Non-clinical Departments Research Articles

COVID-19 and Health-care Business Continuity in Africa: Perceptions of Risks and Vulnerabilities by Mid-level Management Staff in a Tertiary Care Hospital.

The novel SARS-CoV-2 outbreak disrupted businesses globally and created fears in the general public and among health-care professionals. Almost universally, considerations about the coronavirus pandemic and its effects became priority in the daily operations of businesses, leaving hitherto pressing concerns in the back stage. Early in the pandemic, the management of University of Benin Teaching Hospital set up a Business Continuity Team which undertook an evaluation of the perceptions of mid-level hospital managers about their departments' and units' risks and vulnerabilities in the face of the ongoing pandemic. A modified International Labour Organization (ILO) risk profile self-assessment tool which focused on "people," "processes," "profits," and "partnerships" was used to assess mid-level managers' perceptions of their respective departments' and units' risks and vulnerabilities, consequent on the COVID-19 pandemic. Responses were obtained from heads of departments and units using an online survey. Final scores were divided into terciles (three equal groups) in respect of perceived risks and adverse outcomes of the COVID-19 pandemic. Scores in the lower tercile were grouped as low risk/vulnerability, the middle group of scores as medium risk/vulnerability, and scores in the upper tercile as high risk/vulnerability. Responses were obtained from 35 (49.3%) of the 71 clinical and nonclinical departments and units in the hospital. Fifteen of these (42.9%) were clinical. Nineteen (54.2%) departments were assessed to be at high risk/vulnerability, 9 (47.4%) of which were clinical. Twelve (34.3%) departments were assessed to be at medium risk/vulnerability - 4 (33.3%) of them, clinical. No department was assessed to be at low risk. The highest risk ratings were in the domains of "profits" and "partnerships:" 54 (84.4%) mid-level managers assessed their departments and units to be at high risk of the negative impacts of the coronavirus pandemic with respect to "profits" and 51 (79.7%) with respect to "partnerships." Mid-level managers in clinical and nonclinical departments and units assessed their departments and units to be at medium and high risk of the negative impacts of the COVID-19 pandemic, using the ILO's modified tool. Our findings enabled the management of the hospital and the Business Continuity Team to address the specific areas of concerns that were highlighted, develop contingency plans, and frame risk communication during the pandemic, with a view to fostering increased sense of safety in the workforce. This approach to risk assessment is repeatable, and we recommended it to other hospitals in Africa.

Basic medical sciences are pre-clinical subjects, not non-clinical subjects: Say 'No' to the prefix 'Non-'.

Few medical institutions in India, such as the All India Institute of Medical Sciences (AIIMS), use the term pre-clinical in their websites and brochures, but many institutions still use the word 'non-clinical'. In my opinion, the non-clinical departments should be renamed pre-clinical departments. In western countries, the curriculum is divided into pre-clinical and clinical. For example, in Oxford University, the initial instruction in courses such as Anatomy and Physiology is regarded as pre-clinical instruction. Non-clinical departments in western countries are the departments of human resource, accounts and information technology (IT).

Social Needs Screening in Academic Health Systems: A Landscape Assessment.

Screening for social needs has gained traction as an approach to addressing social determinants of health, but it faces challenges regarding standardization, resource allocation, and follow-up care. The year-long study, conducted by the Association of American Medical Colleges, integrated data from conferences, surveys, and key informant interviews to examine the integration of social needs screening into health care services within Academic Health Systems (AHS). The authors' analysis unveiled eight key themes, showcasing AHS's active involvement in targeted social needs screening alongside persistent resource allocation obstacles. AHS are dedicated to efficiently identifying high-risk populations, fostering partnerships with community-based organizations, and embracing technology for closed-loop referrals. However, concerns endure about the utilization of reimbursement codes for social needs and regulatory compliance. AHS confront staffing issues, resource allocation intricacies, and the imperative for seamless integration across clinical and nonclinical departments. Notably, opportunities arise in standardized training, alignment of AHS priorities, exploration of social investment models, and engagement with state-level health information exchanges. Aligning clinical care, research pursuits, and community engagement endeavors holds promise for AHS in effectively addressing social needs.

