Staff Workload Research Articles

Cost impact of the use of a universal cardiac implantable electronic devices remote monitoring solution: results of the Evidence RM study

Abstract Background Remote monitoring (RM) is considered the standard of care for patients with cardiac implantable electronic devices (CIED). In 2023 the HRS/EHRA/APHPRS/LAHRS expert consensus highlighted the potential interest of alert-based monitoring and the use of a third-party platform for RM management. By lightening the RM workload for clinical staff, valuable time and resources can be redirected towards patient care. Purpose This study aims to assess the impact on healthcare expenditures of the adoption of a Universal, vendor-neutral, and alert-focused remote monitoring (RM) platform for CIED in France, as opposed to the Conventional RM conducted via device specific manufacturers' platforms. Methods This study utilizes the French National Health Database (SNDS) to evaluate the effectiveness of RM solutions among patients with implantable cardioverter defibrillators (ICD), including cardiac resynchronization therapy defibrillators (CRT-D). All patients under RM were categorized based on the type of monitoring, either the Universal RM or the Conventional RM. The analysis was conducted on year 2019 and included only patients maintaining consistent RM solutions and device types throughout the entirety of the study period. To mitigate potential biases, costs were adjusted according to age, gender, device type, year of first implantation, year of RM initiation, medical center experience with RM, and Elixhauser score for comorbidities. Results Study cohort consisted of 36,401 patients (age 67.3 ± 13.0 years / male 78.4% / CRT-D 40.1%), 1,482 patients followed using the Universal RM platform and 34,419 patients monitored with the Conventional RM solutions. The study findings revealed a 4% decrease in corrected total costs and a notable 17.8% reduction in hospital costs among patients utilizing the Universal RM. Analysis further identified that this decrease in hospital expenses was primarily influenced by a reduction of the costs associated with cardiovascular diseases. Conversely, the group utilizing the Universal RM experienced a 7.9% increase in total outpatient costs compared to Conventional RM, while ambulatory visit costs remained unchanged. As costs incurred by patients were not included, total costs may however be underestimated. Patients under the Universal RM solution may benefit of more proactive preventive measures delivered through outpatient care. By addressing issues preemptively, critical conditions may be averted, enhancing overall patient management, and diminishing hospital costs. The adoption of a third-party Universal platform may thus yield to cost savings, exemplified by a negative Incremental Cost-Effectiveness Ratio (ICER) of -103€ per Day Alive and Out of Hospital (DAOH) as observed in this study. Conclusions The use of a third-party Universal RM platform showed a positive impact in terms of costs reduction for the French healthcare system on this ICD population.

Healthcare Internet of Things system implementations for COVID-19 prevention

BackgroundIn response to the widespread transmission of COVID-19 in Australia, healthcare facilities implemented stringent infection control measures, and mandatory and manual screening procedures were introduced to ensure the safety of patients and healthcare staff. However, these necessary measures resulted in imbalances within the healthcare system, a shortage of front-line workers and impacts on patient experience and wait times. The prioritization of infection control measures shifted resources away from routine care, causing delays in accessing necessary healthcare services.Methods and FindingsTo address these challenges, we developed and implemented an Internet of Things (IoT) Smart Screening eGate solution in partnership with a large metropolitan children’s hospital in Australia. This solution integrated a contactless health self-service web app, thermal camera, and physical barrier to automate the COVID-19 health screening and data recording process. During the 3-month pilot period, we deployed the eGate at multiple entrances to the hospital, and monitored the number of users of the system in different periods. We also used a framework of formative evaluation to classify user design challenges within limited resources and improved the design of the eGate to enhance its effectiveness. Our findings show that the IoT eGate solution improved the efficiency of the screening process and reduced the workload and exposure risks of front-line staff and anyone who required access to the hospital. By automating the screening process, we reduced the need for manual screening and minimized contact between individuals, thus reducing the risk of potentially infected.ConclusionIn conclusion, our pilot study demonstrated the potential of IoT technologies in improving the efficiency and safety of medical facilities during pandemics and provided a series of recommendations for the translation of IoT technologies for medical facilities, including the importance of co-design and collaboration with stakeholders, user-centered design, and ongoing monitoring and evaluation.

