Health Systems最新文献_第10页

Identification of barriers and enablers to rapid diagnosis along the paediatric stroke chain of recovery using Value-Focused Process Engineering. 使用以价值为中心的过程工程识别障碍和使能器，以便沿着儿科中风恢复链快速诊断。

IF 1.8

Health Systems Pub Date : 2019-09-24 DOI: 10.1080/20476965.2019.1664941

Mark T Mackay, Leonid Churilov, Anna Moon, Ian McKenzie, Geoffrey A Donnan, Paul Monagle, Qi Li, Franz E Babl

{"title":"Identification of barriers and enablers to rapid diagnosis along the paediatric stroke chain of recovery using Value-Focused Process Engineering.","authors":"Mark T Mackay, Leonid Churilov, Anna Moon, Ian McKenzie, Geoffrey A Donnan, Paul Monagle, Qi Li, Franz E Babl","doi":"10.1080/20476965.2019.1664941","DOIUrl":"https://doi.org/10.1080/20476965.2019.1664941","url":null,"abstract":"Coordinated systems of care are required to improve access to reperfusion therapies in paediatric stroke. A conceptual model was developed to map the process-of-care from symptom onset to confirmation of diagnosis. Value-Focused Process Engineering with event-driven process modelling was used to identify barriers and enablers to timely and accurate paediatric stroke diagnosis. Stakeholder interviews were conducted to inform model design, development, demonstration and validation. Barriers included: (i) ambulance dispatcher failure to allocate high-priority response, (ii) childrens' exclusion from paramedic clinical practice guidelines, (ii) non-allocation of high triage category on hospital arrival, (iii) absence of emergency department guidelines for focal neurological deficits, and (iv) computed tomography as the first imaging investigation. Enablers included: (i) public awareness programs, (ii) childrens' inclusion in prehospital emergency stroke algorithms, (iii) re-organisation of health services, with primary paediatric stroke centres, (iv) implementation of triage and neuroimaging decision support tools, and (iv) rapid stroke MRI imaging protocols.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"10 1","pages":"73-88"},"PeriodicalIF":1.8,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1664941","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25510464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Productivity-driven physician scheduling in emergency departments. 急诊部门效率驱动的医生调度。

IF 1.8

Health Systems Pub Date : 2019-09-17 DOI: 10.1080/20476965.2019.1666036

Fanny Camiat, Marìa I Restrepo, Jean-Marc Chauny, Nadia Lahrichi, Louis-Martin Rousseau

{"title":"Productivity-driven physician scheduling in emergency departments.","authors":"Fanny Camiat, Marìa I Restrepo, Jean-Marc Chauny, Nadia Lahrichi, Louis-Martin Rousseau","doi":"10.1080/20476965.2019.1666036","DOIUrl":"https://doi.org/10.1080/20476965.2019.1666036","url":null,"abstract":"The objective of this study is two-fold: to propose an alternative approach for computing the productivity of physicians in emergency departments (EDs); and, to allocate productivity-driven schedules to ED physicians so as to align physician productivity with demand (patient arrivals), without decreasing fairness between physicians, in order to improve patient wait times. Historical data between 2008 and 2017 from the Sacré-Coeur Montreal Hospital ED is analysed and used to predict the demand and to estimate the productivity of each physician. These estimates are incorporated into a mathematical programming model that identifies feasible schedules to physicians that minimise the difference between patients' demand and physicians' productivity, along with the violation of physicians' preferences and fairness in the distribution of shifts. Results on real-world-based data show that when physician productivity is included in the allocation of schedules, demand under-covering is reduced by 10.85% and the fairness between physicians is maintained. However, physicians' preferences (e.g., sum of the differences between the number of wanted shifts and the number of allocated shifts) deteriorates by 7.61%. By incorporating the productivity of physicians in the scheduling process, we see a reduction in EDs overcrowding and an improvement in the overall quality of health-care services.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"10 2","pages":"104-117"},"PeriodicalIF":1.8,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1666036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39076455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Cloud-based multi-media systems for patient education and adherence: a pilot study to explore patient compliance with colonoscopy procedure preparation. 用于患者教育和依从性的基于云的多媒体系统:一项探索患者对结肠镜检查程序准备依从性的试点研究。

