Emerging Health Care Delivery Research Articles

Identifying factors influencing emerging innovations in hospital discharge decision making in response to system stress: a qualitative study

BackgroundThe purpose of this qualitative study was to identify emergent rehabilitation innovations and clinician perceptions influencing their implementation and outcomes related to hospital discharge decision-making during the Coronavirus 2019 pandemic.MethodsRehabilitation clinicians were recruited from the Veterans Affairs Health Care System and participated in individual semi-structured interviews guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Data were analyzed using a rapid qualitative, deductive team-based approach informed by directed content analysis.ResultsTwenty-three rehabilitation clinicians representing physical (N = 11) and occupational therapy (N = 12) participated in the study. Three primary themes were generated: (1) Innovation: emerging innovations in discharge processes included perceived increases in team collaboration, shifts in caseload prioritization, and alternative options for post-acute care. (2) Recipients: innovations emerged as approaches to communicating discharge recommendations changed (in-person to virtual) and strong patient/family preferences to discharge to the home challenged collaborative goal setting; and (3) Context: the ability of rehabilitation clinicians to innovate and the form of innovations were influenced by the broader hospital system, interdisciplinary team dynamics, and policy fluctuations. Innovations described by participants included (1) use of technological modalities for interdisciplinary collaboration, (2) expansion of telehealth modalities to deliver care in the home, (3) changes in acute care case prioritization, and (4) alternative options for discharge directly to home.ConclusionsOur findings reinforce that rehabilitation clinicians developed innovative strategies to quickly adapt to multiple systems-level factors that were changing in the face of the COVID-19 pandemic. Future research is needed to assess the impact of innovations, remediate unintended consequences, and evaluate the implementation of promising innovations to respond to emerging healthcare delivery needs more rapidly.

Role of physical therapists in providing care to older adults in welfare shelters during the hyper-acute phase of a disaster: lessons learned in Wajima City, Japan, after the 2024 Noto Peninsula earthquake

Natural disasters pose significant challenges to affected communities, particularly vulnerable populations such as older adults. The aftermath of the Great East Japan Earthquake highlighted the necessity of welfare shelters to provide essential care. However, little is known about the specific role of physical therapists in these shelters. The aim of this article is to share the experiences and contributions of physical therapists in a welfare shelter in Wajima, Ishikawa Prefecture, immediately after the 2024 Noto Peninsula earthquake. The earthquake, with a magnitude of 7.6, damaged 76,589 houses, injured over 1,100 people, resulting in 245 deaths. The authors comprised a multidisciplinary team, including physical therapists, that provided short-term medical support at a welfare shelter in Wajima. Through several examples, we describe the contribution of physical therapists to evacuees' health outcomes. Physical therapists played multifaceted roles in the welfare shelter, optimizing living environments, conducting physical screenings, and delivering continuous medical care, including respiratory care and exercise programs. The involvement of physical therapists in post-disaster evacuation shelters is crucial for enhancing emergency health care delivery and promoting community resilience.

Healthcare delivery to patients from culturally and linguistically diverse backgrounds in emergency care: a scoping review protocol

BackgroundWorldwide, the culturally and linguistically diverse (CALD) population is increasing, and is predicted to reach 405 million by 2050. The delivery of emergency care for the CALD population can be complex due to cultural, social, and language factors. The extent to which cultural, social, and contextual factors influence care delivery to patients from CALD backgrounds throughout their emergency care journey is unclear. Using a systematic approach, this review aims to map the existing evidence regarding emergency healthcare delivery for patients from CALD backgrounds and uses a social ecological framework to provide a broader perspective on cultural, social, and contextual influence on emergency care delivery.MethodsThe Joanna Briggs Institute (JBI) scoping review methodology will be used to guide this review. The population is patients from CALD backgrounds who received care and emergency care clinicians who provided direct care. The concept is healthcare delivery to patients from CALD backgrounds. The context is emergency care. This review will include quantitative, qualitative, and mixed-methods studies published in English from January 1, 2012, onwards. Searches will be conducted in the databases of CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), SocINDEX (EBSCO), Scopus (Elsevier), and a web search of Google Scholar. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram will be used to present the search decision process. All included articles will be appraised using the Mixed Methods Appraisal Tool (MMAT). Data will be presented in tabular form and accompanied by a narrative synthesis of the literature.DiscussionDespite the increased use of emergency care service by patients from CALD backgrounds, there has been no comprehensive review of healthcare delivery to patients from CALD backgrounds in the emergency care context (ED and prehospital settings) that includes consideration of cultural, social, and contextual influences. The results of this scoping review may be used to inform future research and strategies that aim to enhance care delivery and experiences for people from CALD backgrounds who require emergency care.Systematic review registrationThis scoping review has been registered in the Open Science Framework https://doi.org/10.17605/OSF.IO/HTMKQ

