Hospital Equipment Research Articles

295. Methods for Cost-efficient Real-time Whole Genome Sequencing Surveillance for Enhanced Detection of Outbreaks in a Hospital Setting

Abstract Background Healthcare associated infections (HAI) are common hospital complications associated with increased length of stay, economic burden, morbidity, and mortality. Traditionally, HAI outbreaks were detected using reactive whole genome sequencing (WGS); however, with costs decreasing over time, WGS has become a practical tool for the real time detection of nosocomial outbreaks. This study describes such methods, provides a cost analysis, and reviews notable outbreaks observed while performing real time WGS surveillance of HAIs. EDS-HAT real-time genomic surveillance methodsFigure 1:EDS-HAT real-time genomic surveillance methods A) collect list generation, B) sample collection C) sample processing, D) DNA extraction, E) Library preparation, F) WGS, and G-I) Data analysis, including determining SNPs between samples and infection clusters Methods The Enhanced Detection System for Healthcare-Associated Transmission (EDS-HAT) was devised to identify potential transmitted HAIs in real time among patients admitted to the hospital for ≥ 3 days or with a previous exposure in the prior 30-days (Fig 1). We performed a cost analysis for real time genomic HAI surveillance, based on an average cutoff of 35× coverage per genome, considering personnel, reagents, supplies, and WGS platform. We also considered maximum sample counts that could be sequenced on two platforms (MiSeq or NextSeq), based on genome size (Fig 2). Bioinformatic analyses were completed following WGS, and epidemiological links were investigated for isolates that clustered with ≤ 15 pair-wise SNP differences (C. diff ≤ 2 SNPs). Maximum Sample CountsFigure 2:Maximum number of genomes that can be run on a MiSeq v3 600 cycle flow cell and NextSeq500 v2.5 300 cycle flow cell based on size (Mb). Sample counts were calculated using Illumina coverage calculator based on 80× coverage criteria. Genome size of an average run by the MiGEL lab is shown in comparison Results From November 1, 2021 to October 31, 2023, we sequenced 4,723 isolates (weekly mean N=49). The per sample cost depended on platform used and sample count, totaling $49 or $19 for MiSeq (N=32) and NextSeq (N=96), respectively (Table 1). With the inclusion of personnel costs for 1 lab technician and 1 biostatistician (salary only, based on percent effort) the average weekly cost to run EDS-HAT was $4,293 (range $3,626-$4,758). We highlight multiple outbreaks involving a common hospital unit, equipment, or location (Table 2). Following Infection Prevention (IP) intervention, no additional cases were detected for these clusters on the associated routes. Cost per sample BreakdownTable 1.Cost per sample across MiSeq, NextSeq, and commercial WGS Conclusion We describe time- and cost-efficient methods for real time outbreak surveillance and detection using WGS. These genomic methods, as described in EDS-HAT, can be utilized with traditional epidemiological methods to guide hospital IP teams to mitigate and stop the spread of deadly transmitted HAIs. Notable OutbreaksTable 2.Description of notable outbreaks detected by real-time EDS-HAT HAI surveillance Disclosures Alexander Sundermann, DrPH, CIC, FAPIC, OpGen: Honoraria Lee Harrison, MD, GSK: Advisor/Consultant|Merck: Advisor/Consultant|Pfizer: Advisor/Consultant|Sanofi: Advisor/Consultant

Investigation on neurosurgical technical equipment of hospitals in turkey: a national survey study

Investigation on neurosurgical technical equipment of hospitals in turkey: a national survey study

Factors Influencing the Choice of Healthcare Providers among National Health Insurance Scheme Enrollees in Public and Private Health Facilities in South Western Nigeria: A Mixed Method Study

Objectives: The choice of healthcare facilities is determined by the interaction of several factors and the perceived quality of care provided in the facilities. This study aimed to assess the factors influencing the choice of service providers among NHIS enrollees in public and private health facilities in Southwestern Nigeria. Methods: A cross-sectional and mixed-method study design using both qualitative and quantitative data collection methods. Using a multistage sampling technique, 300 patients were enrolled. Four focus groups with eligible respondents were conducted in public and private health facilities. IBM SPSS was used to analyze the data, and a p-value of less than 0.05 was designated as the significance level. Qualitative data were collated and analyzed using detailed content analysis. Results: The study found that 50 (33.3%) public and 37 (24.7%) private health facilities respondents had ever changed their health care providers respectively, but this was not statistically significant (p=0.098). Determinants of choice of healthcare providers among the public and private health facilities enrollees include; use of facility before joining the scheme (p<0.001), courteous/friendly hospital staff (p=0.042), adequate personnel and equipment (p=0.002), skills and expertise of personnel (p=0.03), use of health facility by majority of colleagues, (p<0.001) and spending greater than 10 years in the scheme (p=0.007). Conclusion: Factors influencing the choice of healthcare providers among respondents in public and private health facilities, were mainly health facility related. Accredited healthcare providers seeking to improve the enrollment of new clients as well as retain their old clients should address these factors.

