Innovations In Patient Care Research Articles

Machine Learning on 50,000 Manuscripts Shows Increased Clinical Research by Academic Cardiac Surgeons

IntroductionAcademic cardiac surgeons are productive researchers and innovators. We sought to perform a comprehensive machine learning (ML)-based characterization of cardiac surgery research over the past 40 y to identify trends in research pursuits. MethodsUS-based academic websites were queried for surgeon profiles. Publications since 1980 were obtained from Web of Science, and publication classifications (e.g., “human”, “animal”) were collected through the National Institutes of Health iCite tool. Publications were deemed “basic or translational” if >50% of their classification was under “animal” or “molecular or cell”, and “clinical” if otherwise. ML-based clustering was performed on publication titles and Medical Subject Heading terms to identify research topics. ResultsA total of 944 cardiac surgeons accounted for 48,031 unique publications. Average citations per year have decreased since 1980 (P < 0.001). The percentage of basic or translational publications by cardiac surgeons has decreased over time (P < 0.001), comprising of only 8% of publications in 2022. Adult cardiac surgeons, those who received an F32, K08, or R01, and those with a PhD were more likely to publish basic or translational research. Top areas of basic or translational research were myocardial reperfusion, aortic aneurysms or remodeling, and transplant immunology. Major areas of clinical research included aortic disease, aortic valve disease, and mechanical circulatory support. Collaboration analysis revealed that 55% of publications were single-center, and the yearly percentage of these publications has decreased over time (P < 0.001). ConclusionsCardiac surgeons are performing less basic or translational research relative to clinical research than ever before. The majority of publications over the past 40 y did not involve cross-center collaboration. Continued support for clinical research is needed, while also encouraging collaborative basic or translational science to foster innovation in patient care.

Digital health startups: growth financing and valuation drivers that signal strength for investors

PurposeThe study investigates the impact of various factors on the number of active investors in digital health startups. Through nine hypotheses, we examine the influence of metrics such as patents, online presence, financial aspects and company valuation on investor interest. The results reveal positive associations between these metrics and investor numbers, highlighting their role in signaling strength and attracting investment. This research enhances the understanding of investor valuation in digital health startups, emphasizing the importance of credible signals for building trust and securing funding. However, we acknowledge limitations in data analysis methods and suggest future research to explore industry signals, longitudinal trends and failed startups for comprehensive insights.Design/methodology/approachThis study delves into the design methodology and approach, aiming to fill gaps in understanding investor roles in valuing digital health ventures. We focus on deciphering factors driving valuations for these startups to secure growth financing. Using signaling theory, we investigate how entrepreneurs communicate their latent strengths to bridge information gaps, aiding investment decisions. We analyze a sample of 482 healthcare startups from the Pitchbook database using Poisson regression in SPSS.FindingsThis research sheds light on the factors driving investor interest in digital health startups. Despite the critical role of entrepreneurs in patient care innovations, the relationship between investor characteristics and funding for digital health technologies still needs exploration. We examine factors influencing investor valuation in healthcare startups and identify patents, social followers and financial disclosures as pivotal elements shaping investor interest. The findings show that all factors for active investors are significant for all variables except similar unique visitors.Originality/valueThese results significantly enhance our understanding of investor decision-making in digital health startups. They confirm the importance of various signals, like patent activity, online presence and financial performance, in attracting investor attention. We utilize unique data sources, offering insights into investors' behavior across different funding stages. In conclusion, these findings underscore investors' crucial role in the growth and funding of healthcare tech startups, emphasizing the need for robust signals to attract investment.

5G-enabled smart hospitals: Innovations in patient care and facility management.

