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Taking a systems approach to promote posttraumatic growth: A position paper 采用系统方法促进创伤后成长:立场文件
Health Systems Pub Date : 2023-10-30 DOI: 10.1080/20476965.2023.2275794
Megan E. Call, Heather R. Walker, Michael L. Good, Joe Borgenicht, Gretchen A. Case, Amy B. Locke
{"title":"Taking a systems approach to promote posttraumatic growth: A position paper","authors":"Megan E. Call, Heather R. Walker, Michael L. Good, Joe Borgenicht, Gretchen A. Case, Amy B. Locke","doi":"10.1080/20476965.2023.2275794","DOIUrl":"https://doi.org/10.1080/20476965.2023.2275794","url":null,"abstract":"ABSTRACTAs health systems emerge from the pandemic, academic medical centres are motivated to have a healthy and resilient workforce. In the face of the collective traumas of the pandemic, we took a systems approach to infuse wellness into our culture by modelling collective recovery in a non-traditional town hall. Over a dozen senior leaders, faculty, staff, and students shared their personal experiences in a virtual forum, nearly 1000 attendees communally supported one another. Since the town hall, a recording of the experience has been broadly viewed, messaging from leaders proliferated, and smaller versions of the same exercise were implemented. At a time when academic medical centres faced multiple challenges, we chose to first value the well-being of our staff at a system-wide level. It is our hope that other academic medical centres leverage our story to hold space for the experiences of the people who make their work possible.KEYWORDS: COVID-19professional well-beingtrauma-informed Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. Members of this group developed the 3 R’s as a collaborative approach to system-level conversations and financial strategy. The 3 R’s influences the development and implementation of this project. More can be read about the 3 R’s here: https://uofuhealth.utah.edu/notes/postings/2021/05/town-hall-moving-forward.php#.YQCMuBNKi8U2. Because this town hall was intended as a community building and quality improvement event, the metrics we use to measure its success are rooted in attendance and participation. These primary goals reflect our hopes for broad institutional change marked by events such as these which – in theory – promise cultural shifts.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136067382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fractured systems: a literature review of OR/MS methods applied to orthopaedic care settings and treatments 骨折系统:OR/MS方法应用于骨科护理设置和治疗的文献综述
Health Systems Pub Date : 2023-10-09 DOI: 10.1080/20476965.2023.2264348
Matthew Howells, Paul Harper, Geraint Palmer, Daniel Gartner
{"title":"Fractured systems: a literature review of OR/MS methods applied to orthopaedic care settings and treatments","authors":"Matthew Howells, Paul Harper, Geraint Palmer, Daniel Gartner","doi":"10.1080/20476965.2023.2264348","DOIUrl":"https://doi.org/10.1080/20476965.2023.2264348","url":null,"abstract":"Orthopaedic systems are facing an impending wave of increased pressures as a result of global ageing populations. This is compounded by the current stresses these services face, as a result of the COVID-19 pandemic, and increasing burden of musculoskeletal conditions. It is vital that measures are taken to alleviate the pressures on these systems, to ensure timely and quality access to care for patients. This literature review presents a taxonomic classification of the applications of Operational Research and Management Science (OR/MS) methodologies to orthopaedic care settings and treatments, covering the general, medical, and methodological context of each paper. Our structured search identified 492 relevant publications that have been included in our analysis. The results found a literature largely dominated by cost analysis applications, typically utilising Markov models or decision trees. Key gaps identified in this review include the lack of holistic modelling of orthopaedic systems and pathways, and limited applications to resource and capacity planning. The implications of our review are that researchers, healthcare professionals and managers can develop a research agenda to address these gaps, and enhance decision support in orthopaedics.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Estimating the workload of a multi-disciplinary care team using patient-level encounter histories. 利用患者层面的就诊历史估算多学科护理团队的工作量
IF 1.2
Health Systems Pub Date : 2023-06-12 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2023.2215848
Ekin Koker, Hari Balasubramanian, Rebecca Castonguay, Aliecia Bottali, Aaron Truchil
{"title":"Estimating the workload of a multi-disciplinary care team using patient-level encounter histories.","authors":"Ekin Koker, Hari Balasubramanian, Rebecca Castonguay, Aliecia Bottali, Aaron Truchil","doi":"10.1080/20476965.2023.2215848","DOIUrl":"10.1080/20476965.2023.2215848","url":null,"abstract":"<p><p>Healthcare spending in the United States is concentrated on a small percentage of individuals, with 5% of the population accounting for 50% of annual spending. Many patients among the top 5% of spenders have complex health and social needs. Care coordination interventions, often led by a multidisciplinary team consisting of nurses, community health workers and social workers, are one strategy for addressing the challenges facing such patients. Care teams strive to improve health outcomes by forging strong relationships with clients, visiting them on a regular basis, reconciling medications, arranging primary and speciality care visits, and addressing social needs such as housing instability, unemployment and insurance. In this paper, we propose a simulation algorithm that samples longitudinal patient-level encounter histories to estimate the staffing needs for a multidisciplinary care team. Our numerical results illustrate multiple uses of the algorithm for staffing under stationary and non-stationary patient enrollment rates.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":" ","pages":"295-315"},"PeriodicalIF":1.2,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47549141","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
