Improve Health Care Delivery Research Articles

Social Acceptance of Mobile Health Technologies Among the Young Population in Nigeria

Mobile devices are widely used in modernizing healthcare delivery because of their unique features related to accessibility, virtual interaction, and connectivity. While developing countries, with limited resources, strive to achieve high healthcare standards, and mobile health (mHealth) solutions could transform healthcare delivery systems in these countries, their functionality is currently limited. This study investigates the potential systematic introduction of mHealth services and their social acceptability in developing countries, with a particular focus on Nigeria. This cross-sectional study was conducted with a sample of university students. Structural equation modeling was used to test the study hypotheses, and descriptive statistics were used to analyze the sociodemographic characteristics of the participants. Psychological and personal characteristics, environmental characteristics, and conditions of use associated with mHealth technology adoption were examined based on eight constructs (health consciousness, trust, social influence, perceived risk, performance expectancy, facilitating conditions, effort expectancy, and behavioral intention). The results indicate that trust and performance expectancy are significant predictors of mHealth acceptance in the surveyed population. The future acceptance of mHealth among young people in developing countries holds great significance for improving healthcare delivery, addressing the unique challenges faced by developing countries, and leveraging the preferences of young individuals, which could contribute to the advancement of mHealth solutions and enhance healthcare accessibility. The findings shed light on the acceptance of mHealth technologies among the young populations of developing countries, with implications for future efforts to improve healthcare delivery and address the healthcare challenges of these countries.

Understanding IT in Healthcare: Relevance and Training Needs of IT in Private Medical Practice.

The integration of Information Technology (IT) into private medical practice is crucial in modern healthcare. Physicians managing office-related IT without proper knowledge risk operational inefficiencies and security. This study determines the relevance of specific IT topics in medical practice and identifies the training needs of physicians for enhancing IT competencies in healthcare. In March 2023 a cross-sectional online survey was conducted with physicians comprising nine IT-related topics in Tyrol, Austria. The survey results highlighted a strong perceived relevance and high demand for IT education among physicians working in their medical practice, especially in areas of core medical IT and security. The majority of responses indicated high relevance (76.7%) and high demand (69.7%) for IT topics in medical practice. The findings underscore a significant need for targeted IT training and support in medical practices, particularly in areas related to the medical practice and security. Addressing these needs could lead to improved healthcare delivery and better management of technological resources in the healthcare sector.

Accuracy of Artificial Intelligence-Based Virtual Assistants in Responding to Frequently Asked Questions Related to Orthognathic Surgery

BackgroundDespite increasing interest in how conversational agents might improve healthcare delivery and information dissemination, there is limited research assessing the quality of health information provided by these technologies, especially in orthognathic surgery (OGS). PurposeThis study aimed to measure and compare the quality of four virtual assistants (VA) in addressing the frequently asked questions about OGS. Study design, setting, and sampleThis in-silico cross-sectional study, assessed the responses of a sample of four VAs through a standardized set of 10 questionnaires related to OGS. Independent variableThe independent variables were the four VAs. The four VAs tested were VA1: Alexa (Seattle, Washington), VA2: Google Assistant (Google Mountain View, California), VA3: Siri (Cupertino, California), and VA4: Bing (San Diego, California). Main outcome variablesThe primary outcome variable was the quality of the answers generated by the four VAs. Four investigators (two orthodontists and two oral surgeons) assessed the quality of response of the four VAs through a standardized set of 10 questionnaires using a five-point modified Likert scale, with the lowest score (1) signifying the highest quality. The main outcome variables measured were the combined mean scores of the responses from each VA, and the secondary outcome assessed was the variability in responses among the different investigators. CovariatesNone AnalysisOne-way analysis of variance (ANOVA) was done to compare the average scores per question. One-way ANOVA followed by Tukey's post-hoc analyses was done to compare the combined mean scores among the VAs and the combined mean scores of all questions were evaluated to determine variability if any amongst different VA’s responses to the investigators. ResultsAmong the four VAs, VA4 (1.32 ± 0.57) had significantly the lowest (best) score, followed by VA2 (1.55±0.78), VA1 (2.67±1.49), and VA3 (3.52±0.50) (p-value<0.001). There were no significant differences in how the VAs: VA3 (p-value = 0.46), VA4 (p-value = 0.45), and VA2 (p-value = 0.44) responded to each of the investigators except VA1 (p-value = 0.003). ConclusionsThe VAs responded to the queries related to OGS, with VA4 displaying the best quality response, followed by VA2, VA1, and VA3. Technology companies and clinical organizations should partner for an intelligent VA with evidence-based responses specifically curated to educate patients.