Smart hospitals represent the pinnacle of healthcare innovation, leveraging cutting-edge technologies to transform patient care and facility management. This article addresses the pressing need for effective implementation of 5G technology in smart hospitals, aiming to enhance connectivity, improve patient outcomes, and drive operational efficiency. The methodology employed involves a comprehensive review of existing literature, case studies, and expert insights to analyze the impact of 5G on various aspects of smart hospital operations. The article highlights the significance of 5G technology in enabling real-time data analytics, remote monitoring, and telemedicine, thus revolutionizing healthcare delivery. By providing high-speed, low-latency connectivity, 5G facilitates seamless communication and collaboration among healthcare providers, leading to more efficient diagnosis, treatment, and patient care. Additionally, the adoption of 5G enables smart hospitals to leverage artificial intelligence (AI)-based solutions for predictive analytics, personalized medicine and enhanced patient engagement. Furthermore, the article explores the potential of 5G-enabled smart hospitals in enhancing disaster preparedness and emergency response efforts. Case studies and examples demonstrate how 5G technology can improve situational awareness, coordinate resources, and deliver timely care during natural disasters and pandemics. Overall, this article underscores the transformative impact of 5G technology on smart hospitals and emphasizes the importance of embracing innovation to meet the evolving needs of patients and communities. By adopting 5G technology, smart hospitals can usher in a new era of healthcare delivery characterized by enhanced connectivity, improved patient outcomes, and unparalleled efficiency.

Recent Developments and Challenges in COVID-19 Care

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has fundamentally transformed global health care, revealing both critical vulnerabilities and significant innovations in patient care. This review delves into the latest advancements in COVID-19 care, with a particular focus on the evolution of therapeutic strategies, the rapid and widespread adoption of telemedicine, and the pressing challenges in addressing mental health during the pandemic. Key developments include significant progress in antiviral and immunomodulatory treatments, which have proven essential in managing severe COVID-19 cases. Concurrently, telemedicine has emerged as a revolutionary tool in health-care delivery, enabling the continuity of care despite widespread disruptions. The pandemic’s profound psychological impact has necessitated the creation of new crisis intervention models, highlighting the importance of adaptable and accessible mental health services. The existing research for this review was conducted using comprehensive searches of databases such as PubMed, Springer, and other reputable sources. This approach ensured that the most current and relevant studies on COVID-19 care, therapeutic advancements, telemedicine, and mental health support were included in the analysis. In conclusion, the ongoing adaptation and application of these innovations will be crucial in determining the resilience and effectiveness of health-care systems in future crises. The lessons learned from the COVID-19 pandemic will continue to inform and shape the evolution of global health-care strategies.

Covering digital health applications in the public insurance system: how to foster innovation in patient care while mitigating financial risks-evidence from Germany.

Digital health applications that support patients in managing their condition can have a positive impact on patients' health and improve the overall care process. In late 2019, as the first country worldwide, Germany included digital health applications in the benefit basket of the statutory health insurance (SHI) system to enable fast, broad-scale patient access and encourage innovation in the digital health industry. While the policy is widely recognized as a pioneering step toward improving patient care through digital technologies, there are concerns regarding the mechanics of the policy and the resulting financial risks for the SHI system. The primary objective of this article is to provide a comprehensive and balanced overview of the German policy by evaluating its success in achieving its goals and by reviewing challenges that have emerged. The secondary objective is to delineate prospective policy options and areas warranting future research. The article analyzes publicly available data of the Federal Institute for Drugs and Medical Devices collected between February 1st and July 17th, 2023, and complements it with empirical findings published by academic institutions and sickness funds. It discusses policy options and related areas of future research to overcome the identified challenges without jeopardizing the purpose of the legislation to encourage innovation in the digital health industry to improve patient care. In line with the goals of the reimbursement policy, the inclusion of digital health applications in the SHI benefit basked has entailed new digital treatment options for patients across multiple disease areas. However, from a health policy perspective, the policy has several shortcomings, including low prescription rates, the temporary reimbursement of digital health applications that lack proven benefit, and a pricing framework that does not take into account the efficacy and efficiency of a treatment and may lead to a suboptimal allocation of public resources. Rather than the public system covering digital health applications without proven benefit, the authors suggest giving SHI organizations more budget authority to directly incentivize research and development activities and to introduce value-based pricing. More research is needed to determine the details of these mechanisms.

