Medical Center Employees Research Articles

Evaluating atherogenic index of plasma as a predictor for metabolic syndrome: a cross-sectional analysis from Northern Taiwan.

The rising global prevalence of metabolic syndrome (MetS), characterized by a constellation of cardiovascular risk factors, underscores the urgent need to identify reliable predictive biomarkers. We hypothesize that an elevated atherogenic index of plasma (AIP) predicts MetS risk through lipid imbalance, but population-specific variations in its predictive strength remain unexplored. Our study aimed to assess AIP), a ratio of triglycerides to high-density lipoprotein cholesterol, as a predictor of MetS. Between 2014 and 2018, our cross-sectional study collected and analyzed health examination data from 9,202 Northern Taiwan Medical Center employees without cardiovascular diseases, diabetes, and end-stage renal disease (ESRD). Our study classified AIP levels equally into three tertiles and evaluated their impact on MetS through a logistic regression model. After adjusting for age, gender, BMI, SBP, FPG, and LDL in our models, the ORs for MetS in the second and third tertiles of the AIP were 3.81 (95% CI: 2.33 to 6.21; OR: 37.14, 95%: 23.22 to 59.39). In addition, women have a higher MetS risk associated with elevated AIP than men across all models. Our research identified the AIP as a significant predictive marker for the prevalence of MetS, suggesting its potential utility in clinical risk assessment and indicating the need for further research to explore its application in preventive strategies and therapeutic interventions.

Predictors of seropositivity to SARS-CoV-2 among employees at a large urban medical center

BackgroundBefore SARS-CoV-2 vaccination availability, medical center employees were at high risk of COVID-19. However, risk factors for SARS-CoV-2 infection in medical center employees, both healthcare and non-healthcare workers, are poorly understood.MethodsFrom September-December 2020, free IgG antibody testing was offered to all employees at a large urban medical center. Participants were asked to complete a questionnaire on work and non-work related risk factors for COVID-19 infection.ResultsSARS-CoV-2 seropositivity was found in 4.7%. Seropositivity was associated with close contact with COVID-19 cases with or without the use of adequate personal protective equipment (PPE), (OR 3.1 [95% CI 1.4–6.9] and OR 4.7 [95% CI 2.0–11.0] respectively), never wearing a mask outside of work (OR 10.1 [95% CI 1.9–57]), and Native Hawaiian/Pacific Islander race (OR 6.3 95% CI (1.6–25)].ConclusionsAmong workers in a large urban medical center, SARS-CoV-2 seropositivity was associated with work-related COVID-19 close contacts and low mask use outside of work, suggesting that non-workplace close contacts are also relevant routes of COVID-19 spread among healthcare workers.

Economics of a health system's direct-to-consumer telemedicine for its employees.

To compare the mean per-episode unit cost for a direct-to-consumer (DTC) telemedicine service for medical center employees (OnDemand) with that of in-person care and to estimate whether the offered service increased the use of care. Propensity score-matched retrospective cohort study of adult employees and dependents of a large academic health system between July 7, 2017, and December 31, 2019. To estimate differences in per-episode unit costs within 7 days, we compared costs between OnDemand encounters and conventional in-person encounters (primary care, urgent care, and emergency department) for any similar condition using a generalized linear model. We used interrupted time series analyses limited to the top 10 clinical conditions managed by OnDemand to estimate the effect of OnDemand's availability on the trends for overall employee per-month encounters. A total of 10,826 encounters among 7793 beneficiaries were included (mean [SD] age, 38.5 [10.9] years; 81.6% were women). The mean (SE) 7-day per-episode cost among employees and beneficiaries was lower for OnDemand encounters at $379.76 ($19.83) relative to non-OnDemand encounters at $493.49 ($25.53), a mean per-episode savings of $113.73 (95% CI, $50.36-$177.10; P < .001). After the introduction of OnDemand, among employees with encounters for the top 10 clinical conditions managed by OnDemand, the trend for encounter rates per 100 employees per month increased marginally (0.03; 95% CI, 0.00-0.05; P = .03). These results suggest that DTC telemedicine staffed by an academic health system and offered directly to employees reduced the per-episode unit costs and only marginally increased utilization, suggesting lower cost overall.

