Today's Health Care Research Articles

Designing Culturally Competent Clinical Decision Support Systems to Reduce Health Disparities in Underserved Populations

Income inequality is associated with poor health. Both the cost of medical care and the utilization of services vary. The high expense of health care pushes a significant portion of Indian households into poverty. The surroundings in which people live, grow, work, and interact with one another are known as social determinants, and they have a big influence on people's well-being which can be reduced by computerized clinical decision support systems. In today's healthcare, computerized clinical decision support systems, or CDSS, represent a paradigm change. Clinicians can use CDSS to support them in making complicated decisions. Rapid advancements have been made in CDSS since they were used in the 1980s. Due to the growing worldwide usage of advanced electronic medical records, they are frequently administered using computerized clinical processes and electronic medical records.

A Comprehensive Blood Bank Management System:Optimizing Donor and Inventory Tracki

An essential part of today's healthcare infrastructure is the Blood Bank Management System (BBMS), which makes sure that blood donations, inventories, and distribution are managed effectively and efficiently. This study provides a thorough examination of BBMS, stressing its salient characteristics, range of applications, and effects on blood bank operations. The study looks into how BBMS implementation can boost patient care, increase overall blood bank efficiency, and lead to better healthcare outcomes. This paper offers important insights into the role of technology in blood bank management through a combination of literature review, system development, and evaluation. Because they offer a consistent supply of blood products for transfusions, surgeries, and medical treatments, blood banks are essential to healthcare systems. However, issues like inventory shortages, waste, and human error are common with traditional blood bank management procedures. This paper's introduction addresses the importance of effective blood bank management and poses the following research question: Howcan blood bank operations be made more effective and efficient with the use of a blood bank management system? The study intends to advance blood bank management techniques and the general standard of patient care by addressing this question.

Exploring Inpatient Unit Nurses’ Experience with Emergency Department Crowding, Access and Flow, and Associated Patient Outcomes

Background: Emergency department crowding and hospital access and flow are complex and long standing issues that negatively impact healthcare delivery. This study aims to address these issues through the perspectives of inpatient unit nurses. Strategies to alleviate ED crowding are supported by research exploring ED staff perspectives; however, a paucity of research exists addressing the perceptions of inpatient unit nurses and other key stakeholders. Methods: The research aims were addressed using qualitative method. Semi-structured virtual interviews were completed with eleven inpatient unit registered nurses from two hospital sites. A 17-question interview tool facilitated the collection of data. Results: Three main themes emerged from the data analysis. Inpatient unit nurses identified ED crowding, hospital access and flow, and site congestion as key areas of concern. In addition, the influence of understaffing was viewed as a contributor to ED crowding, resulting in negative outcomes for patient care. Conclusion: This study is the initial step to understanding different experiences, perceptions and knowledge on emergency department crowding and access and flow processes. Further research exploring diverse viewpoints on this topic is necessary given the interconnected organizational structure of healthcare today and how key stakeholders, outside of the emergency department, strongly influence access block and ED outflow.

Disease Prediction and Drug Recommendation Using ML

In today's dynamic healthcare landscape, the integration of technology has become indispensable. The project sets out to create a cutting-edge healthcare solution that will transform the very foundations of healthcare decision-making by utilizing the powerful powers of machine learning. The main objective of this project is to develop a dual-dashboard system that will serve both patients and medical staff. The main objective is to reduce the gap between patients and healthcare professionals, which has existed for a long time. It makes it possible for people to receive highly personalized health assessments, enables efficient appointment scheduling, and provides doctors with recommendations for data-driven treatments. Ultimately, this project aims to profoundly impact the accessibility and quality of healthcare services. It seeks to enhance the patient experience, augment the precision of medical decision-making, and foster seamless collaboration between individuals and their healthcare providers.

Advancing patient-centered clinical decision support in today's health care ecosystem: key themes from the Clinical Decision Support Innovation Collaborative's 2023 Annual Meeting.