Factors and Reasons Associated With Appointment Non-attendance in Hospitals: A Narrative Review.

Non-attendance at hospital appointments is an extremely prevalent issue impacting healthcare systems on a daily basis. This phenomenon adversely affects patient health and healthcare providers, leading to delays in diagnosis and treatment, inefficient resource utilization, and increased healthcare expenses. The detrimental impact of non-attendance is not limited to patients who miss appointments, the knock-on effects of extended waiting times and reduced appointment availability are felt throughout healthcare systems. The purpose of this narrative review is to explore the factors underlying appointment non-attendance in hospital settings, to improve healthcare delivery and patient adherence. An extensive review of the existing global literature was conducted. Quantitative studies that explored the relationship between appointment non-attendance and patient characteristics, such as age, gender, marital status, education level, distance from the hospital, and source of referral, were included. Younger patients, males, individuals with lower levels of education, and those living farther from hospitals were more likely to miss appointments. Marital status was significant, with married patients showing better attendance, as was referral source, with general practitioner referrals associated with higher non-attendance. Qualitative studies identifying both patient-centered and hospital-specific reasons, such as forgetfulness, appointment time, protracted waiting times, patient-physician relationship, and patients' knowledge and perception of their health condition, were also included in the review. Lack of appointment reminders, difficulties in managing appointments, and inadequate patient-physician communication were significant hospital-specific reasons given for non-attendance. Patients' lack of awareness regarding the importance of attending appointments and limited understanding of their health conditions were also identified as patient-centered contributors. Non-attendance at hospital appointments is a multifaceted issue influenced by a range of socioeconomic, personal, and systemic factors. Addressing these factors requires a holistic approach that includes patient education, improved communication, and tailored healthcare delivery strategies, especially for vulnerable populations in rural areas. Enhanced reminder systems and streamlined appointment management could serve as pivotal interventions to reduce non-attendance rates, ultimately improving healthcare outcomes and resource utilization.

European Health Data Space – Is the Proposed Certification System Effective against Cyber Threats?

Abstract The proposal for a European Health Data Space aims at creating a common space where individuals may control their health data in a trusted and secure way. The objective is not only improving healthcare delivery, but also enhancing the opportunities to use health data for research and innovation. To achieve these results, the proposal implements a mandatory self-certification scheme for European health records systems as well as for wellness devices and applications, setting up essential requirements related to interoperability and security. Although this is the first intervention that sets a horizontal framework that is mandatory for all Member States, the security requirements that are included in the legislative proposal are not sufficiently detailed and comprehensive. Given that cyberthreats are increasing and security incidents affecting health data may potentially have an impact on the lives of patients, it is important that cybersecurity measures are adopted and implemented in the most effective way. The paper will analyse the European Health Data Space proposal pointing to the open issues and doubts that may be emerging and it will compare them with the proposed Cyber Resilience Act, identifying the issues that may be solved thanks to this horizontal regulation and the ones that instead remain open.

Increasing Underrepresented Minority Representation in a General Surgery Residency Program Utilizing a 3-Phase Strategy.

