Hospital Administrators Research Articles

Health informatics to enhance the healthcare industry's culture: An extensive analysis of its features, contributions, applications and limitations

BackgroundHealth informatics is a fast-growing area in the healthcare sector. It concerns the technologies, tools, equipment, and procedures required to gather, store, retrieve, and use health data and medical data. Healthcare informatics provides patients, nurses, hospital administrators, physicians, insurance providers, and other stakeholders with electronic access to medical records through health information technologies (HIT). Health informatics combines nursing science with data science and analytical disciplines to gather, handle, interpret, and convey data, bringing together specialists and making health information accessible and meaningful. MethodsThis research is an outcome of an extensive scopic review, which has been conducted by identifying research and development through search keywords such as “Health informatics,” “Technologies,” and “Healthcare” from databases of Scopus, PubMed, Google Scholar, ResearchGate, and other research platforms. Further, the most relevant papers are identified and studied. FindingsThis paper explores health informatics, its technologies, and their need in the present healthcare domain. It also identifies vital aspects, characteristics, and versatile contributions of health informatics to the healthcare sector. Further, the paper identifies and discusses significant health informatics applications in the healthcare field. Patients' health information can be effectively analysed individually or in groups using health informatics technologies to meet diverse requirements. InterpretationEffective use of health informatics improves practice management as information is quickly shared among healthcare professionals, patients and other stakeholders. Healthcare informatics specialists' knowledge of utilising data to assist choice-making and creating best practices. It enables healthcare organisations to identify specific data offering the appropriate information for the given therapy, procedure, or training. Informatics in healthcare also addresses issues at the macro level of the organisation and also at the personal level of patient care via innovative technologies and best practices.

Challenges of Family-Centered Care in a Neonatal Intensive Care Unit during the Visitation Restrictions After COVID-19 Pandemic Peak: A Qualitative Study of Parents’ and Nurses’ Perspectives

Family-centered care is crucial for parent-infant bonding and collaborative healthcare in neonatal intensive care units. COVID-19 visitation restrictions have hindered this care’s effectiveness and posed challenges in Thai units. This study, conducted in a southern Thailand hospital, explored nurses’ and parents’ perspectives on implementing family-centered care during restricted visitation policies, providing globally applicable insights. An exploratory-descriptive qualitative approach was used, involving semi-structuredinterviews with ten nurses and ten parents to explore their nuanced perspectives from June to August 2023. The interviews were conducted face-to-face, individually, using a semi-structured interview guide, and the transcripts were analyzed using thematicanalysis to identify significant themes. Findings from this study comprised five themes: 1) Having a mindset to involve parents in care, 2) Parents receiving psychological support, 3) Challenges of communication, 4) Negative impact of restricted visiting times, and 5) Accommodating flexible visiting hours in exceptional circumstances. Providing the best possible care for infants requires an adaptable and flexible approach to meet each family’s unique needs. Additionally, healthcare providers need to explore how they can implementfamily-centered care effectively during visiting restrictions in the NICU in different contexts. Further research is necessary to investigate the practical implementation of this by nurses and how hospital administrators can support it in Thai neonatal intensive care units under policies restricting family visits.

Expanding Integrated Physiatric Care: A Method to Building Capacity in Physical Medicine and Rehabilitation.

Siloed and episodic care delivery is often not equitable, high-quality, or sustainable. Transitioning from separate care settings, with potentially divergent care models, to an integrated care model is not always straightforward. Some experiences in expanding collaborative care between physiatrists and other healthcare providers for a variety of patient populations and care settings within a university physical medicine and rehabilitation (PM&R) division are shared as a means to inspire the uptake of care integration initiatives more broadly within the specialty. After an initial survey of care integration across multiple clinical sites, the university division: highlighted successful integrated care models; discussed integrated care models at every divisional retreat; reached out to clinicians in other specialties to collaboratively explore expansion; developed a "one-pager" on what physiatrists do; and invited collaborative specialists from integrated clinics to PM&R national and/or international meetings. Since 2019, divisional activity in integrated care has grown and evolved substantially. Future work will focus on: further expansion of integrated clinical care; scholarly evaluation of integrated care models; expansion of academic activity resulting from integration; and advocacy to healthcare providers, hospital administrators, and health system funders about the potential value of care integration in improving rehabilitation outcomes.