This perspective summarizes key themes that arose from stakeholder discussions at the inaugural Clinical Decision Support Innovation Collaborative (CDSiC) 2023 Annual Meeting. The CDSiC is an Agency for Healthcare Research and Quality (AHRQ)-funded innovation hub for patient-centered clinical decision support (PC CDS). The meeting took place on May 16-17, 2023, and engaged 73 participants that represented a range of stakeholder groups including researchers, informaticians, federal representatives, clinicians, patients, and electronic health record developers. Each meeting session was recorded and had 2 notetakers. CDSiC leadership analyzed the compiled meeting notes to synthesize key themes. Participants discussed 7 key opportunities to advance PC CDS: (1) establish feedback loops between patients and clinicians; (2) develop new workflows; (3) expand the evidence base; (4) adapt the CDS Five Rights for the patient perspective; (5) advance health equity; (6) explore perceptions on the use of artificial intelligence; and (7) encourage widespread use and scalability of PC CDS. Innovative approaches are needed to ensure patients' and caregivers' voices are meaningfully included to advance PC CDS.

Root cause analysis of cases involving diagnosis.

Diagnostic errors comprise the leading threat to patient safety in healthcare today. Learning how to extract the lessons from cases where diagnosis succeeds or fails is a promising approach to improve diagnostic safety going forward. We present up-to-date and authoritative guidance on how the existing approaches to conducting root cause analyses (RCA's) can be modified to study cases involving diagnosis. There are several diffierences: In cases involving diagnosis, the investigation should begin immediately after the incident, and clinicians involved in the case should be members of the RCA team. The review must include consideration of how the clinical reasoning process went astray (or succeeded), and use a human-factors perspective to consider the system-related contextual factors in the diagnostic process. We present detailed instructions for conducting RCA's of cases involving diagnosis, with advice on how to identify root causes and contributing factors and select appropriate interventions.

Lessons learned from the Health Resources and Services Administration health workforce well-being grantees.

Burnout and moral injury are among the most pressing issues facing healthcare and public safety today. In 2021, Congress provided $120 million through the American Rescue Plan Act for 44 Health Resources and Services Administration grants to implement evidence-informed strategies to address burnout and improve mental health among the health workforce. This article examines facilitators and barriers to implementation and reported impact of grantees' interventions. Key informant interviews (n = 39) and surveys (n = 36) with grantees were conducted between May and August 2023 and qualitatively analyzed using inductive and deductive approaches. This study found grantees were adapting their program modality, timing, and content to meet the needs of their workforce. Many grantees were increasingly focused on training/engaging leadership, establishing structures for worker engagement, and allowing worker voice and priorities to guide operational changes. Though many grantees could not yet report program impact, those who could provide early data documented decreases in staff turnover, burnout, and moral distress. A common challenge was ongoing resource constraints, including staff and leadership turnover. Findings suggest health and public safety organizations continued to struggle with staffing post-COVID, increasing the challenges of implementing their programs to improve burnout and well-being. However, just 18 months into their activities, grantees reported their efforts were leading to changes in organizations, culture, and the experiences of individuals. Key lessons include the importance of engaging workers, building trust, and developing intentional communication, evaluation, and feedback strategies to advance organizational-level efforts to improve worker and learner well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implementing the Debriefing Assessment for Simulation in Healthcare (DASH) Tool for Training Medical Faculty.

Introduction Despite simulation being widely recognized as an essential component of medical education, there remains a dearth of literature on its implementation and effectiveness in pre-clerkship medical education. In order to effectively encompass healthcare simulations within medical instruction, it is imperative to first address the often neglected gap in faculty development and training. With this in mind, we aim to present our experience in implementing the Debriefing Assessment for Simulation in Healthcare (DASH) tool in training faculty at Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA. Methods Twenty participating faculty practiced instructing a simulation session and completed the DASH tool. Quantitative and qualitative approaches were used to report the findings. Results The Survey Rater and Student DASH version results were analyzed using the Mann-Whitney U test to see if there was a difference between the two groups for each question. Conclusions All faculty participating in healthcare simulations should be trained in order to deliver a structured debriefing experience. In healthcare medical simulation, the identification of faculty training is imperative to address many of the challenges of healthcare today, including patient safety issues and limitations of medical training in hospital settings. Implications The study aims to serve as a template that researchers can use in identifying potential faculty training development, as the benefits of having faculty trained in simulation methodology are successful in higher educational settings. Further studies in simulation-based education faculty training are recommended.

