Discover health systems最新文献

{"title":"Clinical empathy: definition, measurement, correlates, group differences, erosion, enhancement, and healthcare outcomes","authors":"M. Hojat, V. Maio, Charles A. Pohl, J. Gonnella","doi":"10.1007/s44250-023-00020-2","DOIUrl":"https://doi.org/10.1007/s44250-023-00020-2","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45355590","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}

{"title":"Can acute care surgery sustain as a specialty in Singapore?","authors":"Brian Wca Tian","doi":"10.1007/s44250-023-00023-z","DOIUrl":"https://doi.org/10.1007/s44250-023-00023-z","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48616434","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}

{"title":"Evidencing built health system reconfiguration policy","authors":"G. Mills, Antonio Rojas García, R. Raine","doi":"10.1007/s44250-022-00008-4","DOIUrl":"https://doi.org/10.1007/s44250-022-00008-4","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46632044","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}

{"title":"The association between the problem list and chronic pain management","authors":"Tina L. Rylee, David J. Copenhaver, Christiana Drake, Jill Joseph","doi":"10.1007/s44250-022-00016-4","DOIUrl":"https://doi.org/10.1007/s44250-022-00016-4","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"19 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41273399","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}

{"title":"Does a decannulation protocol exist in COVID-19 patients? The importance of working in a multiprofessional team.","authors":"E Cavalli, G Belfiori, G Molinari, A Peghetti, A Zanoni, E Chinelli","doi":"10.1007/s44250-023-00031-z","DOIUrl":"10.1007/s44250-023-00031-z","url":null,"abstract":"<p><p>As a Covid Hub in Emilia Romagna, we have experienced an increasing number of tracheostomized patients, prompting us to develop a standardized decannulation protocol for COVID-19 ARDS patients. Currently, there are no guidelines or protocols for decannulation in this population, and few studies have investigated the early outcomes of tracheostomy in COVID-19 patients, with no detailed analysis of the decannulation process. We recognized the importance of mutual reliance among our team members and the significant achievements we made compared to previous decannulation methods. Through the optimization of the decannulation process, we identified a clear, safe, and repeatable method based on clinical best practice and literature evidence. We decided to implement an existing standardized decannulation protocol, which was originally designed for severe brain-damaged patients, due to the growing number of COVID-19 patients with tracheostomy. This protocol was designed for daily practice and aimed to provide a uniform approach to using devices like fenestrated cannulas, speaking valves, and capping. The results of our implementation include:expanding the applicability of the protocol beyond severe brain-damaged patients to different populations and settings (in this case, patients subjected to a long period of sedation and invasive ventilation)early activation of speech therapy to facilitate weaning from the cannula and recovery of physiological swallowing and phonationearly activation of otolaryngologist evaluation to identify organic problems related to prolonged intubation, tracheostomy, and ventilation and address proper speech therapy treatmentactivation of more fluid and effective management paths for decannulation with a multiprofessional team.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10099004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9906759","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}

{"title":"Analyzing Yemen's health system at the governorate level amid the ongoing conflict: a case of Al Hodeida governorate.","authors":"Raof Al Waziza, Rashad Sheikh, Iman Ahmed, Ghassan Al-Masbhi, Fekri Dureab","doi":"10.1007/s44250-023-00026-w","DOIUrl":"10.1007/s44250-023-00026-w","url":null,"abstract":"<p><strong>Background: </strong>Yemen is regarded as one of the Middle East's poorest countries. Decades of political, economic, and social difficulties have culminated in the current protracted conflict. As a result, the globe experienced its worst humanitarian catastrophe. The ongoing war has affected several public services, notably the health sector, which is operating at less than half its capacity. This study aims to examine Yemen's health system at the governorate level (Al Hodeida) amidst the current conflict. It analyzes current challenges and produces suggestions for enhancement.</p><p><strong>Methods: </strong>The study used qualitative research methods such as Key Informant Interviews (KIIs) and document analysis. The study used WHO's health systems framework to measure health system performance. Twelve KIIs were conducted via Skype with several health stakeholders. In addition, documents were analyzed to inform the subject guide, generate themes, and aid in the triangulation of results.</p><p><strong>Results: </strong>According to the study findings, the governorate health system managed to offer a minimum level of healthcare services while making some advances in outbreak control jointly with other partners. One of the main difficulties confronting the governorate's health system is a severe lack of financial resources forcing it to rely entirely on external aid. Furthermore, other significant deficiencies include inadequate health system organogram, low reporting capacities, insufficient funding, and scarcity of health professionals.</p><p><strong>Conclusion: </strong>Yemen's frail health system has been weakened by almost eight years of insecurity and conflict. If the current scenario continues, most of Yemen's health system's operations and indicators will likely deteriorate. On the other hand, progress in some areas, such as primary healthcare (PHC) services and disease management, is remarkable. However, for better performance, Yemen's health system leadership and stakeholders should seek a holistic strategy to improve the entire dimensions of the health system.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9912550","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}