Use of blended feeds in children requiring tube feeding.

The use of blended tube feeding (BTF) in children is a controversial area with persistent concerns regarding the nutritional adequacy and risk of associated infections and equipment complications. Parents in Australia are electing to use BTF in their children despite local hospital guidelines, calling for further research to support its use. A retrospective case-series study was conducted at a tertiary paediatric hospital, to characterise the paediatric population electively using BTF and evaluate their clinical outcomes. Demographic, anthropometric and clinical data were collected from pre-existing medical records. Data from 178 clinical visits of 26 participants were included in analysis. The median age of participants was 4.1 years (range 7 months -14 years). BTF was most commonly used for symptom control (n = 8, 30.8%). The most common cause of clinical presentation during the use of BTF was respiratory conditions (number of presentations = 60, 47.2%). There was no reported increase in hospital presentations, gastrointestinal infections or equipment complications with the use of BTF. BTF did not promote weight gain in this population of children, particularly those who were already underweight. This case-series found the use of BTF in a paediatric population with underlying complex medical conditions requiring enteral nutrition was driven by parental preference and the goals of symptomatic control. BTF did not demonstrate benefits of weight gain, though it was not associated with an increase in complications and hospital admission.

METHODS OF FORMING OPEN RECREATIONAL SPACES IN CHILDREN'S HOSPITALS (A CASE STUDY OF THE KHARKIV CITY)

The article examines the features of the formation of open recreational spaces (ORS) for children's hospitals (CHs) in Kharkiv. Based on the analysis of regulatory documents, it was found that in Ukraine CHs are divided into multi-profile and single-profile, as well as specialized institutions. Multi-profile institutions provide a wide range of medical services for children with various diseases, for example, regional and city children's hospitals, while singleprofile institutions focus on the treatment of specific diseases, such as infectious or oncological. Specialized centers (rehabilitation, cardiology, etc.) are also distinguished that require special areas for rest and rehabilitation. The analysis of CHs in Kharkiv showed that most institutions have imperfectly organized territories, often unsuitable for full-fledged use. Many hospitals are parts of medical complexes or are located in dense urban development, which limits the space for ORS. The main shortcomings are insufficient landscaping, lack of necessary areas for children with various types of diseases, lack of special areas for rehabilitation and limited access for children with disabilities. Based on the analysis of the typology and needs of different hospitals, general recommendations for the Kharkov CHs were developed. For multi-profile hospitals, it is recommended to create multifunctional areas that will allow for physical rehabilitation, educational activities and relaxation, etc. (multimodal spaces, safe play, sports, recreational, etc.) For single-profile hospitals, it is worth providing highly specialized areas that will meet specific needs: sensory spaces for ophthalmology and otolaryngology hospitals, sports grounds with adaptive equipment for physiotherapy and traumatology hospitals. Thus, the article justifies the need to create ORSs in CHs that take into account the needs of different categories of patients. The proposed solutions are aimed at reducing stress, stimulating physical activity, and ensuring psychoemotional comfort, which ultimately contributes to the accelerated recovery of children and the improvement of working conditions for medical personnel.

Electrophoretic deposition of chitosan/gelatin/hydroxyapatite nanocomposite coatings on 316 L stainless steel for biomedical applications