Design and Fabrication of Unmanned Arial Vehicle (UAV) Emergency Medical Purpose

This paper presents an Emergency Drone Delivery System (EDDS) designed to expedite medical supply transport in critical situations. The system utilizes unmanned aerial vehicles (UAVs) equipped with medical payloads to swiftly deliver essential supplies such as blood, vaccines, and medication to remote or inaccessible locations. Key features include real-time monitoring, route optimization, and autonomous operation, ensuring rapid response times and efficient resource allocation during emergencies. Through case studies and simulations, the efficacy and potential impact of EDDS in enhancing emergency healthcare delivery are demonstrated

The Effectiveness of Point of Care Ultrasound in Emergency Department

Point of Care Ultrasound (POCUS) has rapidly evolved into an essential diagnostic tool within Emergency Departments (EDs) in recent years. This review highlights the pivotal role of POCUS in facilitating prompt diagnosis and timely initiation of treatment by Emergency Physicians, leading to notable improvements in patient outcomes. By enabling rapid assessment and aiding in the formulation of a most likely diagnosis within minutes, POCUS contributes significantly to reducing the length of hospital stays and mitigating the morbidity and mortality associated with complications arising from delayed treatment. This abstract underscores the indispensable nature of POCUS in enhancing the efficiency and effectiveness of emergency healthcare delivery, ultimately improving patient care and outcomes.

Go Science Drone Med Box – Medical Emergency Drone for Emergency Healthcare Management

The Medical Emergency Drone Box stands as a transformative development in healthcare technology, designed to address a spectrum of emergency medical needs. This paper delineates the comprehensive capabilities of the device, which ranges from its potential role in rural healthcare support to its utilization in critical emergencies, road accidents, and even organ transportation. The device integrates advanced sensors, such as body temperature and pulse detection units, to facilitate real-time monitoring and data-driven decision-making during medical interventions. It also incorporates a WiFi module and microcontrollers for efficient data transmission and seamless connectivity. To ensure the maintenance of required medical standards, the drone box includes a heating and cooling system for preserving critical medical supplies. The cloud-based storage of sensor data allows healthcare professionals to remotely access vital information in real-time. Moreover, the device is built to operate effectively even in regions with limited electrical access, courtesy of its robust battery backup system. Additional features include charging units and an assortment of essential medical equipment like portable defibrillators and drilling machines. Solar Panels are also added as a redundant power support. This paper aims to showcase the multifaceted features, data-centric functionalities, and the enormous potential the Medical Emergency Drone Box holds in revolutionizing emergency healthcare delivery across diverse settings. Developed by Go Science Technical Team. IndexTerms – Go Science, Medical Emergency Drone Box, Healthcare Innovation, Critical medical Interventions, Sensor Technology, Real-Time Data Monitoring, Data Transmission, Battery Back-up, Rural healthcare, Road Accidents, Organ Transportation, Cloud Data Storage, Portable Medical Equipment.

The Role of Telemedicine in Improving Healthcare Outcome: A Review

Telemedicine is an emerging healthcare delivery model that uses information and communication technologies (ICTs) to give medical services remotely. This model is gaining increasing attention due to its potential to improve healthcare outcomes, particularly in resource-limited settings. Telemedicine has been shown to improve patient access to medical care, reduce healthcare costs, and increase patient satisfaction. Telemedicine also offers medical education and training opportunities, remote consultations and diagnoses, and remote patient health status monitoring. This paper provides an overview of the potential benefits of telemedicine. It highlights some critical challenges to its widespread adoption, including regulatory and policy issues, technical and infrastructure constraints, and data privacy and security issues. The paper concludes by discussing future directions for telemedicine and the need for continued research and innovation to ensure its success as a sustainable healthcare delivery model.