Underrepresented minority groups (URMs) in surgery are not significantly increasing despite evidence suggesting that diversity in health care providers leads to excellent patient outcomes and care. Efforts to increase URM representation in surgical residency programs are essential for addressing disparities and improving health care delivery. This retrospective study outlines a three-phase strategy implemented at a large academic-affiliated hospital to increase URM representation in its general surgery residency program. The strategy encompassed interview selection with a holistic review and implicit bias training for interviewers, modification of the interview scoring rubric, and post-interview recruitment efforts, including a virtual second look event for URM applicants. Following the implementation of these strategies, the URM match rate improved from 0 to 33.3% in the first year and was sustained at 33.3% in the subsequent year. Consequently, the representation of URMs in the residency program rose from 6.7% before our intervention to 13.3% afterwards. This structured approach successfully increased URM representation in a surgical residency program, affirming the success of targeted recruitment strategies. By promoting a diverse and inclusive environment, the program better reflects the community it serves, with aims at improved patient care and patient satisfaction.

Dyadic care to improve postnatal outcomes of birthing people and their infants: A scoping review protocol.

Dyadic care, which is the concurrent provision of care for a birthing person and their infant, is an approach that may improve disparities in postnatal health outcomes, but no synthesis of existing dyadic care studies has been conducted. This scoping review seeks to identify and summarize: 1) dyadic care studies globally, in which the birthing person-infant dyad are cared for together, 2) postnatal health outcomes that have been evaluated following dyadic care interventions, and 3) research and practice gaps in the implementation, dissemination, and effectiveness of dyadic care to reduce healthcare disparities. Eligible studies will (1) include dyadic care instances for the birthing person and infant, and 2) report clinical outcomes for at least one member of the dyad or intervention outcomes. Studies will be excluded if they pertain to routine obstetric care, do not present original data, and/or are not available in English or Spanish. We will search CINAHL, Ovid (both Embase and Medline), Scopus, Cochrane Library, PubMed, Google Scholar, Global Health, Web of Science Core Collection, gray literature, and WHO regional databases. Screening will be conducted via Covidence and data will be extracted to capture the study design, dyad characteristics, clinical outcomes, and implementation outcomes. The risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal Tool. A narrative synthesis of the study findings will be presented. This scoping review will summarize birthing person-infant dyadic care interventions that have been studied and the evidence for their effectiveness. This aggregation of existing data can be used by healthcare systems working to improve healthcare delivery to their patients with the aim of reducing postnatal morbidity and mortality. Areas for future research will also be highlighted. This review has been registered at Open Science Framework (OSF, https://osf.io/5fs6e/).

Bridging the gap: How investing in advanced practice nurses could transform emergency care in Africa.

This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.

Parental satisfaction with neonatal intensive care unit services and associated factors in Ethiopia: systematic review and meta-analysis

BackgroundIn the context of healthcare, satisfaction is the attainment of adequate or acceptable treatment and serves as both a benchmark for quality and the ultimate objective of providing care. In neonatal care facilities, parent satisfaction is a key measure of the quality of the services offered to the newborns and aids in improving healthcare delivery. This is the first systematic review aiming to address critical knowledge gaps regarding factors influencing parental satisfaction with neonatal intensive care unit services, and determine pooled prevalence in Ethiopia.MethodsAfter comprehensive systematic search for full texts in the English language through an electronic web-based search strategy from databases of PubMed, CINAHL, Embase, African Journals Online, PsycINFO, and Google Scholar, included a total of 8 articles. Checklists from the Joanna Briggs Institute were used to assess the studies’ quality of methodology. STATA version 14 software for windows was used for all statistical analyses and meta-analysis was done using a random-effects method. Subgroup and sensitivity analyses were performed to clarify the source of heterogeneity.ResultsPooled national level of parents’ satisfaction with neonatal intensive unit service was 57.87% (95% CI (49.99, 65.75%)). Age of respondents and availability of chair were significantly associated with parents’ satisfaction with neonatal intensive unit service.Conclusions and recommendationIn our review we found that nearly half of parents expressed dissatisfaction with neonatal intensive unit service, which is high. Age of respondents and availability of chair in neonatal intensive unit waiting area were significantly associated with neonatal intensive unit service. Efforts to enhance parental satisfaction with neonatal intensive unit services are crucial, given that nearly half of parents reported dissatisfaction. Necessary infrastructure should be fulfilled to increase parental satisfaction with neonatal intensive unit service.(PROSPERO) International prospective register of systematic reviews:CRD42023483474

Equity and Justice in Family Medicine Clinical Care and Teaching Must Incorporate a Reproductive Justice Framework.

