Patient-centered Health Care Research Articles

Expectations and Perceptions of Medical Rehabilitation in Times of Pandemic from the Perspective of Individuals in Need of Rehabilitation and Rehabilitation Patients - A Qualitative Study

Over the past four years, medical rehabilitation providers and their staff have developed strategies to adapt to a new reality of care during the COVID-19 pandemic. The aim of this qualitative survey was to assess patients' expectations from and perceptions of rehabilitation in times of pandemic. The results can contribute to the development of recommendations on how pandemic-related challenges in rehabilitative care can be overcome. In order to gain insights into the perspective of (potential) applicants and rehabilitation patients, 33 guided, individual telephone interviews were conducted. The interview partners were recruited via two cooperation facilities, social media and a network-based snowball approach. The interviews were transcribed and analysed by means of qualitative content analysis in a multi-stage process based on the procedure recommended by Kuckartz. Potential applicants and rehabilitation patients commented on expected challenges and opportunities during rehabilitation and on the needs for rehabilitative care during the pandemic. On the one hand, restrictions on therapy and leisure time activities were reported. They also reported psycho-social challenges such as feelings of loneliness and isolation due to contact restrictions. On the other hand, potential patients also perceived opportunities during rehabilitation. They perceived the protective and hygiene measures in the facilities, lower clinic utilisation and smaller group sizes as well as the opportunity to make use of health services and social contact as positive aspects. The results show that rehabilitation can be perceived as relieving and health-promoting even in times of a pandemic, despite protective measures that can be restrictive. For some respondents, it is the protective measures that are decisive for the success of and health maintenance during rehabilitation. Whereas the strategies used by the facilities during the COVID-19 pandemic imposed restrictions on patients, their measures to prevent infections and at the same time ensure patient-centered health care brought positive effects and sustainable opportunities for rehabilitation.

Synergistic Collaboration of Pharmacists and Nurses in Enhancing Patient Care

Collaboration between pharmacists and nurses is widely seen as an important synergistic collaboration in enhancing patient care by addressing issues such as drug mistakes, growing healthcare expenditures, and complex illness management. Their combined expertise enhances patient care by optimizing drug therapy, improving patient education, and reducing preventable medication-related issues. This article reflects the synergistic collaboration of pharmacists and nurses in enhancing patient care. A literature analysis was done to investigate research on multidisciplinary interaction between pharmacists and nurses in diverse healthcare settings, with an emphasis on their roles in drug management, patient education, and therapy optimization to reduce any avoidable interactions. Collaboration dramatically lowers medication mistakes, increases patient adherence, and improves overall clinical results, including chronic disease management. Despite the benefits, communication gaps and ambiguous responsibilities hinder successful synergistic collaboration. Addressing these hurdles through improved training and integration of certain healthcare systems software for better collaboration is critical to maximize the advantages of this collaborative effort. Pharmacist-nurse collaboration improves patient care and safety, and overcoming current obstacles can lead to more efficient, patient-centered healthcare systems. Despite the great perks of collaboration, there are certain obstacles to smooth collaborations. These obstacles can be addressed by providing proper training and integration of AI and other technical software for a smooth collaboration. With the partnership between pharmacists and nurses, much scope will be realized to improve patient-centered care. The removal of present obstacles and incitement of closer collaboration will make it possible for healthcare systems to improve clinical results, lower prescription errors, and guarantee more effective and patient-focused care delivery.

Enhancing Patient-Centered Care Through Process Improvement: A Systematic Review of patient Satisfaction Outcomes

Patient-centered care has become a cornerstone in modern healthcare, focusing on personalized, respectful, and effective treatment that meets patients' unique needs and preferences. Process improvement methodologies, such as Lean, Six Sigma, and workflow optimization, have been increasingly adopted to streamline healthcare operations, reduce inefficiencies, and improve the quality of care. However, the specific impact of these methodologies on patient satisfaction within patient-centered care frameworks remains to be systematically evaluated. This systematic review aims to examine the effects of Lean, Six Sigma, and workflow optimization on patient satisfaction outcomes in patient-centered care settings, offering evidence-based insights for healthcare providers and policymakers.A comprehensive search was conducted across multiple databases, including PubMed, CINAHL, and Cochrane Library, to identify studies published from 2016 onward that evaluated patient satisfaction outcomes related to Lean, Six Sigma, and workflow optimization within patient-centered care models. Eligible studies were screened, assessed for quality, and analyzed based on patient satisfaction outcomes. Data extraction and quality assessments followed PRISMA guidelines.Findings from the selected studies indicate that process improvement methodologies positively impact patient satisfaction, with notable improvements in wait times, care coordination, and communication quality. Lean and workflow optimization showed a significant reduction in bottlenecks, while Six Sigma was associated with error reduction and standardized practices, contributing to higher patient satisfaction scores.Lean, Six Sigma, and workflow optimization methodologies offer promising avenues to enhance patient-centered care by improving patient satisfaction metrics. These methodologies provide healthcare organizations with structured approaches to meet patient needs more effectively and consistently, reinforcing the critical role of process improvement in achieving high-quality, patient-centered healthcare.