Radiological Features of T1a Renal Cell Carcinoma on Axial Unenhanced Computed Tomography.

CT has become a commonly used diagnostic procedure in clinical practice, particularly in emergency healthcare delivery. Accordingly, the increase in CT usage has increased the likelihood of incidental detections (ID) of renal cell carcinomas (RCCs). This article discusses key points and limitations associated with the diagnosis and characterization of T1a RCC (≤4 cm in diameter) and shows how to improvise on the differentiation of T1a RCC with unenhanced CT (UE-CT). We retrospectively reviewed UE-CT findings of cases associated with the histopathologic diagnosis of T1a RCC and examined the discrimination capacity and radiological characteristics with regard to small RCCs (SRCCs). Detection and characterization of T1a RCC based on UE-CT are not easy in many cases due tolimitations in CT findings, but there are notable radiological features to facilitate detection and differentiation. The growth pattern is important for the detection of SRCCs. Internal characteristic features (average attenuation, heterogeneity) are useful for the characterization of the RCC. In addition, CT image visualization techniques may help improve the detectability of RCCs on UE-CT. Radiological features are important in detecting SRCCs and facilitating further examination. In this study, we discuss some cases of T1a RCCs and evaluate the radiological characteristics of the tumors seen on UE-CT.

A Review of State-of-the-Art on Enabling Additive Manufacturing Processes for Precision Medicine

Abstract Precision medicine is an emerging healthcare delivery approach that considers variability between patients, such as genetic makeups, in contrast to the current one-size-fits-all approach that is designed to treat the average patient. The White House launched the Precision Medicine Initiative in 2015, starting an endeavor to reshape healthcare delivery. To translate the concept of precision medicine from the bench to practice, advanced manufacturing will play an integral part, including the fabrication of personalized drugs and drug delivery devices and drug screening platforms. These products are highly customized and require robust yet flexible manufacturing systems. The advanced manufacturing field has rapidly evolved in the past five years. In this state-of-the-art review, products manufactured for precision medicine will be introduced, followed by a brief review of processing materials and their characteristics. A review on different manufacturing processes applicable to those aforementioned products is provided. The current status of the development of regulatory submission and quality control considerations are also discussed. Finally, this paper presents a future outlook on manufacturing processes used for precision medicine.

Building health service management workforce capacity in the era of health informatics and digital health – A scoping review

IntroductionHealth informatics and digital health, two rapidly growing disciplines, are becoming increasingly important to the sustainability of health service provision, highlighted especially through the COVID-19 pandemic. To maximise the benefits of the adoption and growth of health informatics and digital health, health service managers play a critical role in leading and managing the implementation and transformation of the system, both strategically and operationally, whilst still needing to manage ‘business as usual’. ObjectivesThe objectives of the paper are to present and discuss the findings from a scoping review identifying: 1) competencies required for health service managers leading the implementation and transformation of informatics and digital technology in the health sector; and 2) factors that are critical to building the management workforce capacity in the era of health informatics and digital health. MethodsA scoping review of the literature was conducted in 2020 focussing on identifying empirical articles published in the English language since the year 2000 using a number of keywords such as ‘health informatics’, ‘digital health’, ‘electronic health’, ‘competencies’, ‘capability’, ‘proficiency’, ‘qualification’, ‘certification’, ‘health manager’, ‘health executive’ and ‘health administrator’. The literature search was guided by a PRISMA approach searching within eight databases: Scopus, ProQuest, Web of Science, ACM Digital Library, CINAHL, PubMed, Google Scholar and ProQuest Dissertations. ResultsAfter duplicates were removed, 941 publications were included for title screening as the result of an initial review. Title screening selected 185 articles to be included for abstract screening by two reviewers confirming 19 papers relevant to the focus of the current paper which were included in data extraction and content analysis. The analysis identified the additional competency of ‘information and data management’ be included as a core competency for health service managers. The analysis also confirmed additional elements for the following four core management competencies that are important to health service managers working in the digital health context, including: 1) leadership; 2) operational and resource management; 3) personal, interpersonal and professional qualities, and 4) understanding the industry and environment. Factors that are critical to developing the system and organization capacity in the use of health informatics and digital health technology, and leading and managing the adoption in the healthcare organizations were identified in three categories: 1) policy/system; 2) organizational structure and processes; and 3) people factors. ConclusionsThis paper has taken an important step in confirming the competency requirements for health services managers that are relevant to leading and managing in the health informatics and digital health space, consequently indicating the directions for developing a competent workforce in meeting the existing and emerging healthcare delivery challenges, both now and in the future.