Rates of National Institutes of Health Funding for Surgeon-Scientists, 1995-2020

Surgeon-scientists are uniquely positioned to facilitate translation between the laboratory and clinical settings to drive innovation in patient care. However, surgeon-scientists face many challenges in pursuing research, such as increasing clinical demands that affect their competitiveness to apply for National Institutes of Health (NIH) funding compared with other scientists. To examine how NIH funding has been awarded to surgeon-scientists over time. This cross-sectional study used publicly available data from the NIH RePORTER (Research Portfolio Online Reporting Tools Expenditures and Results) database for research project grants awarded to departments of surgery between 1995 and 2020. Surgeon-scientists were defined as NIH-funded faculty holding an MD or MD-PhD degree with board certification in surgery; PhD scientists were NIH-funded faculty holding a PhD degree. Statistical analysis was performed from April 1 to August 31, 2022. National Institutes of Health funding to surgeon-scientists compared with PhD scientists, as well as NIH funding to surgeon-scientists across surgical subspecialties. Between 1995 and 2020, the number of NIH-funded investigators in surgical departments increased 1.9-fold from 968 to 1874 investigators, corresponding to a 4.0-fold increase in total funding (1995, $214 million; 2020, $861 million). Although the total amount of NIH funding to both surgeon-scientists and PhD scientists increased, the funding gap between surgeon-scientists and PhD scientists increased 2.8-fold from a $73 million difference in 1995 to a $208 million difference in 2020, favoring PhD scientists. National Institutes of Health funding to female surgeon-scientists increased significantly at a rate of 0.53% (95% CI, 0.48%-0.57%) per year from 4.8% of grants awarded to female surgeon-scientists in 1995 to 18.8% in 2020 (P < .001). However, substantial disparity remained, with female surgeon-scientists receiving less than 20% of NIH grants and funding dollars in 2020. In addition, although there was increased NIH funding to neurosurgeons and otolaryngologists, funding to urologists decreased significantly from 14.9% of all grants in 1995 to 7.5% in 2020 (annual percent change, -0.39% [95% CI, -0.47% to -0.30%]; P < .001). Despite surgical diseases making up 30% of the global disease burden, representation of surgeon-scientists among NIH investigators remains less than 2%. This study suggests that research performed by surgeon-scientists continues to be underrepresented in the NIH funding portfolio, highlighting a fundamental need to support and fund more surgeon-scientists.