Advancing Precision Oncology with Digital and Virtual Twins: A Scoping Review.

Digital twins (DTHs) and virtual twins (VTHs) in healthcare represent emerging technologies towards precision medicine, providing opportunities for patient-centric healthcare. Our scoping review aimed to map the current DTH and VTH technologies in oncology, summarize their technical solutions, and assess their credibility. A systematic search was conducted in the main bibliographic databases, identifying 441 records, of which 30 were included. The studies covered a wide range of cancers, including breast, lung, colorectal, and gastrointestinal malignancies, with DTH and VTH applications focusing on diagnosis, therapy, and monitoring. The results revealed heterogeneity in targeted topics, technical approaches, and outcomes. Most twining solutions use synthetic or limited real-world data, raising concerns regarding their reliability. Few studies have integrated real-time data and machine learning for predictive modeling. Technical challenges include data integration, scalability, and ethical considerations, such as data privacy and security. Moreover, the evidence lacks sufficient clinical validation, with only partial credibility in most cases. Our findings underscore the need for multidisciplinary collaboration among end-users and developers to address the technical and ethical challenges of DTH and VTH systems. Although promising for the future of personalized oncology, substantial steps are required to move beyond experimental frameworks and to achieve clinical implementation.

A Review: Blockchain Effect on Healthcare and IoMT

Blockchain technology is changing several sectors of the economy, but healthcare is one of the most affected. This study looks at how blockchain is changing healthcare procedures, especially in terms of improving data sharing security and transparency, which is essential for precise diagnosis and efficient treatment. Traditional healthcare systems can be improved to provide more dependable and accessible health records, guaranteeing prompt and accurate medical care, by integrating blockchain. In discussing how blockchain affects the administration of Electronic Health Records (EHRs), the paper emphasizes how patient data can be protected from the risks associated with private companies' centralized control. The management of health information is more secure thanks to this decentralized method, which lowers the chances of data breaches and unauthorized access. The study also examines the growing market for the Internet of Medical Things (IoMT) and consumer medical devices, highlighting the significance of public-private sector cooperation in the creation of blockchain-based healthcare initiatives. For healthcare technologies to advance and to satisfy customer expectations for linked medical devices, these partnerships are essential. This study essentially offers a thorough examination of how blockchain technology is transforming the healthcare sector, specifically about EHR administration and IoMT integration. The study emphasizes the necessity of implementing this technology to build more safe, effective, and patient-centered healthcare systems by discussing its potential and obstacles.

The role of a Macmillan senior pharmacy technician in a regional cancer centre in Northern Ireland: an evaluation

