knowledge empowers healthcare systems to adapt, innovate and deliver high-quality care for a higher impact on patient outcomes.

AOA Critical Issues Symposium: The Dynamic Environment of Health Care.

The dynamic health-care environment continues to undergo disruptive change. As the health-care system emerges from the pandemic, underlying issues have progressively become critical. Private equity acquisition is dramatically increasing, and consolidation in the entire health-care system limits choice and access. Challenges in the workforce and supply chain persist, adding pressure on already strained health-care organizations. Innovative solutions are required to provide equitable value-based access to orthopaedic care.

Distance Energy-Efficient Soft Computing Model for Data Forwarding in Healthcare Sensor Network

Data forwarding is a crucial process in computer networking and telecommunications. It involves the transmission of data packets from a source to a destination within a network. The forwarding process is fundamental for enabling communication between devices on different segments of a network and plays a vital role in maintaining the overall performance and reliability of the network infrastructure. This paper presents the development and evaluation of the Threshold Congestion Data Forwarding Soft Computing (TCDF-SC) algorithm, designed for healthcare sensor networks. The algorithm combines threshold-based congestion management with soft computing techniques to enhance data forwarding efficiency in dynamic healthcare environments. Through extensive simulations, TCDF-SC demonstrates scalability, achieving high total packets forwarded and maintaining a reliable packet delivery ratio as the network scales. The algorithm minimizes average transmission delay and optimizes energy consumption, ensuring timely and energy-efficient data transmission. Comparative analysis against existing protocols, LEACH and BCP, highlights TCDF-SC’s superior performance across key metrics, positioning it as a promising solution for healthcare sensor networks. This research contributes to the advancement of data transmission optimization in healthcare, addressing critical requirements of reliability, energy efficiency, and adaptability in dynamic healthcare settings. Further validation and real-world experimentation will enhance the algorithm’s applicability in diverse healthcare scenarios, fostering advancements in patient monitoring and healthcare applications.

Impact of AI on Healthcare with Specific Reference to Nurses' Education

Integrating Artificial Intelligence (AI) in healthcare has revolutionized the industry by enhancing patient care, optimizing clinical workflows, and improving healthcare professionals' education and training. This paper explores the multifaceted impact of AI on healthcare delivery, specifically focusing on its influence on nurse education. AI-driven technologies have ushered in a new era of personalized learning, enabling nurses to acquire essential skills, stay current with medical advancements, and adapt to dynamic healthcare environments. Additionally, AI-powered tools have streamlined administrative tasks, allowing nurses to allocate more time to patient care. However, this transformation has challenges, including concerns about job displacement, data privacy, and the need for effective AI curriculum integration. This abstract provides a glimpse into the broader discussion surrounding AI's role in healthcare delivery and its implications for nurse education, highlighting its promises and challenges in shaping the future of nursing practice.

When to err is inhuman: An examination of the influence of artificial intelligence-driven nursing care on patient safety.

Artificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision-making. The boundaries between human- and nonhuman-driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment like never before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision-making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed.

How An Established Health System Ventures Forth: Ochsner Invests in the Future.

The founding of Ochsner Ventures followed the natural evolution of more than a decade of growth and expansion of Ochsner Health's offerings and capabilities beyond traditional patient care. This growth has enabled the health system to bring critical services to underserved communities across the Gulf South. Ochsner Ventures supports promising companies both in and beyond the region while bringing forward new solutions to healthcare sector challenges and improving health outcomes, access, and equity. In a dynamic healthcare environment amid the persistent effects of the COVID-19 pandemic, Ochsner Health is executing a multiyear strategic plan to reinforce its mission and maintain a position of strength in the region. One aspect of the strategy focuses on the diversification and pursuit of new value by creating new revenue, additional savings, cost reductions, innovations, and amplifying existing assets and capabilities.

Cognitive and Non-Cognitive Determinants of Academic Performance in Nursing

Nursing education is a rigorous and demanding pursuit, requiring a comprehensive understanding of medical knowledge, critical thinking skills, and effective clinical practice. The success of nursing students in academic and clinical settings is influenced by a myriad of factors that encompass both cognitive and non-cognitive determinants. This paper examines the key cognitive determinants, which include critical thinking, problem-solving abilities, clinical reasoning, and memory skills. These cognitive factors provide the foundational framework for grasping intricate medical concepts and making informed decisions in real-world healthcare scenarios. Furthermore, this paper delves into the non-cognitive determinants that significantly impact academic performance in nursing education. Factors such as motivation, emotional intelligence, resilience, and interpersonal skills play a pivotal role in shaping a nursing student's approach to learning, coping with challenges, and delivering patient-centered care. The importance of cultural competence, adaptability, and teamwork is also explored, as they contribute to effective collaboration in the dynamic healthcare environment. Recognizing the intricate relationship between cognitive and non-cognitive determinants is imperative for nursing education programs. By fostering a nurturing learning environment, offering mentorship and support services, and integrating experiential learning opportunities, nursing institutions can equip their students with the tools needed to excel academically and become well-rounded, compassionate, and skilled nurses. This paper underscores the significance of addressing both cognitive and non-cognitive factors to ensure the holistic development of nursing students and their future contributions to healthcare.