PENDAMPINGAN DIGITALISASI SEKOLAH SMPIT AJIMUTU GLOBAL INSANI TAMBUN UTARA-BEKASI MENUJU MANAJEMEN SEKOLAH BERBASIS DIGITAL

In the digital era, the application of information technology in schools is crucial to enhance the efficiency and quality of educational management. This Community Service (PkM) activity aims to assist Sekolah Menengah Pertama Islam Terpadu (SMPIT) Ajimutu Global Insani Tambun Utara-Bekasi in implementing digital-based school management. The main objective of this activity is to optimize the school's management system through a tailored application that meets the school's needs, called DigiMS (Digital School Management). DigiMS will be built web-based which will be hosted and use a domain name, and a mobile-based application will be created which will be submitted to the Playstore. The method used includes stages of analyzing the existing school management system, developing the DigiMS application, providing training for staff and teachers on how to use the application, and monitoring and evaluating the application's implementation. Data was collected through direct observations at the partner school, interviews with staff, and efficiency measurements before and after the implementation of the digital system. The results of this activity showed a significant increase in operational efficiency, especially in student data management, financial administration, and internal and external communication. The main conclusion from this program is that adopting digital-based management through DigiMS can improve the effectiveness of school management and ease staff workloads in their daily tasks. Additionally, this program has a positive impact on the school's readiness to face the challenges of the digital era. This program is part of the 2024 Fiscal Year PKM Grant from Kemdikbudristek-DRTPM, conducted by lecturers and students from Universitas Nusa Mandiri.

Elderly care and health monitoring using smart healthcare technology: An improved routing scheme for wireless body area networks

AbstractHypertensive patients need regular checkups and constant monitoring for taking time critical decisions by the medical experts. Unfortunately, it is hard to maintain uninterrupted patient health surveillance due to limited medical staff resulting in an increasing mortality rate annually. Thanks to recent developments in wireless sensor networking, we can monitor constantly and efficiently diverse parameters of a network. Similarly, Wireless Body Area Networks (WBANs) have become a well‐known sub‐branch of Wireless Sensor Networks. Such sensor networks can be leveraged for patient health monitoring, minimising the medical staff workload. Wireless Body Area Networks require tiny sensor nodes with limited battery power. Therefore, it is always desirable to design effective routing schemes that can enhance network lifetime, and reduce packet drop ratio. In this paper, we re‐simulate and explain in detail the results of a selected published journal article for WBANs and provide some modifications to improve the network's overall performance. Based on these amendments, the modified protocol successfully extends the operational time of the network than the original. Our performance evaluation parameters are dead nodes, throughput, residual energy, and path loss versus the number of rounds. These analyses support effective solutions that improve network performance and data delivery ratio.

Caring in crisis: addressing patient safety, burnout, and long hours in healthcare

