Continuous Improvement Efforts Research Articles

Developing a Cost-Effective Surgical Scheduling System Applying Lean Thinking and Toyota's Methods for Surgery-Related Big Data for Improved Data Use in Hospitals: User-Centered Design Approach.

Surgical scheduling is pivotal in managing daily surgical sequences, impacting patient experience and hospital resources significantly. With operating rooms costing approximately US $36 per minute, efficient scheduling is vital. However, global practices in surgical scheduling vary, largely due to challenges in predicting individual surgeon times for diverse patient conditions. Inspired by the Toyota Production System's efficiency in addressing similar logistical challenges, we applied its principles as detailed in the book "Lean Thinking" by Womack and Jones, which identifies processes that do not meet customer needs as wasteful. This insight is critical in health care, where waste can compromise patient safety and medical quality. This study aims to use lean thinking and Toyota methods to develop a more efficient surgical scheduling system that better aligns with user needs without additional financial burdens. We implemented the 5 principles of the Toyota system: specifying value, identifying the value stream, enabling flow, establishing pull, and pursuing perfection. Value was defined in terms of meeting the customer's needs, which in this context involved developing a responsive and efficient scheduling system. Our approach included 2 subsystems: one handling presurgery patient data and another for intraoperative and postoperative data. We identified inefficiencies in the presurgery data subsystem and responded by creating a comprehensive value stream map of the surgical process. We developed 2 Excel (Microsoft Corporation) macros using Visual Basic for Applications. The first calculated average surgery times from intra- or postoperative historic data, while the second estimated surgery durations and generated concise, visually engaging scheduling reports from presurgery data. We assessed the effectiveness of the new system by comparing task completion times and user satisfaction between the old and new systems. The implementation of the revised scheduling system significantly reduced the overall scheduling time from 301 seconds to 261 seconds (P=.02), with significant time reductions in the revised process from 99 seconds to 62 seconds (P<.001). Despite these improvements, approximately 21% of nurses preferred the older system for its familiarity. The new system protects patient data privacy and streamlines schedule dissemination through a secure LINE group (LY Corp), ensuring seamless flow. The design of the system allows for real-time updates and has been effectively monitoring surgical durations daily for over 3 years. The "pull" principle was demonstrated when an unplanned software issue prompted immediate, user-led troubleshooting, enhancing system reliability. Continuous improvement efforts are ongoing, except for the preoperative patient confirmation step, which requires further enhancement to ensure optimal patient safety. Lean principles and Toyota's methods, combined with computer programming, can revitalize surgical scheduling processes. They offer effective solutions for surgical scheduling challenges and enable the creation of a novel surgical scheduling system without incurring additional costs.

Relevant factors to implement continuous improvement in administrative services of public universities: an action research study

The research presented in this article focuses on enhancing the quality of administrative services in a higher education institution, addressing the scarcity of concrete examples of continuous improvement in public services. The study investigates the applicability and effectiveness of continuous improvement methodologies in a public service context, emphasising the distinct challenges faced by public institutions, such as a culture of silos, in implementing process improvements. The article employs an action research methodology, which involves researchers collaborating with university administrative personnel to identify improvement opportunities, implement solutions, and measure the impact of these initiatives on service quality. The impact of continuous improvement initiatives on the quality of administrative services offered by the university is assessed through participant perceptions, service user feedback, and the improvement of main processes within the university departments. The research identifies several barriers and facilitators to continuous improvement within the university’s administrative services, including organisational culture, employee involvement and commitment, communication, goal clarity, and resource availability. The study provides insight into how these factors influence the success of continuous improvement efforts. Based on the findings, the study offers recommendations for deploying continuous improvement workshops at the university. These recommendations aim to address the identified barriers, leverage facilitators, and enhance the overall quality of administrative services. The article contributes to understanding continuous improvement in public service contexts and provides practical guidance for implementing such initiatives in higher education institutions.

Optimizing the Use of Dose Error Reduction Software on Intravenous Infusion Pumps.