Investigating Nurses’ and Nurse Managers’ Experiences During the COVID-19 Pandemic: A Phenomenological Study

Background: Türkiye is ranked close to last among OECD countries in terms of the ‘number of nurses per 1,000 people’. Nurses and nurse managers already devotedly provided services under difficult conditions during normal periods before the pandemic, and this became even harder during the pandemic. Therefore, it is important to investigate the experiences of nurses and nurse managers during the pandemic to make improvement in nursing care for future possible pandemics. Objective: This study aimed to explore the experiences of nurses and nurse managers during the COVID-19 pandemic. Method: The study used the phenomenological qualitative approach. The sample consisted of 14 nurse managers and 14 nurses who were working during the COVID-19 pandemic. Data were collected via online voice and video calls using a semi-structured interview form. The findings were reported in accordance with the consolidated criteria for reporting qualitative research. Results: Following analysis of the data, the attitudes of nurse managers and nurses in Türkiye related to the COVID-19 pandemic challenges and experiences divided into three themes: “Communication”, “Training”, and “Working Conditions/Environment”. Conclusion: In the study, nurses emphasized that their work environments were negatively impacted during the COVID-19 pandemic. Additionally, it was concluded that nurse managers exerted significant efforts to facilitate communication, to meet nurses’ needs for training, and to improve staff nurses’ working conditions. Some nurses noted that hospital administrators and nursing service managers provided social and psychological support. The study also revealed that the sensitivity and genuine approach of nurse managers enhanced nurses’ resilience. Nurse managers’ management skills and nurses’ experiences during the pandemic provide valuable insights and evidence for effectively managing future pandemics and similar disasters.

Work engagement among nurses in the context of the COVID-19 pandemic: A systematic review.

Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement. To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic. It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed. Ethical approval was not required for this systematic review. A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement. The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized.

Addressing Healthcare Disparities through Community-Based Hospital Management Initiatives

Addressing healthcare disparities among underserved communities has become a pressing concern for healthcare providers and policymakers alike. This study aims to investigate the role of community-based hospital management initiatives in mitigating healthcare disparities and improving access to quality care. Utilizing a qualitative research approach, the study employs a multiple case study methodology to explore successful community-based hospital management initiatives implemented in various regions. Data was collected through semi-structured interviews with hospital administrators, healthcare professionals, and community stakeholders, as well as document analysis of hospital policies and reports. The findings reveal that community-based hospital management initiatives, such as community health worker programs, culturally tailored healthcare services, and collaborative partnerships with local organizations, can effectively address healthcare disparities by enhancing healthcare accessibility, cultural competence, and community engagement. However, the study also highlights challenges faced by hospitals, including limited resources, language barriers, and social determinants of health that require a multifaceted approach. The research concludes that community-based hospital management initiatives have the potential to bridge the gap in healthcare disparities, but their success relies on strong leadership, sustainable funding, and a genuine commitment to community empowerment and collaborative efforts with various stakeholders.

Gratitude and depressive symptoms in Chinese nurses: From a self-determination theory perspective.

A common psychological problem among nurses is depression, potentially affecting their well-being and job performance. It is vital to explore how to alleviate nurses' depressive symptoms. The current research explored the mediating impact of basic psychological needs satisfaction on the link of gratitude with depressive symptoms. The nurses in this study were from mainland China. A total of 724 subjects completed an online questionnaire, which included measures of depressive symptoms, basic psychological needs satisfaction and gratitude. Our research found that gratitude was negatively linked to depressive symptoms. Furthermore, basic psychological needs satisfaction had a partial mediation effect on the link of gratitude with depressive symptoms after controlling for five demographic variables. These results suggest that gratitude may influence depressive symptoms via basic psychological needs satisfaction. Our study found that basic psychological need satisfaction partially mediates the gratitude-depression relationship in nurses. The result means that hospital administrators and nurse leaders should design gratitude interventions to alleviate nurses' depressive symptoms. They also help nurses decrease depressive symptoms by creating an environment that meets their basic psychological needs.