Madam, The World Health Organization defines patient safety as preventing errors and adverse effects to patients associated with health care and “to do no harm to patients”. Specifically, in low and middle-income countries (LMICs), about 134 million adverse events occur each year due to unsafe care in hospitals, resulting in 2.6 million deaths annually. [1] Along with other determining factors, professional well-being, long hours, and burnout syndromes also influence patient care. [2] Burnout is a condition directly linked to workplace environment, stemming from occupational stress and extended working hours. Garcia, C.L. et al., through meta-analysis, found a relationship between the development of burnout and patient safety actions, with a probability of superiority of 66.4%. High levels of burnout and worsening patient safety are related to external factors such as high workload, long working hours, lack of a secure environment, and interpersonal relationships. [3] These findings raise concerns, particularly in a country like Pakistan, where the extent of understaffing and high workload can be inferred from the following statistics: The doctor-to-population ratio in Pakistan was 1:1000 in 2018 [4]. In contrast, the doctor-to-population ratio in Malaysia was 2.2:1000 in 2018 [5]. As a result of this shortage, the current workforce in Pakistan is negatively affected. In a study by Kasi PM et al. on postgraduate trainees in Pakistan, individuals under stress were more likely to report longer working hours. This increased workload made them prone to medical errors, which ultimately undermines the patient safety culture. A study conducted at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC) compared the benchmarks from hospitals in the USA and discovered that high staff workload is a significant concern among staff [6] In Pakistan, where healthcare resources are limited, fostering a culture of effective work-hour management and breaks is essential for creating a healthier and safer environment for health professionals and patients. Ensuring adequate staffing levels to distribute the workload and prevent overburdening is essential. Providing designated areas for relaxation, offering mental health resources and mindfulness programmes like yoga or meditation can help doctors to cope with stress. Furthermore, promoting a culture of multidisciplinary teamwork, a mentorship program, and effective handover protocols during shift changes can ensure continuity of care. Medical institutes should invest in technology that can streamline administrative tasks and reduce paperwork burden. ---Continue

Improving assessment for work-based learning and degree apprenticeships in business through a co-designed peer review process

Involving students in peer review has substantial benefits for students’ learning and development and, more pragmatically, for staff workload. This paper reports on a student-led effort to co-design a peer review formative assessment task. The assessment is part of a personal development module within a higher education degree apprenticeship programme delivered via blended mode by a business school in South-East England. This case study on student-staff partnership offers a description of the process and a reflection on the impacts from both the student and staff perspective. It suggests that student co-design and peer review activities complement work-based learning, effectively bringing the prior experiences and academic skills of mature/professional students into the classroom.

Remote Healthcare: Development of a Centralized Patient Monitoring System for Ward Patients.

Patient monitoring is an essential practice in healthcare settings to assess well-being and medical conditions. This study proposes a central patient monitoring system enabling healthcare personnel to have a comprehensive perspective of multiple patients' health state from a central location. The proposed prototype enables healthcare providers to detect and respond to changes in patients' condition efficiently. The project contains multiple patient monitoring units with each measuring temperature, ECG, SpO2, and heart rate along with a display on a centralized screen. The hardware of monitors is placed at each patient bed connected with all the patients and the result of each patient can be seen from the general ward counter. Different sensors are used to design monitoring units and are connected with node MCU through different pin connections. Node MCU sends the information gathered from sensors to the Raspberry pi unit using Wi-Fi. The real-time data of patients are being displayed and saved using server “thing speak”. There are different options on the server window to switch between different patients’ real time results to monitor them. The proposed prototype uses computer technology to monitor the vital signs of multiple patients on a single monitor from a centralized location using internet which may eventually reduce the time and workload of medical staff leading to improved patient care.

Do Midnight Censuses Accurately Portray Hospital Bed Occupancy?

Hospital bed occupancy serves as an important indicator of healthcare system efficiency, directly impacting patient care quality and staff workload. This study delves into the efficacy of midnight census, a conventional method for assessing bed occupancy, in supporting hospital operational planning. Historically, the midnight census has been utilised to gauge bed occupancy; however, its reliability is debated due to fluctuations throughout the day. This paper presents an analysis of 5.5 years of patient flow data from one of the hospitals in Queensland, Australia, scrutinising the statistical associations between different occupancy levels, e.g., midnight, peak, average, and minimum. The findings shed light on the efficacy of the midnight census and suggest the adoption of an hourly-based occupancy rate for more accurate capacity planning and management.