Abstract Introduction In the UK, up to two-thirds of all cancer patients have at least one comorbidity, with around half having multiple long-term conditions (LTCs).1 Older people with cancer often require multiple medications including cancer-specific treatments, supportive care medications, and medications for pre-existing LTCs. They are therefore at higher risk of the adverse effects of polypharmacy, inappropriate prescribing, drug-drug interactions, and drug-disease interactions. Complexity of medication regimens and treatment burden can cause confusion and medicines mismanagement, thereby influencing a patient's ability to adhere to treatment with the outcome being an increased chance of treatment failure. It is thus essential that medicines be optimised in these patients.2 The Oncology Pharmacy Team based in the North West Cancer Centre, located on the Altnagelvin acute hospital site in the Western Health and Social Care Trust, Northern Ireland, secured Macmillan funding to provide a specialist medicines optimisation service to older patients about to start cancer treatment (the Medicines Optimisation in Older People with Cancer [MOOC] Service). A pharmacy technician and pharmacist were recruited and the service implemented from October 2023. The roles are new and innovative and require extensive evaluation. Aim To evaluate the introduction of the Macmillan senior pharmacy technician into the oncology pharmacy team, analysing impact on medicines optimisation and patient safety. Methods A census approach was taken to include all patients with a new cancer diagnosis and medicines reconciliation (MedRec) completed by the pharmacy technician during the study period. The technician identified and rectified any issues prior to the patient’s first scheduled treatment. Patients with significant medicines-related concerns, or aged ≥65 years and taking ≥8 drugs, were referred to the Macmillan pharmacist for holistic medication review. Data collected included number of MedRecs completed by the pharmacy technician (relative to total completed by the team weekly), cancer diagnosis, medicines-related problems identified, interventions made, other activities completed, and time directed away from the pharmacist. Analysis of patient age and number of medications taken informed whether inclusion criteria for MOOC pharmacist referral were appropriate. Results The specialist medicines optimisation service started in October 2023, however, data collection for the purpose of this study commenced on 1st January and took place over a two-month period.101 patients (aged 69.0 ± 5.7 years, range 57 -74 years)) taking an average of 12.6 medicines (range = 8-18), and recently diagnosed with cancer were reviewed by the pharmacy technician. On average, the technician completed 76.4% of medicines reconciliations each week. 120 medicines-related problems were identified, and 178 interventions made. The service yielded net cost savings of £826.34 (pharmacist time saved). Nine patients were referred to the MOOC pharmacist service; a further five patients did not consent to referral. Discussion / Conclusion Although the evaluation of the MOOC service is ongoing, this interim analysis demonstrated that integration of the pharmacy technician into the oncology team yielded cost savings and reduced and improved provision of patient-centred healthcare and safety. Inclusion criteria for the MOOC pharmacist review were confirmed via analysis of patient age and number of medicines taken.

Factors affecting healthcare workers burnout and their conceptual models: scoping review

BackgroundThe occupational stress that contributes to the development of burnout syndrome remains one of the greatest scientific challenges. Despite years of research into burnout and its determinants, burnout continues to attract the attention of researchers, and healthcare workers (HCWs) continue to experience burnout in large numbers. Burnout has a significant impact on both the mental and physical well-being of HCWs and reduces patient-centered healthcare. This review aims to identify the factors affecting healthcare workers’ burnout (FAHCWB) and their conceptual models.MethodsThe review was conducted according to Arksey and O'Malley's framework using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Searches were conducted in PubMed, Scopus, Wiley, ProQuest, Sage, Science Direct, and EBSCO using the following keywords: healthcare professionals, burnout, and internal/external factors. Empirical, qualitative, quantitative, and mixed-design research articles published in English with full-text access in peer-reviewed journals that investigated the FAHCWB were included. For an in-depth analysis of the included articles, the authors developed a data synthesis table, and thematic analysis was applied to the analysis.ResultsAccording to the inclusion criteria, 38 articles were selected for further data analysis. Six main themes were identified: (1) FAHCWB; (2) conceptual models of FAHCWB; (3) research tools for studying FAHCWB; (4) findings on FAHCWB in the context of different models; (5) differences between findings from different models; (6) what is known and not known about FAHCWB. The results of the review show that most researchers conduct research on factors affecting burnout (FAB) based on factors related to the work environment, with fewer studies based on individual factors, including personality factors. Most of the research is based on the model developed by Maslach et al. The Maslach Burnout Inventory (MBI) has been used in most studies.ConclusionsDespite years of research, burnout continues to evolve rapidly, indicating that scientific research needs to be re-focused. Research should be conducted using different conceptual models and new research tools that allow the syndrome to be studied from a multidimensional perspective, including both the work environment and individual factors.

Digital health intervention for children with ADHD to improve mental health intervention, patient experiences, and outcomes: a study protocol