Intravenous infusions have the potential to cause significant harm in patients and are associated with a high rate of adverse drug events and medication errors. Infusion pumps with dose error reduction software (DERS) can be used to reduce errors by establishing safe infusion parameters. In 2019, a quality improvement project was initiated with the aim to increase DERS compliance from 46% to 75% at our specialty institution by October 1, 2022. An interdisciplinary group was tasked with improving compliance with DERS by identifying key drivers, including informed staff, engaged staff, and an accurate smart pump library. We used the Model for Improvement framework to guide this improvement project, and Plan-Do-Study-Act (PDSA) cycles were used to plan for interventions. PDSA cycles included drug library updates, education, and unit-level compliance reporting. Weekly average DERS compliance was monitored as the outcome measure, and weekly pump alerts per 100 infusions were monitored as a balancing measure; statistical process control charts were used to monitor measures from 2018 to 2022. Over the course of 25 months, 8 PDSA cycles resulted in 5 centerline improvements from a baseline mean of 46% to a final mean of 78%. Pump alerts per 100 infusions decreased from 15.9 to 6.4 with the first PDSA cycle and then continued to decrease to 3.9 with subsequent interventions. Although features like DERS can help ensure safe medication administration, continuous improvement efforts to increase DERS compliance without increasing alert burden are needed to ensure that benefits of this technology are optimized.

Customer Feedback Management Across Support Service Units in the University of the Cordilleras

Feedback from customers are essential inputs for an organization’s improvement specially when managed effectively, may it be in industries, businesses, or educational institutions. This study aimed to describe the procedure on managing customer feedback implemented by the various support service units in the University of the Cordilleras. The researcher utilized a qualitative research design. Data were collected using a semi-structured interview conducted online with twenty (20) office personnel selected through purposive sampling. They were from the Student Welfare Services, Libraries, Career Development Center, Guidance and Counseling Office, Medical Clinic, Registrar’s Office, Student Development and Welfare Office, Occupational Safety and Health, Center for Social Responsibility, Marketing Communications and Enrollment Services; and Accounting Office. The inductive thematic approach was used to analyze data which highlighted interesting themes identifying three (3) primary processes in managing customer feedback – 1) gathering feedback, 2) documentation and 3) addressing feedback. Feedback sources may include surveys, evaluations, and interviews via traditional or online methods. Documentation entails collating and classifying feedback, which then leads to the identification of actionable items. The research findings suggest that customer feedback management extends beyond mere data collection and documentation; instead, it requires actions, actual measures and continuous improvement efforts that are monitored and sustainable.

Supporting PK-12 continuous school improvement efforts in a school–university partnership network

PurposeThis paper will discuss one university’s efforts to initiate a process to better support PK-12 continuous school improvement goals for all 13 schools in their PDS network as a way to broaden the university’s mission and respond more formally to the individual school communities with which they partner.Design/methodology/approachThe paper is conceptual in that it presents an innovative idea to stimulate discussion, generate new ideas and advance thinking about cross-institutional collaboration between universities and professional development schools.FindingsThe paper provides insights and ideas for bringing about change and growth in a seasoned PDS partnership network by connecting PK-12 continuous school improvement efforts to PDS partnership work.Originality/valueThis paper fulfills an identified need to study how seasoned partnerships can participate in simultaneous renewal by offering ideas that school–university partnership leaders can build upon as they make efforts to participate in the process of growth and change.