MP46-12 TWENTY YEAR TEMPORAL TRENDS IN SHORT AND LONG-TERM OUTCOMES AFTER RADICAL CYSTECTOMY

You have accessJournal of UrologyCME1 Apr 2023MP46-12 TWENTY YEAR TEMPORAL TRENDS IN SHORT AND LONG-TERM OUTCOMES AFTER RADICAL CYSTECTOMY Majed Alrumayyan, Alexandre Zlotta, Neil Fleshner, Katherine Lajkosz, and Girish Kulkarni Majed AlrumayyanMajed Alrumayyan More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , Neil FleshnerNeil Fleshner More articles by this author , Katherine LajkoszKatherine Lajkosz More articles by this author , and Girish KulkarniGirish Kulkarni More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003292.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy is a standard of care to treat muscle invasive urothelial bladder cancer. To improve outcomes, innovations in patient care, such as improved selection and preparation for surgery, Enhanced Recovery After Surgery protocols and implementation of extended Venous thromboembolism (VTE) prophylaxis have been introduced. The purpose of this study is to assess whether these changes have led to improvements in short and longer term outcomes in patients treated with Radical cystectomy for bladder cancer over the last 20 years. METHODS: This is a retrospective study of patients whom underwent Radical cystectomy from 2000 to 2020 in University Health Network Toronto, Canada.This time period was divided into 5 groups: 2000-2003, 2004-2007, 2008-2011, 2012-2015 and 2016-2020. Outcomes assessed included overall survival and metastasis free survival. The study also assessed the number of lymph nodes dissected, the rate of Venous thromboembolism (VTE), and use of neoadjuvant and adjuvant chemotherapy and their association with the outcomes. Univariable and multivariable analysis, adjusted for age, Charlson comorbidity index, and TNM stage, were compared between the temporal time groups. RESULTS: A total of 728 patients were included. There was no variance in age among all groups, with mean age of 68 years. 76% of patients were males. The Charlson comorbidity index mean was 3 in the last few years (p<0.001). Regarding the staging; PT0 after cystectomy was 14.3% and 14.7% from (2012-2020) (p<0.001). In the first few years, PT4 stage was found to be higher with 21%. As time evolved, Non muscle invasive bladder cancer increased to 45% (p<0.001). The mean number of lymph nodes dissected was 15 with no difference between the groups (p 0.39). In the most recent years, neoadjuvant chemotherapy was given more 34.3% and 46.6% (p<0.001). While Adjuvant Chemotherapy was given more to patients from (2000 to 2007) 27.5% and 25.2% (p<0.001). In the early years (2000-2003) VTE after surgery was 14.3% (p<0.001). VTE after neoadjuvant chemotharepy was 6.8% (p<0.001). Overall survival showed no difference in the 5 groups followed for 1 year with mortality mean between 19% and 27% and and also in the first 4 groups followed for 5 years after the surgery (p 0.67 and 0.29). Metastasis free survival as well showed no difference between the groups followed for 1 and 5 years with mean of 22.5% and 49% (p 0.23 and 0.27). CONCLUSIONS: We noted improved use of neoadjuvant chemothrepy, increase in non muscle invasive bladder cancer, decrease in VTE post surgery and stable survival rate across time. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e635 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Majed Alrumayyan More articles by this author Alexandre Zlotta More articles by this author Neil Fleshner More articles by this author Katherine Lajkosz More articles by this author Girish Kulkarni More articles by this author Expand All Advertisement PDF downloadLoading ...

Digital capability: An essential nursing skill for proficiency in a post-COVID-19 world.

We explored the importance of digital technologies to health responses during the COVID-19 pandemic. The benefits, challenges and barriers to developing digital capabilities are identified, and strategies to establish enduring digital proficiency among nurses and healthcare colleagues gained during the pandemic are canvassed. Since the mid-20th century, technology uptake by health practitioners has prioritised digital information and communication technology. The COVID-19 pandemic accelerated the need to adapt digital communication to dangerous clinical workplaces. Organisational policies enabled digital capabilities to replace in-person processes while preserving regulatory compliance, safety and security of patient information and staff deployment. All evidence was accessed from publicly available sources. The COVID-19 pandemic was a catalyst for implementing Technology Enhanced Care Services. Health practitioners need appropriate digital capabilities for their roles and scope of practice. Nursing proficiency includes technological skills. Combining the Jisc Digital Capability Framework and the Health and Care Digital Capabilities Framework helps nurses achieve the technical expertise needed for clinical proficiency in contemporary healthcare environments. Healthcare workforce digital capability requires policies that resource digital technologies and individual user skills in dangerous COVID-19 workplaces. All involved must be abreast of technological changes and monitor technology effectiveness in innovation in patient care, professional education and evidence-based infectious disease management of healthcare systems. Nurses and other practitioners in COVID-19-compromised settings must be able to use the embedded digital technologies in patient care, clinical management and education. Policies securing resources for nurses to learn to use digital technologies will ensure that digital systems are regularly upgraded and that nurses develop proficiency in using technology in their clinical practice. Work and workplace redesign needs compatible computer systems and software to support nursing innovation and digital proficiency.