Since European settlement, the United States has controlled the reproduction of communities of color through tactics ranging from forced pregnancies, sterilizations, and abortions to immigration policies and policies that separate children from their families. Lesbian, gay, bisexual, transgender, queer (or questioning), asexual, intersex, and gender diverse people (LGBTQIA+) have been persecuted for sexual behavior and gender expression, and also restricted from having children. In response, women of color and LGBTQIA+ communities have organized for Reproductive Justice (RJ) and liberation. The Reproductive Justice framework, conceived in 1994 by the Women of African Descent for Reproductive Justice, addresses the reproductive health needs of Black women and communities from a broad human rights perspective. Since then, the framework has expanded with an intersectional approach to include all communities of color and LGBTQIA+ communities. Notwithstanding, reproductive injustice negatively impacts the health of already marginalized and oppressed communities, which is reflected in higher rates of maternal mortality, infant mortality, infertility, preterm births, and poorer health outcomes associated with race-based stress. While the impact of racial injustice on disparate health outcomes is increasingly addressed in family medicine, Reproductive Justice has not been universally incorporated into care provision or education. Including the RJ framework in family medicine education is critical to understanding how structural, economic, and political factors influence health outcomes to improve health care delivery from a justice and human rights perspective. This commentary describes how an RJ framework can enhance medical education and care provision, and subsequently identifies strategies for incorporating Reproductive Justice teaching into family medicine education.

A Randomized Controlled Trial of a Pay-for-Performance Initiative to Reduce Costs of Care for High-Need Psychiatric Patients.

Pay-for-performance (P4P) initiatives hold promise for improving health care delivery but are rarely applied to behavioral health or tested in randomized controlled trials (RCTs). This RCT examined the effectiveness of a P4P initiative to reduce total cost of 24-hour care among patients with high needs for psychiatric care in a large county in California. From August 2016 to March 2022, a total of 652 adult residents of Santa Clara County, California, were enrolled in a P4P initiative (mean±SD age=46.7±13.3 years, 61% male, 51% White, and 60% diagnosed as having a bipolar or psychotic disorder). Participants were randomly assigned to usual full-service partnerships from the county (N=327) or a comparable level of care from a contractor who agreed to a schedule of financial penalties and rewards based on whether enrollees (N=325) used more or less care than a historical cohort of similar county patients. The primary outcome was total cost of 24-hour psychiatric services. Secondary outcomes were costs of each of the 24-hour care services. The proportion of the total sample that used 24-hour psychiatric services decreased over the 36-month study period. Intent-to-treat analyses revealed no differences between the two study conditions in total care costs during the follow-up period. No significant care utilization differences were observed between the two conditions in most of the individual 24-hour services. A P4P initiative for high-need patients was no more effective than usual care for reducing costs of 24-hour psychiatric care.

IJCM_245A: Beyond the Basics: Insights into Pharmacovigilance Literacy among Postgraduate Medical students: A Mixed-Methods study from central India.

Background: Pharmacovigilance ensures medical intervention safety by detecting, assessing, understanding, and preventing adverse drug effects or related issues. As the guardians of patient well-being, healthcare professionals, particularly postgraduate medical students, are integral contributors to the pharmacovigilance landscape. Understanding their knowledge, attitudes, and practices in this domain is essential for fostering a culture of drug safety and continuous improvement in healthcare delivery. The present study aspires to identify potential gaps in awareness, uncover barriers to active participation in pharmacovigilance activities, and, ultimately, offer insights that can inform targeted educational interventions. Objectives: To assess the knowledge levels of postgraduate medical students regarding pharmacovigilance, to examine their attitudes towards reporting adverse drug reactions, and explore the practical application of pharmacovigilance principles in their clinical practice. Additionally, the study aimed to identify potential barriers and facilitators influencing their engagement with pharmacovigilance activities. Methodology: This research adopted a mixed-method approach, combining quantitative and qualitative techniques to provide a comprehensive understanding of the subject matter. In Qualitative phase the focused group discussion has been undertaken followed by developing the questionnaire which after validation was used for quantitative data collection. The study population comprised postgraduate medical students from the tertiary care institute of central India. Data analysis involved thematic analysis for qualitative data and statistical techniques for quantitative data. Results: It was observed that the knowledge of the participants regarding ADR reporting and pharmacovigilance was poor. Conclusion: Various barriers regarding ADR reporting were identified, and appropriate interventions were suggested by the participants.