In addition to the basic and main parts of hospital equipment, 316 L stainless steel is widely utilized in futures such as nails and screws, wires and medical bone clips, dental implants, heart springs (stents), needles, surgical scissors, etc. In the present study, the electrophoretic deposition of a composite based on chitosan (CS), gelatin, nano and microparticles of hydroxyapatite on a 316 L stainless steel substrate was investigated. Hydroxyapatite particles are added to it due to the ossification abilities of steel and due to an enhanced adhesion and bone production, CS and biocompatible gelatin polymer particles were also added to hydroxyapatite. These particles were mixed in an ethanol/deionized water/acetic acid solution to create a suspension for the electrophoretic procedure. A mixture of 5 g l-1of hydroxyapatite, 0.5 g l-1of CS, and 1 g l-1were present in the suspension. The best coating time was 1200s, and the best voltage was 30 V. The high density of the hydroxyapatite particles in the CS/gelatin polymer matrix was seen in scanning electron microscopy pictures. Additionally, the outcomes of the immersing samples in the simulated body fluid were evaluated, and the results revealed that, after 14 d, hydroxyapatite nanoparticles grew more rapidly than microparticles. The presence of CS, gelatin, and hydroxyapatite in the coating was verified by energy dispersive x-ray spectroscopy, Fourier transform infrared spectroscopy, and x-ray diffraction. Electrochemical impedance spectroscopy (EIS) and Potentiodynamic polarization in Phosphate-buffered saline were used to assess the corrosion results. In comparison to the bare sample, the corrosion resistance of the coated sample increased from 1.22 × 105to 7.17 × 105Ω.cm2under best circumstances, according to EIS results. Additionally, in the polarization test, the corrosion potential increased from -225.24 to -157.01 mV (vs. SCE) and the corrosion current dropped from 2.159 to 1.201 µA cm-2.

Current state of dermatovenereological medical organizations’ equipment for dermascopy

Background: The use of the dermascopy for diagnosing skin diseases is determined by the clinical guidelines. Foreign-made dermatoscopes make up 99% of the equipment of medical organizations in Russia. However, under the conditions of economic sanctions, the supply and maintenance of medical products by foreign companies in Russia has been significantly reduced or completely stopped, which may negatively affect the quality of medical care. Aims: To assess the current state of technical support of medical organizations of the dermatovenereology profile with equipment for dermascopy. Materials and methods: Information on the availability of dermatoscopes was obtained from 72 medical organizations of the dermatovenereological profile. The obtained data were structured, standardized and brought to a general form. Further processing of the information was carried out using descriptive statistics methods. Results: The surveyed medical organizations are equipped with 1,716 devices for dermascopy, of which 1,700 (99.1%) units are foreign-made, 16 (0.9%) units are Russian-made. Of the total number of dermatoscopes, 1,580 (92.1%) devices are portable models, 86 (5.0%) are digital devices with software and 50 (2.9%) are video dermatoscopes. Most of the foreign medical equipment - 1,546 units (90.1%) is made in Germany. In 31 (48.4%) medical organizations, the number of dermatoscopes is less than the number of dermatovenereology offices. The equipment of 24-hour hospitals with dermatoscopes is 5.2%, day hospitals - 17.1%. Conclusions: There is a need to equip medical organizations with high-quality dermatoscopes. In the context of economic sanctions, the development and registration of the national dermatoscope is an urgent task.

Research on Evaluation System of Medical Imaging Equipment Dynamic Acquisition Technology Based on Multiple Criteria Decision Analysis

To construct an evaluation model system for dynamic data acquisition methods of medical imaging equipment in hospitals. The analytic hierarchy process (AHP) of the multiple criteria decision analysis method is used to study the model. Through multi-criteria decision analysis, the evaluation index system of dynamic data acquisition technology of medical imaging equipment is constructed from aspects such as the reliability and traceability of data acquisition, the interactivity of the acquisition mode, and the extensibility of application analysis. A hierarchical evaluation model of dynamic acquisition technology for medical imaging equipment is constructed, which includes 5 primary indexes, 14 secondary indexes, and 38 tertiary indexes. We have constructed a qualitative and quantitative evaluation index for the dynamic acquisition technology of medical imaging equipment. The weight of the quantitative index "reliability" is 30%, and the weights of the qualitative indexes "security", "traceability", "interactivity", and "scalability" are 25%, 20%, 15%, and 10% respectively. It can be used to study the methods and technical characteristics of three kinds of dynamic data acquisition of medical equipment and form a technical evaluation scheme for dynamic data acquisition.

BN O04 - Trends in the management of bile duct stones in the United Kingdom: Are we following the evidence?