Key Business of Health Care Topics and Strategies to Implement Within Doctor of Pharmacy Curricula

Objective. To explore pharmacist alumni perspectives on what topics and how the business of health care should be incorporated into pharmacy school training.Methods. An exploratory sequential mixed-methods design was used. Focus groups were conducted to elicit pharmacist alumni perspectives about business of health care topics and strategies for student learning and curricular implementation. Purposive sampling was used to identify alumni participants who could provide substantive feedback aligned with the needs of this evaluation. Ten alumni attended one of three focus groups over a two-month period. Thematic coding was used to identify themes. Results from the focus groups were used to inform survey development distributed to alumni of the pharmacy school. Survey data were analyzed using descriptive statistics.Results. Findings from the focus groups and survey indicated that the business topics most important for students to learn were communication strategies, health care operations, the health care payer system, managing teams, and career options within pharmacy. Focus group participants recommended a variety of activities to help students learn and apply business topics and emphasized that simulations and real-world experiences were needed to help students learn these topics and assess their understanding. Instructors should be currently or recently employed in the business sector to provide credibility. Barriers to implementation occur at both the student and curricula level.Conclusion. The possession of business skills and knowledge play a critical role in helping the pharmacy profession advance within a dynamic health care environment. Recommendations were provided on key business content important for Doctor of Pharmacy students to learn and strategies to implement within a pharmacy program.

The Effect of Empowerment And Self-Efficacy On Employees’ Perceptions Of Quality Of Care

Background: Empowerment in work palace denotes to better decision making power which enable the worker to have greater control of their jobs. In conventional organizational structures, functioning of the organization revolve around the designing of the set rules and methods. It was though that if organization makes employees obligatory to follow such structures the effectiveness and efficiency may improve. However, later, researchers found out that by fitting employees to the specific job structures, organizations lose their potential as well as performance because employees creativity and innovation got restricted. Therefore, conventional practices may not be suitable for operating in complex and dynamic healthcare environment. To achieve organizational goals with more efficiently, employee empowerment to some extent is in need because independence that comes with empowerment encourages employees to voice their opinions that benefit healthcare organizations in uplifting the patient safety and quality of care they offer. Therefore, study intends to assess the state of employees’ empowerment in public hospitals located in Al Qassim region, Saudi Arabia. Moreover, the study intends to explore the effect on employee’s empowerment has on employee’s perceptions of quality of care and patient safety. Methods Using a cross-sectional research design, the study collected data from 119 employees working in different public hospitals of Al Qassim region. The online questionnaire consists of 30 questionnaire items, was developed using Google Doc to address the research questions of the study. Results The healthcare employees responded to their demographic characteristics, empowerment, self-efficacy, and quality of care have been improvising in the facility. This finding showed that the respondents are empowered to make decisions and are better at performing their given jobs. Furthermore, the outcome of the study exhibited that employee empowerment is associated with respondents’ perceptions of quality care and patient safety. The results from the study may also help healthcare administrators and policy makers to understand the current level of employee empowerment and self-efficacy. The findings can immensely help healthcare administrators and policymakers to design policies and strategies to improve the quality of care in Saudi health organizations Conclusion The study explores the issue of empowerment in the context of Saudi public healthcare hospitals. It shows that in healthcare workers of Saudi Hospitals located in Al Qassim region believe that they possess certain decision-making authority to perform their jobs. The study also shows that the respondents think that their organizations deliver quality of care and are concerned about patient safety.

General healthcare policy and its influence on management practices: A review

This review paper explores the intricate relationship between healthcare policy and management practices within the healthcare sector, highlighting how policies shape management strategies and impact the operational realities of healthcare organizations. It delves into the challenges of aligning management practices with evolving healthcare policies and the vital role of healthcare managers in policy advocacy and implementation. Through a comprehensive analysis, the paper discusses emerging trends in healthcare policy, including the shift towards value-based care, digital health expansion, and the emphasis on health equity and their implications for management practices. Recommendations for healthcare managers and policy-makers are provided, emphasizing the importance of strategic alignment, innovation, and stakeholder engagement in enhancing healthcare delivery and outcomes. This paper offers insights into navigating the dynamic healthcare environment, leveraging policy changes as opportunities for improvement, and ensuring the effective implementation of healthcare policies.