Decoding the persistence of delayed hospital discharge: An in-depth scoping review and insights from two decades.

This article addresses the persistent challenge of Delayed Hospital Discharge (DHD) and aims to provide a comprehensive overview, synthesis, and actionable, sustainable plan based on the synthesis of the systematic review articles spanning the past 24 years. Our research aims to comprehensively examine DHD, identifying its primary causes and emphasizing the significance of effective communication and management in healthcare settings. We conducted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) method for synthesizing findings from 23 review papers published over the last two decades, encompassing over 700 studies. In addition, we employed a practical and comprehensive framework to tackle DHD. Rooted in Linderman's model, our approach focused on continuous process improvement (CPI), which highlights senior management commitment, technical/administrative support, and social/transitional care. Our proposed CPI method comprised several stages: planning, implementation, data analysis, and adaptation, all contributing to continuous improvement in healthcare delivery. This method provided valuable insights and recommendations for addressing DHD challenges. Our DHD analysis revealed crucial insights across multiple dimensions. Firstly, examining causes and interventions uncovered issues such as limited discharge destinations, signaling unsustainable solutions, and inefficient care coordination. The second aspect explored the patient and caregiver experience, emphasizing challenges linked to staff uncertainty and negative physical environments, with notable attention to the underexplored area of caregiver experience. The third theme explored organizational and individual factors, including cognitive impairment and socioeconomic influences. The findings emphasized the importance of incorporating patients' data, recognizing its complexity and current avoidance. Finally, the role of transitional and social care and financial strategies was scrutinized, emphasizing the need for multicomponent, context-specific interventions to address DHD effectively. This study addresses gaps in the literature, challenges prevailing solutions, and offers practical pathways for reducing DHD, contributing significantly to healthcare quality and patient outcomes. The synthesis introduces the vital CPI stage, enhancing Linderman's work and providing a pragmatic framework to eradicate delayed discharge. Future efforts will address practitioner consultations to enhance perspectives and further enrich the study. Our scoping review synthesizes and analyzes existing systematic review articles and emphasizes offering practical, actionable solutions. While our approach does not directly engage patients, it strategically focuses on extracting insights from the literature to create a CPI framework. This unique aspect is intentionally designed to yield tangible benefits for patients, service users, caregivers, and the public. Our actionable recommendations aim to improve hospital discharge processes for better healthcare outcomes and experiences. This detailed analysis goes beyond theoretical considerations and provides a practical guide to improve healthcare practices and policies.

133 Research in Action: Engaging Clinicians to Advance the Academic Learning Health System

OBJECTIVES/GOALS: Research in Action is an on-demand, interactive curriculum designed to increase the ability of clinicians to advance the Academic Learning Health System (aLHS). The 7-module course provides clinicians with the knowledge and skills to lead rigorous quality improvement (QI) projects, translating research evidence into practice. METHODS/STUDY POPULATION: We engaged nurses, physicians, and advanced practice providers (APPs) working in the health system to participate in focus group and advise us in the creation of the curriculum. We conducted focus groups with these stakeholders on the proposed learning objectives, course content, and mode of delivery (in person, virtual, hybrid). Informed by the focus groups, the course was designed for hybrid format so participants could either (1) access the modules on-demand, or (2) learners could participate in a facilitator moderated course where the modules served as the curriculum to guide development of a QI project. The Iowa Model of Evidence-Based Practice was the framework for curriculum development. Upon completion of the modules, stakeholders reviewed each module and provided feedback for improvement. RESULTS/ANTICIPATED RESULTS: Research in Action is a 7-module course, with modules addressing the following topics: (1) Introduction to Quality Improvement, (2) Identify the Problem and Write a Purpose Statement, (3) Form a Team, (4) Appraise and Synthesize the Literature, (5) Design and Pilot the Project, (6) Integrate and Sustain Practice Change, (7) Disseminate the Results. The curriculum is being piloted with multiple clinician groups in the health system. In the next phase of development, a facilitator guide will be created to guide a cohort of clinicians to apply knowledge through discussion sessions and completion of a QI project in the healthcare setting. We anticipate scaling the program for spread to diverse clinician groups in the health system. Pre- and post-implementation data are being collected from current pilot sites. DISCUSSION/SIGNIFICANCE: The aLHS is an essential means for improving healthcare delivery. Research in Action, a hybrid training curriculum, engages frontline clinicians in creating and leading QI projects that implement research evidence into practice to solve problems commonly encountered in the healthcare setting; thus, supporting the advancement of the aLHS.