IF 1.8

Health Systems Pub Date : 2019-09-12 DOI: 10.1080/20476965.2019.1663974

Benjamin Schooley, Tonia San Nicolas-Rocca, Richard Burkhard

{"title":"Cloud-based multi-media systems for patient education and adherence: a pilot study to explore patient compliance with colonoscopy procedure preparation.","authors":"Benjamin Schooley, Tonia San Nicolas-Rocca, Richard Burkhard","doi":"10.1080/20476965.2019.1663974","DOIUrl":"https://doi.org/10.1080/20476965.2019.1663974","url":null,"abstract":"Technology based patient education and adherence approaches are increasingly utilized to instruct and remind patients to prepare correctly for medical procedures. This study examines the interaction between two primary factors: patterns of patient adherence to challenging medical preparation procedures; and the demonstrated, measurable potential for cloud-based multi-media information technology (IT) interventions to improve patient adherence. An IT artifact was developed through prior design science research to serve information, reminders, and online video instruction modules to patients. The application was tested with 297 patients who were assessed clinically by physicians. Results indicate modest potential (43.4% relative improvement) for the IT-based approach for improving patient adherence to endoscopy preparations. Purposively designed cloud-based applications hold promise for aiding patients with complex medical procedure preparation. Health care provider involvement in the design and evaluation of a patient application may be an effective strategy to produce medical evidence and encourage the adoption of adherence apps.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"10 2","pages":"89-103"},"PeriodicalIF":1.8,"publicationDate":"2019-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1663974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39076454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Clinical pathway modelling: a literature review. 临床路径建模：文献综述。

IF 1.2

Health Systems Pub Date : 2019-09-11 DOI: 10.1080/20476965.2019.1652547

Emma Aspland, Daniel Gartner, Paul Harper

引用次数: 0

Using the theory of constraints' processes of ongoing improvement to address the provider appointment scheduling system execution problem. 利用约束过程的持续改进理论，解决了提供者预约调度系统的执行问题。

IF 1.8

Health Systems Pub Date : 2019-09-01 DOI: 10.1080/20476965.2019.1646105

James F Cox

引用次数: 3

The potential role of dashboard use and navigation in reducing medical errors of an electronic health record system: a mixed-method simulation handoff study. 仪表板使用和导航在减少电子健康记录系统的医疗差错中的潜在作用:一项混合方法模拟切换研究。

IF 1.8

Health Systems Pub Date : 2019-05-28 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1620637

Danny T Y Wu, Smruti Deoghare, Zhe Shan, Karthikeyan Meganathan, Katherine Blondon

{"title":"The potential role of dashboard use and navigation in reducing medical errors of an electronic health record system: a mixed-method simulation handoff study.","authors":"Danny T Y Wu, Smruti Deoghare, Zhe Shan, Karthikeyan Meganathan, Katherine Blondon","doi":"10.1080/20476965.2019.1620637","DOIUrl":"https://doi.org/10.1080/20476965.2019.1620637","url":null,"abstract":"The dashboards of electronic health record (EHR) systems could potentially support the chart biopsy that occurs before or after physician handoffs. In this study, we conducted a simulation handoff study and recorded the participants' navigation patterns in an EHR system mock-up. We analyzed the navigation patterns of dashboard use in terms of duration, frequency, and sequence, and we examined the relationship between dashboard use in chart biopsy and the errors identified after handoffs. The results show that the participants frequently used the dashboard as an information hub and as an information resource to help them navigate the EHR system and answer the questions in a nursing call. Moreover, using the dashboard as an information hub can help reduce imprecision and factual errors in handoffs. Our findings suggest the need for a \"context-aware\" dashboard to accommodate dynamic navigation patterns and to support clinical work as well as to reduce medical errors.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"8 3","pages":"203-214"},"PeriodicalIF":1.8,"publicationDate":"2019-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1620637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37459953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Development of a computerized paediatric intensive care unit septic shock pathway: improving user experience. 计算机化儿科重症监护病房脓毒性休克路径的发展:改善用户体验。

IF 1.8

Health Systems Pub Date : 2019-05-28 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1620638

Lauren Shivers, Sue S Feldman, Leslie W Hayes

引用次数: 2

The impact of systemic innovations for transforming transplant systems. Lessons learned from the German lung transplantation system. A qualitative study. 系统创新对移植系统转型的影响。德国肺移植系统的经验教训。定性研究。

IF 1.8

Health Systems Pub Date : 2019-05-16 eCollection Date: 2020-01-01 DOI: 10.1080/20476965.2019.1604086