Assessment of level of stress among post-graduate trainees working in tertiary care hospital in a district of Assam

Background: Medical education is itself very vast, stressful and challenging. Stressful condition can lead to many psychological responses like anxiety, depression, irritability, restlessness, sleep disturbances etc. The postgraduate students are at risk of developing stress due to their professional duties, workloads, peer pressure, academic activities and so on. Thus, the study has been initiated to find out the level of stress and its related factors among the post graduate students in a Tertiary care hospital of Assam. Methods: The cross-sectional study was conducted on all the postgraduate students in a tertiary care hospital during March’23 to June’23. By convenience sampling technique around 108 post graduate students were participated in the study. The level of stress had been assessed by perceived stress scale (PSS-10), stress related symptoms from self reporting questionnaire (SRQ-20), and sleep quality by insomnia severity index scale. Results: The study found out that 98 (90.74%) had moderate, 6 (5.55%) high and 4(3.74%) low level of stress. The stress was associated with marital status, gender, residence and clinical and non-clinical departments. Out of 75 male (69.45%), 72 (96% ) moderate, 2 (2.6% ) high and 1 (1.3%) low level of stress and 33 (30.55%) female participants, 81.8% had moderate, 4 (1212%) high, and 2 (6.06%) had low level of stress. Conclusions: The study had concluded that stress was found to be prevalent among the study participants.

Abstract A030: Identifying LGBTQ+-related barriers and gaps in patient and workplace environments: An LGBTQ+ environmental needs assessment at Perlmutter Cancer Center

Abstract Background: The LGBTQ+ community faces disproportionately higher cancer-related health disparities compared to the general population. Lack of access, knowledge, and cultural attitudes are known factors attributing to lower rates of receiving cancer-preventative services, as well as higher rates of later-stage cancer diagnoses. Many factors contribute to these disparities, including finding a trusted provider, poor visual representation at clinics, missing sexual orientation and gender identity (SOGI) data, and negative patient experiences. To address these issues and to promote equitable care it is important to identify gaps and barriers that present in patient and healthcare staff environments. The LGBTQ+ Staff Task Force (STF) at NYU Langone Health Perlmutter Cancer Center (PCC) will utilize the Exploration, Planning, Implementation, Sustainment (EPIS) framework to address these inequities. Methods: As part of the “Exploratory” phase, the STF will deploy an environmental needs assessment survey, to evaluate patient and employee areas. The assessment includes the following LGBTQ+ domains to evaluate the environments: Policy; Visualization and Safety; Knowledge and awareness education; Complaint and Feedback Reporting; Workplace Inclusions and Non-discrimination; Resources. The survey will be administered to all clinical and non-clinical departments of PCC and will be completed by STF members from their respective departments and by managers or supervisors from each department location. Surveys will be submitted electronically via REDCap Data will be analyzed by the research team and discussed in small focus groups. Discussion: The LGBTQ+ Needs Assessment will be carried out across all PCC departments and locations within an 8-week period between May and July 2023. The findings from utilizing the EPIS framework will enable the identification of gaps and barriers to inclusive patient care and evaluate the efficacy of current processes and resources in place for LGBTQ+ patients and employees. Findings will inform strategies and planning to decrease identified factors impacting access to equitable healthcare. Citation Format: Alexandr Trifonov, Rachel Monahan, Megan C. Haseltine, Kevin Moore, Gwendolyn P. Quinn, Rachel Nelson, Abraham Chachoua, Jason Domogauer. Identifying LGBTQ+-related barriers and gaps in patient and workplace environments: An LGBTQ+ environmental needs assessment at Perlmutter Cancer Center [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A030.

A National Survey of Job Satisfaction and Workload Among Emergency Medicine (EM) Residency Faculty.