Performance Evaluation of Government Section Employees at The Mappak District Office, Tana Toraja District

The aim of this research is to evaluate the performance of government section employees at the Mappak District office, Tana Torja Regency. In the context of the regional autonomy policy provided by Law Number 32 of 2014, regional governments have a greater responsibility to accelerate regional development and improve community welfare. One important aspect of implementing the regional autonomy policy is improving the performance of public services, which is realized through evaluating the performance of government officials. The Mappak District Office has a significant role in providing administrative and government services at the local level. Evaluation of the performance of the government section is carried out to identify successes, obstacles and improvements in the delivery of public services. These performance evaluation parameters include the smoothness of the administrative process related to service operational standards, the ability of the government section to work in accordance with existing duties and functions, the response from the surrounding community regarding government services, the relationship that exists between the government section and the surrounding community and the availability of facilities to support activities and government section services at the Mappak sub-district office, Tana Toraja Regency. With continuous evaluation and continuous improvement efforts, it is hoped that the performance of government can continue to improve in providing effective and efficient services to the community. The results of this evaluation will be the basis for continuous improvement and development, so that government section employees at the Mappak sub-district office, Tana Toraja Regency can provide better services to the community on an ongoing basis.

A POCUS-first pathway to streamline care for children with suspected ileocolic intussusception.

As point-of-care ultrasound (POCUS) has emerged as a valuable tool for intussusception screening, this quality improvement study aimed to implement a "POCUS-first" pathway in a Pediatric Emergency Department (ED) to streamline workflow and expedite care for children with suspected intussusception. This was a prospective analysis of children diagnosed with ileocolic intussusception in a Pediatric ED between June 2022 and June 2023. The study compared the "POCUS-first" cohort with the group receiving only radiology-performed ultrasound. Key outcomes included physician initial assessment to radiology-performed US time and physician initial assessment to reduction time. Continuous improvement efforts incorporated pediatric emergency medicine physician training, education, and pathway dissemination through plan-do-study-act cycles. The study included 29 patients in the "POCUS-first" pathway group and 70 patients in the non-POCUS group. The "POCUS-first" pathway demonstrated a significantly shorter physician initial assessment to reduction time compared to the non-POCUS group (170.7min vs. 240.6min, p = 0.02). Among non-transferred patients, the "POCUS-first" group also had a significantly shorter emergency department length of stay (386min vs. 544min, p = 0.047). Implementation of a "POCUS-first" pathway for managing ileocolic intussusception led to notable improvements in process efficiency. The shorter physician initial assessment to reduction time highlights the potential for expedited decision-making and intervention. These study findings support the potential of this pathway to optimize the management and outcomes of children with ileocolic intussusception.

Dental Service Quality and Patient Satisfaction: Insights From Anutapura General Hospital, Palu City

Introduction: In line with Indonesia's healthcare development, this study investigates the impact of service quality dimensions on patient satisfaction in dental clinics at Anutapura General Hospital, Palu City. Emphasizing health as a fundamental human right, the research aligns with national objectives for comprehensive healthcare efforts.&#x0D; Method: Employing quantitative methods, data from 97 patients was collected through convenience sampling, focusing on dimensions including physical evidence, reliability, responsiveness, assurance, and empathy.&#x0D; Result: Analysis revealed significant correlations between these dimensions and patient satisfaction. Notably, patients perceiving good physical evidence and reliability reported higher satisfaction levels. However, responsiveness showed a positive trend without statistical significance. Assurance and empathy emerged as crucial determinants, significantly influencing patient satisfaction. These findings emphasize the importance of infrastructure investment, staff training, and patient-centered care approaches in enhancing service quality.&#x0D; Conclussion: The study underscores the need for continuous quality improvement efforts to achieve better healthcare outcomes in dental care settings. Prioritizing patient perspectives, fostering trust and empathy in patient-provider relationships, and sustaining quality enhancement initiatives are vital for advancing healthcare quality and patient satisfaction in Indonesia's evolving healthcare landscape.

Assessment of the organizational factors in incident management practices in healthcare: A tree augmented Naive Bayes model.

Despite the exponential transformation occurring in the healthcare industry, operational failures pose significant challenges in the delivery of safe and efficient care. Incident management plays a crucial role in mitigating these challenges; however, it encounters limitations due to organizational factors within complex and dynamic healthcare systems. Further, there are limited studies examining the interdependencies and relative importance of these factors in the context of incident management practices. To address this gap, this study utilized aggregate-level hospital data to explore the influence of organizational factors on incident management practices. Employing a Bayesian Belief Network (BBN) structural learning algorithm, Tree Augmented Naive (TAN), this study assessed the probabilistic relationships, represented graphically, between organizational factors and incident management. Significantly, the model highlighted the critical roles of morale and staff engagement in influencing incident management practices within organizations. This study enhances our understanding of the importance of organizational factors in incident management, providing valuable insights for healthcare managers to effectively prioritize and allocate resources for continuous quality improvement efforts.