Exploratory analysis using discrete event simulation modelling of the wait times and service costs associated with the maximum wait time guarantee policy applied in a rheumatology central intake clinic. 探索性分析使用离散事件模拟建模的等待时间和服务成本与最大等待时间保证政策应用于风湿病中心门诊
IF 1.2
Health Systems Pub Date : 2023-06-01 eCollection Date: 2025-01-01 DOI: 10.1080/20476965.2023.2219293
Toni Tagimacruz, Monica Cepoiu-Martin, Deborah A Marshall
{"title":"Exploratory analysis using discrete event simulation modelling of the wait times and service costs associated with the maximum wait time guarantee policy applied in a rheumatology central intake clinic.","authors":"Toni Tagimacruz, Monica Cepoiu-Martin, Deborah A Marshall","doi":"10.1080/20476965.2023.2219293","DOIUrl":"10.1080/20476965.2023.2219293","url":null,"abstract":"<p><p>Adherence to wait time benchmark targets for the diagnosis and initiation of interventions for rheumatoid arthritis is crucial in altering the disease trajectory. We analysed the impact of the maximum wait time guarantee (MWTG) policy for routing referrals for the initial rheumatologist consults on the waiting and service costs. We modelled a central intake system for a rheumatology clinic as a discrete event simulation (DES) model. Using data from a central intake and rheumatology clinic as input to the model of the system, we simulated the arrival of referrals and rheumatologist visits of patients. We demonstrated the impact of the referral policy on system performance and compared the system costs in an MWTG policy and first-available-appointment policy scenarios. MWTG policy is an option for a wait time management strategy but comes with essential cost considerations. Healthcare managers and policymakers should consider the DES approach to support referral decision policy choices.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47741236","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
Assessment of implementation barriers of blockchain technology in public healthcare: evidences from developing countries. 区块链技术在公共医疗领域的实施障碍评估：来自发展中国家的证据。
IF 1.8
Health Systems Pub Date : 2023-05-23 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2206446
Sudhanshu Joshi, Manu Sharma
{"title":"Assessment of implementation barriers of blockchain technology in public healthcare: evidences from developing countries.","authors":"Sudhanshu Joshi, Manu Sharma","doi":"10.1080/20476965.2023.2206446","DOIUrl":"10.1080/20476965.2023.2206446","url":null,"abstract":"<p><p>The widespread use of Blockchain technology (BT) in nations that are developing remains in its early stages, necessitating a more comprehensive evaluation using efficient and adaptable approaches. The need for digitalization to boost operational effectiveness is growing in the healthcare sector. Despite BT's potential as a competitive option for the healthcare sector, insufficient research has prevented it being fully utilised. This study intends to identify the main sociological, economical, and infrastructure obstacles to BT adoption in developing nations' public health systems. To accomplish this goal, the study employs a multi-level analysis of blockchain hurdles using hybrid approach. The study's findings provide decision- makers with guidance on how to proceed, as well as insight into implementation challenges.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 2","pages":"223-242"},"PeriodicalIF":1.8,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9523970","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
Long term simulation analysis of deceased donor initiated chains in kidney exchange programs. 肾脏交换计划中已故供者启动链的长期模拟分析
IF 1.8
Health Systems Pub Date : 2023-04-04 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2023.2197023
Utkarsh Verma, Nayaran Rangaraj, Viswanath Billa, Deepa Usulumarty
{"title":"Long term simulation analysis of deceased donor initiated chains in kidney exchange programs.","authors":"Utkarsh Verma, Nayaran Rangaraj, Viswanath Billa, Deepa Usulumarty","doi":"10.1080/20476965.2023.2197023","DOIUrl":"10.1080/20476965.2023.2197023","url":null,"abstract":"<p><p>Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a ©DD donates kidneys directly to a©DD wait-list. The idea of initiating an exchange chain starting from a ©DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates ©DD-initiated chains, considering both paired exchange registry and ©DD allocations simultaneously and addressing the overlap issue between the exchange registry and ©DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to ©analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of ©DDs, these chains can significantly increase potential transplants.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"1 1","pages":"121-132"},"PeriodicalIF":1.8,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42859045","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
A new vision and direction for Health Systems. 卫生系统的新愿景和新方向。