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to timely and targeted mental health intervention for children at significant risk for poor outcomes. The present paper will describe our planned protocol to evaluate the efficacy of CoolTaCo via randomized control trial (RCT).Methods/designWe will recruit 60 children (ages 8–12) with ADHD who will be randomized to either immediate (n = 30) or delayed (n = 30) treatment (i.e., a waitlist control group). Among those randomized to immediate treatment, half will be assigned to DHI (delivered via a smartwatch and smartphone application), the other half to an active control treatment as usual (TAU). Unlike the DHI group, the TAU group will receive the smartwatch with no assigned activities, applications, or interventions on the devices. The intervention period will last 16 weeks; after a participant has been in the delayed treatment group for 16 weeks and has completed the post-waiting period assessment, they will be randomly assigned to either the intervention or active control group. Thus, 30 participants will complete the intervention, and 30 will complete the active control, with half of the total sample completing a waitlist period.DiscussionIndividuals with ADHD have complex needs. Despite improvement in outcomes following cognitive behavioral therapies (CBT) and pharmaceutical treatment, long-term maintenance is a challenge often not addressed by traditional medical approaches, and, as we described, ineffective approaches to information sharing across points of care create further barriers to progress. Our research will fill a significant gap in translating early treatment investments and gains into long-term, sustainable outcomes.This study was registered as a clinic trial at ClinicalTrials.gov (Digital Health Intervention for Children With ADHD, ID# NCT06456372) on 06/13/2024.

Development of Worksheets for Immunomodulator Shared Decision-Making to Facilitate Patient-Clinician Communication: A Quality Improvement Project Employing Design Thinking Principles.

Shared decision-making (SDM) is a principle of humanistic, patient-centered health care within the field of rheumatology. However, clear communication between patients and their clinicians regarding the benefits and risks of immunomodulators may be challenging in a clinical setting. The design-thinking process is a human-centered approach to quality improvement that can help to identify insights to uphold high-quality communication. The development process adhered to the Stanford design thinking process framework, encompassing 5 stages: (1) empathize, (2) define, (3) ideate, (4) prototype, and (5) test. During the empathy stage, quality improvement members spent 4 hours immersed in the clinical setting observing how patients and clinicians engage in SDM conversations. These observations were augmented by unstructured debriefing sessions to better understand the needs and drivers of high-quality SDM. Following this, a rapid ideation workshop was convened to generate creative solutions. These led to rapid prototyping and testing, yielding a final product. The iterative design process identified 4 critical needs: (1) ensuring comprehensibility of materials, (2) upholding accuracy of information, (3) balancing standardization with individualization, and (4) promoting retention of knowledge. During the rapid ideation workshop, the concept of a Worksheet for Immunomodulator Shared Decision-Making (WISDM) was introduced and selected for further elaboration. This led to the creation of 5 prototypes for methotrexate, which were subsequently tested. These were reconciled and modified to make a final product. The WISDM template contains 7 elements that support SDM. Forty-five WISDMs were created for 23 immunomodulators. Further investigation will focus on how WISDMs exactly impact SDM.

Ethnic inequalities in primary care experiences for people with multiple long-term conditions: Evidence from the general practice patient survey

ObjectivesTo examine the relationship between ethnicity and experiences of primary care for people with multiple long-term conditions (MLTCs) and assess the relative importance of demographic, practice, and area-level factors as influences on primary care experiences across ethnic groups. Study designA retrospective study using 2018–19 GP Patient Survey data linked to General Practice Workforce data and small area data published by the Office for National Statistics. MethodsWe conducted multilevel regression analysis to assess the relationship between ethnicity and experience of accessing primary care and interacting with healthcare professionals. We built separate regression models for each outcome and included (i) each covariate separately, (ii) demographic factors and (iii) demographic, practice, and area-level factors. ResultsUpon full adjustment Arab, Bangladeshi, Chinese, Indian, Pakistani, other Asian, mixed white and Asian, and other white people with MLTCs have lower levels of satisfaction with primary care access and interacting with healthcare professionals compared with white British people. The influence of demographic, practice and area-level factors is not uniform across ethnic groups; demographic factors account for the inequalities in levels of satisfaction with access to primary care between white British people and Black other, mixed other, mixed white & Black Caribbean and Gypsy & Irish Travellers. However, practice and area-level factors strengthen inequalities in the experience of accessing primary care for Bangladeshi, Indian and Pakistani people. ConclusionsGiven the link between patient satisfaction and patient-related health outcomes, the lower levels of satisfaction with accessing primary care and interacting with healthcare professionals among the aforementioned minoritised ethnic groups are concerning and require further scrutiny. Qualitative studies are required to understand and address the sources of poor experiences in primary care for minoritised people with MLTCs to improve patient-centred healthcare and outcomes.