Abstract Background Common bile duct stones (CBDS) are typically managed in two stages: Endoscopic Retrograde Cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). However, access to ERCP can be limited or require referral, has a high failure rate, often necessitates additional imaging, and may involve multiple procedures. Increasing evidence suggests that single-stage management, involving LC with intraoperative imaging and bile duct exploration when indicated, is cheaper, more effective, and reduces overall length of stay. British Society of Gastroenterology guidance states that it is a valid alternative to ERCP. This study aimed to determine whether clinical practice aligns with this evidence. Method National Health Service (NHS) Admitted Patient Care publications summarise Hospital Episode Statistics by financial year and are openly accessible. OPCS4 Procedure Codes were screened by two authors and categorised as “operative” or “endoscopic.” Codes detailing the management of CBDS or bile duct exploration were included, while ambiguous codes or those for non-stone indications were excluded. Data pertaining to these codes were extracted from the Admitted Patient Care publications for 2012 to 2022 and summarised in a Microsoft Excel spreadsheet. Trends were analysed using a Non-Seasonal Mann-Kendall Trend Test Results A total of 249,475 procedures for CBDS were performed over the ten-year period, with a mean patient age of 67. Annually, the total number of procedures increased from 21,365 to 27,668 (p=0.002). Endoscopic procedures increased from 19,716 to 25,976 (p=0.002), while operative procedures remained stable (1,649 to 1,692, p=0.431). Consequently, the proportion of endoscopic management rose from 92.3% to 93.9% (p<0.001). The mean age of patients undergoing operative procedures was ten years younger than those undergoing endoscopic procedures (57 vs. 67 years) Conclusion Despite evidence and guidance supporting single-stage procedures, there is a trend towards endoscopic management of CBDS in the UK. This may be due to operational pressures on the NHS, including the sequelae of the COVID-19 pandemic, or reflect challenges within hospital culture, skill mix, or equipment availability.

Selection of Biomedical Equipment for public hospitals in Sri Lanka: A stakeholder perspective

Background: Health technology is an important component in delivering healthcare services. Healthcare technology can be expensive and often does not align with the unique needs of under-resourced areas. Out of the variety of health technologies, biomedical equipment is one of the major assets for any healthcare institution, and it plays an important role in healthcare delivery.Unlike developed countries, Sri Lanka lacks a system for choosing effective biomedical equipment for hospitals. This study explored current practices to improve the biomedical equipment selection process.Purpose: The study aims to assess stakeholders’ perceptions of the decision-making process for selecting biomedical equipment in selected line ministry hospitals in the Western Province of Sri Lanka.Methodology: This cross-sectional study was conducted in four (4) line ministry hospitals, with each facility representing a specific level identified within the line ministry. A survey using a self-administered Questionnaire (SAQ) and a desk review using a checklist were conducted to assess the stakeholders' perceptions of the decision-making process in selecting biomedical equipment.Results: The stakeholders' survey revealed low awareness of the unavailability of an HTA policy, institutional guidelines, and essential biomedical equipment list. Equipment requests were mainly paper-based, finalized by a committee, and took over two days to process. Respondents found the decision-making process inconvenient and dissatisfying.The finalized requests assessed through the checklist revealed that they were incomplete, lacking crucial information, such as the Requesting Officer and infrastructure details, and not accounting for financial, environmental, and equipment demand factors.Conclusions: The decision-making system practiced was revealed to be inefficient, inconsistent, and noncomprehensive. It was also found to be made without due consideration of factors related to equipment, finance, infrastructure, human resources, and services. Therefore, establishing a proper need assessment and prioritization method with criteria is recommended.

Identifying the factors influencing the quality of education from the perspective of nursing students: A qualitative study.

Nursing education in Iran suffers from challenges such as inadequate training time, non-scientific methods, lack of facilities, and so on. Nursing students can better discuss these issues and identify variables affecting their education. Thus, this study sought to uncover factors affecting education quality from nursing students' perspectives. This is a qualitative study that was conducted on nursing students in 2022. Purposive sampling chose 20 undergraduate nursing students from Abadan University of Medical Sciences, Abadan, Iran. The data was acquired using a semi-structured interview. Content analysis was performed using MAXQDA-10 software to extract relevant themes. The factors derived from content analysis were classified into two internal and external main themes and six sub-themes, including professors, students, the university/education department, hospitals, and the educational system. Analyzing the strengths and weaknesses of trainers and professors in practical programs and teaching new practical teaching methods can effectively enhance the quality of nursing education. Also, giving training and welfare equipment and necessities in educational hospitals and changing the headlines and contents of some nursing courses will improve education quality.

Accuracy of Patient-Collected Vital Signs.