Internet of Healthcare Things (IoHTs) Technology to Strengthen Nigeria Health Systems: A predictive technique for Syndromic Surveillance of Suspected cases of Filovirus Diseases in Africa.

Infectious disease should be early recognised, treated timely and adequately, otherwise it spreads and leads to many other complications that is capable of causing health hazards, which can relatively become a cause of multiple cases of death. The emergence and re-emerging of Filovirus diseases especially in African continent are alarmingly threatening the healthcare workers and poses greater fatality rate. Ebola Virus Disease (EVD) and Marburg Virus Disease (MVD) are in the family of Filovirus infectious disease, that is predicted to continue emerging especially in regions where the reservoir host species are known. The upsurge of Internet of Things (IoTs) in Healthcare has provision very many technological advancement and positive solutions to healthcare challenges across the globe especially in many developed countries of the world. Internet of Healthcare Things (IoHTS) is a pool of innovative technological medical related devices that are connected together to provide seemingly control management, monitoring and surveillance, predictive detection and information sharing, etc that is capable of improving quality of healthcare delivery. Thus, early recognition, and timely detection and response to highly contagious and deadly virus is critically important in this modern era. This research study employs the Case-Study methodology to present an investigative framework of the use of Internet of Healthcare Things (IoHTs) technique to detect, predict and real-time report of -re-emerging Filovirus diseases in order to provide early recognition, quick response and intervention management with improved contact tracing tool of Geographical Information System (GIS) for active surveillance for informed decision-making on emergency healthcare delivery while minimizing the spread of the viruses. The study proposes to apply the emerging IoTs innovations to symptomatically detect and predict particular Filovirus (MVD or EVD) based on the defined physiological condition systematically presented. The objectives of the study are not limited to properly review the existing frameworks suitable for the research study, and design the propose architectural framework for the performance improvement of the system. The outcome is to provide a scientific way of detecting and predicting re-emerging Filovirus Diseases, and reporting such data in real-time for improve rapid response to emergency health intervention. The system structure is logically abreast with the technique to provide Suspected individuals with opportunity to early, easily and speedily detect and predict (know) their health condition during any Filovirus (EVD and MVD) outbreaks, and significantly minimize the spread of the diseases. Keywords : Ebola Virus Disease, Marburg Virus Disease, Internet of Healthcare Things, Smart Health Care, Filovirus, Predictive Detection, Syndromic Surveillance and Real-Time Reporting. DOI: 10.7176/CEIS/13-2-05 Publication date: April 30 th 2022

Vascular injuries: Aetiology, presentation and management outcomes at a tertiary hospital in Lagos, Nigeria.

This retrospective study covered the period from January 2015 to December 2021. Information of interest were extracted from the medical records of each participant. The results from the data analysis were presented in charts and tables. Seventy-four patients aged 15-78 years (mean 32.30 ± 13.75 years) were included in this study. The male-to-female ratio was 3.6:1. The most common causes were gunshot injury, road traffic accident and iatrogenic injuries. The mean duration from injury to presentation was 9.85 h and mean duration from presentation to restoration of flow was 7.3 h. The most common injured artery was the femoral artery, whereas the most common vein was inferior vena cava. Primary vascular repair was done in majority of the cases. Amputation was performed in 18.9% with loss of viability of the limb. Vascular injury though relatively uncommon remains a challenging and life-threatening disease predominantly in young adult males. Urgent intervention prevents limb loss and mortality. Favourable outcome is accomplished by improving emergency healthcare delivery and well-equipped vascular centres with adequately trained personnel in the nation's hospitals.