Clients and carers: Healthcare professionals’ roles in medical device development processes in SMEs

Purpose of the article With the call for patient-centred healthcare, designers and healthcare professionals collaborate increasingly, as both health and design researchers advocate closer engagement between the two. Yet the existing literature is scarce in describing the actual roles taken up by healthcare professionals in these collaborations. Addressing this gap, this article investigates the participation of healthcare professionals in medical device development in SMEs. Materials and methods The research context is Ankara, Turkey, where most design and development activities in medical sector are geared towards export substitution, undertaken with limited resources. The analysis is based on data gathered through semi-structured interviews with 32 professionals, including design professionals, managers, physiotherapists and engineers involved in the design of around 25 medical devices. Results and conclusion This article identifies four main roles that healthcare professionals take in medical device development: business partners, expert users, mediators, and medical professionals. These roles entail diverse responsibilities with various objects of collaboration with designers, making significant contributions to medical design.

Collection and use of patient-reported experience measures: approach to improve health care

Abstract Background Patient experience is one of the fundamental determinants of healthcare quality. There is progress in the collection of PREM in national level for hospitalized patients since 2020 in Latvia. Aim Analyze (2020.-2022.) in-patients Top-box rates about communication, share-decision making, patient safety and Net Promoter Score (NPS). Methods Project starting point was 2019. Agreement with EC, Sant’Anna School, Ministry of Health and Centre for Disease Prevention and Control of Latvia. Since 2020, the collection of PREM has been taking place regularly in hospitals (around 40% from all hospitals) and on average 20% response rate of those who agreed to participate in the survey. PREM questionnaire according to HCAHPS (Consumer Assessment of Healthcare Providers and Systems) standards, including Picker Institute patient experience questions. In line with OECD (Organization for Economic Co-operation and Development) recommendations, patient safety issues are also included. Top-box rates (most positive response) and percentiles (25th - 75th) were calculated. Results Totally 17019 adult (18 years and more) patient responses were analyzed with response rate 20.3% (n = 83983). 74.6% (67.5-78.2) during hospital stay doctors always explain things in a way you could understand and sufficiently involved in the decision-making process of treatment - 75.0% (70.1-81.4). During hospital stay 4.1% (n = 601) experienced patient safety incidents which were patient-reported. The most common groups were wrong patients, medication errors, incl. adverse drug reactions and falls. Hospitals achieved a NPS of 61 for 3 year period (2020.-2022.). Conclusions Collecting information about the patient experience may be the starting point for engaging patients and moving to more patient-centered health care. The results of these in-patient PREM data can be used to identify areas of improvement and make changes to better meet the needs and expectations of their patients. Key messages • It is a good practice for the implementation of new health care quality data - patient experience reported measures at the national level. • Feedback about the patient experience on regular basis provides insight into patient needs, preferences and values, which can help to improve the quality and safety of care.

Patient-Centered Healthare as Part of Medical Corporate Culture

Patient-centered medicine is a relatively new model for planning, implementing, and evaluating healthcare services. It is based on mutually beneficial partnerships between healthcare providers, patients, and their families. However, the existing models of patient-centered healthcare have a number of disadvantages. The article introduces patient-centered healthcare as part of corporate culture adopted by various medical organizations. The authors developed a component model for the empirical study of patient-centered healthcare in terms of corporate culture. It involved five components, i.e., corporate culture, attitude to patient, attitude to work / professional image, adherence to ethical principles, and motivation. The model was tested using assessment methods developed by the authors, as well as using the Questionnaire of Professional Motivation by K. Zamfir as modified by A. A. Rean and the Mouton-Blake Corporate Culture Test. The sample involved 267 medical employees of urban medical organizations, Primorye Region. The respondents demonstrated a general understanding of patient-centered approach, which they interpreted as communication skills with patients. The dominant culture was that of task, which allowed medical staff to achieve their goals through collective decisions and mutual assistance. However, this mutual assistance was mandated to them due to the lack of personnel. The model demonstrated a good potential for yielding psychological and organizational technologies for training, support, and correction of patient-centered issues in medical organizations.

Patient-centered lean healthcare management from a humanistic perspective

BackgroundHealthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients’ emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model.MethodsThe study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach.ResultsEight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare’s focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture.ConclusionsThis research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries.