Relationship between profitability and financial factors of hospitals after a period of austerity and health care reforms: evidence from Greece

PurposeThe reduction of government expenditure in the healthcare system, the difficulty of finding new sources of funding and the reduction in disposable income per capita are the most important problems of the healthcare system in Greece over the last decade. Therefore, studying the profitability of health structures is a crucial factor in making decisions about their solvency and corporate sustainability. The aim of this study is to investigate the effect of economic liquidity, debt and business size on profitability for the Greek general hospitals (GHs) during the period 2016–2018.Design/methodology/approachFinancial statements (balance sheets and income statements) of 84 general hospitals (GHs), 52 public and 32 private, over a three-year period (2016–2018), were analyzed. Spearman’s Rs correlation was carried out on two samples.FindingsThe results revealed that there is a positive relationship between the investigated determinants (liquidity, size) and profitability for both public and private GHs. It was also shown that debt has a negative effect on profitability only for private GHs.Practical implicationsIncreasing the turnover of private hospitals through interventions such as expanding private health insurance and adopting modern financial management techniques in public hospitals would have a positive effect both on profitability and the efficient use of limited resources.Originality/valueThese results, in conjunction with the findings of the low profitability of private hospitals and the excess liquidity of public hospitals, can shape the appropriate framework to guide hospital administrators and government policymakers.

Trends in the surgical treatment for metastatic spinal tumor in Japanese administrative data between 2012 and 2020.

Both cancer diagnosis/treatment modality and surgical technique for the spine have been developed recently. Nationwide trends in the surgical treatment for metastatic spinal tumors have not been reported in the last decades. This study aimed to examine recent trends in the surgical treatment for spinal metastasis and in-hospital patient outcomes using nationwide administrative hospital discharge data. The Diagnosis Procedure Combination database from 2012 to 2020 was used to extract data from patients who underwent surgical procedures for spinal metastasis with the number of non-metastatic spinal surgery at the institutions that have performed metastatic spine surgeries at least one case in the same year. Trends in the surgical treatment for spinal metastasis, patients' demographics, and in-hospital mortality/outcomes were investigated. This study analyzed 10,321 eligible patients with spinal metastasis. The surgical treatment for spinal metastasis increased 1.68 times from 2012 to 2020, especially in fusion surgery, whereas the proportion of metastatic spinal surgery retained with a slight increase in the 2%s. Distributions of the primary site did not change, whereas age was getting older. In-hospital mortality and length of stay decreased over time (9.9-6.8%, p < 0.001; 37-30days, p < 0.001). Postoperative complication and unfavorable ambulatory retained stable and slightly decreased, respectively. During the last decade, surgical treatment for spinal metastasis, especially fusion surgery, has increased in Japan. In-hospital mortality and length of stay decreased. Recent advances in cancer treatment and surgical techniques might influence this trend.

Use of bispecific antibodies (BsAbs) in community practices: Key attributes to develop logistics and workflow for management of cytokine release syndrome (CRS).

e13575 Background: Establishing workflows to monitor and manage CRS in community practice settings presents unique challenges that may not be encountered in more specialized centers. Real world experience was gathered from OneOncology specialists to understand key steps, common challenges, and best practices to establish CRS workflows in community practices. Methods: Qualitative data were gathered via a 90-minute focus group and follow-up interviews. Participants were MD or PharmD community heme-oncology providers in physician-owned practices with 10-20 physicians. As of January 2024, participants had treated over 30 patients with commercially available BsAbs. Theme matrix techniques facilitated data analysis and presentation. Results: Catalysts for developing CRS workflows were the addition of BsAbs to the practice formulary, identification of practice leaders willing to drive protocol development, and education of clinic and hospital staff who would manage patients treated with BsAbs. Key steps in the workflow included defining lines of communication within the practice during and after office hours, designating leads to oversee staff training, and creating practice-specific management plans. A process for potential inpatient admission for moderate/severe CRS was developed in collaboration with hospital administrators and nursing leaders. Lines of communication between the treating practice, pharmacy, and hospital care staff before, during, and after treatment were established, and methods to ensure availability of necessary medications were identified. Finally, patient support and the logistics of patient/caregiver education on BsAb therapy, symptoms of CRS, and how and when to access care was highlighted. Conclusions: Use of BsAbs in the community requires thoughtful coordination between oncology practices and hospitals. Keys to success include defining flexible, practice-specific workflows for managing CRS, transitioning patients efficiently from clinic to inpatient setting, and careful training of staff, patients, and caregivers. [Table: see text]