Treatment trials for viral conjunctivitis: what we have learned and how we can improve.

Treatment trials for viral conjunctivitis: what we have learned and how we can improve.

The Effect of an Education Module to Reduce Weight Bias among Medical Centers Employees: A Randomized Controlled Trial

Introduction: Weight bias, stigma, and discrimination are common among healthcare professionals. We aimed to evaluate whether an online education module affects weight bias and knowledge about obesity in a private medical center setting. Methods: An open-label randomized controlled trial was conducted among all employees of a chain of private medical centers in Israel (n = 3,290). Employees who confirmed their consent to participate in the study were randomized into intervention or control (i.e., “no intervention”) arms. The study intervention was an online 15-min educational module that included obesity, weight bias, stigma, and discrimination information. Questionnaires on Anti-Fat Attitudes (AFA), fat-phobia scale (F-scale), and beliefs about the causes of obesity were answered at baseline (i.e., right before the intervention), 7 days, and 30 days post-intervention. Results: A total of 506, 230, and 145 employees responded to the baseline, 7-day, and 30-day post-intervention questionnaires, respectively. Mean participant age was 43.3 ± 11.6 years, 84.6% were women, and 67.4% held an academic degree. Mean F-scale scores and percentage of participants with above-average fat-phobic attitudes (≥3.6) significantly decreased only within the intervention group over time (p ≤ 0.042). However, no significant differences between groups over time were observed for AFA scores or factors beliefs to cause obesity. Conclusions: A single exposure to an online education module on weight bias and knowledge about obesity may confer only a modest short-term improvement in medical center employees’ fat-phobic attitudes toward people with obesity. Future studies should examine if reexposure to such intervention could impact weight bias, stigma, and discrimination among medical center staff in the long-term.

Clinical and occupational risk factors for coronavirus disease 2019 (COVID-19) in healthcare personnel.

To identify characteristics associated with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in healthcare personnel. Retrospective cohort study. A multihospital healthcare system. Employees who reported SARS-CoV-2 exposures and/or symptoms of coronavirus disease 2019 (COVID-19) between March 30, 2020, and September 20, 2020, and were subsequently referred for SARS-CoV-2 PCR testing. Data from exposure and/or symptom reports were linked to the corresponding SARS-CoV-2 PCR test result. Employee demographic characteristics, occupational characteristics, SARS-CoV-2 exposure history, and symptoms were evaluated as potential risk factors for having a positive SARS-CoV-2 PCR test. Among 6,289 employees who received SARS-CoV-2 PCR testing, 873 (14%) had a positive test. Independent risk factors for a positive PCR included: working in a patient care area (relative risk [RR], 1.82; 95% confidence interval [CI], 1.37-2.40), having a known SARS-CoV-2 exposure (RR, 1.20; 95% CI, 1.04-1.37), reporting a community versus an occupational exposure (RR, 1.87; 95% CI, 1.49-2.34), and having an infected household contact (RR, 2.47; 95% CI, 2.11-2.89). Nearly all HCP (99%) reported symptoms. Symptoms associated with a positive PCR in a multivariable analysis included loss of sense of smell (RR, 2.60; 95% CI, 2.09-3.24) or taste (RR, 1.75; 95% CI, 1.40-2.20), cough (RR, 1.95; 95% CI, 1.40-2.20), fever, and muscle aches. In this cohort of >6,000 healthcare system and academic medical center employees early in the pandemic, community exposures, and particularly household exposures, were associated with greater risk of SARS-CoV-2 infection than occupational exposures. This work highlights the importance of COVID-19 prevention in the community and in healthcare settings to prevent COVID-19.