Emerging Trends in Health Care: What to Prepare for Now and Beyond

Back to table of contents Previous article Next article Government & LegalFull AccessEmerging Trends in Health Care: What to Prepare for Now and BeyondGloria Umali, R.N., M.S., C.P.H.R.Gloria UmaliSearch for more papers by this author, R.N., M.S., C.P.H.R.Published Online:25 Oct 2022https://doi.org/10.1176/appi.pn.2022.11.11.27AbstractStaying on top of the latest trends in health care should ensure that risk mitigation strategies are in place within your practice setting.iStock/ipopbaThe COVID-19 pandemic precipitated many transformations and changes within the health care industry. As a result, the pursuit of innovation in patient care is a greater priority, giving rise to new and emerging health care trends that are forcing the industry to reinvent itself to stay atop of the constantly changing needs.Use of Technology to Deliver Cost-Effective CareThe disruption of the traditional medical visit caused by the pandemic made patients and health care professionals rely more heavily on digital health to receive and deliver care. This increased technological utilization and reliance must come with awareness that innovation may create or enhance potential risks, including patient harm and privacy and confidentiality breaches.Health EquityThe COVID-19 pandemic magnified existing patterns of systemic health inequities. Encouraging patients to provide accurate demographic information and urging health care professionals to identify means of increased cultural competency are essential to influence positive health outcomes. Cultural competency helps avoid potential failures to diagnose incidents related to cultural bias.Artificial IntelligenceAdvances made over the past few years in the areas of artificial intelligence (AI) and data analytics have uncovered even more potential health care opportunities. While AI’s impact on society remains an ongoing ethical debate, supporters maintain that it improves the quality of everyday life. AI is unquestionably a valuable tool in health care, but it bears the risk of causing societal harm. AI vendors and developers must continue to recognize that health inequities exist, and bias must be prevented from entering AI systems; otherwise, it could exacerbate concerns related to data accuracy, health equity, and safety.Workforce ShortageThe American College of Healthcare Executives’ survey titled “Top Issues Confronting Hospitals in 2021” revealed that staffing shortages have replaced financial challenges as CEOs’ top concern. Workforce shortages are driving (and will continue to be one of the drivers of) overall health care costs. Practices must continue allocating resources for workforce retention to continuously meet patient needs.Scope of Practice Expansion for Advanced Practice PractitionersWhile the pandemic underscored problems with access and provider shortages, the push for expansion of scope of practice for advanced practice practitioners (APPs) continues to spark debate within state legislatures and medical communities.Health LawA number of factors could impact health law, including the following:No Surprises Act: The No Surprises Act was signed into law to promote greater transparency for consumers. The law requires significant changes in operations and patient communications, and health care professionals must ensure changes are implemented and comply with the requirements of the law.Consolidation: “Top 10 Issues in Health Law 2022” published in Health Law Connections, stated that behavioral health transactions accelerated by the pandemic led to greater exposure of the behavioral health market to consolidation. It cited improved outcomes and overall cost savings as the primary incentives for consolidation. It also predicted that a strong behavioral health market consolidation will entice more talent to the profession, thereby bringing about permanent resolution to chronic provider shortages in behavioral health.Trends like AI, market consolidation, and technology-led care advancements aim to improve the quality of health care and population’s health. Staying on top of current health care trends is a must for health care professionals as changes in the health care system show no signs of slowing down. Staying abreast of these issues should ensure that risk mitigation strategies are proactively in place within your practice setting. ■This information is provided as a risk management resource for Allied World policyholders and should not be construed as legal or clinical advice. This material may not be reproduced or distributed without the express, written permission of Allied World Assurance Company Holdings Ltd., a Fairfax company (“Allied World”). Risk management services are provided by or arranged through AWAC Services Company, a member company of Allied World. © 2022 Allied World Assurance Company Holdings, Ltd. All Rights Reserved.Gloria Umali, R.N., M.S., C.P.H.R.M., is a risk management consultant in the Risk Management Group of AWAC Services Company, a member company of Allied World. Risk Management services are provided as an exclusive benefit to insureds of the APA-endorsed American Professional Agency Inc. liability insurance program. ISSUES NewArchived