Requirements Gathering for Building a Hospital Queuing Dashboard and Automatic Voice Dialing

This research analyzes how the queuing process currently occurs at Porsea Hospital which still uses a manual system and to analyze how this system can influence the effectiveness of the queuing process between patients and the hospital administration. The focus of this research is to build a tool called the hospital queue dashboard and automatic voice dialing. Data collection was carried out using qualitative methods and through descriptive data analysis using archival research techniques. With archival research, ten journals were studied as references in building the system. The results obtained from the journals studied are that changes are still needed in the system used to overcome the current queues, considering that the tools used in the system are still less efficient in their use for patients and administration. Therefore, researchers will build a system called hospital queue dashboard and automatic voice dialing using components consisting of a 16 x 4 LCD as a dashboard to display queue numbers and patient queue status, an Arduino speaker as a caller for patient queue numbers and using buttons as buttons. the input that the patient will press to receive the desired output. which will be used to overcome queuing problems that occur in hospitals and overcome inefficient queuing processes. It is hoped that this system can be a solution in overcoming the queuing process in hospitals and can increase efficiency and comfort between patients and hospital administration in the queuing process.

The risk of repeated suicidal presentations following residential treatment for substance use disorders: A recurrent event analysis using linked administrative data

BackgroundIndividuals seeking alcohol and other drug (AOD) treatment consistently experience higher rates of suicidal behaviours and death by suicide when compared to the general population. By linking residential AOD treatment data to administrative healthcare and death datasets, we aimed to examine suicide-related behaviours and identify risk and protective factors for these events following discharge from residential treatment. MethodsParticipants included 1056 individuals aged 18–69 (M = 32.06, SD = 9.55, male = 696,65.9 %) admitted to three residential treatment facilities in Queensland, Australia from January 1, 2014 to December 31, 2016. Treatment data was linked to administrative hospital, emergency department (ED), mental health service, and Registry of Deaths data 2-years post-discharge. ICD-10 codes were used to identify and analyse suicide-related events. ResultsWithin 2-years post-discharge, 175 (16.6 %) individuals had a suicide-related event (n = 298 episodes). The highest proportion of episodes (11.1 %) occurred within 1-month of discharge. Higher risk of a recurrent suicide-related event was associated with receiving a Disability Support Pension (aHR = 1.69 (95%CI:1.10,2.59), two or more previous episodes of residential AOD treatment (aHR = 1.49 (95%CI:1.30,2.15). Completing residential treatment was associated with a lower risk of suicide-related events (aHR = 0.54 (95%CI:0.35,0.83). LimitationsThe amalgamation of suicidal ideation, attempts, and death into a single outcome oversimplifies their complex nature and interplay. The exclusive focus on one service provider limits generalisability, and data constraints and missingness preclude many analyses. ConclusionsUnderstanding suicidal behaviours and critical risk periods following discharge from residential treatment is crucial for improving continuing care, developing effective suicide prevention, and implementing targeted interventions among this high-risk population.