Introduction: Telehealth has emerged as an important clinical setting for managing acute respiratory tract infections (ARIs), potentially reducing emergency department and urgent care overcrowding, and reducing nosocomial transmission. Many current algorithms for ARI management incorporate information on patient vital signs. However, the accuracy of vital signs collected by patients using readily available home devices and techniques has not been studied. Methods: A cross-sectional sample of patients seen for urgent conditions at a hospital emergency and urgent care center were given instructions and low-cost, readily available devices to collect their vital signs. A trained research coordinator collected a parallel set of vital signs using standard hospital equipment, serving as the gold standard. We analyzed the performance of patient-collected vital signs compared with vital signs collected by a trained research coordinator. Results: A total of 300 patients completed the study. Patient-collected vital signs were highly specific for traditional levels of abnormalities (HR >100 beats per min, RR >24 breaths per min, temperature >100.4 degrees Fahrenheit, oxygen saturation <94 percent); however, sensitivity was poor for elevated heart rate by pulse estimation (25%) and elevated respiratory rate (60%). Heart rate and oxygen saturation by pulse oximeter and oral temperature had higher sensitivity. Conclusions: Vital signs measured and provided by patients are not uniformly accurate, particularly when using manual techniques rather than automated devices. Telehealth algorithms that rely on these values could provide incorrect triage and management advice.

Intra-arterial chemoembolization as a component of neoadjuvant treatment of rectal cancer. Literature review

Interventional oncology is a rapidly evolving field of cancer treatment. Minimally invasive techniques, such as transarterial embolization with chemotherapeutic and radioactive agents, are common treatments and are found in many guidelines for the treatment of primary and metastatic liver lesions. It is known that the growth and development of a malignant neoplasm is primarily determined by angiogenesis. Rapid growth is ensured where the formation is directly related to the arterial bed. Therefore, when the drug is injected into the target vessel and providing tissue ischemia, it is possible to achieve a high degree of tumor pathomorphosis. This technique has an advantage for patients who, in some cases, cannot be treated surgically, and also increases the effectiveness of the chemotherapeutic effect. With the advent of necessary equipment in hospitals and the accumulation of experience in the use of minimally invasive interventions, it became possible to implement a new method of treating tumors of various localizations. In this review, we consider the results of domestic and foreign authors on the topic of intra-arterial chemoembolization before surgical treatment in patients with rectal cancer. It is noted that the analysis of the literature revealed a small number of works devoted to the chosen topic, despite the relevance of this problem for modern oncology.

Detection of Coronavirus Disease 2019 (COVID-19) Virus on the Surface of Hospital Settings by Quantitative Real-Time Polymerase Chain Reaction

Background &amp; Objectives: Coronavirus disease 2019 (COVID-19) has had a profound impact on human health, with over 704,753,890 confirmed cases and 7,010,681 deaths reported to date. This study aimed to evaluate the contamination rate of COVID-19 on high-risk surfaces at Valiasr Hospital in Fasa, Iran, using molecular testing. Materials &amp; Methods: A total of 142 surface swabs, immersed in viral transport medium (VTM), were collected and transported to the Virology Reference Laboratory at the Cohort Center of Fasa University of Medical Sciences for COVID-19 virus testing. The presence of the virus was assessed using the real-time polymerase chain reaction (RT- qPCR) technique (QIAquant 96 5plex), following the manufacturer’s protocol (Qiagen, MD, USA). Results: Among the 142 samples obtained from surfaces and equipment in the COVID-19 ward, two samples tested positive for COVID-19. Similarly, two samples from the coronavirus isolation ward were found to be positive using RT-qPCR. The positive samples were collected from a patient’s bed and the interior bed of an insulated room. No COVID-19 contamination was detected on hospital surface samples outside these areas. Conclusion: This study identified a low rate of COVID-19 contamination on hospital surfaces and equipment in Fasa city. The findings suggest that the hospital environment could serve as a potential source of COVID-19 transmission, particularly among healthcare providers, visitors, and patients.