Facing the challenges of gynaecological endoscopic surgical practice in Nigeria: A review

Background: The scope of gynaecological endoscopy in Nigeria is expanding as more experience is gained with training and collaborations. However, this advancement is limited by multi-faceted challenges, especially in our sub region. Objectives: To evaluate the experiences and challenges of gynaecologic endoscopic surgical practice in Nigeria. Materials and Methods: An electronic literature search of all articles published on gynaecologic endoscopic surgery in Nigeria between 1984 and 2023 was conducted using High wire, Google, Google scholar, PubMed, Hinari, Web of Science and Springer Link. All relevant peer-reviewed articles and publications were identified, retrieved, and reviewed. Telephone and face-to-face interviews with Endoscopic surgeons from public and private institutions across the country were conducted as it related to challenges and experiences of practice. Data was collated in a pre-structured spreadsheet and analyzed with the Statistical Package for Social Science version 25. Results are presented as frequency tables and percentages. Results: The study identified lack of public awareness, socio-cultural, economic, low budgetary allocation to healthcare, decline in national infrastructure, conflict, and insecurity as non-institutional challenges. The institutional challenges reported were limited number of public institutions offering gynaecological endoscopic services, with practice more in private hospitals. Conclusion: Gynaecological endoscopic practice is largely suboptimal due to limited facilities and personnel, as well as a lack of political will. Efforts should be made to address these challenges and to proffer potential solutions that will improve healthcare delivery to women.

The Role of Artificial Intelligence in the Identification and Evaluation of Bone Fractures.

Artificial intelligence (AI), particularly deep learning, has made enormous strides in medical imaging analysis. In the field of musculoskeletal radiology, deep-learning models are actively being developed for the identification and evaluation of bone fractures. These methods provide numerous benefits to radiologists such as increased diagnostic accuracy and efficiency while also achieving standalone performances comparable or superior to clinician readers. Various algorithms are already commercially available for integration into clinical workflows, with the potential to improve healthcare delivery and shape the future practice of radiology. In this systematic review, we explore the performance of current AI methods in the identification and evaluation of fractures, particularly those in the ankle, wrist, hip, and ribs. We also discuss current commercially available products for fracture detection and provide an overview of the current limitations of this technology and future directions of the field.

Multilingual Medical Language Models: A Path to Improving Lay Health Worker Effectiveness (Student Abstract)

The COVID-19 pandemic has exacerbated the challenges faced by healthcare delivery in developing nations, placing additional strain on already fragile infrastructure and healthcare systems. This has prompted an increased reliance on lay healthcare workers (LHWs) to meet the surging demand for services. Due to limited formal training, many LHWs have resorted to using unreliable sources, such as internet searches, to access medical information. Large language models (LLMs) offer a promising opportunity to support LHWs by providing accurate, context-sensitive information for improving healthcare delivery, provided they are appropriately fine-tuned on domain-specific multilingual data. This paper delves into critical issues and presents potential solutions for developing LLM-powered virtual assistants tailored to LHWs serving Telugu and Hindi-speaking populations. Key focal points include the customization of language and content to suit local contexts, the integration of feedback mechanisms to continuously enhance assistance quality, and the delicate balance between automation and human oversight.