Blockchain's Transformative Potential in Healthcare

In Blockchain in Healthcare Today, the journal explores blockchain's transformative potential, its current applications, and the path forward for its integration into the healthcare ecosystem. The healthcare industry is currently facing significant challenges and opportunities after COVID-19. As we navigate the complexities of increasing healthcare costs and technological updates for better patient outcomes, innovative technologies are emerging as pivotal tools for healthcare transformation. Healthcare digital platforms have witnessed revolutionizing the dynamics of healthcare systems using disruptive technologies. However, while these technologies have garnered extensive attention for their transformative potential, there remains a critical gap in our understanding of the impact of digital technology on the healthcare industry. Population health management has critical challenges in data protection, sharing, and interoperability, where personalized medicines and wearable devices are highlighted as a concern. Patients and medical personnel need a safe and simple way to record, transmit, or access information through networks without fearing for their safety. Using blockchain technology can help address these problems (Haleem et al., 2021).

ICT Effect on India's Healthcare Management Services Development

In today's healthcare services, information and communication technology is no longer only employed to automate procedures. Rather, Information Communication Technology is being utilized as a significant system for offering kinds of help to individuals. The execution of ICT in the clinical benefits region enjoys accomplished different benefits, such as enhanced revenue, effectiveness, efficacy, faster service, customer satisfaction, ease for customers, flexibility in operation, continuously operations, capacity money saved, and expense benefits. ICT has been used in the healthcare industry in many creative ways that have improved communication between physicians, patients, and other stakeholders. This can be accomplished by enlisting the aid of social entrepreneurs to help create a wealth opportunity. The researcher's goal in this study is to evaluate how widely ICT is being used in India's various health fields. It is additionally considered critical to identify and evaluate the technology in the medical services area to recommend appropriate proactive, protecting, and advancing methodologies that would improve the authenticity and viability of medical services offices in India

The Human-Technology Continuum.

Managers in health care today face an array of digital technologies that assist or augment certain human tasks. But these technologies are often fraught and present challenges to managers, whose competencies must evolve to keep pace with technological advancements. Drawing on theory about technology, work, and organizations, we present a human-technology continuum to facilitate this discussion for managers. Furthermore, we illustrate how managerial competencies are linked to the entire human-technology continuum, rather than to specific technologies, using diabetes management examples. The human-technology continuum indicates that augmentative technologies are layered onto assistive ones in health care settings. This suggests that technological advancements not only enhance but alter managerial competencies. Digital technology stretches the boundaries of managers' day-to-day work in health care. Therefore, we make the following suggestions so the managers can be responsive to ongoing digital transformations: restructuring work, training the workforce, neutralizing threats, establishing ethical boundaries, and building partnerships.

Review on IoT-Driven Infusion Monitoring & Management System

Effective intravenous (IV) infusion management and monitoring are essential in today's healthcare environment to guarantee patient safety and improve the standard of care. In order to overcome the drawbacks of conventional IV drip monitoring techniques, this study describes the creation of a contactless, Internet of Things-driven infusion monitoring and management system. With the use of cutting-edge sensor technology and Internet of Things connection, the suggested system combines real-time IV drip liquid level monitoring and control, delivering precise and ongoing updates. Healthcare practitioners may now monitor and analyse patient data remotely thanks to the gathered data's constant updating and transmission to the Think Speak cloud platform. With its combination of real- time data collecting, cloud-based analytics, and emergency alert features, the proposed contactless IoT-driven infusion monitoring and management system represents a substantial improvement in healthcare technology. Using the power of IoT and cloud computing, this invention seeks to enhance overall patient outcomes, optimize IV treatment administration, and decrease human monitoring efforts. To increase patient safety, the system has an emergency alarm mechanism based on GSM modules. This feature ensures that caregivers are notified promptly of any irregularities or critical IV drip levels, allowing for prompt treatment. By providing real-time signals, the device lessens the risks related to delayed reactions to IV fluid failure or depletion. Formulating a real-time model for IV drip liquid level monitoring is the main goal of the system. By employing non-invasive sensors to identify and record the drip rate and fluid levels, this gadget assures precise tracking without having physical contact with the IV apparatus. Keywords: Internet of Things, ESP32 microcontroller, Biomedical, GSM, Relay, LCD Display.