Early Career Success in Scientific Funding Is Disparate Across Surgical Subspecialties

INTRODUCTION: Surgeon-scientists are uniquely positioned to translate between the laboratory and clinical settings to drive innovation in patient care. However, research success varies significantly across subspecialties. Early-career success in transitioning from an NIH K-award to a R01 grant is critical for an independent research career. We hypothesize that this transition is delayed for surgeon-scientists and would differ across surgical subspecialties. Understanding success in K-to-R01 transition may inform subspecialty-specific support to enhance the surgeon-scientist pathway. METHODS: NIH-funded surgeon-scientist were identified from the NIH RePORTER database. K-award recipients were defined as surgeon-scientists with K01/K02/K07/K08/K22/K23/K25/K76/K99 grants. Subsequent R01 funding was tracked for each K-award recipient using their unique NIH identification number. Five- and ten-year K-to-R01 transition rates were determined for each surgical subspecialty. RESULTS: Between 1995 and 2020, 729 surgeon-scientists received K-awards. A total of 195 (26.75%) and 288 (39.51%) received R01 funding within 5 and 10 years, respectively (p < 0.01; Fig. 1). K-to-R01 transition rates differed significantly across surgical specialties. Otolaryngology (34.69%), plastic (35.00%) and cardiothoracic surgery (33.33%) had the highest 5-year K-to-R01 transition rates. Otolaryngology (50.00%), cardiothoracic (45.83%), vascular (44.68%), and neurosurgery (42.31%) had the highest 10-year K-to-R01 transition rates. Orthopedic surgery had both the lowest 5-year (20.00%) and 10-year (30.00%) K-to-R01 transition rate.CONCLUSION: K-to-R01 transition rate varied significantly across surgical subspecialties, with otolaryngology, cardiothoracic, vascular, and neurosurgery having the highest rates, and orthopedic surgery having the lowest rate. These differences may reflect disparate institutional, surgical society and national support for early career research endeavors for surgeons and warrants further investigation.

SP-0210 Innovations in patient care through RTT advanced practice

SP-0210 Innovations in patient care through RTT advanced practice

Artificial intelligence in orthopaedics surgery: transforming technological innovation in patient care and surgical training.

Artificial intelligence (AI) is an exciting field combining computer science with robust data sets to facilitate problem-solving. It has the potential to transform education, practice and delivery of healthcare especially in orthopaedics. This review article outlines some of the already used AI pathways as well as recent technological advances in orthopaedics. Additionally, this article further explains how potentially these two entities could be combined in the future to improve surgical education, training and ultimately patient care and outcomes.

Innovations in Emergency Airway Management: Lessons-Learned from Early Cross-Cultural Management of Covid-19

The Texas Tech University Center for Emerging Energy Sciences Research Group implemented rapid translation and analytics of Chinese COVID-19 medical literature in February 2020, which enabled emerging innovations in patient care. Specifically, techniques to optimize patient care through improved ventilation and oxygenation recognizing newly discovered pathophysiology were designed and prototyped in this invention. COVID-19 respiratory distress distinguishes itself from acute respiratory distress syndrome (ARDS) and pathophysiology of SARS-COV-2 by requiring higher O2 and lower pressure requirements for adequate oxygenation. Specifically, low positive end-expiratory pressure ventilator parameters are necessary to optimize patient care. Paradoxically, COVID-19 patients display severe "silent" hypoxemia often associated with near normal respiratory compliance. This clinical presentation is considered unusual for severe ARDS patients and implies non-uniformity in disease management of acute respiratory and pre-hospital patients. A clinical need for new innovative approaches to management that may also benefit decompression sickness, high altitude pulmonary edema and other chronic respiratory disease patients.&lt;br/&gt; We present these observations as an example of the need for closely-collaborating, interdisciplinary teams to facilitate rapid innovation when sudden, severe health threats first emerge. This approach is invaluable to medical innovations needed to counter threats due natural to man-made conditions.