Do mid‐level providers enhance hospital cost per discharge or triple aim performance efficiency? An exploratory analysis

AbstractHospital administrators are shifting care delivery models toward an approach that uses more caregivers in the form of mid‐level providers (MLPs), such as nurse practitioners, physician assistants, and clinical nurse specialists. To date, however, healthcare operations management (OM) literature remains ambiguous about longitudinal empirical associations between mid‐level providers and hospital costs, quality, and other performance measures. We analyze how the extent of MLP employment used by a hospital is associated with hospital operational outcomes, as reflected by hospital cost per discharge and Triple Aim Performance (TAP) efficiency metrics. Our findings indicate percent MLP usage is positively associated with efficiency metrics for hospital clinical quality, technical efficiency, and patient experience, but not associated with hospital costs. We also find percent MLP usage is associated with the likelihood that hospitals excel on all TAP metrics simultaneously. Post‐hoc exploratory analyses suggest the associations exhibit differential outcomes across hospital efficiency quantiles, while sub‐sample analyses motivate boundary conditions for some hypothesized MLP associations. We contribute to healthcare OM research by providing one of the first panel data analyses of MLPs, improving insights relative to extant work. By giving key stakeholders useful findings about outcomes associated with hospital staffing trends, our managerial contribution helps hospital administrators understand empirical consequences of the increasing use of MLPs.

Moral Distress, Burnout, Turnover Intention, and Coping Strategies among Korean Nurses during the Late Stage of the COVID-19 Pandemic: A Mixed-Method Study

The COVID-19 pandemic has exacerbated the difficulties nurses face, resulting in higher turnover rates and workforce shortages. This study investigated the relationships between nurses’ moral distress, burnout, and turnover intention during the last stage of the COVID-19 pandemic. It also explored the coping strategies nurses use to mitigate moral distress. Utilizing a mixed-method approach, this study analyzed data from 307 nurses caring for patients with COVID-19 in acute care hospitals through an online survey conducted in November 2022. Our data analysis encompassed quantitative methods, including descriptive statistics and path analysis, using a generalized structural equation model. For the qualitative aspect, we examined open-ended responses from 246 nurses using inductive content analysis. The quantitative findings revealed that nurses’ moral distress had a significant direct effect on turnover intention. In addition, burnout significantly mediated the relationship between moral distress and turnover intention. Qualitative analyses contextualized the relationships uncovered in the quantitative analyses. The qualitative analysis identified various positive and negative coping strategies. Positive strategies included a commitment to minimize COVID-19 transmission risks, adopting a holistic approach amidst the challenges posed by the pandemic, voicing concerns for patient safety, engaging in continuous learning, and prioritizing self-care. Conversely, negative strategies involved adopting avoidance behaviors stemming from feelings of powerlessness and adopting a passive approach to one’s role. Notably, some participants shifted from positive to negative coping strategies because of institutional barriers and challenges. The findings underscore the importance for hospital administrators and nurse managers to acknowledge the impact of the pandemic-related challenges encountered by nurses and recognize the link among moral distress, burnout, and turnover intention. It highlights the essential role of organizational and managerial support in fostering effective coping strategies among nurses to address moral distress.

Service mix and financial performance in rural hospitals: A contingency theory perspective.

Rural hospitals are increasingly at risk of closure. Closure reduces the availability of hospital care in rural areas, resulting in a disparity in health between rural and urban citizens, and it has broader economic impacts on rural communities as rural hospitals are often large employers and are vital to recruiting new businesses to a community. To combat the risk of closure, rural hospitals have sought partnerships to bolster financial performance, which often results in a closure of services valuable to the community, such as obstetrics and certain diagnostic services, which are viewed as unprofitable. This can lead to poor health outcomes as community members are unable to access care in these areas. In this article, we explore rural hospital service offerings and financial performance, with an aim to illuminate if specific service offerings are associated with positive financial performance in a rural setting. Our study used hospital organization data, as well as county-level demographics with periods of analysis from 2015 and 2019. We employed a pooled cross-sectional regression analysis with robust standard errors examining the association between total margin and service lines among rural hospitals in the United States. The findings suggest that some services deemed unprofitable in urban and suburban hospital settings-such as obstetrics and drug/alcohol rehabilitation-are associated with higher margins in rural hospitals. Other unprofitable service lines-such as psychiatry and long-term care-are associated with lower margins in rural hospitals. Our results suggest the need of rural hospitals to choose services that align with environmental circumstances to maximize financial performance. Hospital administrators in rural settings need to take a nuanced look at their environmental and organizational specifics when deciding upon the service mix. Generalizations regarding profitability should be avoided to maximize financial performance.