387. Predictors of Seropositivity to SARS-CoV-2 Among Workforce Members at a Large Urban Medical Center

BackgroundPrior to SARS-CoV-2 vaccination availability, medical centers workers were at significant COVID-19 (COVID) infection risk. As part of a program offering free SARS-CoV-2 serology tests to medical center employees, we examined risk factors for prior COVID infection.MethodsFrom Sept. to Dec. 2020, we advertised free IgG antibody testing to all Los Angeles County-Univ. of Southern California Medical Center (LAC+USC) workforce members (clinical and non-clinical) via repeated email blasts. Antibody was determined using the Abbott SARS-Cov-2 IgG test against SARS-CoV-2 nucleocapsid protein. Program participants were asked to fill out a detailed epidemiologic questionnaire about work and non-work COVID risks on their cell phone or on paper at the time of phlebotomy. All testing was done prior to COVID vaccine availability.ResultsAmong approximately 10,500 workforce members, 1327 had serologies done. Among those 1273 (96%) completed the questionnaire and were included in the analysis. SARS-CoV-2 IgG antibodies were found in 60 (4.7%). In bivariate analysis, we found associations between SARS-CoV-2 seropositivity and persons who previously tested positive for COVID (OR 175.8 [95% CI 77.6 – 398.6]), persons who thought they had prior COVID but tested negative (OR 3.9 [95% CI 1.3 – 11.4]), and persons who thought they had prior COVID but did not get a COVID test (OR 4.2 [95% CI 1.4 – 12.5]). In a multivariate model of SARS-CoV-2 seropositivity examining work- and non-work-related COVID exposures (Table), seropositivity was associated with work-related COVID exposure without adequate personal protective equipment (PPE) (OR 5.1 [95% CI 2.1 – 12.2]), work-related COVID exposure with adequate PPE (OR 3.5 [95% CI 1.5 – 8.0]), never wearing a mask outside of work (OR 7.1 [95% CI 1.3 – 38.4]), and Native Hawaiian/Pacific Islander race (OR 6.6 [95% CI 1.7 – 23.4]). Seropositivity was inversely associated with living at home with multiple age groups (OR 0.4 [95% CI 0.2 – 0.8]). Multivariate Model of Exposures Associated with Positive COVID Serology Among LAC+USC Workforce Members ConclusionAmong workers in a large urban medical center prior to COVID vaccine availability, SARS-CoV-2 seropositivity was associated with work-related COVID exposures and low mask use outside of work, suggesting that COVID transmission in workforce members occurs both via occupational and non-occupational routes.Disclosures Loren G. Miller, MD, MPH, Medline (Grant/Research Support, Other Financial or Material Support, Contributed product)Stryker (Other Financial or Material Support, Contributed product)Xttrium (Other Financial or Material Support, Contributed product)

Rolling Up the Sleeve: Equitable, Efficient, and Safe COVID-19 Mass Immunization for Academic Medical Center Employees.

Novel coronavirus disease 2019 (COVID-19) vaccine administration has faced distribution barriers across the United States. We sought to delineate our vaccine delivery experience in the first week of vaccine availability, and our effort to prioritize employees based on risk with a goal of providing an efficient infrastructure to optimize speed and efficiency of vaccine delivery while minimizing risk of infection during the immunization process. This article aims to evaluate an employee prioritization/invitation/scheduling system, leveraging an integrated electronic health record patient portal framework for employee COVID-19 immunizations at an academic medical center. We conducted an observational cross-sectional study during January 2021 at a single urban academic center. All employees who met COVID-19 allocation vaccine criteria for phase 1a.1 to 1a.4 were included. We implemented a prioritization/invitation/scheduling framework and evaluated time from invitation to scheduling as a proxy for vaccine interest and arrival to vaccine administration to measure operational throughput. We allotted vaccines for 13,753 employees but only 10,662 employees with an active patient portal account received an invitation. Of those with an active account, 6,483 (61%) scheduled an appointment and 6,251 (59%) were immunized in the first 7 days. About 66% of invited providers were vaccinated in the first 7 days. In contrast, only 41% of invited facility/food service employees received the first dose of the vaccine in the first 7 days (p < 0.001). At the vaccination site, employees waited 5.6 minutes (interquartile range [IQR]: 3.9-8.3) from arrival to vaccination. We developed a system of early COVID-19 vaccine prioritization and administration in our health care system. We saw strong early acceptance in those with proximal exposure to COVID-19 but noticed significant difference in the willingness of different employee groups to receive the vaccine.