Faculty workload, and its relation to job satisfaction, has not been well studied in Emergency Medicine (EM). Methods:A cross-sectional survey was conducted among EM physician faculty at 49 residency programs across the United States. We collected information on clinical and non-clinical (education, administration, and research) workload, demographics, and EM department characteristics, as well as job satisfaction measured using the Global Job Satisfaction (GJS) scale. Comparisons were made using Wilcox signed rank tests. Multivariable associations with job satisfaction were assessed in a regression model. Of 1,791 surveys sent, 265 were completed.The quantity of contracted clinical and non-clinical hours was lower than the actual clinical (difference (95% confidence interval (CI)): 2.7 (1.5-4.1)) and non-clinical hours (6.0 (3.8-8.8)) worked.Respondents preferred a distribution of 50% clinical work. However, the actual percentage was 62% (difference (95% CI): 14.4% (10.8%-17.6%)).Identifying as core faculty and required logging of non-clinical hours were associated with improved job satisfaction while increased percentage of time spent in the clinical and administrative domains were associated with significant declines. The estimated actual work performed by EM physician faculty is greater than contracted and misaligned with their preferred type of work, the latter of which is associated with decreased job satisfaction. Improved job satisfaction and faculty retention might be achieved by increasing the percentage of time devoted to education and research, by increasing the core faculty contingent and by implementing tracking of non-clinical efforts.

Changes in sick leave utilization at an academic medical center during the COVID-19 pandemic

PurposeThe coronavirus disease 2019 (COVID-19) pandemic drastically changed work arrangements, but COVID-19's impact on employee leave utilization is unclear. The authors sought to understand how sick leave and vacation leave utilization changed during the pandemic among clinical and non-clinical departments at an academic medical center (AMC).Design/methodology/approachClinical departments were defined as work units with a primary mission of providing direct patient care. Per-person, per-month leave utilization data were obtained from the AMC's time-keeping system for 3 clinical departments and 4 non-clinical departments in the first 12 months of the pandemic and the preceding 12 months. Monthly data for each department were analyzed with mixed-effects regression.FindingsAvailable data represented 402 employees from 3 clinical departments and 73 employees from 4 non-clinical departments. The authors found no statistically significant change in sick leave utilization among either clinical or non-clinical departments. Vacation leave utilization decreased during the pandemic by 5.9 h per person per month in non-clinical departments (95% confidence interval [CI]: −8.1, −3.8; p < 0.001) and by 3.0 h per person per month in clinical departments (95% CI: −4.3, −1.7; p < 0.001).Originality/valueAmong employees in clinical departments, the authors found no increase in sick leave utilization and a decrease in vacation utilization. These findings are concerning for presenteeism, risk of burnout or understaffing resulting in workers' inability to take time away from work in clinical departments.

A cross-sectional study of awareness, knowledge, and attitude in pharmacoeconomics related to antibiotic usage in medical postgraduate students

Background: Pharmacoeconomics is one of the burgeoning branch of pharmacology. In the scenario of popping up of various numbers of pharmaceutical companies the prices of various drugs especially antibiotics is varied and this study will help to decrease the expenditure of antibiotics where ever possible. Aim and Objectives: This study will create awareness in medical postgraduates about prices of antibiotics, which will decrease irrational financial burden on patients and decrease in incidence of antibiotic resistance and adverse effects. Materials and Methods: The study design is cross-sectional, observational, and questionnaire-based. A preformed questionnaire containing 30 questions was given to 110 medical postgraduate students. Along with demographic data, their awareness, knowledge, and attitude on pharmacoeconomics related to antibiotic usage were analyzed using appropriate statistical tools. Results: One hundred students were aware of term pharmacoeconomics (90.9%), out of which 58% learned from PG curriculum. Knowledge was considered good when the participants answered 50% of the questions related to terms about pharmacoeconomics. In this context, about 28 female students and 11 male students had good knowledge about pharmacoeconomics (P = 0.02). Students of clinical specialty were more knowledgeable than non-clinical department (P = 0.01). Knowledge about some popular antibiotics prices was questioned. Students were well aware of beta lactum antibiotic prices (60%) compared to other groups. Least awareness was with prices of antifungal drugs. About 63% of students were cost conscious while prescribing antibiotics. The frequency of prescribing an antibiotic suggested by medical representative was about 38%. Conclusion: The medical postgraduates who participated in this study had a good awareness regarding definition of term pharmacoeconomics. However, knowledge in depth about pharmacoeconomics was hard up. Hence, we recommend to inculcate pharmacoeconomics in 2nd-year MBBS course as a part of pharmacology, where in the students are taught to calculate the expenditure of various treatments. Regular continuing medical education must be conducted to update about pharmacoeconomics related to antibiotic usage. This study will further decrease the cost of treatment in patients.