IF 1.8
Health Systems Pub Date : 2023-03-08 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2180173
Samir Chatterjee, Kathy Kotiadis, Daniel Gartner
{"title":"A new vision and direction for <i>Health Systems</i>.","authors":"Samir Chatterjee, Kathy Kotiadis, Daniel Gartner","doi":"10.1080/20476965.2023.2180173","DOIUrl":"10.1080/20476965.2023.2180173","url":null,"abstract":"","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"1-2"},"PeriodicalIF":1.8,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492040","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
A genetic algorithm-based strategic planning framework for optimising accessibility and costs of general practices in Northland, New Zealand. 基于遗传算法的战略规划框架，用于优化新西兰Northland的一般做法的可及性和成本
IF 1.8
Health Systems Pub Date : 2023-02-16 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2174454
Fulvio D Lopane, Melanie Reuter-Oppermann, Andrea Raith, Daniel J Exeter, Ilze Ziedins, Richard Dawson
{"title":"A genetic algorithm-based strategic planning framework for optimising accessibility and costs of general practices in Northland, New Zealand.","authors":"Fulvio D Lopane, Melanie Reuter-Oppermann, Andrea Raith, Daniel J Exeter, Ilze Ziedins, Richard Dawson","doi":"10.1080/20476965.2023.2174454","DOIUrl":"10.1080/20476965.2023.2174454","url":null,"abstract":"<p><p>Shortage of general practitioners (GP) is a challenge worldwide, not only in Europe, but also in countries like New Zealand. Providing primary care in rural areas is especially challenging. In order to support decision makers, it is necessary to first assess the current GP coverage and then to determine different scenarios and plans for the future. In this paper, we first present a thorough overview of related literature on locating GP practices. Second, we propose an approach for assessing the GP coverage and determining future GP locations based on a genetic algorithm framework. As a use case, we have chosen the rural New Zealand region of Northland. We also perform a sensitivity analysis for the main input parameters.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"1 1","pages":"332-356"},"PeriodicalIF":1.8,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41535798","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
Using stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway 使用随机模拟模型研究挪威分散式免入单元的入住率
IF 1.8
Health Systems Pub Date : 2023-02-15 DOI: 10.1080/20476965.2023.2174453
Meetali Kakad, M. Utley, F. A. Dahl
{"title":"Using stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway","authors":"Meetali Kakad, M. Utley, F. A. Dahl","doi":"10.1080/20476965.2023.2174453","DOIUrl":"https://doi.org/10.1080/20476965.2023.2174453","url":null,"abstract":"ABSTRACT Identifying alternatives to acute hospital admission is a priority for many countries. Over 200 decentralised municipal acute units (MAUs) were established in Norway to divert low-acuity patients away from hospitals. MAUs have faced criticism for low mean occupancy and not relieving pressures on hospitals. We developed a discrete time simulation model of admissions and discharges to MAUs to test scenarios for increasing absolute mean occupancy. We also used the model to estimate the number of patients turned away as historical data was unavailable. Our experiments suggest that mergers alone are unlikely to substantially increase MAU absolute mean occupancy as unmet demand is generally low. However, merging MAUs offers scope for up to 20% reduction in bed capacity, without affecting service provision. Our work has relevance for other admissions avoidance units and provides a method for estimating unconstrained demand for beds in the absence of historical data.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46265431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the impact of software quality models in healthcare software systems. 评估软件质量模型对医疗保健软件系统的影响。
IF 1.2
Health Systems Pub Date : 2023-01-08 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2022.2162445
Elisabetta Ronchieri, Marco Canaparo
{"title":"Assessing the impact of software quality models in healthcare software systems.","authors":"Elisabetta Ronchieri, Marco Canaparo","doi":"10.1080/20476965.2022.2162445","DOIUrl":"10.1080/20476965.2022.2162445","url":null,"abstract":"<p><p>Health and medical care are safety-critical environments. The development of a safe and reliable healthcare software system is one of the most important processes which may affect the accuracy of clinical decision making and have an impact on determining diagnoses of and treatment for diseases. The aim of this study is to assess if software quality models, such as McCall, can have an impact on healthcare software quality for the purpose of reducing software failures. We have identified the main criticalities of healthcare software systems based on existing literature, software quality models and programming language standards; we have related these criticalities to software characteristics; we have analysed the relationship between the main criticalities of healthcare software systems and their software characteristics. The following criticalities - the risk of changing hard-coded software and the importance of developing maintainable software - must be addressed at the start of the software development process.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"12 1","pages":"85-97"},"PeriodicalIF":1.2,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131150","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
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