Cost Savings From a Policy to Diagnose and Prevent Transmission of Adenoviral Conjunctivitis in Employees of a Large Academic Medical Center

Adenoviral conjunctivitis is highly contagious, can be associated with systemic infections, and can cause chronic visual impairment. It accounts for a large proportion of acute conjunctivitis. Outbreaks of epidemic keratoconjunctivitis (EKC) are costly in terms of productivity loss from work furloughs and spread to patients and have resulted in clinic and departmental closures. To examine the institutional cost savings of a policy to diagnose adenoviral conjunctivitis and triage and furlough medical center employees with this condition to prevent outbreaks. This quality improvement study assessed Johns Hopkins Medicine employees with red eye from November 1, 2011, through October 31, 2018, who were triaged at the occupational health clinic whose conditions were diagnosed using polymerase chain reaction (PCR) validated for adenoviral conjunctivitis. Only employees with positive PCR test results were furloughed, with furlough length tailored to subtype (a minimum of 2 weeks for EKC and 1 week otherwise). Total number of furloughs avoided and cost savings associated with reducing unnecessary furloughs. Of 2142 employees with red eye, 1520 (71.0%) underwent PCR testing; 130 (8.6%) had positive adenoviral PCR test results, of whom 41 (31.5%) had EKC. Furloughing 130 employees with positive PCR test results vs furloughing all 1520 employees clinically suspected of having adenoviral conjunctivitis represented an estimated annual savings of $442 073, or $3 094 511 during 7 years. The cost of performing PCR on employees suspected of having adenoviral conjunctivitis was 5.0% of the cost associated with furloughing all employees with red eye. No outbreaks occurred. In this quality improvement study, this policy, notable for development and use of PCR for adenoviral conjunctivitis on a large scale, resulted in substantial cost savings from fewer work furloughs compared with the number of employees who would have been furloughed based on clinical diagnosis. These results may provide impetus for policy adoption by other institutions and for development of a rapid, sensitive, and specific diagnostic test for adenoviral conjunctivitis.

Assessment of indicators of nervous and emotional stress in medical center personnel depending on the characteristics of their professional activity

Introduction. Digital technologies are actively used in the work of specialists of medical centers of various profiles, which causes the impact on employees of a number of professional factors that determine the characteristics of their work. The aim of the study is to evaluate the influence of professional factors on the functional state of the employees' body and the glutathione system as an objective indicator of stress based on the analysis of the subjective perception of the medical center employees of the specifics of working with personal computers and psychophysiological testing. Materials and methods. The study involved 109 specialists of medical centers (25 ophthalmologists, 31 representatives of the secondary medical staff - nurses and paramedics, 53 office employees). The anonymous survey concerned the assessment of working conditions and their impact on the functional state of the body of the respondents. Performance and stress tolerance indicators were evaluated using three standard questionnaires. The study of 66 subjects' levels of glutathione in the blood: total, reduced, oxidized and the ratio of reduced and oxidized - was used to analyze the relationship of the neuro-emotional nature of labor with the reaction of oxidative stress. Statistical processing of the obtained data was carried out using traditional methods of variation statistics and calculating the value of the odds ratio (OR) with a 95% confidence interval (CI). Results. The survey revealed a significant proportion of people in all groups of respondents who constantly use computer technology in their work. Describing the quality of the processed information, doctors more than representatives of other groups note its complexity, importance, negative emotional color, a high degree of responsibility and tension. Doctors more often than average medical staff and office workers associate the manifestation of fatigue with an uncomfortable state of the visual organ, nervous system, and musculoskeletal system. The subjects showed reduced performance and stress tolerance with the most pronounced negative trends in the group of doctors. Changes in the glutathione system were detected, indicating the presence of oxidative stress in 40% of ophthalmologists and office workers, and in half of nurses. Conclusions. The work of specialists of medical centers of various profiles in accordance with their assessment is characterized by high nervous and emotional stress, due to the need to process a significant amount of complex and important professionally significant information. Subjectively noted by respondents the influence of working conditions on the functional state of the body is confirmed by indicators of the glutathione system, which can be used as indicators of nervous and emotional stress.

Assessing fear of COVID-19 at an academic medical center.