An Empirical Study on the Use of Digital Technologies to Achieve Cost-Effectiveness in Healthcare Management.

Objectives: Healthcare cost reduction is one of the major challenges of the current era. This study was based on the general system theory-based view to assess the significance of sensing communication technologies and processing actuation technologies in improving healthcare quality, leading to cost reduction. Moreover, the contingent rule of healthcare supply chain management in enhancing the influence of improved quality on healthcare cost reduction was also empirically tested. Methods: The sample of the study comprised 337 middle and senior healthcare managers employed in various government and private hospitals and health institutions in Jakarta, Indonesia. The administrative departments of each hospital and health institution was visited to take their consent to conduct this survey at their clinical and non-clinical departments. The data collected was analyzed using SmartPLS ver. 4 software. Results: Results reveal a significant direct and indirect influence of sensing communication technologies and processing actuation technologies on achieving cost-effectiveness in the healthcare sector, in the presence of perceived quality improvement as a mediator. However, the strength of the associations varied and was based on highly reliable and familiar nature of sensing communication technologies compared to processing actuation technologies which were emerging and gaining popularity in recent years. Conclusion: Considering the healthcare cost as a critical factor based on limited resources in emerging economies, healthcare institutions/centers should use digital technologies to achieve cost-effectiveness for providing healthcare facilities in the industry 4.0 era.

Post-COVID presumptive stressful life-events and depression among faculties

Introduction: Stress is an inhabitable component in a doctor’s life. Apart from the personal life, working environments add a huge components of stress in life, which later convert into depression. The unprecedent event of COVID act as top up in adding various stressful events among healthcare professionals. Objectives: The aim of this study was to measure the post-COVID amount of presumptive life stress and depression among the faculties in a tertiary care institute. Methods: It was a cross-sectional study conducted at SCB Medical College, Cuttack for the period of 6 months, i.e. January’21 to June’21. Faculties of all the departments of SCB medical college was considered as study participants and by stratified sampling 72 faculties were considered for this study. Presumptive stressful life event scale (PSLE) was used to measure the stress and Zung self-assessment depression scale (SDS) was used for the measurement of depression among the study participants. The analysis was done “R” software version 4.0.3. Results: A total of 72 faculties were included in this study. Among them, 51(70.83%) were from clinical, 13(18.05%) from para-clinical and 8(11.12%) from non-clinical departments, females (52.8%) and males (47.2%).

Analysis of occupational stress, burnout, and job satisfaction among dental practitioners.

Dental practitioners can be prone to stress because of the long working hours, high patient expectations, and work environment. To investigate dimensions of occupational stress among dental practitioners leading to burnout and to model its causality with job satisfaction. An analytical cross-sectional study was conducted for five months. A sample of 302 practicing dental practitioners was selected using the consecutive sample technique. This sample included dental practitioners working in clinical and non-clinical departments of public and private sector universities as well as those doing private general practice. A self-administered structured questionnaire based on the Work Stress Questionnaire was sent using Survey Monkey. Descriptive statistics were calculated. Spearman correlation was applied between stress scores and job satisfaction. A Chi-square test was applied to look into the association between stress levels and different categories. Univariate and multivariate analysis was performed. The prevalence of overall occupational stress was high among dental practitioners (83.4%). Occupational stress was greatest in females (55.8%), dental practitioners in the private sector (55.7%), and general dental practitioners (GDPs) (47%). The overall prevalence of job satisfaction among dental professionals was 30%. Occupational stress was significantly associated with burnout and job dissatisfaction in dentistry. Stress levels and working hours were statistically and positively associated, whereas the association between stress levels and job satisfaction was inversely and significantly associated. The prevalence of occupational stress among dental practitioners was high and the level of job satisfaction was moderate. The model between these variables was well-fitted.