NEXT-GEN Medicine: Designing Drugs to Fit Patient Profiles

Abstract: Personalized medicine, with its focus on tailoring drug formulations to individual patient profiles, has made significant strides in healthcare. The integration of genomics, biomarkers, nanotechnology, 3D printing, and real-time monitoring provides a comprehensive approach to optimizing drug therapies on an individual basis. This review aims to highlight the recent advancements in personalized medicine and its applications in various diseases, such as cancer, cardiovascular diseases, diabetes mellitus, and neurodegenerative diseases. The review explores the integration of multiple technologies in the field of personalized medicine, including genomics, biomarkers, nanotechnology, 3D printing, and real-time monitoring. As these technologies continue to evolve, we are entering an era of truly personalized medicine that promises improved treatment outcomes, reduced adverse effects, and a more patient-centric approach to healthcare. The advancements in personalized medicine hold great promise for improving patient outcomes and reducing adverse effects, heralding a new era in patient-centric healthcare.

Efficacy of the informed consent process for surgical procedures: a review of the literature

Background: Informed consent is a communication process between a patient and their healthcare team to acquire a patient’s approval to undergo a medical intervention. It is essential to the delivery of legal, safe, and patient-centred health care. Despite this, it is often inadequately implemented in clinical practice which frequently contributes to patients having little understanding and can lead to unfavourable outcomes. Furthermore, interventions to improve the consent process are not well recognized. Ultimately, the evaluation of these factors in this review will be of relevance in improving patient-centred care. Objectives: Explore degree of understanding and retention of information amongst surgical patients during the informed consent process, identify outcomes of obtaining inadequate informed consent, and evaluate interventions that improve comprehension of surgical treatment. Methods: The first electronic search was conducted through EBSCOhost to identify relevant literature on MEDLINE, Academic Search Complete, and CINAHL Plus. A second search was completed through PubMed. Exclusion and inclusion filters were applied, and duplicates removed, which yielded 200 articles. Title/Abstract screening yielded 15 articles which have then undergone full text review to assess for eligibility. This generated the 10 articles used in this review. Results: Surgical patients have poor comprehension with regards to the benefits, risks, and alternatives of their procedure. Although most patients receive some information about their procedure, this was not suited to their personal goals and needs. Surgical patients also greatly benefited from interventions that were assessed to increase patient understanding and improve the informed consent process. Conclusion: Informed consent is poorly delivered based on the analysis of patient understanding and outcomes. Further research on interventions to improve these elements are recommended as previous studies show notable improvement.

Block Medcare: Advancing Healthcare Through Blockchain Integration

In an era driven by information exchange, transparency and security hold crucial importance, particularly within the healthcare industry, where data integrity and confidentiality are paramount. This paper investigates the integration of blockchain technology in healthcare, focusing on its potential to revolutionize Electronic Health Records (EHR) management and data sharing. By leveraging Ethereum-based blockchain implementations and smart contracts, we propose a novel system that empowers patients to securely store and manage their medical data. Our research addresses critical challenges in implementing blockchain in healthcare, including scalability, user privacy, and regulatory compliance. We propose a solution that combines digital signatures, Role-Based Access Control, and a multi-layered architecture to enhance security and ensure controlled access. The system's key functions, including user registration, data append, and data retrieval, are facilitated through smart contracts, providing a secure and efficient mechanism for managing health information. To validate our approach, we developed a decentralized application (dApp) that demonstrates the practical implementation of our blockchain-based healthcare solution. The dApp incorporates user-friendly interfaces for patients, doctors, and administrators, showcasing the system's potential to streamline healthcare processes while maintaining data security and integrity. Additionally, we conducted a survey to gain insights into the perceived benefits and challenges of blockchain adoption in healthcare. The results indicate strong interest among healthcare professionals and IT experts, while also highlighting concerns about integration costs and technological complexity. Our findings underscore the transformative potential of blockchain technology in healthcare, pointing towards a new era of patient-centric and secure healthcare services. By addressing current limitations and exploring future enhancements, such as integration with IoT devices and AI-driven analytics, this research contributes to the ongoing evolution of secure, efficient, and interoperable healthcare systems.

Transitions in Immunoassay Leading to Next-Generation Lateral Flow Assays and Future Prospects.