This study measured the degree of COVID-19-related fear among academic medical center employees, identified subsections with high COVID-19 fear, and validated the Fear of COVID-19 Scale with medical professionals in the United States. This study is a cross-sectional, internet-based survey delivered by Qualtrics. The survey was conducted at the Oklahoma University Health Sciences Center between May 21 and June 18, 2020. The medical center is composed of seven healthcare colleges, child and adult hospitals, a Veterans Hospital, and outpatient services clinics across the Oklahoma city area. Faculty, staff, and students (N = 1,761) from the Oklahoma University Health Sciences Center completed the survey. COVID-19 fear is highest among nonclinical employees, smokers, and those with pre-existing conditions. Males and females, both clinicians and nonclinicians, appear to express their COVID-19 fears differently. Employees worried most about their families contracting the virus. The Fear of COVID-19 Scale is a valid and reliable assessment instrument among US healthcare workers. Responses were compared based on pre-existing medical condition(s), patient care or nonpatient care, sex, and occupational specialization. Analyses reveal a strong Cronbach's α measure of internal consistency (α = 0.87). Significant differences were observed among employees with a nonclinical emphasis (p = 0.02), with a predisposing medical health condition (p < 0.001), and with a nonacademic occupational specialization (p < 0.01), and by sex (p < 0.001). COVID-19 fear significantly impacts academic medical center employees. Medical centers should address both healthcare and nonhealthcare workers' COVID-19-related fears. It is important to recognize that men and women may have different types of fears and express them differently, necessitating a gender-specific approach to managing COVID-19 fears. Employees with pre-existing conditions or who have vulnerable family members require additional support to remain fully functional and on the job.

Effects of Bluetooth-Enabled Desk Ellipticals on Office Work Performance: Rationale, Design, and Protocol for a Randomized Trial With Overweight and Obese Adults.

BackgroundWorkplaces that provide opportunities for physical activity without requiring extra time for activity could help counteract the obesity epidemic. Desk ellipticals can contribute to activity-supportive workplace environments; however, the feasibility of engaging employees in pedaling ellipticals during simultaneous office work has not been well evaluated.ObjectiveWe aim to present the rationale and methods from an ongoing randomized trial with overweight and obese employees that will evaluate (1) the effects of pedaling a compact desk elliptical on work performance and (2) the influence of different incentive types and schedules on desk pedaling quantity.MethodsOverweight and obese medical center employees are being recruited in dyads for a 2 (gift card type: healthier food vs Amazon) by 3 (gift card schedule: immediate incentive contingent on individual pedaling quantity; immediate incentive partially contingent on dyads’ joint pedaling quantity; and delayed noncontingent pedaling incentive) cluster randomized within-subjects factorial trial. All participants receive a Bluetooth-enabled desk elliptical for 4 weeks and access to a mobile app that provides real-time pedaling feedback. The primary aims are to assess (1) change in employee work performance from pre- to postelliptical installation via employee and supervisor ratings and (2) effects of gift card type and schedule on quantity of objectively measured desk pedaling completed.ResultsData collection is ongoing. We expect to complete main outcome analyses in 2020.ConclusionsThis trial represents one of the earliest attempts to assess the effects of desk pedaling and pedaling-incentive types in real-world offices. It could help bridge the research-to-practice gap by providing evidence on whether desk pedaling can be sustained without compromising work performance.International Registered Report Identifier (IRRID)DERR1-10.2196/16275

The Effect of Career Development and Work Environment on Job Satisfaction at PT E-Tirta Medical Center Employees Jakarta

This study aims to determine: (1) Effect of career development on employee work satisfaction PT. E-Tirta Medical Center, (2) The influence of work environment on employee work satisfaction of PT. E-Tirta Medical Center, (3) Influence of career development and work environment to job satisfaction of PT. E-Tirta Medical Center. The type of research used is survey. Population in this research is employees of PT. E-Tirta Medical Center. Sampling technique using purposive sampling method with the number of samples of 100 people. Data collection techniques using questionnaires that have been tested for validity and reliability. Data analysis techniques used to answer the hypothesis is multiple regression. The results of this study indicate that: (1) Variable career development have a positive effect on employee work satisfaction PT E-Tirta Medical Center. This is evidenced from the tcount of 2.864 with a significance value of &lt;0.05, and the regression coefficient has a positive value of 0.224; (2) Work environment variable positive influence on employee job satisfaction at PT. E-Tirta Medical Center. This can be proved from the tcount of 2,864, with significance value of &lt;0.05, and the regression coefficient has a positive value of 0.869; (3) Variable of career development and work environment influence simultaneously to job satisfaction of employees at PT. E-Tirta Medical Center. This can be proved from the value of Fhitung of 59.382 while Ftable for n = 64 of 3.14, with significance &lt;0.05.