Advancing traffic safety through the safe system approach: A systematic review

The Safe System Approach (SSA) has emerged as a comprehensive framework for enhancing traffic safety through system-wide interventions. This systematic review, conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzes 82 relevant studies categorized based on the SSA pillars: safe road users, safe vehicles, safe speeds, safe roads, and post-crash care. The review provides insights into SSA's effectiveness in reducing road traffic fatalities and injuries, exploring implementation challenges and opportunities, including policy initiatives, institutional frameworks, and stakeholder collaborations. The findings highlight the potential for SSA to create a more forgiving and resilient transportation system, offering valuable guidance for policy decisions, future research, and interventions aimed at promoting safer road environments. SSA's comprehensive strategy for Safe Road Users encompasses considerations of road system design, behavior modification, and tailored measures for vulnerable users, showcasing its versatility in addressing diverse challenges. In the realm of Safe Vehicles, SSA actively involves manufacturers in a cycle of continuous improvement, rigorous testing, and collaborative efforts to establish new safety regulations. The emphasis on managing Safe Speeds, aligning with human parameters, and involving communities reflects SSA's adaptable nature and provides insights for establishing context-specific speed limits. SSA contributes significantly to Safe Roads through its implementation of innovative countermeasures, forgiving road designs, and the integration of emerging disciplines, resulting in a notable reduction in fatalities and injuries. In the domain of Post-Crash Care, SSA's integrated perspective fosters collaboration among emergency services, medical professionals, and the justice system. It addresses challenges through standardized approaches and information sharing, ensuring a comprehensive and unified approach to road safety. This review contributes to the ongoing efforts to prioritize safety and transform the transportation landscape on a global scale.

The master’s degree in development practice: a case study of twelve university programs

Sustainable development is a global priority. However, a lack of research exists on the programs designed to train sustainable development practitioners. This multi-case case study, possibly the first to describe the programs that trains development practitioners, utilized case study theory and semi-structured interviews with program administrators to describe sustainable development programs offered by 12 higher education institutions in eight countries with membership in the Global Association of Masters in Development Practice. The results revealed five themes or key drivers, nine advantages, and four deficiencies. Two drivers were enrollment-focused (admission of students with prior work experience in development and financial support), two were curriculum-focused (incorporation of field work and integration of specific knowledge aspects and skills training in the curricula), and one was institutional attitude (adoption of a culture of flexibility). The most common challenges were impacts from the COVID-19 pandemic. These results provide insights for continuous improvement efforts of program administrators for students in sustainable development. The practical methodology developed can be replicated and adapted for investigation of similar programs and other disciplines in higher education.

Advancing zoo animal welfare through data science: scaling up continuous improvement efforts.

Advancing zoo animal welfare through data science: scaling up continuous improvement efforts.

Perceptions and Utility of Course Evaluations in US Pharmacy Schools

ObjectiveThis study aimed to describe the purpose, implementation, and perceived utility of course evaluations in pharmacy programs. MethodsAfter a literature review, a 34-item survey was developed, pretested, and sent to assessment administrators at accredited pharmacy programs (N = 139) with at least 3 follow-ups. Descriptive and inferential statistics were performed in IBM SPSS Statistics software. ResultsA total of 90 programs responded (64.7% response rate). Most students (94%) were offered the opportunity to complete course evaluations. Some students completed evaluations during the course (47%), while others did so within 1 week of completion of the course (49%). Whether or not class time was given for students to complete the survey was often dependent on faculty choice (52.2%). Results were typically released after final grades were posted (92%), in time to use for the next semester of teaching (77%). Faculty were chosen to be evaluated by the number of teaching hours (50%) followed by all instructors (45.6%). Programs used the results for performance reviews by chairs (91%), course coordinator reviews (84%), and committee continuous quality improvement efforts (72%). Most programs did not provide faculty guidance on using evaluations (78%) nor development/mentoring (57%); only 22% of programs offered student development in completing evaluations. ConclusionWhile most programs invite feedback from all students via evaluations, most did not provide guidance to faculty on how to use this feedback for faculty or course development purposes. A more robust process to optimize the use of course evaluations should be developed.