Inadequate sanitation in healthcare facilities: A comprehensive evaluation of toilets in major hospitals in Dhaka, Bangladesh.

Lack of access to functional and hygienic toilets in healthcare facilities (HCFs) is a significant public health issue in low- and middle-income countries (LMICs), leading to the transmission of infectious diseases. Globally, there is a lack of studies characterising toilet conditions and estimating user-to-toilet ratios in large urban hospitals in LMICs. We conducted a cross-sectional study in 10-government and two-private hospitals to explore the availability, functionality, cleanliness, and user-to-toilet ratio in Dhaka, Bangladesh. From Aug-Dec 2022, we undertook infrastructure assessments of toilets in selected hospitals. We observed all toilets and recorded attributes of intended users, including sex, disability status, patient status (in-patient/out-patient/caregiver) and/or staff (doctor/nurse/cleaner/mixed-gender/shared). Toilet functionality was defined according to criteria used by the WHO/UNICEF Joint-Monitoring Programme in HCFs. Toilet cleanliness was assessed, considering visible feces on any surface, strong fecal odor, presence of flies, sputum, insects, and rodents, and solid waste. Amongst 2875 toilets, 2459 (86%) were observed. Sixty-eight-percent of government hospital toilets and 92% of private hospital toilets were functional. Only 33% of toilets in government hospitals and 56% in private hospitals were clean. A high user-to-toilet ratio was observed in government hospitals' outpatients service (214:1) compared to inpatients service (17:1). User-to-toilet ratio was also high in private hospitals' outpatients service (94:1) compared to inpatients wards (19:1). Only 3% of toilets had bins for menstrual-pad disposal and <1% of toilets had facilities for disabled people. A high percentage of unclean toilets coupled with high user-to-toilet ratio hinders the achievement of SDG by 2030 and risks poor infection-control. Increasing the number of usable, clean toilets in proportion to users is crucial. The findings suggest an urgent call for attention to ensure basic sanitation facilities in Dhaka's HCFs. The policy makers should allocate resources for adequate toilets, maintenance staff, cleanliness, along with strong leadership of the hospital administrators.

Need for education of psychiatric evaluation of offenders with mental disorders: A questionnaire survey for Japanese designated psychiatrists.

The management of offenders with mental disorders has been a significant concern in forensic psychiatry. In Japan, the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue. However, numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization (AIH) scheme, which lacks clarity and updated standards. To explore current as well as optimized learning strategies for risk assessment in AIH decision making. We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders. The findings of this study's survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training. This underscores the pressing need for structured training protocols in AIH consultations. Moreover, feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

Development and validation of a short clinical risk management implementation (Short CRiMI) questionnaire

Clinical Risk Management (CRM) is an important instrument to continuously improve safety of health care delivery. In Germany, hospitals are required by law to implement CRM and incidence reporting systems. Since 2010, nation-wide surveys have been conducted periodically to evaluate implementation of CRM in hospitals. The instrument used in these surveys is constantly being updated to reflect previous experiences, as well as to adapt to ongoing trends and developments in CRM practices. The survey instrument used in 2022 consisted of up to 200 items and took up to an hour to complete. In this study, we aimed to develop a short instrument to measure the level of CRM implementation in hospitals, evaluate its psychometric properties, and to offer benchmarking data for health care facilities of different sizes.We used data collected in 2022 as part of KHaSiMiR study, employing a cross-sectional self-reported online survey. The hospital administrations were invited to designate one CRM manager to participate in the study. Out of 1,411 general hospitals invited, 401 responses were collected (response rate of 28%). After removing the cases with excessive missings, we imputed remaining missing values using multiple imputation, and split the resulting sample (n=362) in two halves (i.e., exploratory and testing subsamples). A principal component analysis was applied on the first subsample. We validated the resulting model using confirmatory factor analysis in the testing subsample. We evaluated internal consistency, and tested external validity of the established instrument using correlation analysis with two single-item measures: subjective evaluation of CRM implementation compared to similar organizations and compared to own ideal level. The principal component analysis included 45 items from the full instrument. The analysis resulted in a three-factor model with 26 items. In the confirmatory factor analysis, the model demonstrated acceptable fit with the data according to the commonly used fit indices: Chi2/df=1.36, CFI=0.941, TLI=0.930, RMSEA=0.045 (90% CI=0.032–0.056), SRMR=0.049. Cronbach’s alpha of all three factors was good (>0.70). All three factors had statistically significant positive correlations with each other (0.359–0.497) and with the two single items (0.282–0.532). None of the correlations were high enough (>0.7) to indicate multicollinearity.The proposed short clinical risk management implementation (Short CRiMI) questionnaire is psychometrically valid and can be used to rapidly evaluate CRM implementation in hospitals. Further research can provide evidence of its external validity and association with quality and safety outcomes. Benchmarking data can be used to compare the results with the data from the most recent Germany-wide survey.