Reimagining “Palaces for the People”: A Critical Review of Public Libraries’ Engagement with the Asocial Society

The “loneliness epidemic,” a public health crisis characterized by reports of higher levels of social isolation and loneliness, has been attributed to features of modern living, including urbanization and the increase of one-person households. Public library workers are contending with individuals navigating this crisis. Findings are presented from a state-of-art literature review focussed on recent English-language, peer-reviewed studies (n=235) of public library programming, services, technology and policies in the context of trends in the contemporary asocial society. Across published research, public libraries fostered connection through the following means: encouraging feelings of belonging, creating connections through technology, reinforcing cultural identities, creating safe physical spaces, addressing issues of accessibility, creating new educational programming, and creating new recreational/social programming. The findings allow for a reimagining of the roles of public libraries but not without a reckoning about workplace culture and workloads of library staff.

Factors That Influence Medical Retrieval Decisions in Remote Central Australia

Introduction Medical retrieval services play a key role in the transportation of unwell patients from remote communities across Australia. Decision to retrieve a patient from a remote community is dependent on unique characteristics of remote locations and thus different to urban and rural retrievals. The study aims to explore various factors that affect medical practitioner decisions to retrieve patients from remote central Australian communities. Methods Semi-structured interviews were conducted with 36 staff involved in medical retrieval processes in central Australia. The data collection and analyses were part of a broader study evaluating a newly implemented medical retrieval model in central Australia. All interviews were recorded and transcribed. Transcripts were co-coded inductively by two researchers using NVivo software. Similar codes were grouped into themes, one of which related to the range of factors that affect decisions to retrieve a patient or request a retrieval which is the focus of this paper. Results: Decision-making about who, when and how to retrieve patients was complex and involved trade-offs. Severity of patient illness, resource availability (e.g. transport infrastructure, remote area staff workload and fatigue), the skills, experience and relationships with community of primary health care and medical retrieval staff, strength of primary health care systems in remote communities, specific primary health care and retrieval policies, and innovations in disease prevention and management influenced medical retrieval decisions. Conclusion: It is critical to understand that both general and contextual factors unique to remote communities affect medical retrieval decisions. Decisions are highly complex and necessitate trade-offs, frequently related to resource scarcity, which are somewhat different from those of urban retrieval services. Resource allocation in the context of providing retrieval services for remote populations must account for differences in burden of disease, cultural requirements, workforce characteristics and overall access to health care compared to urban populations.

Investigating innovations in outpatient services: a mixed-methods rapid evaluation.

Within outpatient services, a broad range of innovations are being pursued to better manage care and reduce unnecessary appointments. One of the least-studied innovations is Patient-Initiated Follow-Up, which allows patients to book appointments if and when they need them, rather than follow a standard schedule. To use routine national hospital data to identify innovations in outpatient services implemented, in recent years, within the National Health Service in England. To carry out a rapid mixed-methods evaluation of the implementation and impact of Patient-Initiated Follow-Up. The project was carried out in four sequential workstreams: (1) a rapid scoping review of outpatient innovations; (2) the application of indicator saturation methodology for scanning national patient-level data to identify potentially successful local interventions; (3) interviews with hospitals identified in workstream 2; and (4) a rapid mixed-methods evaluation of Patient-Initiated Follow-Up. The evaluation of Patient-Initiated Follow-Up comprised an evidence review, interviews with 36 clinical and operational staff at 5 National Health Service acute trusts, a workshop with staff from 13 National Health Service acute trusts, interviews with four patients, analysis of national and local data, and development of an evaluation guide. Using indicator saturation, we identified nine services with notable changes in follow-up to first attendance ratios. Of three sites interviewed, two queried the data findings and one attributed the change to a clinical assessment service. Models of Patient-Initiated Follow-Up varied widely between hospital and clinical specialty, with a significant degree of variation in the approach to patient selection, patient monitoring and discharge. The success of implementation was dependent on several factors, for example, clinical condition, staff capacity and information technology systems. From the analysis of national data, we found evidence of an association between greater use of Patient-Initiated Follow-Up and a lower frequency of outpatient attendance within 15 out of 29 specialties and higher frequency of outpatient attendance within 7 specialties. Four specialties had less frequent emergency department visits associated with increasing Patient-Initiated Follow-Up rates. Patient-Initiated Follow-Up was viewed by staff and the few patients we interviewed as a positive intervention, although there was varied impact on individual staff roles and workload. It is important that sites and services undertake their own evaluations of Patient-Initiated Follow-Up. To this end we have developed an evaluation guide to support trusts with data collection and methods. The Patient-Initiated Follow-Up evaluation was affected by a lack of patient-level data showing who is on a Patient-Initiated Follow-Up pathway. Engagement with local services was also challenging, given the pressures facing sites and staff. Patient recruitment was low, which affected the ability to understand experiences of patients directly. The study provides useful insights into the evolving national outpatient transformation policy and for local practice. Patient-Initiated Follow-Up is often perceived as a positive intervention for staff and patients, but the impact on individual outcomes, health inequalities, wider patient experience, workload and capacity is still uncertain. Further research should include patient-level analysis to determine clinical outcomes for individual patients on Patient-Initiated Follow-Up and health inequalities, and more extensive investigation of patient experiences. This study is registered with the Research Registry (UIN: researchregistry8864). This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 16/138/17) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 38. See the NIHR Funding and Awards website for further award information.