The Effect of Language on Access to Timely COVID-19 Vaccination of Solid Abdominal Organ Transplant Recipients.

In dynamic healthcare environments including the COVID-19 pandemic, it is paramount to communicate health recommendations expediently and clearly. Research has shown social determinants of health affect the impact of COVID-19 on abdominal transplant recipients, but there has been less research on the effect of language proficiency. This is a cohort study of time to first COVID-19 vaccination among abdominal organ transplant recipients in an academic medical center in Boston, MA between 18 December 2020, and 15 February 2021. Cox proportional hazards analysis of time to vaccination by preferred language were adjusted for race, age group, insurance, and transplanted organ. Among 3001 patients, 53% were vaccinated during the study period. Language preference other than English was independently associated with delay to vaccination (0.64, p = 0.001), on adjusted analysis. In addition, Black, Hispanic and other race patients were less likely to be vaccinated than white patients (0.58, 0.67, 0.68 vs. reference, all p < 0.03). Language preference other than English is an independent barrier to solid abdominal organ transplant recipients' access to timely COVID-19 vaccination. Equity in care should be improved by providing targeted services to minority language speakers.

Navigating Excellence: Curriculum Mapping and Student-Centric Learning in Undergraduate Medical Education

Undergraduate medical education continually adapts to evolving healthcare demands. This article delves into two transformative approaches—curriculum mapping and student-centric learning—that have reshaped medical education. Curriculum mapping is a structured process enhancing educational programs by aligning them with goals, fostering student-centered learning, and facilitating continuous improvement and accreditation monitoring. Student-centric learning tailors education to individual needs, encouraging engagement, critical thinking, and problem-solving. Integrating these approaches empowers learners, deepens comprehension, nurtures lifelong learning, and equips students for success in a dynamic healthcare environment. Aligning objectives, content, and assessments with students' needs creates a holistic educational experience.

Peer feedback as a medium to facilitate reflective practice among pharmacy students in a case-based learning environment

IntroductionThe ability to reflect is a key element in preparing pharmacy professionals to meet the challenges of a dynamic health care environment. This mixed-methods study explored the pedagogical benefits of peer feedback by designing, developing, and implementing a peer feedback activity to facilitate reflective practice among pharmacy students. MethodsTwenty second-year doctor of pharmacy (PharmD) students in a required pharmacotherapy course participated in a systematic peer feedback activity and five of these students volunteered for semi-structured interviews. ResultsNo significant correlation was found between perceived effectiveness of peer feedback and students' reflective thinking skills. Qualitative interview data revealed three major themes regarding PharmD students' perception of peer feedback as an instructional strategy to promote reflective practice: (1) the cognitive process of providing feedback, (2) the cognitive process after receiving peer feedback, and (3) perceptions of peer feedback as a tool to exercise reflective practice. ConclusionsAlthough limited in sample size, important lessons were learned on how to design, develop, and implement a peer feedback activity.

Embedding and supporting inquiry beyond research: Reframing our thinking as healthcare leaders

Research and scholarship (which we interchangeably term inquiry) and leadership are often viewed as separate professional pillars within academic frameworks and not seen as linked in individual skillset, qualities or competencies [1,2]. Given this, our innovation-driven healthcare organization pursued a goal to shift our thinking in regards to inquiry as being essential to the leadership competencies that are harnessed in a dynamic healthcare environment.

A whole-of-health system approach to improving care of frail older persons.

The population is aging, with frailty emerging as a significant risk factor for poor outcomes for older people who become acutely ill. We describe the development and implementation of the Frail Older Persons' Collaborative Program, which aims to optimise the care of frail older adults across healthcare systems in Queensland. Priority areas were identified at a co-design workshop involving key stakeholders, including consumers, multidisciplinary clinicians, senior Queensland Health staff and representatives from community providers and residential aged care facilities. Locally developed, evidence-based interventions were selected by workshop participants for each priority area: a Residential Aged Care Facility acute care Support Service (RaSS); improved early identification and management of frail older persons presenting to hospital emergency departments (GEDI); optimisation of inpatient care (Eat Walk Engage); and enhancement of advance care planning. These interventions have been implemented across metropolitan and regional areas, and their impact is currently being evaluated through process measures and system-level outcomes. In this narrative paper, we conceptualise the healthcare organisation as a complex adaptive system to explain some of the difficulties in achieving change within a diverse and dynamic healthcare environment. The Frail Older Persons' Collaborative Program demonstrates that translating research into practice and effecting change can occur rapidly and at scale if clinician commitment, high-level leadership, and adequate resources are forthcoming.