Performance analysis of mono-stage three-phase DC-AC converter with reduced logic power supply circuits

This paper presents the performance analysis of a mono-stage three-phase DC-AC converter with reduced logic power supply circuits. The power DC-AC power converter of the proposed system is formed by arrangement of one inductor, two power switches, and one capacitor in an opener-like configuration to yield each leg of the inverter. During the inversion process, the number of capacitor elements that charges up (builds electrical energy) or discharges across the power switches will be equal to the number of inductors that discharges or builds up magnetic energy that terminates in between the power switches and vice versa. Under this condition, the proposed system, boosts and converts DC power to AC power and at the same time maintains energy balance in the system in one stage power conversion phenomenon unlike conventional power inverters. The logic power supply circuit used in the proposed system has fewer component counts and performs optical isolation unlike its conventional counterparts which have larger component counts and isolate by electromagnetic induction. The proposed system achieved the following results: lower and cheaper logic power supply circuits, simulated phase voltages of 327.8 V and 326.6 V and 329.8 V at THDs of 0.09879 %, 0.2569 % and 0.2905 % and average phase currents of 6.30A, 6.32A and 6.26A, respectively, and experimented: scaled down phase-A, B, and C average voltages of 66.95 V, 65.6 V and 68.93 V at phase angles of 0°, 120°, and -120° respectively. The performance analysis of the mono-stage three-phase DC-AC converter with reduced logic power supply circuits can be used in home appliances, hospital equipment, communication-based power stations, and drive systems such as electric vehicles.

Why do new-borns die? Perspectives of community members and health care providers in the Lawra municipality of the Upper West Region, Ghana

BackgroundNeonatal deaths contribute significantly to under-five mortality and serve as a crucial indicator of a country’s socioeconomic development, quality of life, and health status. These deaths occur both at home and in health facilities. Therefore, the perspectives of community members and healthcare providers are essential in defining neonatal survival.AimThis study explored the perceived causes of neonatal deaths among healthcare professionals and community members at the Lawra Municipality in the Upper West Region, Ghana.MethodThis study employed a qualitative descriptive approach. A purposive sample of 30 participants including 18 community members and 12 healthcare providers, was selected. Data were gathered using Focus Group Discussion (FGD), transcribed verbatim, coded and analysed using thematic-content analysis.ResultsThree themes were constructed to describe the factors leading to newborn deaths both at health facilities and in the community. These factors included: (1) personal factors related to newborns, mothers/families and health staff; (2) physical factors related to hospital facilities and equipment; and (3) logistical factors related to transport, referral and presentation delays.ConclusionThe study identified differences in perspectives between healthcare providers and community members, which can affect interventions in neonatal care. Health authorities are encouraged to develop a shared vision to engage communities by addressing geographic-specific factors causing neonatal deaths. This approach can help in understanding how collective actions can contribute to reducing neonatal deaths.

Corporate Donations in the Context of Covid-19: Insights on Trust and Policy Innovation Opportunities

This study aims to investigate the determinants of corporate donations during the initial phase of the Covid-19 pandemic, focusing on the Portuguese context. It explores the interplay between pandemic-related factors, corporate structures, recipient profiles, and media coverage on the levels of corporate donations. In the absence of publicly available data, a comprehensive database of corporate donations was constructed by analyzing over six thousand news pieces from various media sources between March and May 2020. The database comprises 1171 donations from 709 different institutions. The relationship between corporate donations and multiple variables was examined, including the epidemiological progression of the pandemic, corporate ownership structures, recipient characteristics, and media coverage. Our analysis reveals that during the initial wave of the Covid-19 pandemic in Portugal, corporate donations were predominantly made by large companies, primarily directed toward their local regions. Notably, nearly 93% of all donations were allocated to the National Health System. PPEs and hospital equipment were the preferred donation items among the contributing companies. These findings shed light on the factors influencing corporate donation behavior during emergency situations and provide valuable insights into trust levels within the healthcare system. This study contributes to the existing literature by offering a unique exploration of corporate donation behavior during the Covid-19 pandemic, specifically in Portugal. The comprehensive dataset and findings provide novel insights into the factors shaping corporate donation decisions during crises. Doi: 10.28991/ESJ-2024-08-05-010 Full Text: PDF

Pandemic Action Plan: Phase 3-Lessons Learned from Implementation. "What Did We Learn?"