Economic Evaluation of Remote Monitoring for Implantable Cardiac Devices: Evidence from a Remote-Care Study.

The adoption of remote monitoring (RM) is especially relevant for patients with implantable cardiac devices due to their high risk of hospitalization and the need for frequent outpatient visits. Though RM can help with early detection of cardiac episodes, it may also increase the number of tasks healthcare providers engage in to monitor patients' health. The adoption of RM may increase healthcare providers' workloads, potentially impacting the quality of care and increasing the risk of clinician-provider burnout. Little is known about the link between RM adoption and changes in healthcare providers' workloads. Using data from a non-randomized clinical trial conducted in 2021-2022 at a University Hospital in Korea, we examined the relationship between RM adoption and changes in patient time savings and healthcare providers' workloads. The clinical trial included patients with a cardiac implantable electronic device compatible with the Biotronik Home Monitoring System. For patients, RM was associated with a 41-minute decrease in total visit duration, attributed to reductions in both wait time (37 minutes; P<0.001) and total examination time (3.7 minutes; P=0.137). For healthcare providers, RM was linked to an increase in overall workload by 107.9 minutes per patient. The increase was primarily due to managing RM alerts (91.8 minutes) and preparing monthly patient reports (19.9 minutes). Our findings suggest that RM was associated with a decrease of 1540 KRW (44%) in average cost of care per minute. RM is associated with time-saving patient benefits and increased healthcare providers' workloads. Even though this was a single-center study with a small number of patients, our research highlights the importance of carefully examining changes in healthcare staff workloads linked to the adoption of RM within the national health insurance system.

Enterprise risk management implementation challenges in medical laboratories in Harare, Zimbabwe.

Medical laboratories play crucial roles in healthcare, and effective enterprise risk management (ERM) is necessary to ensure business continuity, patient safety, and quality of care. In medical laboratories, ERM is important for enhancing patient safety, regulatory compliance and accreditation, quality management, business continuity, and cyber security. By following ERM principles and approaches, the medical laboratories can proactively manage their risks, improve patient safety, and maintain a high level of quality and reliability of outcomes. However, implementing ERM in medical laboratories faces unique challenges. This study explored the specific challenges and offers practical solutions for overcoming them to ensure successful ERM implementation in Harare, Zimbabwe. A cross-sectional survey was done through 41 self-administered questionnaires and interviews with medical laboratory staff from the six main medical laboratories in Harare. Data were analyzed using the Statistical Package for Social Sciences version 22. Quantitative data were analyzed using descriptive statistics such as frequencies and percentages. Qualitative data were analyzed using mean scores of Likert scale responses. The main challenges identified in the study included increased workload, staffing, organizational structures, timeliness of information, inadequate information technology support, and insufficient financial support in ERM. These can be addressed by portfolio management of risks, leveraging on cutting edge technology, restructuring to ensure swift responses to issues and redistributing staff workload, and training personnel to avoid burnouts and ensure maximum efficiency. Implementing ERM in medical laboratories requires understanding and addressing these challenges. By following the ERM principles and approaches the medical laboratories can proactively manage their risks, improve patient safety and maintain a high level of quality and reliability of outcomes ERM is still a new approach in the sector and needs further research.