Pioneering a Value-Based Purchasing Initiative for Ambulatory Surgery Centers in TRICARE West.

Pioneering a Value-Based Purchasing Initiative for Ambulatory Surgery Centers in TRICARE West.

The acceptability and safety of video triage for ambulance service patients and clinicians during the COVID-19 pandemic.

Introduction:In response to anticipated challenges with urgent and emergency healthcare delivery during the early part of the COVID-19 pandemic, Yorkshire Ambulance Service NHS Trust introduced video technology to supplement remote triage and ‘hear and treat’ consultations as a pilot project in the EOC. We conducted a service evaluation with the aim of investigating patient and staff acceptability of video triage, and the safety of the decision-making process.Methods:This service evaluation utilised a mixture of routine and bespoke data collection. We sent postal surveys to patients who were recipients of a video triage, and clinicians who were involved in the video triage pilot logged calls they attempted and undertook.Results:Between 27 March and 25 August 2020, clinicians documented 1073 triage calls. A successful video triage call was achieved in 641 (59.7%) cases. Clinical staff reported that video triage improved clinical assessment and decision making compared to telephone alone, and found the technology accessible for patients. Patients who received a video triage call and responded to the survey (40/201, 19.9%) were also satisfied with the technology and with the care they received. Callers receiving video triage that ended with a disposition of ‘hear and treat’ had a lower rate of re-contacting the service within 24 hours compared to callers that received clinical hub telephone triage alone (16/212, 7.5% vs. 2508/14349, 17.5% respectively).Conclusion:In this single NHS Ambulance Trust evaluation, the use of video triage for low-acuity calls appeared to be safe, with low rates of re-contact and high levels of patient and clinician satisfaction compared to standard telephone triage. However, video triage is not always appropriate for or acceptable to patients and technical issues were not uncommon.

GROUND GLASS OPACITY- (GGO) MIMICS AND ITS CHAMELEONS IN THE ED A LITERATURE REVIEW

Background : The COVID-19 pandemic has created an unprecedented health care crisis with, disruptions in both routine and emergency health care delivery and immense strain on health care resources . The clinical spectrum of disease with coronavirus disease (COVID-19) infection is variable and ranges from an asymptomatic infection or mild upper respiratory tract illness to severe viral pneumonia with respiratory failure and occasionally death. In a resourceconstrained environment with a high community burden of the disease and rapid point-of-care testing either unavailable or showing negative results, CT has been used to rapidly triage patients into non COVID-19, possible COVID-19, or most likely COVID-19 . As per the Fleischner Society consensus statement, CT is appropriate in certain scenarios, including for patients who are at risk for and/or develop clinical worsening .The common chest CT findings of COVID-19 are multiple ground glass opacity(most common), consolidation and interlobular septal thickening in both lungs, which are mostly distributed under the pleura. The ground-glass opacities are usually peripherally located with the lower lobes being commonly involved. Imaging differentiation is important for management and isolation purposes and for appropriate disposition of patients . (1,7) The purpose of this article is to discuss the common presentations of emergency department with ground glass opacities and to review the differential diagnosis of typical imaging findings of COVID-19. Ground glass opacities appear in a variety of disease processes of emergenc Conclusion : y department presentations . Not all presentations with GGO” s have SARS COV2 or Covid -19 viral pneumonia .

HealthyBlockchain for Global Patients

An emerging healthcare delivery model is enabling a new era of clinical care based on well-informed decision-making processes. Current healthcare information systems (HISs) fall short of adopting this model due to a conflict between information security needed to implement the new model and those already enforced locally to support traditional care models. Meanwhile, in recent times, the healthcare sector has shown a substantial interest in the potential of using blockchain technology for providing quality care to patients. No blockchain solution proposed so far has fully addressed emerging cross-organization information-sharing needs in healthcare. In this paper, we aim to study the use of blockchain in equipping struggling HISs to cope with the demands of the new healthcare delivery model, by proposing HealthyBlockchain as a granular patient-centered ledger that digitally tracks a patient’s medical transactions all along the treatment pathway to support the care teams. The patient-centered ledger is a neutral tamper-proof trail time-stamp block sequence that governs distributed patient information across the decentralized discrete HISs. HealthyBlockchain connects patients, clinicians, and healthcare providers to facilitate a transparent, trustworthy, and secure supporting platform.