In the field of clinical testing, the traditional focus has been on the development of large-scale analysis equipment designed to process high volumes of samples with fully automatic and high-sensitivity measurements. However, there has been a growing demand in recent years for the development of analytical reagents tailored to point-of-care testing (POCT), which does not necessitate a specific location or specialized operator. This trend is epitomized using the lateral flow assay (LFA), which became a cornerstone during the 2019 pandemic due to its simplicity, speed of delivering results-within about 10 min from minimal sample concentrations-and user-friendly design. LFAs, with their paper-based construction, combine cost-effectiveness with ease of disposal, addressing both budgetary and environmental concerns comprehensively. Despite their compact size, LFAs encapsulate a wealth of technological ingenuity, embodying years of research and development. Current research is dedicated to further evolving LFA technology, paving the way for the next generation of diagnostic devices. These advancements aim to redefine accessibility, empower individuals, and enhance responsiveness to public health challenges. The future of LFAs, now unfolding, promises even greater integration into routine health management and emergency responses, underscoring their critical role in the evolution of decentralized and patient-centric healthcare solutions. In this review, the historical development of LFA and several of the latest LFA technologies using catalytic amplification, surface-enhanced Raman scattering, heat detection, electron chemical detections, magnetoresistance, and detection of reflected electrons detection are introduced to inspire readers for future research and development.

Reimagining and rebranding advance care planning.

Advance care planning (ACP) has traditionally aimed at ensuring that patients' end-of-life (EOL) wishes are understood and respected. However, recent literature raises concerns about its effectiveness, with many trials indicating that ACP does not significantly improve goal-concordant care, enhance quality of life or reduce healthcare costs. This is because patients' future decisions are influenced by their transient preferences due to projection bias. To remain relevant, ACP requires a radical shift in perspective, implementation and branding. First, ACP's mission must be redefined with a focus on: Educate, Share and Prepare. This perspective emphasises ongoing conversations about patient health and illness, sharing of patients' current values and goals of care and preparation for the future, rather than making definitive future decisions. Second, ACP should be integrated into routine care, normalising these discussions. Simplifying ACP processes and shifting incentives to support shared responsibility among stakeholders can enhance integration. Last, rebranding ACP as 'Advance Care Preparation' can clarify its purpose, distinguishing it from EOL planning and increasing its uptake. This rebranding ensures that ACP meets the evolving needs of patients and their families, ultimately enhancing the quality of care and patient satisfaction. These changes in perspective, implementation and branding can transform ACP into a valuable tool for delivering compassionate, patient-centred healthcare, making it relevant to all individuals.

Unlocking success: Multidisciplinary rounds for effective discharge planning.

341 Background: Multidisciplinary rounds (MDR) streamline collaboration among healthcare professionals across various disciplines to devise patient progress and post-hospitalization transition plans. In our gynecology oncology inpatient unit, coordinating patient care involves multiple teams aiming for discharge objectives. While nurses oversee the care plan, physicians, advanced practice providers, case managers, and other key stakeholders possess essential insights to effective discharge planning. The aim of our study was to evaluate the impact of structured MDR implementation on discharge accuracy, effectiveness, and hospital throughput. Methods: In April 2022, our gynecologic oncology inpatient team implemented structured MDRs to enhance discharge processes, focusing on patient outcomes and hospital throughput. The initiative aimed to identify discharge barriers early, set goals, and address challenges collaboratively through: 1) Interdisciplinary Assessment: Using standardized tools to evaluate patient status and care needs; 2) Review of Clinical Data: Analyzing medical records via EHR systems; 3) Collaborative Decision-Making: Using decision-support tools to set the Estimated Discharge Date (EDD); 4) Patient Engagement: Involving patients and families in shared decision-making; 5) Documentation and Communication: Ensuring clear EDD documentation and effective communication through team huddles, bedside rounds, and discharge planning meetings. EDD reporting, discharge order timing, and patient discharge time were tracked using our Care Team Transformation Dashboard. Results: The implementation of structured MDR led to significant improvements in discharge processes. We observed enhanced accuracy in EDD, with a 2.9% increase, and a notable rise in the completion of discharge orders before 9 am, showing a 60.5% increase (Table). The percentage of patients leaving the hospital before noon increased by 20.4%, highlighting MDRs effectiveness in facilitating timely discharge, enhancing intradisciplinary collaboration, and streamlining discharge efficiency. Conclusions: MDRs play a pivotal role in improving teamwork, quality of care, and patient outcomes. Setting EDDs through structured MDR processes enhances proactive discharge planning, thereby reducing delays and optimizing patient flow, ultimately contributing to the delivery of high-quality, patient-centered healthcare. Measure Preintervention: 1/2023-1/2024 Postintervention02-05/2024 Percentage Increase EDD accuracy 1 day prior 46.9 48.3 2.9% Discharge orders before 9am 33.4 53.6 60.5% Discharges prior to noon 19.1 23.0 20.4%