Effect of Educational Nursing Guidelines on Self-management and Health-Related Quality of Life for Hemodialysis Patients.

Chronic kidney disease is the biggest problem in health care today, and the primary replacement therapy, hemodialysis, has a severe impact on both self-management and quality of life. This study aimed to evaluate the effect of educational nursing guidelines on self-management and health-related quality of life for hemodialysis patients. A quasi-experimental design was used. A convenience sample of 100 hemodialysis patients in the hemodialysis unit at Ismailia General Hospital, 50 patients for the study and 50 patients for the control groups. Data were collected using a patient demographic information questionnaire, hemodialysis self-management scale, and survey instrument on kidney disease quality of life 36-item (KDQOL-36). The intervention was conducted over 12 weeks in five sessions, from implementing the guidelines to the post-test phase. The control group received the usual care. SPSS version 23, descriptive statistics, and inferential statistics like independent t-test and Pearson Chi-square test were used. Regarding self-management dimensions, a statistically significant difference was found between the study and control group regarding problem-solving and communications, fluid control, diet, self-advocacy, and emotional control with p < 0.001, and effect size 5.89,4.99, 5.06, and 4.54, respectively. Regarding the quality of life domains, a statistically significant difference was found between the study and control group regarding physical functioning, mental functioning, the burden of kidney disease, management of symptoms, and kidney disease effect with p < 0.001 and the effect size 9.39, 6.07, 1.86, 7.65, and 6.96, respectively. Educational guidelines are effective for improving self-management and quality of life.

Internal Medicine Nursing Education Enhances Student Competency and Care Quality through Structured Training Modules

Background: The evolving demands of healthcare and advances in medical science have reshaped nursing practices, emphasizing the need for methodical and efficient care delivery. The nursing process, central to modern nursing, facilitates personalized care and priority-setting, essential in today's healthcare landscape. This study explores the impact of a structured internal medicine nursing practice training module on student competency, with a focus on diagnostic accuracy and patient care planning. Methods: An illustrative study was conducted with 130 second-year nursing students at a state-funded university from 2014 to 2016. Students participated in a training module designed around Gordon's functional health patterns, aimed at improving their practical skills in internal medicine. Data were collected through questionnaires assessing students' perceptions of the module's effectiveness in clinical practice, with analyses performed using SPSS. Results: The training module significantly enhanced students' confidence and efficiency in diagnosing and planning care, with 51% of participants finding it "Very helpful" in identifying issues and 80% supporting its use in creating nursing interventions. However, some challenges were noted, particularly in the areas of critical thinking and theoretical knowledge application. Conclusion: The internal medicine nursing practice training module proves to be an effective tool in improving students' clinical skills, diagnostic accuracy, and patient care outcomes. Addressing the identified challenges in critical thinking could further enhance the module's impact, ensuring that future nurses are well-equipped to meet the demands of modern healthcare.

Defining the Value of Vascular Surgery Service at a Tertiary Academic Medical Center