Integrating Hospital-Based Harm Reduction Care-Harnessing the Nursing Model.

Hospitals are risk environments for people who use drugs, and most hospitals are unprepared to deliver substance use disorder (SUD) care, including harm reduction (HR) interventions. HR philosophy clashes with traditional hospital hierarchy and norms, and staff may resist HR interventions due to stigma, fear of enabling substance use, legal and safety concerns. Nurses are central to hospital culture and care and could promote and deliver HR care. Our US hospital has an inter-professional addiction consult service (ACS) that includes medical providers, social workers, and peers. We developed and launched a hospital-based registered nurse-(RN) led HR intervention, including distributing safe-use supplies (eg, syringes). We describe model development and early experience, using an Exploration, Preparation, Implementation, and Sustainment framework. ACS experiences and community HR interventions informed our exploration phase. In the preparation phase we secured funding from Medicaid payers for a 2-year pilot, including full-time RN salary and HR supplies. We elicited buy-in from hospital executive leaders, partly by partnering with nurse champions who described unmet patient care and staff education needs. We consulted hospital lawyers and developed an institution-wide media campaign targeting staff, including in-person booths distributing naloxone and materials promoting international overdose awareness day (eg, "#EndOverdose" buttons). We collaborated with local and national experts to develop the intervention, which includes RN bedside HR education and staff trainings. The Implementation was from September 2022 to March 2023. We trained 459 staff (over 15 trainings) and conducted 209 patient encounters. Generally, patients and staff embraced the HR RN role, including previously controversial safe-use supply distribution. Sustainment efforts include engaging stakeholders in continuous improvement and evaluation efforts. A nurse-led hospital-based HR intervention can expand patient services, support staff, and bridge HR and medical models.

How might rubric-based observations better support teacher learning and development?

ABSTRACT Background Many education systems internationally expect schools to participate in continuous instructional improvement programmes. One tool used within these processes is the structured, rubric-based classroom observation, focused on the evaluation of teaching. Such observations are a common feature of formative evaluation systems, teacher coaching programmes, within-school teacher collaborative structures, and other local, regional or national frameworks. However, a question arises as to how rubric-based observations may better support teacher learning and development. Purpose and sources Drawing on existing theoretical arguments and empirical work, this paper seeks to contribute to discussion about rubric-based classroom observation and its relationship with teacher learning and instructional improvement. Main arguments Observation rubrics can be regarded as summaries of a community’s understanding of good instruction. When generated in a way that makes this understanding accessible to teachers in the context of their own practice, they have the potential to place the rubric’s, and teachers’, understandings of good teaching ‘in conversation’ with each other. This could provide valuable opportunities for teachers to refine and expand their understandings of good instruction. Embedding rubric-based observations in school structures can, thus, facilitate continuous improvement efforts by better supporting teacher self-reflection, feedback, and collaboration. However, many uses of observation within school contexts tend to prioritise the rubric’s, rather than teachers’, understanding of good teaching. This risks turning observations from tools of learning into tools of judgement, disrupting the pathway through which they might support teacher learning and instructional improvement. Conclusion Our discussion draws attention to the potential benefits yielded and the challenges that may occur in using rubric-based observations to support teacher learning. It highlights factors that need consideration in efforts to leverage rubric-based observations to better promote continuous teacher learning, ultimately positively influencing student learning.