COVID-19 and emergency care for adults experiencing homelessness.

Homeless individuals face many barriers to accessing healthcare, and EDs are often their primary entry point to the healthcare system. The COVID‐19 pandemic has the potential to exacerbate existing social inequities and health disparities, including barriers to accessing social services and healthcare. Addressing the complex social and chronic health issues associated with homelessness can be challenging within the acute care environment. This perspective reflects upon the delivery of emergency healthcare to patients experiencing homelessness, and highlights strategies for optimising health outcomes during and beyond the pandemic.

ASHA Sets 2020 Advocacy Priorities Targeting Workload, Reimbursement, and More

You have accessThe ASHA LeaderASHA News1 Mar 2020ASHA Sets 2020 Advocacy Priorities Targeting Workload, Reimbursement, and More Jeffrey P. ReganMA Jeffrey P. Regan Google Scholar More articles by this author , MA https://doi.org/10.1044/leader.AN10.25032020.65 SectionsAboutPDF ToolsAdd to favorites ShareFacebookTwitterLinked In In this era of unprecedented polarization and uncertainty, it is more important than ever that lawmakers and policymakers across the country understand the value of audiologists and speech-language pathologists. Despite the political cacophony, ASHA has hit the ground running this year, building on last year’s successes and aggressively advocating on behalf of the professions in several key priority areas. ASHA’s 2020 Public Policy Agenda guides our advocacy efforts. This member-driven and member-written resource—approved by the Board of Directors—sets ASHA’s top public policy priorities in schools, health care, early intervention, and professional practice. In schools, ASHA is advancing new legislative language to promote manageable workload, reduce excessive caseload, and streamline documentation burdens for our school-based members. We are also fighting for fair and equitable wages, as well as increased access to and funding for the services we provide. In health care, ASHA continues to advance several initiatives that would protect and expand comprehensive coverage of and payment for services provided in a variety of health care settings. We are also working to ensure fair productivity and documentation standards, and that emerging health care delivery systems and new payment models include our services. It is essential to preserve licensure and certification requirements for the professions, protect the professions’ defined scopes of practice, mitigate workforce shortages, and support a robust, diverse graduate and undergraduate student population. ASHA is working to expand state adoption of the new Audiology and Speech-Language Pathology Interstate Compact, and to advance congressional initiatives that would diversify the student population in graduate audiology and speech-language pathology programs. ASHA also recognizes a commitment to the 40 million Americans who have a communication disorder. We are working on several initiatives designed to benefit the patients, clients, and students our members serve. This diverse objective includes supporting the preservation of Medicaid eligibility and benefits, ensuring that families have objective information with which to make informed decisions about treatment and care, and promoting devices and technologies that are safe for consumers. The 2020 Public Policy Agenda recognizes the pivotal role that ASHA members play as advocates for the professions, and highlights resources for members who want to stay informed and get involved, including the 60-Second Advocacy Update, ASHA Take Action, and ASHA-PAC. Author Notes Jeffrey P. Regan, MA, is ASHA director of government affairs and public policy. [email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 25Issue 2March 2020 Get Permissions Add to your Mendeley library History Published in print: Feb 28, 2020 Metrics Downloaded 314 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2020 American Speech-Language-Hearing AssociationLoading ...

Antibiotic Prescribing in Urgent Care: Implementing Evidence-Based Medicine in a Rapidly Emerging Health Care Delivery Setting

Antibiotic Prescribing in Urgent Care: Implementing Evidence-Based Medicine in a Rapidly Emerging Health Care Delivery Setting

Combating infectious disease epidemics through China's Belt and Road Initiative.

Combating infectious disease epidemics through China's Belt and Road Initiative.