BackgroundVascular surgeons play a critical role in the functioning of a healthcare system. As a service line, vascular surgery not only performs its own complex operations but also provides support to other surgical specialties by assisting in the management of vascular-related complications. Previous reports have acknowledged the value of consulting vascular surgeons; however, these studies have primarily been limited to single-center series. In this study, we aim to contribute to the existing literature by sharing our experience and highlighting the financial value of consulting vascular surgeons at a large tertiary academic medical center. MethodsInstitutional electronic medical records were retrospectively queried for all operations performed by vascular surgeons from 2020-2022. Two separate procedural groups were identified. The first group comprised all surgeries where vascular surgery was listed as a co-surgeon for other surgical specialties. The second group comprised all surgeries where vascular surgery was the primary surgeon for service-level cases. Service cases were defined as operations resulting directly from (1) iatrogenic complications from other services, (2) consultations for traumatic injury, or (3) primary surgeon for non-vascular cases. The Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule was used to calculate work relative value units (wRVU) per primary procedure code. ResultsA total of 7821 surgeries were performed with vascular involvement over the study period. Of these, 726 operations (9.3%) were co-surgeon cases requiring intraoperative vascular assistance, from 109 surgeons across all 16 surgical specialties. There was no missing data. The most common specialties requesting vascular assistance included cardiac surgery (n=247, 34.0%), orthopedic surgery (n=152, 20.9%), and neurosurgery (n=131, 18.0%). Total procedural wRVU for co-surgeon cases was 16,220, and total charges exceeded $77.5 million dollars. Vascular surgery served in a primary surgeon role in an additional 154 service-level cases (2.0%) resulting from ten non-surgical services. The most common service-level indication was iatrogenic vascular injury (n=87, 56.4%), and the majority of service-level cases required urgent or emergent surgery (n=123, 79.9%). These procedures generated an additional 2,150 wRVU and $1.1 million dollars in charges for the hospital system. Of all co-surgeon or service-level cases, 19.1% (n=168) occurred after-hours and 10.3% (n=91) occurred on a holiday or weekend. ConclusionVascular surgery is crucial to the operation of all surgical services and many non-surgical service lines within an academic medical center. Apart from providing essential services for primary vascular diseases, the vascular surgery service line offers substantial financial benefits to the healthcare system through its consulting role. A considerable portion of operative consultations are performed under urgent or emergent circumstances, often necessitating surgical intervention outside regular working hours or on holidays/weekends. These findings have significant implications for assessing the value and compensation of vascular surgeons in today's healthcare landscape.

Medication Adherence among Patients with Non-Communicable Diseases in a Tertiary Hospital: A Descriptive Cross-sectional Study.

Non-communicable diseases (NCDs) are a leading cause of mortality, with a projected rise from 38 million in 2012 to 52 million by 2030. Among NCDs, hypertension, diabetes and Chronic Obstructive Pulmonary Disease are the major burdens in healthcare today, requiring long-term therapies and a significant effort in maintaining treatment adherence. A descriptive cross-sectional study design was adopted to determine medication adherence among patients with non-communicable diseases using non-probability, consecutive sampling techniques after ethical approval from same institute (Reference number: 524). Medication adherence was assessed on 322 patients attending the outpatient department, using a structured interview schedule, after getting Ethical approval from the Institution Review Committee. Morisky medication adherence scale (MMAS-4), Culig adherence Scale, and Beliefs about Medications (BMQ) tool were used to determine the adherence level, causes of non-adherence and belief in medication respectively. Data was coded and analysed using SPSS version 16. Descriptive statistics were used to summarise the data. The study population exhibited a mean age of 58 ± 12.80 years, with male participants 190 (59.01%). The present study revealed that 148 (45.96%) of the participants have a high adherence level to prescribed medication, and 246 (76.40%) strongly believed that without medication they would be very sick and life would be impossible. The study found that less than half of participants fully adhered to prescribed medicine, with forgetfulness identified as a primary cause of non-compliance.

Antibiotic Prescribing by Digital Health Care Providers as Compared to Traditional Primary Health Care Providers: Cohort Study Using Register Data.