Inventory management practices and performance of electoral systems in Kenya

Effective inventory management plays a pivotal role in the overall performance and functionality of systems across various sectors. In the context of electoral systems, where precision, efficiency, and transparency are paramount, the management of inventory, including the planning, tracking, and control of resources, is of utmost importance. Therefore, the study sought to determine the role of inventory management practices on the performance of electoral systems in Kenya. The research design that was used in this study was a longitudinal research design. The population for this study consisted of 373 Commission Secretary/Chief Executive Officer (CS/CEO), Deputy Commission Secretary (DCS), Directors, Managers, County Election Managers, and Constituency Election Coordinators within 290 constituencies of Kenya's August 2017 election. A total of 373 respondents were used as the sample size for the study. Data was used as primary and secondary. While self-administered questionnaire and interview guide were used to collect primary data, the study reviewed the previous evaluation reports to seek the secondary data on General election performance. The data was collected and then analyzed by both descriptive and inferential statistical tools. Being that the study dealt with the relationship study, the study therefore used a regression model as a tool of analysis and the results that were generated were presented in the form of tables. The results of this study benefited policy makers, managers, administrators, citizens all whole, researchers, consultants, scholars, and trainers involved in Election Administration. This study tested the null hypotheses that inventory management practices had no significant role in the performance of electoral systems in Kenya. Pragmatism paradigm approach and mixed method research were adopted in this study. The questionnaire tested both validity and reliability. Quantitative and qualitative techniques were used to analyze the collected data with the assistance of Statistical Package for Social Sciences (SPSS) software version 25. Multiple regression and correlation analysis were carried out. The regression analysis results demonstrated a strong and significant role of inventory management practices on the performance of electoral systems. The R-squared values indicated that approximately 79% of the variation in electoral system performance was explained by inventory management practices. The adjusted R-squared value of 0.788 accounted for the number of predictors in the model. In conclusion, the study reveals that efficient inventory management practices significantly influence the performance of electoral systems in Kenya, emphasizing the need for standardized handling, storage, and transportation processes, the adoption of technology-driven monitoring systems, centralized inventory management, just-in-time approaches, regular cycle counting, and continuous improvement efforts. However, there remains unexplained variance in performance, warranting further investigation to identify additional influential factors. Additionally, future research should extend its focus to other countries in the East African region to comprehensively assess inventory management practices and their impact on electoral system performance

RESEARCH AND DESIGN OF THE MARKETING CLOUD SALESFORCE CRM ARCHITECTURE DEPENDING ON THE COMPANY'S MARKETING STRATEGY

The purpose of the study is to increase the level of effective attraction of new customers and retention of the company's existing customer base through the implementation of innovative marketing strategies. The expediency of using the concept of customer relationship management (CRM) and the use of CRM-class information systems to achieve the goal has been proven. The CRM platform Salesforce Marketing Cloud, which belongs to cloud types of information systems, was studied. A description of the Salesforce Marketing Cloud business logic is given, which includes decision-making based on analytical data, customer segmentation, automation of an individual approach to customers with the aim of increasing customer loyalty and increasing company revenue. Salesforce Marketing Cloud provides an opportunity to create and manage personalized marketing activities, interact with customers through various channels, analyze the effects of marketing efforts for continuous improvement of the company's marketing strategies. The functionality and features of the main components of Salesforce Marketing Cloud were studied. Salesforce Marketing Cloud allows you to effectively manage email marketing, mobile marketing, social media campaigns and other types of marketing. Salesforce Marketing Cloud empowers companies to create and manage personalized marketing efforts, engage with customers across multiple channels, and analyze their marketing efforts for continuous improvement. Salesforce Marketing Cloud architecture was designed for behavioral segmentation of the company's customers. A web application has been developed to improve the platform users' experience with customer data stored in Data Extensions. To automate customer segmentation based on their behavioral data, Automation Studio was used, SQL queries were built, and Data Views system data tables were used. The developed architecture of Marketing Cloud Salesforce CRM based on behavioral segmentation is an important tool for the implementation of the company's marketing strategy, ensuring the successful attraction and retention of customers, as well as for achieving strategic goals.