Survey of medical center employees’ willingness and availability to donate blood in support of a civilian warm fresh whole blood program

In military settings, utilizing warm fresh whole blood (WFWB) was associated with reduced mortality; however, there are multiple challenges for administering WFWB to civilians. The authors aimed to determine barriers to hospital employees emergently donating to civilian WFWB programs. We surveyed hospital employee willingness to donate emergently, familiarity with blood donation, and queried baseline demographics. The electronic survey was disseminated to a random sample of employees. Descriptive and univariate analyses were performed. Three thousand surveys were sent; 883 were returned (28 percent). The majority of respondents were female (n = 630, 71 percent). Respondent familiarity with WFWB donation included very/somewhat familiar (n = 381, 43 percent) and somewhat-not/not-at-all familiar (n = 356, 40 percent). Most were definitely or somewhat willing to emergently donate (n = 660, 75 percent). Four hundred and sixty would drive from home to donate (52 percent). The majority worked day-time shifts (n = 754, 85 percent). In regards to donation history, 366 (41 percent) had donated blood more than ten times, but 138 (16 percent) had never donated. Barriers to emergent donation were identified (55 percent), with the most common being childcare responsibilities (n = 242; 27 percent). Hospital employees are willing to donate WFWB emergently, but program implementation must address donor availability and logistical barriers. Future research should assess feasibility of a civilian WFWB program by determining regulatory challenges, development of a quality system for emergency donations, assessment of optimal workforce structure, potential impact to the general blood inventory, as well as patient and community perspectives regarding untested blood units.

Five-year trends in adenoviral conjunctivitis in employees of one medical center

To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented. Observational report with a retrospective evaluation of a current quality improvement initiative. Johns Hopkins Medicine, Baltimore, Maryland.ParticipantsJohns Hopkins Medicine employees. Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed. From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05). Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.

0246 The Associations between Subjectively Unrefreshing Sleep and the Workplace

Employee fatigue and sleepiness can lead to increased hostility, decreased mood, plus absentee and presenteeism. Decreased work performance due to fatigue or sleepiness can lead to significant financial deficit for companies. One study estimated a $54 million loss attributed to fatigue-related productivity reductions at four U.S. based companies. With almost 76% of employees feeling “tired many days of the week,” these losses are relevant to many businesses. The aim of this study was to assess the associations between subjective sleep quality and workplace performance. A sample of OSF HealthCare Saint Francis Medical Center employees (n= 573, age 18–69) completed a 20-question survey about perceived sleep quality, work attendance, and the reported effects of sleepiness, tiredness, or fatigue on their mood and interactions in the workplace. Results were evaluated with univariate and multivariate analyses. When asked if sleep is usually refreshing, more subjects reported no than yes (n=325, 248 respectively (56.7%, 43.3%)). Those who reported that sleep is not refreshing were also more likely to declare sleepiness, tiredness, or fatigue at work (n=187 vs. n=62 (57.5%, 25.0%) p = 0.0002). Similarly, the same subjects were more likely to report that sleepiness, tiredness, or fatigue negatively affected their moods and workplace interactions (n=48 vs. n=11 (14.7%, 4.44%) p < 0.0001). Finally, those with unrefreshing sleep were also 1.8 times more likely to report tardiness to work than did those with refreshing sleep (OR = 1.8, 95% CI: 1.1–2.8; p = 0.0136). These findings that self-reported unrefreshing sleep is associated with adverse workplace outcomes, including tardiness, worsened mood, and difficulty with workplace relations suggest that attention to sleep health and education in the workplace may be worthwhile. N/A

Stress management in the workplace for employees with hypertension: a randomized controlled trial.