"Direct-to-consumer (DTC) telemedicine" is increasing worldwide and changing the map of primary health care (PHC). Virtual care has increased in the last decade and with the ongoing COVID-19 pandemic, patients' use of online care has increased even further. In Sweden, online consultations are a part of government-supported health care today, and there are several digital care providers on the Swedish market, which makes it possible to get in touch with a doctor within a few minutes. The fast expansion of this market has raised questions about the quality of primary care provided only in an online setting without any physical appointments. Antibiotic prescribing is a common treatment in PHC. This study aimed to compare antibiotic prescribing between digital PHC providers (internet-PHC) and traditional physical PHC providers (physical-PHC) and to determine whether prescriptions for specific diagnoses differed between internet-PHC and physical-PHC appointments, adjusted for the effects of attained age at the time of appointment, gender, and time relative to the COVID-19 pandemic. Antibiotic prescribing data based on Anatomical Therapeutic Chemical (ATC) codes were obtained for Region Sörmland residents from January 2020 until March 2021 from the Regional Administrative Office. In total, 160,238 appointments for 68,332 Sörmland residents were included (124,398 physical-PHC and 35,840 internet-PHC appointments). Prescriptions issued by internet-PHC or physical-PHC physicians were considered. Information on the appointment date, staff category serving the patient, ICD-10 (International Statistical Classification of Diseases, Tenth Revision) diagnosis codes, ATC codes of prescribed medicines, and patient-attained age and gender were used. A total of 160,238 health care appointments were registered, of which 18,433 led to an infection diagnosis. There were large differences in gender and attained age distributions among physical-PHC and internet-PHC appointments. Physical-PHC appointments peaked among patients aged 60-80 years while internet-PHC appointments peaked at 20-30 years of age for both genders. Antibiotics with the ATC codes J01A-J01X were prescribed in 9.3% (11,609/124,398) of physical-PHC appointments as compared with 6.1% (2201/35,840) of internet-PHC appointments. In addition, 61.3% (6412/10,454) of physical-PHC infection appointments resulted in antibiotic prescriptions, as compared with only 25.8% (2057/7979) of internet-PHC appointments. Analyses of the prescribed antibiotics showed that internet-PHC followed regional recommendations for all diagnoses. Physical-PHC also followed the recommendations but used a wider spectrum of antibiotics. The odds ratio of receiving an antibiotic prescription (after adjustments for attained age at the time of appointment, patient gender, and whether the prescription was issued before or during the COVID-19 pandemic) during an internet-PHC appointment was 0.23-0.39 as compared with a physical-PHC appointment. Internet-PHC appointments resulted in a significantly lower number of antibiotics prescriptions than physical-PHC appointments, adjusted for the large differences in the characteristics of patients who consult internet-PHC and physical-PHC. Internet-PHC prescribers showed appropriate prescribing according to guidelines.

Vasectomy of finances sidelines politicians' promises of 24/7 services

The German healthcare system is outdated, no longer reflects reality and needs to be reformed. In addition to a lack of ideas, there is a lack of courage and will to implement necessary reforms. Where will current developments lead us? When it comes to financing the healthcare system, immense challenges await political decision-makers. Demographic change is already posing major problems for healthcare today. Parallel to the increase in the number of patients, the time that physicians have available for their patients has been decreasing for years. Ultimately, social change and the increase in part-time employment mean that there is significantly less money available. Patient dissatisfaction is increasing as expectations are not being met. While hospitals receive financial support, the outpatient sector has been left empty-handed for years. As financial investors are forcing their way into outpatient care, the focus must be prevented from being purely on maximizing profits. Thus, areorganization of the healthcare system is necessary.

Цифровизация сферы здравоохранения: тенденции развития и биоинформационная web-платформа компании Онко Генотест

Currently, an urgent task in all spheres of society is the creation of industry-specific digital platforms based on various economic methods for processing large amounts of information. The success of the implementation of the target program “Digital Economy of the Russian Federation” as a whole, and therefore the transition of sec-tors of the Russian economy to digitalization, largely depends on its solution. The healthcare sector today is among the leaders not only in the creation, but also in the practical application of digital platforms for the compre-hensive treatment of a wide range of diseases based on innovative approaches. In the course of the research, promising directions for the development of the global healthcare digitalization market in the field of medical diag-nostics and pharmacogenetics, as well as the activities of its main participants in the field of oncology, were iden-tified. The innovative advantages of the bioinformational web platform of the company Onco Genotest LLC are shown, ensuring the competitiveness of its activities.

Leading and managing a multidisciplinary team in health and social care: a critical and personal reflection.

This article presents a synthesis of the leadership and management knowledge and experience gained while participating in project work in health and social care. The first part presents a critical evaluation of leadership and management across health and social care services, with a focus on a multidisciplinary team in a ward setting. The second part presents a critical reflection on a personal leadership and management experience during the project using an appropriate model of reflection, a synthesis of lessons learnt and application to future practice as a registered nurse. A range of theories and frameworks related to leadership, management and team working are critically evaluated and a critical understanding of both political and economic perspectives within today's healthcare system is presented.