Patient and provider’s perspective on barriers and facilitators for medication adherence among adult patients with cardiovascular diseases and diabetes mellitus in India: a qualitative evidence synthesis

ObjectiveTo explore the various stakeholders’ perspectives on barriers and facilitators for medication adherence among patients with cardiovascular diseases (CVDs) and diabetes mellitus (DM)in India.DesignSystematic review of qualitative studies.Data sourcesA comprehensive...

INNV-41. MY STORI – A SYMPTOM TRACKING AND REPORTING INSTRUMENT MOBILE APPLICATION FOR BRAIN TUMOR PATIENTS

Abstract INTRODUCTION Managing symptom burden is an integral part of brain tumor patient care, but tools to facilitate tracking symptoms and self-management for this population are lacking. Reporting is often limited to self-report as part of clinical follow-up care, or episodic between visits if symptoms are severe. While general-purpose and cancer-specific mobile applications that track medical symptoms are becoming more prevalent, they may not cover the entire range of symptoms experienced by patients with brain tumors or allow tracking of self-management strategies. METHODS We developed an iOS operating system mobile application using Apple’s UIKit, Foundation, WebKit, and Core Graphics frameworks. Core Data and iCloud were used to implement local and cloud-based data storage for personal use. Findings from our Outcomes Surveys informed selection of core symptoms to track. A multidisciplinary team of neuro-oncology scientists, providers, and communication specialists developed self-care content from evidence-based sources. RESULTS We developed My STORI, a free mobile application to capture the experiences of brain tumor patients. Patients and their family members can track daily symptoms and their impact on function and record any actions that were taken to mitigate them. Evidence-based self-care information on how to recognize, manage, and report symptoms is provided. Graphical summaries of how these symptoms evolve over time, and how they are impacted by clinical appointments, treatment, and self-care activities can be displayed and compiled into reports that can be shared with their care team, family, or health care record. CONCLUSIONS Mobile applications have the potential to promote self-care, facilitate symptom management, and enable intuitive, frequent, and convenient reporting of clinically relevant data to the health-care team. The My STORI application is an innovation in patient care guided by evidence-based research and can be used to track symptom management, promote self-care, and enhance communication to improve clinical care and research.

Comparative Evaluation of Hospital Environmental Performance based on ISO 14031 Evaluation Model

Introduction: Hospitals are working to create innovation in patient care throughout the world while maintaining high quality standards. Since in implementing this innovation, hospitals have an impact on the natural environment, hospital managers are constantly developing management plans to conserve energy and dispose medical waste properly to reduce the damage to patients, surrounding communities, and the natural environment. Therefore, this study evaluated the important and effective indicators in order to target the measures in the field of hospital environmental management. Methods: This cross-sectional analysis was designed and implemented in 2018 and 2019 in Trita subspecialty hospital in the west of Tehran. To implement this study, ISO 14001 standard was used and ISO 14031 standard was applied to monitor it. Results: According to the findings, 18 important and basic indicators were defined in the field of environmental performance for the hospital and the relevant indicators were measured. Correction and improvement of indicators was clearly observed in 2018 and 2019. Most of the corrective actions and the most noticeable changes were related to waste. Conclusion: The use of environmental assessment models along with managerial support for corrective action can protect the environment in the long run and improve public health. Moreover, proper management of the hospital waste can reduce the costs.

Persistent Challenges in the Hepatitis C Virus Care Continuum for Patients in a Central Texas Public Health System.