While behavioral interventions can improve blood pressure (BP) in individuals with hypertension, getting such services to people who could benefit remains difficult. Workplace programs have potential as dissemination vehicles. The objective is to evaluate the effectiveness of a standardized stress management program delivered in groups at the workplace for reducing BP compared with enhanced usual care. This randomized controlled trial studied 92 urban medical center employees with hypertension randomized into two groups. The intervention was a 10-week group workshop on cognitive-behavioral coping skills. Enhanced usual care included self-help materials for BP reduction and physician referral. Intervention group participants' systolic BP (SBP) decreased 7.5 mm Hg over controls between baseline and follow-up, from 149.1 (95% CI: 146.0-152.1) to 140.0 (95% CI: 134.7-145.2), p < .001. The differential change between intervention and enhanced usual care groups (Group × Time interaction) was 7.5 mm Hg (t = -2.05; p = .04). Diastolic BP reductions were not significantly different. Scores on measures of emotional exhaustion and depressive rumination showed significant improvements and correlated with reductions in SBP. There was no significant change in the usual care group. A standardized worksite group intervention produced clinically meaningful reductions in SBP in participants with hypertension.

The Influence Of Physical Activities At The Workplace On Private Medical Center Employees

Being aware of the increase in obesity and sedentary lifestyle, many organizations develop intervention programs to improve the health of their employees by offering them various physical activities at work. PURPOSE: To assess the barriers of engaging in physical activity among medical center employees, and the mental and physical impact of participation in physical activity lessons at work. METHODS: 231 private medical center employees including physicians, paramedical and administrative staff participated in this study. 135 participants were not active in the lessons and 96 (70%) who were active, practiced twice weekly in various activities: Pilates, yoga, running, cycling, and Zumba. RESULTS: The physical activity group was found to have a higher workplace satisfaction level (p<.001), a decrease in burnout (p<.01), better health perceptions (p<.01), lower weight (p<.05), a reduction in chronic morbidity and drug consumption (p<.05), less smoking and liquor consumption (p<.01), healthier eating and sleeping habits (p<.001) and more physical activity outside of working hours (p<.01). Among the main barriers to participate in the activity lessons at work for the non-active group were: unsuitable lesson schedule (62%) lack of desire for sport (61%), lack of time (53%), fatigue (44%), prior family commitments (39%), non-payment of activity time (35%), and unawareness of the physical activity programs (27%). CONCLUSIONS: Physical activity programs at medical centers promote employees health thereby neutralizing negative aspects such as worker burnout, mental and physical fatigue and increases employee satisfaction at the workplace. Therefore, more promotion of physical activity at the workplace should be encouraged in order to increase employee participation. However, further research is needed in public medical center to verify these research findings among healthcare employees.

Using telephony data to facilitate discovery of clinical workflows.

Discovery of clinical workflows to target for redesign using methods such as Lean and Six Sigma is difficult.VoIP telephone call pattern analysis may complement direct observation and EMR-based tools in understanding clinical workflows at the enterprise level by allowing visualization of institutional telecommunications activity. To build an analytic framework mapping repetitive and high-volume telephone call patterns in a large medical center to their associated clinical units using an enterprise unified communications server log file and to support visualization of specific call patterns using graphical networks. Consecutive call detail records from the medical center's unified communications server were parsed to cross-correlate telephone call patterns and map associated phone numbers to a cost center dictionary.Hashed data structures were built to allow construction of edge and node files representing high volume call patterns for display with an open source graph network tool. Summary statistics for an analysis of exactly one week's call detail records at a large academic medical center showed that 912,386 calls were placed with a total duration of 23,186 hours.Approximately half of all calling called number pairs had an average call duration under 60 seconds and of these the average call duration was 27 seconds. Cross-correlation of phone calls identified by clinical cost center can be used to generate graphical displays of clinical enterprise communications.Many calls are short.The compact data transfers within short calls may serve as automation or re-design targets.The large absolute amount of time medical center employees were engaged in VoIP telecommunications suggests that analysis of telephone call patterns may offer additional insights into core clinical workflows.

Three-Month Treatment for Latent Tuberculosis Infection (LTBI) with Rifapentine and INH (R&amp;I) in a Medical Center Employee Health Service (EHS): Strategy and Advantages

Three-Month Treatment for Latent Tuberculosis Infection (LTBI) with Rifapentine and INH (R&amp;I) in a Medical Center Employee Health Service (EHS): Strategy and Advantages