Abstract 3468: Emerging lessons from patient-reported hospital discharge experiences among hospitalized cancer patients with frequent emergency department use

Abstract Background: While teamwork is essential to providing high-quality patient-centered care, challenges in interprofessional collaboration and decision-making in the hospital settings are common, especially for cancer patients. The purpose of this study was to identify emerging themes related to hospital discharge experiences among patients hospitalized for cancer who became frequent emergency department (ED) users following their hospital discharge. Design &amp; Methods: A cohort of cancer patients discharged from an academic health center in Montreal (Canada) between October 2014 and November 2016 was assembled. Frequent ED (FED) users were identified as patients who had a &amp;gt; 4 ED visits in the year following hospital discharge using health administrative claims from the provincial universal health care program. Qualitative analysis of telephone interviews conducted with patients 30 days’ post-discharge were used for in-depth exploratory analyses to characterize hospital discharge experiences and transition process from the hospital to the community. Results: A cohort of 1253 cancer patients was formed. The mean age was 70.9 (SD=11.8) and the most frequent cancers included 488 (38.9%) respiratory and 309 (24.6%) upper digestive cancer. Overall, 14.5% (n=182) of patients became FED users. Content analyses revealed the most common emerging themes from the FED patients interviews on hospital discharge experiences. These included:1. Early hospital discharge putting patients at high risk of being re-admitted and going back to the ER shortly after that. Some patients mentioned post-discharge complications and emerging of new health issues that could have been avoided if patient was kept in the hospital for longer.2. Lack of communication between different specialists at the hospital. Some patients mentioned the help of a nurse as crucial during inpatient stays in maintaining communication between doctors. 3. Lack of communication of medications prescribed. Some patients mentioned the lack of communication of what doses was modified, what medications were stopped and which ones were newly prescribed.4. The need to schedule follow-up appointments at the time of hospital discharge. This becomes especially important for vulnerable patients who have been on pain medication during the hospital stay, affecting their cognitive abilities and making post-discharge planning more difficult. Conclusions: This study using integrated data from administrative claims and patient interviews provided insights into the challenges related to hospital discharge experiences and transition into community among hospitalized cancer patients with frequent emergency department use. Application of our findings could assist in hospital discharge preparation and improvement in healthcare delivery and health outcomes. Citation Format: Siyana Kurteva, Robyn Tamblyn. Emerging lessons from patient-reported hospital discharge experiences among hospitalized cancer patients with frequent emergency department use [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3468.

Implementation of DevOps in healthcare systems

The integration of DevOps practices within healthcare systems has emerged as a promising approach to enhance agility, efficiency, and reliability in delivering healthcare services. This systematic review explores the implementation of DevOps methodologies within healthcare contexts, focusing on its impact on quality of care, operational efficiency, and overall system performance. Through a comprehensive analysis of existing literature, this review synthesizes key findings, challenges, and best practices associated with DevOps adoption in healthcare. The review highlights successful case studies, identifies common patterns in DevOps implementation, and examines the role of cultural transformation, automation, and collaboration in fostering successful DevOps practices within healthcare organizations. Additionally, this review discusses the potential benefits and limitations of applying DevOps principles in healthcare settings, offering insights for practitioners, researchers, and policymakers seeking to leverage DevOps to improve healthcare delivery.

Implementation of DevOps in healthcare systems

The integration of DevOps practices within healthcare systems has emerged as a promising approach to enhance agility, efficiency, and reliability in delivering healthcare services. This systematic review explores the implementation of DevOps methodologies within healthcare contexts, focusing on its impact on quality of care, operational efficiency, and overall system performance. Through a comprehensive analysis of existing literature, this review synthesizes key findings, challenges, and best practices associated with DevOps adoption in healthcare. The review highlights successful case studies, identifies common patterns in DevOps implementation, and examines the role of cultural transformation, automation, and collaboration in fostering successful DevOps practices within healthcare organizations. Additionally, this review discusses the potential benefits and limitations of applying DevOps principles in healthcare settings, offering insights for practitioners, researchers, and policymakers seeking to leverage DevOps to improve healthcare delivery.