Strategies for adapting under pressure: an interview study in intensive care units

BackgroundHealthcare systems are operating under substantial pressures. Clinicians and managers are constantly having to make adaptations, which are typically improvised, highly variable and not coordinated across teams. This study aimed...

A national survey of medical staffs' required capability and workload for accelerator-based boron neutron capture therapy.

This study aimed to identify the required capabilities and workload of medical staff in accelerator-based boron neutron capture therapy (BNCT). From August to September 2022, a questionnaire related to the capabilities and workload in the accelerator-based BNCT was administered to 12 physicians, 7 medical physicists and 7 radiological technologists engaged in BNCT and 6 other medical physicists who were not engaged in BNCT to compare the results acquired by those engaged in BNCT. Only 6-21% of patients referred for BNCT received it. Furthermore, 30-75% of patients who received BNCT were treated at facilities located within their local district. The median required workload per treatment was 55h. Considering additional workloads for ineligible patients, the required workload reached ~1.2 times longer than those for only eligible patients' treatment. With respect to capabilities, discrepancies were observed in treatment planning, quality assurance and quality control, and commissioning between medical physicists and radiological technologists. Furthermore, the specialized skills required by medical physicists are impossible to acquire from the experience of conventional radiotherapies as physicians engaged in BNCT were specialized not only in radiation oncology, but also in other fields. This study indicated the required workload and staff capabilities for conducting accelerator-based BNCT considering actual clinical conditions. The workload required for BNCT depends on the occupation. It is necessary to establish an educational program and certification system for the skills required to safely and effectively provide BNCT to patients.

S2VQ-VAE: Semi-Supervised Vector Quantised-Variational AutoEncoder for Automatic Evaluation of Trail Making Test.

Computer-aided detection of cognitive impairment garnered increasing attention, offering older adults in the community access to more objective, ecologically valid, and convenient cognitive assessments using multimodal sensing technology on digital devices. In this study, we aimed to develop an automated method for screening cognitive impairment, building on paper- and electronic TMTs. We proposed a novel deep representation learning approach named Semi-Supervised Vector Quantised-Variational AutoEncoder (S2VQ-VAE). Within S2VQ-VAE, we incorporated intra- and inter-class correlation losses to disentangle class-related factors. These factors were then combined with various real-time obtainable features (including demographic, time-related, pressure-related, and jerk-related features) to create a robust feature engineering block. Finally, we identified the light gradient boosting machine as the optimal classifier. The experiments were conducted on a dataset collected from older adults in the community. The experimental results showed that the proposed multi-type feature fusion method outperformed the conventional method used in paper-based TMTs and the existing VAE-based feature extraction in terms of screening performance. In conclusion, the proposed deep representation learning method significantly enhances the cognitive diagnosis capabilities of behavior-based TMTs and streamlines large-scale community-based cognitive impairment screening while reducing the workload of professional healthcare staff.

Establishing a Comprehensive Nursing Clinic Using the Case Management Model.

To explore the practical effect of the case management model in a comprehensive nursing clinic. Based on the case management model, the authors constructed a comprehensive nursing clinic providing wound care, ostomy care, peripherally inserted central catheter care, drainage tube care, nursing consultations, and home care. They evaluated the practical effect of the comprehensive nursing clinic according to workload, economic benefits, and satisfaction of the medical staff and patients. Since the inception of the comprehensive nursing clinic, the number of visits has increased by 63.57%, and the satisfaction of patients and medical staff has also improved. This comprehensive nursing clinic based on the case management model meets the medical needs of patients, has improved the satisfaction of patients and the medical staff, and enhances the professional sense of value and comprehensive quality of specialized nurses.