Antoniya Hauerwaas, Ursula Weisenfeld

{"title":"The impact of systemic innovations for transforming transplant systems. Lessons learned from the German lung transplantation system. A qualitative study.","authors":"Antoniya Hauerwaas, Ursula Weisenfeld","doi":"10.1080/20476965.2019.1604086","DOIUrl":"https://doi.org/10.1080/20476965.2019.1604086","url":null,"abstract":"The aim of this paper is to demonstrate the potential of the systemic innovations approach for transforming transplantation systems. It explores potential leverage points for intervening in the LTx-system as well as possible paths of transformation. We present possible transition pathways giving the example of the German Lung transplantation system that teeters on the brink of collapse due to system failures and organ scarcity and illustrate systemic innovations as core mechanisms for systems change in health systems. Desk research and semi-structured experts interviews provided qualitative data for a deductive-inductive coding and a rigorous qualitative content analysis of the data. Depending on the systemic innovations chosen to achieve systems change, transplant systems follow different transformational paths: from a collapse to a leapfrogging towards a non-human transplantation system. Thus, global health areas like transplantation benefit from analysis on systemic innovations as these support researchers, public policy and regulators by developing transformative strategies in healthcare systems.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"9 1","pages":"76-93"},"PeriodicalIF":1.8,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1604086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37829238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Real-Time Automated Hazard Detection Framework for Health Information Technology Systems. 卫生信息技术系统实时自动危害检测框架。

IF 1.8

Health Systems Pub Date : 2019-05-07 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1599701

Olufemi A Omitaomu, Ozgur Ozmen, Mohammed M Olama, Laura L Pullum, Teja Kuruganti, James Nutaro, Hilda B Klasky, Helia Zandi, Aneel Advani, Angela L Laurio, Merry Ward, Jeanie Scott, Jonathan R Nebeker

{"title":"Real-Time Automated Hazard Detection Framework for Health Information Technology Systems.","authors":"Olufemi A Omitaomu, Ozgur Ozmen, Mohammed M Olama, Laura L Pullum, Teja Kuruganti, James Nutaro, Hilda B Klasky, Helia Zandi, Aneel Advani, Angela L Laurio, Merry Ward, Jeanie Scott, Jonathan R Nebeker","doi":"10.1080/20476965.2019.1599701","DOIUrl":"https://doi.org/10.1080/20476965.2019.1599701","url":null,"abstract":"An increase in the reliability of Health Information Technology (HIT) will facilitate institutional trust and credibility of the systems. In this paper, we present an end-to-end framework for improving the reliability and performance of HIT systems. Specifically, we describe the system model, present some of the methods that drive the model, and discuss an initial implementation of two of the proposed methods using data from the Veterans Affairs HIT and Corporate Data Warehouse systems. The contributions of this paper, thus, include (1) the design of a system model for monitoring and detecting hazards in HIT systems, (2) a data-driven approach for analysing the health care data warehouse, (3) analytical methods for characterising and analysing failures in HIT systems, and (4) a tool architecture for generating and reporting hazards in HIT systems. Our goal is to work towards an automated system that will help identify opportunities for improvements in HIT systems.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"8 3","pages":"190-202"},"PeriodicalIF":1.8,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1599701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37460010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Combining regression trees and panel regression for exploring and testing the impact of complementary management practices on short-notice elective operation cancellation rates. 结合回归树和面板回归，探索和测试补充管理措施对临时通知的择期手术取消率的影响。

IF 1.2

Health Systems Pub Date : 2019-04-19 DOI: 10.1080/20476965.2019.1596338

Reza Salehnejad, Manhal Ali, Nathan Proudlove

{"title":"Combining regression trees and panel regression for exploring and testing the impact of complementary management practices on short-notice elective operation cancellation rates.","authors":"Reza Salehnejad, Manhal Ali, Nathan Proudlove","doi":"10.1080/20476965.2019.1596338","DOIUrl":"10.1080/20476965.2019.1596338","url":null,"abstract":"Variation in the performance of providers across healthcare systems is pervasive. It is recognised as both a major concern and an opportunity for learning and improvement. Variation between providers is broadly considered to be due to management practices and contextual factors such as catchment-area demographics. However, there is little understanding of the ways in which these impact on performance and how they can be measured. We use recent developments in both regression trees and panel regression techniques to explore and then statistically test complementary alignments of management practices whilst taking into account contextual factors. We apply this to 5 years of NHS hospital trust data, examining performance on short-notice cancellation rates. We find that different alignments of management practices give rise to quite different short-notice cancellation rates between trusts, with some being substantially lower. Our research offers a data-driven approach for identifying optimal clusters of management practices.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"9 4","pages":"326-344"},"PeriodicalIF":1.2,"publicationDate":"2019-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738292/pdf/THSS_9_1596338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10292914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0