A Comparison of Ukrainian Hospital Services and Functions Before and During the Russia-Ukraine War

Since the full-scale Russian invasion, hospitals in Ukraine have been compelled to close or operate at reduced capacity due to inadequate supplies, damage, or destruction caused by war. To analyze hospital services in Ukraine during the period before and after the Russian invasion. Of the 450 hospitals currently functioning in Ukraine, a cross-sectional survey was carried out with the participation of 74 hospitals from 12 oblasts. Hospital administrators responded to an online survey with questions on the use of hospital services. Data were abstracted from hospital databases for the prewar period (before February 23, 2022) and during the war (February 23, 2022, to May 30, 2023). Hospital services (including emergency services, preventive services, screenings, laboratory tests, obstetrics, telehealth, pharmacy, and rehabilitation services) were compared during the prewar and war periods. Of 450 Ukrainian hospitals in operation, 74 hospitals (16.0%) across 12 oblasts provided data for the current analyses. During the war, daily emergency admissions increased to 2830, compared with 2773 before the war. At the same time, hospitals reported reduced laboratory testing (72 [97%] vs 63 [85%]), tobacco education (52 [70%] vs 36 [49%]), cancer screening (49 [66%] vs 37 [50%]), gynecological services (43 [58%] vs 32 [43%]), rehabilitation services (37 [50%] vs 27 [36%]), pharmacy services (36 [49%] vs 27 [36%]), and telehealth programs (33 [45%] vs 21 [28%]). Hospitals reported additional difficulties during the war, including disruptions in the supply chain for essential equipment and pharmaceuticals, shortages of laboratory test kits, delays in the delivery of crucial medications, and problems around appropriate medication storage due to power outages. The ongoing war has inflicted profound devastation on Ukraine's hospitals. The findings of this cross-sectional survey offer valuable insights into the formidable challenges that hospitals confront in war-affected regions and underscore the pressing necessity for bolstering support to sustain and enhance hospital services during wartime.

Adaptive Ambulance Management System

The ability to quickly and accurately retrieve information is essential for emergency medical response. This project integrates biometric technology and web applications to offer a comprehensive solution for improving emergency medical services. Our approach starts with the use of a fingerprint scanner, which records information on patients and guardians and links it to distinctive fingerprints. A Node MCU processes and stores this data, making it possible to quickly and securely identify patients in urgent situations. The Node MCU displays patient information on an LCD panel as soon as they provide their fingerprint. Both ambulance drivers and hospital administration have access to a user-friendly web application simultaneously. The software gives users access to a database of nearby hospitals that is divided into public and private facilities. Soon, the selected hospital will be informed about the patient condition and able to make the treatment arrangements earlier. The patient's preferences and the resources at their disposal can help ambulance crew make wise selections. Ambulance crew have two selection buttons, one is government hospital selection button and another is private hospital selection button. By reducing response times, this function improves patient care. In order to safeguard sensitive patient data, the project places a strong emphasis on data security and privacy. Our goal is to maximize emergency medical response through this integrated system, ensuring that patients receive prompt and efficient care when it counts.