The Influence of Work Discipline and Workload on Employee Performance

This study was done by selecting a sample of 40 respondents from the population. This study investigates the use of SPSS 22 software for Windows operating systems. The research findings are as follows: A study was conducted to assess the work discipline of employees at a bank in Bandung. The data processing revealed that the average rating of respondents' responses was 2.98, which falls within the "Good enough" threshold. The workload of staff at a bank in Bandung was assessed by analyzing data processing results from respondents. The average score received was 3.00, which falls within the "Good enough" requirements for the test findings. The data processing findings from respondents at one of the banks in Bandung provided an overview of employee performance. The average score received was 3.28, which falls within the "Quite good" requirement for test results. The impact of work discipline and workload on employee performance at a bank in Bandung is as follows: the direct influence of work discipline on employee performance is 28.40%, and the indirect influence through work discipline is 17.44%. Therefore, the total influence of work discipline on employee performance is 46.95%. The impact of workload on employee performance at a bank in Bandung is directly influenced by work discipline, accounting for 17.44% of the total influence. Additionally, there is an indirect influence of 29.53% through workload, resulting in a total influence of work discipline on employee performance of 76.8% at this particular bank in Bandung. The impact of work discipline on employee performance at a bank in Bandung is measured at 0.546 or 54.6%, indicating a reasonably good correlation. Similarly, the influence of workload on employee performance at the same bank in Bandung is measured at 0.352 or 35.2%. The criteria are highly stringent, and the correlation between work discipline and workload is 0.892 or 89.2%, indicating a strong association. When considered jointly or concurrently, these factors have a combined total influence of 76.48%, with work discipline accounting for 46.95% and workload accounting for 29.53%. Hence, the overall impact amounts to 76.8%. The results indicate that the impact of these two variables falls within the very significant range, while the remaining elements, which have not been examined, also influence employee performance by 23.2%.

Automatic robotic doppler sonography of leg arteries

PurposeRobot-assisted systems offer an opportunity to support the diagnostic and therapeutic treatment of vascular diseases to reduce radiation exposure and support the limited medical staff in vascular medicine. In the diagnosis and follow-up care of vascular pathologies, Doppler ultrasound has become the preferred diagnostic tool. The study presents a robotic system for automatic Doppler ultrasound examinations of patients’ leg vessels.MethodsThe robotic system consists of a redundant 7 DoF serial manipulator, to which a 3D ultrasound probe is attached. A compliant control was employed, whereby the transducer was guided along the vessel with a defined contact force. Visual servoing was used to correct the position of the probe during the scan so that the vessel can always be properly visualized. To track the vessel’s position, methods based on template matching and Doppler sonography were used.ResultsOur system was able to successfully scan the femoral artery of seven volunteers automatically for a distance of 20 cm. In particular, our approach using Doppler ultrasound data showed high robustness and an accuracy of 10.7 (±3.1) px in determining the vessel’s position and thus outperformed our template matching approach, whereby an accuracy of 13.9 (±6.4) px was achieved.ConclusionsThe developed system enables automated robotic ultrasound examinations of vessels and thus represents an opportunity to reduce radiation exposure and staff workload. The integration of Doppler ultrasound improves the accuracy and robustness of vessel tracking, and could thus contribute to the realization of routine robotic vascular examinations and potential endovascular interventions.

Efficacy and safety of a digital check-in and triage kiosk in emergency departments: a systematic review protocol

IntroductionIncreasing demand for healthcare services worldwide has led to unprecedented challenges in managing patient flow and delivering timely care in emergency care settings. Overcrowding, prolonged waiting times, reduced patient satisfaction...