The COVID-19 pandemic created critical challenges for hospitals and health care providers. Suddenly clinics were forced to close; elective procedures were delayed; scheduled visits were canceled; emergency rooms were overcrowded; hospital beds, equipment, and personal protective equipment (PPE) were in short supply; and staff were faced with rapidly changing circumstances, care protocols, trauma, and personal risk. To better address challenges of the ongoing COVID-19 pandemic and prepare for future pandemics, the National Telemedicine Technology Assessment Resource Center (TTAC) was asked to develop a Pandemic Response Action Plan that would allow its users to address critical issues with available telemedicine and related technologies. The project was constructed in 3 phases. Phase 1-Develop a Pandemic Response Action Plan and a Pandemic Response Action Plan Policy and Regulatory Summary, which identifies the regulatory challenges as well as policy recommendations. Phase 2-Publish the Action Plan and the Policy and Regulatory Summary. Phase 3-Look at health care providers who used the approaches, tools, and technology in the Pandemic Action Plan and document the results. This document represents Phase 3. This document is Phase 3. In this report we look back at health care providers who used the approaches in the Phase 1 Pandemic Response Action Plan as published in Phase 2. In this document we report on the challenges and results of implementing parts of the Pandemic Action Plan. It records the findings, conclusions, and recommendations resulting from the experience of health care providers and the professional experiences of the team and their organizations in implementing parts or all of the plan. Methods: The same multidisciplinary team that constructed Phase 1 and Phase 2 were engaged to develop this Phase 3 report. The members of the team represent leadership expertise and key stakeholders in health care delivery during a pandemic (administration, infection control, physicians, nurses, public health, contingency planning, disaster response, and information technology) as well as a facilitator. For Phase 3, the group used structured brainstorming to define the findings, issues, and results of their own organizations' digital health response to the pandemic. In addition, eight health care providers (hospitals) identified by the Telemedicine Resource Centers' (TRCs) organizations, who used the Pandemic response Plan (created in Phases 1 and 2), were interviewed. All interviews were conducted by the same facilitator with leaders (CEO, and leaders of the telemedicine programs) in each of the eight programs, using a standard questionnaire created by the team. Current literature references are included in this report to illustrate when findings are known to have broader applicability. Conclusions: The impact of the COVID-19 Pandemic was severe and identified multiple critical challenges and weaknesses. Applying the approaches, tools, and technology outlined in the Pandemic Response Action Plan proved to be effective in addressing critical provider challenges. However, implementing these tools during a crisis was difficult unless the organization had experience with the tools and necessary workflows in advance. Implementing these tools as part of standard workflows and everyday operations increased the capabilities and resilience of these organizations in the provision of care during this and for future pandemics.

Feelings and Physics: Emotional, Psychological, and Other Soft Human Requirements, by Model‐Based Systems Engineering

ABSTRACTTraditionally, engineering encourages requirements statements that are objective, testable, quantitative, atomic descriptions of system technical behavior. But what about “soft” requirements? When products deliver psychologically or emotionally based human experiences, subjective descriptions may frustrate engineers. This challenge is important for products appealing to senses of style, enjoyment, fulfillment, stimulation, power, safety, awareness, comfort, or similar emotional or psychological factors. Automobiles, buildings, consumer products, packaging, graphic user interfaces, airline passenger compartments and flight decks, and hospital equipment provide typical examples. This paper shows how model‐based systems engineering helps solve three related problems: (1) integrating models of “soft” human experience with hard technical product requirements, (2) describing how to score traditional “hard” technology products in terms of “fuzzier” business and competitive marketplace issues, and (3) coordinating marketing communication and promotion with the design process. The resulting framework integrates the diverse perspectives of engineers, stylists, industrial designers, human factors experts, and marketing professionals.

Adverse Event Management Tool for Hospitals: A Game-Changer for Patient Safety

As medical technology continues to advance, concerns about associated risks to both patients and healthcare providers arise. Ensuring high-quality healthcare delivery stands as a paramount objective for every healthcare institution. Among the essential attributes required to meet this goal is the safety of all stakeholders. Nevertheless, numerous instances arise wherein unintended incidents occur involving healthcare personnel during the delivery of patient care. This study utilized a mixed-methods approach incorporating interviews, observations, and statistical analysis to investigate the occurrence of adverse events related to medical equipment in hospitals. The findings reveal that, despite 84% of surveyed nursing personnel indicating no experience with adverse events caused by medical equipment, factors such as inadequate preventive maintenance, lack of training, budget constraints, and staff shortages support the need for the development of patient safety support tools, as all the aforementioned factors increase the likelihood of unintentional errors during patient care. Based on these findings, a tailored reporting tool was developed to streamline the documentation of equipment failures and adverse events within hospitals. Designed based on identified needs and characteristics, this tool aims to facilitate timely notification of critical events, especially those with the potential to impact patient safety.