Pengembangan Strategi Bersaing untuk Meningkatkan Kualitas Sekolah Menengah Pertama

The background of this study is the decreasing number of students and classes in one junior high school. This study aims to determine the strengths, weaknesses, opportunities, and threats in the school by developing suitable competitive strategies to improve the school quality and the number of students and classes. This research is qualitative research using the research and development (R &amp; D) method with the Borg and Gall development model which is limited to the seventh step. The study was conducted in a junior high school. The subjects of the study were school principal, teachers, staff, and school observers. Data was collected by interview, documentation studies, questionnaires, and Focus Group Discussion (FGD) techniques. Data was analyzed with a qualitative descriptive analysis using Miles and Huberman model. Activities in data analysis included data reduction, data display, and conclusion drawing/verification. The result of the study show that the school is in quadrant II which indicates that the condition of the school is quite stable, but it faces many obstacles, therefore it is necessary to carry out a diversification strategy. The proposed diversification strategy includes curriculum diversification and service expansion and continuous improvement efforts.

Reviving Hope: A Comprehensive Review of Post-resuscitation Care in Pediatric ICUs After Cardiac Arrest.

This comprehensive review thoroughly examines post-resuscitation care in pediatric ICUs (PICUs) following cardiac arrest. The analysis encompasses adherence to resuscitation guidelines, advances in therapeutic interventions, and the nuanced management of neurological, cardiovascular, and respiratory considerations during the immediate post-resuscitation phase. Delving into the complexities of long-term outcomes, cognitive and developmental considerations, and rehabilitation strategies, the review emphasizes the importance of family-centered care for pediatric survivors. A call to action is presented, urging continuous education, research initiatives, and quality improvement efforts alongside strengthened multidisciplinary collaboration and advocacy for public awareness. Through implementing these principles, healthcare providers and systems can collectively contribute to ongoing advancements in pediatric post-resuscitation care, ultimately improving outcomes and fostering a culture of excellence in pediatric critical care.

The pattern of emergency department length of stay in Saudi Arabia: an epidemiological Nationwide analyses of secondary surveillance data.

Emergency department length of stay is a vital performance indicator for quality and efficiency in healthcare. This research aimed to evaluate the length of stay patterns in emergency departments across Saudi Arabia and to identify predictors for extended stays. The study used secondary data from the Ministry of Health's Ada'a program. Using a retrospective approach, the study examined data from the Ada'a program on emergency department length of stay from September 2019 to December 2021. These data covered 1,572,296 emergency department visits from all regions of Saudi Arabia. Variables analyzed included quality indicators, year of visit, shift time, hospital type, and data entry method. The analysis was conducted using multiple linear regression. The study found that the median length of stay was 61 min, with significant differences among related predictors. All associations were significant with a value of p of less than 0.001. Compared to 2019, the length of stay was notably shorter by 28.5% in 2020 and by 44.2% in 2021. Evening and night shifts had a shorter length of stay by 5.9 and 7.8%, respectively, compared to the morning shift. Length of stay was lower in winter, summer, and fall compared to spring. Patients in levels I and II of the Canadian Triage and Acuity Scales had longer stays than those in level III, with those in level I reaching an increase of 20.5% in length of stay. Clustered hospitals had a longer length of stay compared to the non-clustered ones. Pediatric hospitals had a 15.3% shorter stay compared to general hospitals. Hospitals with data entered automatically had a 14.0% longer length of stay than those entered manually. Patients admitted to the hospital had a considerably longer length of stay, which was 54.7% longer compared to non-admitted patients. Deceased patients had a 20.5% longer length of stay than patients discharged alive. Data at the national level identified several predictors of prolonged emergency department length of stay in Saudi Arabia, including shift time, season, severity level, and hospital type. These results underline the necessity of continuous monitoring and improvement efforts in emergency departments, in line with policy initiatives aiming to enhance patient outcomes in Saudi Arabia.