Teleworking from home experiences during the COVID-19 pandemic among public health workers (TelEx COVID-19 study)

BackgroundWhen working from home (WFH) became temporarily necessary for staff as a result of the COVID-19 pandemic in 2020, it had to be implemented without significant organisational experience or understanding of WFH and its complexities. This study aims to determine the impacts experienced by staff who have undertaken WFH during the COVID-19 pandemic.MethodsThis was an observational cross-sectional study using survey with a purposive sampling strategy for staff from corporate and non-clinical departments. These staff undertook WFH during COVID-19 pandemic in 2020. None of these staff had any direct operational roles in a hospital facility and clinical service. Participants’ self-reports of their mood while working in their normal workplace and while WFH were collected via the Scale of Positive and Negative Experience (SPANE), a validated affect balance questionnaire. The responses from the open-ended question were analysed using thematic analysis approach.ResultsA total of 143 participants completed the survey responses. Majority (61%) WFH for four or more months as a result of the COVID-19 pandemic. Participants rated their skills very highly on the technologies with an average rating of 9 (out of 10) for computer skills, smartphones and videoconferencing/teleconferencing applications. Participants felt WFH was an improvement on normal working, in particular in relation to their ability to concentrate and be productive. The “SPANE” relating to affect balance while WFH was completed by 124 participants (85.7%), resulting in a mean score of 5.45 (S.D. 2.98). The SPANE relating to normal working conditions was completed by 127 participant (88.8%) resulting in a mean score of 2.70 (S.D 3.69). This indicated that while participants’ positive emotions typically predominated in both situations, they felt slightly more positive on average with WFH. Over 90% participants reported that they would take the opportunity to WFH again if it were offered. Data obtained from the open-ended questions had complimented the findings of the structure close-ended questions in the benefits of remote working and support for their health and wellbeing. The open-ended questions had provided additional information on challenges which the participants encountered during the WFH experience and their suggested preference to sustain this workplace practice.ConclusionsThis study highlighted factors that impacted workers’ work processes, productivity, physical and mental health well-being while WFH and provided a foundation for considering how to best support a positive WFH experience.

Mental health problems in health-care workers of tertiary level COVID-19 care centers in Central India

Background: The health-care workers (HCWs) who are overburdened during the COVID-19 pandemic are at increased risk of developing psychological disorders. Aim: The aim of this study was to assess the magnitude of psychological problems such as depression, anxiety, and fear of COVID-19 among the HCWs and to study their correlates. Material and Methods: The study is an online multicentric cross-sectional survey of mental health problems in the HCWs of three tertiary level COVID care centers in Central India. HCWs were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Fear of COVID-19 Scale. Results: Out of 467 HCWs assessed, 25.5% of the participants had depression (defined by PHQ-9 score of more than 5), whereas anxiety was present in 24.4% of the study subjects (defined by GAD-7 score of more than 5). Forty-six percent of the participants had medium-to-high levels of fear of COVID-19. Female gender, working in the nonclinical department, direct involvement in care of COVID-19 patients, perceived worsening of physical health status following the pandemic outbreak, and past history of psychiatric problem were the factors significantly associated with presence of depression as well as anxiety. Age of the participant had a positive correlation with fear of COVID-19 and a negative correlation with depression and anxiety levels. Conclusion: HCWs serving in COVID hospitals are vulnerable to develop mental health problems and appropriate screening measures and interventions should be designed so as to preserve mental health of this vital task force.

ROLE OF STUDENTS’ RESEARCH ACTIITY IN FOSTERING PROFESSIONAL COMPETENCE AT THE DEPARTMENT OF PATHOPHYSIOLOGY OF POLTAVA STATE MEDICAL UNIVERSITY