BackgroundDirect-acting antiviral treatment regimens cure >95% of chronic hepatitis C virus (HCV) infections, but recent studies indicate that <25% of patients in the United States receive treatment. Patients need to overcome barriers on the steps of the care continuum in order to be prescribed treatment. We aimed to examine the steps of the HCV care continuum up to prescription of HCV therapy among patients receiving care within a large safety net health care system in Houston, Texas.MethodsWe used electronic medical records to identify patients with positive screening tests for HCV antibodies between July 1, 2017, and June 30, 2018, and abstracted data on their advancement through the care continuum for HCV. We used logistic regression to identify factors associated with patient navigation through the continuum.ResultsOf the 2450 patients screening positive for HCV antibodies, 2016 (82.3%) received quantitative RNA testing, of whom 1081 (53.6%) exhibited chronic infection. Providers referred 915 (84.6%) to specialty care for evaluation, 540 of these patients (50.0%) received their specialist evaluation, and 299 (27.7%) received a prescription for treatment. Patients with history of substance use were less likely to be prescribed treatment (adjusted odds ratio, 0.66; 95% CI, 0.49–0.88).ConclusionsWe found substantial attrition at each stage of the HCV care continuum. In particular, history of substance abuse was a predictor of nonprescription. Challenges in the care continuum motivate increased provider education as well as the adoption of recent innovations in patient care.

The Value of Nursing Research.

Innovations in patient care, nursing, and the practice environment are hallmarks of organizations receiving American Nurses Credentialing Center (ANCC) Magnet Recognition. In this month's "Magnet Perspectives" column, the chair and vice-chair of ANCC's Commission on Magnet Recognition examine the growing importance of nursing research on patient care and outcomes and the role of Magnet hospitals as research pacesetters for the nursing profession. The authors discuss the critical difference between research and evidence-based practice, why both are important, and how organizations can develop the structures and processes to inspire and advance a robust culture of clinical inquiry.

Magnet® Nurses of the Year Ignite Innovation.

Innovations in patient care, nursing, and the practice environment are the hallmark of Magnet organizations. Establishing new ways of achieving high-quality care is the result of transformational leadership, empowering structures and processes, and exemplary professional practice in nursing. From coast to coast, clinical nurses take advantage of these opportunities to change care for the better, improve the patient experience, and drive the science of nursing forward. American Nurses Credentialing Center's National Magnet Nurse of the Year Awards recognize and reward this work. Five outstanding clinical nurses are honored, 1 in each of the Magnet Model components: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations, and improvements; and empirical outcomes. This month's Magnet Perspectives column spotlights the 2019 award winners and their achievements and examines how Magnet environments support and encourage their success.

Northwell Health Laboratories: The 10-Year Outcomes After Deciding to Keep the Lab.

Northwell Health Laboratories were established in 1997, serving the Northwell Health system. In 2008, the health system considered minority entry into a joint venture with a commercial laboratory. Based on arguments made by Northwell laboratory leadership, the decision was made to retain full ownership of the laboratory. To evaluate the 10-year outcomes of the 2008 decision and assess the value of a fully integrated laboratory service line for a regional health network. Ten-year outcomes were analyzed including financial, volume, and value-based activities. First, a fully integrated laboratory service line was created, with unified medical and managerial leadership. Second, Core Laboratory volumes and revenues grew at annualized rates of 4.5% and 16.0%, respectively. Third, hospital-based laboratory costs were held either constant, or grew in accordance with strategic clinical programs. Fourth, laboratory services were able to provide leadership in innovative system clinical programming and value-based payment programs. Fifth, the laboratories became a regional asset, forming a joint venture affiliation with New York City Health + Hospitals, and supporting distressed hospitals in Brooklyn, New York. Lastly, Northwell Health Laboratories have become a reputational asset through leadership in 2 consortia: The Compass Group and Project Santa Fe. The 10-year outcomes have exceeded projections made in 2008, validating the decision to retain the laboratories as a wholly owned system asset. The laboratories are now well positioned for leading innovation in patient care and for helping to drive a favorable posture for the health system under new payment models for health care.