Student research activity is one of the most important forms of the education and the driving force of quality assurance activities. Ukraine has developed a regulatory and legal framework that ensures high-quality research work, which should meet the needs of future specialists in intellectual and professional development and increase their professional competence. The involvement in research work requires, first of all, gaining deep theoretical and practical knowledge in medicine, well-designed extra-curricular activities to guide students in their mastering methodology of scientific research and developing research skills, and university promotion. The experience of Poltava State Medical University convincingly proves that the most effective means of improving the quality of training is the regular active involvement of students in research activity. The role of scientific knowledge in higher education is decisive, since the active participation of the teaching staff in fostering research skills makes it possible to demonstrate the latest scientific achievements and their practical application. Structured research activities, woven into the medical school curriculum provide an opportunity to evince the intellectual potential of both students and educators, to contribute to deeper investigation of medical problems, to master the methods of scientific investigation, and to realize the importance of such activity in increasing one's competitiveness in the labour market. This approach also contributes to better comprehension of professional information, to develop mindset associated with high professionalism.&#x0D; Pathophysiology as a discipline is at the junction of theoretical and clinical disciplines that serves as a wide background to meet the diversity of students’ scientific demands and interests. Involving students into structured research activities not only promotes gaining special knowledge, but also builds up ethical and deontological foundations of future successful medical research career; enhances team spirit and cooperation between students and educators. This interaction enables in clearly stating their focus and research question, engaging in an adequate critical discussion of the strengths and weaknesses of the study methods, and offering conclusions that are properly qualified in the scope given the evidence gathered and analyzed. This department is proud to maintain a high university rank on student research results performance among the non-clinical departments. The culmination of knowledge in this developmental trajectory can reinforced and extend other aspects of high quality training.

Planning and Setting Up of a Communication Program for Hospitalized COVID-19 Patients: Challenges and Potential Solutions in Resource Constrained Setting

Background The recent onset of COVID-19 pandemic has necessitated many patients to be hospitalized in the COVID-19 treating centers. Owing to the need for isolation of these patients and minimizing the risk of transmission to healthy people, COVID-19-positive patients are completely restricted from meeting their friends and families. This gives rise to anxiety amongst the patients' relatives as they are not able to monitor the progress of the patients and have to depend entirely on the healthcare staff for any updates regarding the patient. In contrast, the treating doctors are undergoing severe stress due to the unknown nature of the virus and the risks involved in treating patients. They are thoroughly exhausted after the long hours donning the personal protection equipment (PPE). Objective To structure and form an interface for communication between the treating physician and the families, as a “communication team,” to decrease the workload on the treating physicians and minimize their contact time in a COVID-19 setting. Results The addition of a communication team improved the physicians' efficiency of patient management and family satisfaction. Several challenges were faced during the setting up of this interface effectively. However, most of these were dealt with along the way. The communication team was instrumental in allaying the anxiety of the family with respect to their patients' clinical condition. This also ensured engagement of doctors from non-clinical and laboratory-based departments in the COVID-19 treatment process. Conclusion Adding up a communication team for communicating clinical updates to the family in a resource-limited scenario greatly improved communication and thus family satisfaction of the COVID-19-positive patients.

Assessment of Stress among Doctors due to Covid-19

Introduction: During infectious disease outbreaks, doctors are at high risk of infection, infecting others, and psychological distress. This study aimed to determine the prevalence of stress and anxiety in physicians during the COVID- 19 outbreak in India. Material and Methods: This is a cross-sectional surveybased study conducted at the Department of Psychiatry of a tertiary care medical college and hospital. For the purpose of this study, a Google survey form was created and circulated among all the doctors through WhatsApp groups in June and August 2021. The doctors included JRs, SRs and faculty. All the doctors were included except those who had themselves suffered from COVID-19 or if their family members had suffered since that could have led to increased stress and skewed the findings. The Perceived stress scale (PSS-10) was used to assess perceived stress. Results: In this study total subjects are 217 among 128 were males and 89 females. The maximum number of subjects were in the age group of 31-40 years which were 31.7% (n =69) followed by age group 41–50 years having 36.4% (n = 78) in this group and 17.9% were &gt;51 years. This participant worked at different duties during Covid-19 pandemic era. 23 participants were High stress degree of stress on PSS, 135 (62.2%) Participants displayed moderate degree and 59 (27.1%) shows low level of stress during pandemic era. Further inspection in context of department wise stress distribution reveals that 217 subject among Non-clinical department pool shows high degree of stress were 4.1% moderate degree were 24.8% and 10.5% found having low level of stress. Conclusion: Doctors working in COVID-19 wards perceive considerable stress. Stress management should be an integral part of the curriculum of doctors so that they can serve the humanity efficiently and effectively during the pandemic and in future.

Prevalence of SARS-CoV-2 antibodies in multiple sclerosis: The hidden part of the iceberg

Background. We compared the prevalence of SARS-CoV-2 IgG/IgM in multiple sclerosis (MS), low-risk, and high-risk populations and explored possible clinical correlates. Methods. In this cross-sectional study, we recruited MS patients, low-risk (university staff from non-clinical departments), and high-risk individuals (healthcare staff from COVID-19 wards) from 11 May to 15 June 2020. We used lateral flow immunoassay to detect SARS-CoV-2 IgG and IgM. We used t-test, Fisher’s exact test, chi square test, or McNemar’s test, as appropriate, to evaluate between-group differences. Results. We recruited 310 MS patients (42.3 ± 12.4 years; females 67.1%), 862 low-risk individuals (42.9 ± 13.3 years; females 47.8%), and 235 high-risk individuals (39.4 ± 10.9 years; females 54.5%). The prevalence of SARS-CoV-2 IgG/IgM in MS patients (n = 9, 2.9%) was significantly lower than in the high-risk population (n = 25, 10.6%) (p < 0.001), and similar to the low-risk population (n = 11, 1.3%) (p = 0.057); these results were also confirmed after random matching by age and sex (1:1:1). No significant differences were found in demographic, clinical, treatment, and laboratory features. Among MS patients positive to SARS-CoV-2 IgG/IgM (n = 9), only two patients retrospectively reported mild and short-lasting COVID-19 symptoms. Conclusions. MS patients have similar risk of SARS-CoV-2 infection to the general population, and can be asymptomatic from COVID-19, also if using treatments with systemic immunosuppression.

Burnout and resilience in doctors in clinical and preclinical departments in a tertiary care teaching and dedicated COVID-19 hospital.

Background:The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level.Aim:The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments.Materials and Methods:This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor–Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor–Davidson Resilience Scale.Results:The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9).Discussion:Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout.Conclusion:Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

Faculty wellness in academic medicine: Addressing stressors in the workplace.

Burnout is widely regarded as a syndrome resulting from chronic occupational stress. While physician burnout has been the subject of extensive research, physician wellness has been proposed as an alternative framework for understanding physician distress. The purpose of this qualitative study was to understand the organizational context of faculty wellness within an academic health care system. Semi-structured interviews were conducted with 24 chairs of clinical and non-clinical departments in a US university school of medicine. Chairs described several system-level factors perceived to interfere with faculty wellness such as a stricter regulatory environment, the loss of professional autonomy, the up or out promotion system, limitless hours, and the rise of shadow work. While all chairs articulated some degree of responsibility for the wellness of their faculty, some said they lacked the skills or knowledge of resources to fully engage in this role. Findings from this study are consistent with recent research on physician burnout, which has pivoted from describing burnout as an individual responsibility to including the professional, organizational, and societal factors which likely contribute to physician job satisfaction and well-being. As health care organizations, including academic medical centers, move toward systems-based solutions for physician occupational health, it will be incumbent upon organizational leaders to make administrative decisions favoring physician wellness.

Service design in the healthcare space with a special focus on non-clinical service departments: A synthesis and future directions.

Although there has been a tremendous change in the way diseases are diagnosed and treated, the ways in which health care delivery has been managed has seen very little change.Several academic studies have arisen in the area of service design, but an amalgamation of this research, especially in the area of healthcare services is not available. The aim of this systematic review is to evaluate the published research on service design in healthcare and accordingly identify the gaps and scope of future research. After analyzing the articles and reviewing the Service design in healthcare literature, the following are our main contributions: (i) clarification of the service design concept and the developments that appears in the literature review of service design in the healthcare sector; (ii) classification of the service design tools and techniques that are most commonly used in the healthcare sector; (iii) demonstration of the service design as the preponderant construct that is used as a tool and technique to improve quality and efficiency in the healthcare service.The resultant systematic review reveals a change in the type of research carried out, the service design tools used and a shift towards service design from using the co-design tool to other methods. The paper highlights the gaps in the very limited amount of empirical work in the non-clinical healthcare space and accordingly a model is recommended.