{"title":"Exploring pandemic preparedness in higher education: lessons learnt from students' lived experiences during a critical time.","authors":"Jinan Abi Jumaa, Rodolfo Catena, Elliot Brown, Saikou Sanyang, Alessandro Tridico, Dawn Weaver","doi":"10.1007/s44250-023-00024-y","DOIUrl":"10.1007/s44250-023-00024-y","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has had a marked impact on educational disruption and progression of students. Linked to this, studies have demonstrated increases in depression, anxiety, and stress, with long-term outcomes yet to be understood. Students in Higher Education (HE) were at particular risk due to circumstances such as financial stress from job loss, shifting to online learning and uncertainties about the future, with many international students isolated from social support networks. This study explored lived experiences of determinants for academic disruption in HE students during the COVID-19 pandemic across Germany and the UK.</p><p><strong>Methods: </strong>The study used qualitative secondary data collected from extension and mitigation claim forms from 2019 until 2021 from a university with campuses in the UK and Germany. A phenomenological perspective was utilised to draw out experiences and insights into determinants for mitigation from students to enhance our understanding of real problems encountered during a period of crisis. Thematic data analysis was used to create themes of influence for mitigation of assessments.</p><p><strong>Results: </strong>Themes identified pre and during the COVID-19 pandemic included; pre-COVID: work-related commitments; bereavement; illness of a family member; mental and physical health issues; natural disasters, during 2020/21, themes created were; COVID-19 social impacts; workplace and financial demands; psychological distress; physical illness, with subthemes evolving such as family responsibilities; and caring for others; furlough and its financial impacts; heavy workload for frontline health care workers; mental health impacts; physical abuse and crime, COVID-19 physical symptoms.</p><p><strong>Conclusion: </strong>We suggest an Integrated 'Determinants of Wellbeing Framework' for supporting HE students during critical times such as a pandemic. Our suggested framework was adapted from determining health inequalities and the concept of the 'flourishing student' that maps the relationship between the student, their environment and well-being. It is hoped the framework will serve to inform future theories around disruption to student progression and to explore the relevant impact on educational outcomes in HE thus assisting in appropriate support planning.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9906756","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}

{"title":"Optimisation of perioperative procedural factors to reduce the risk of surgical site infection in patients undergoing surgery: a systematic review.","authors":"P Calò, F Catena, D Corsaro, L Costantini, F Falez, B Moretti, V Parrinello, E Romanini, A Spinarelli, G Vaccaro, F Venneri","doi":"10.1007/s44250-023-00019-9","DOIUrl":"10.1007/s44250-023-00019-9","url":null,"abstract":"<p><p>Surgical site infections (SSI) are the leading cause of hospital readmission after surgical procedures with significant impact on post-operative morbidity and mortality. Modifiable risk factors for SSI include procedural aspects, which include the possibility of instrument contamination, the duration of the operation, the number of people present and the traffic in the room and the ventilation system of the operating theatre.The aim of this systematic review was to provide literature evidence on the relationship between features of surgical procedure sets and the frequency of SSI in patients undergoing surgical treatment, and to analyse how time frames of perioperative processes and operating theatre traffic vary in relation to the features of the procedure sets use, in order tooptimise infection control in OT. The results of the systematic review brought to light observational studies that can be divided into two categories: evidence of purely clinical significance and evidence of mainly organisational, managerial and financial significance. These two systems are largely interconnected, and reciprocally influence each other. The decision to use disposable devices and instruments has been accompanied by a lower incidence in surgical site infections and surgical revisions for remediation. A concomitant reduction in post-operative functional recovery time has also been observed. Also, the rationalisation of traditional surgical sets has also been observed in conjunction with outcomes of clinical significance.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9912549","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}

{"title":"Impact of COVID-19 visitation policies and hospital capacity on discharge readiness in medicine patients.","authors":"Andrea S Wallace, Sonja E Raaum, Erin Phinney Johnson, Angela P Presson, Chelsea M Allen, Mackenzie Elliott, Alycia A Bristol, Catherine E Elmore","doi":"10.1007/s44250-023-00060-8","DOIUrl":"10.1007/s44250-023-00060-8","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 impacted the experience of being hospitalized with the widespread adoption of strict visitation policies to ensure healthcare worker safety. One result was decreased time of caregivers at the bedside of hospitalized patients.</p><p><strong>Objective: </strong>To understand the impact of pandemic-related system effects on patient-reported discharge preparation.</p><p><strong>Design: </strong>This mixed methods study included interviews with a sample of discharged patients during April 2020, and quantitative hospital data from April 2020 to February 2021.</p><p><strong>Participants: </strong>616 patients completed a measure of discharge readiness on their day of discharge and 38 patients completed interviews about their discharge experiences.</p><p><strong>Main measures: </strong>Readiness for discharge (RHDS), visitation policies, ward structure changes, COVID-19-unit census, time into the COVID-19 pandemic, patient characteristics (age, sex, race/ethnicity), admission type (planned/unplanned, for COVID-19), and discharge destination (home, home health, skilled nursing).</p><p><strong>Key results: </strong>Adult patients aged 30-45 (vs. young and older adult patients) and those being discharged to places other than home (e.g., skilled nursing facility) or to out-of-state residences report lower readiness (<i>p</i> < 0.05) on RHDS. Patient interviews revealed some gaps in discharge communication but, overall, patients expressed high discharge readiness and few concerns about how COVID-19 system changes impacted their discharge preparation.</p><p><strong>Conclusions: </strong>While there is some evidence that visitation policies and unit census may impact patient perceptions of discharge preparation, personal characteristics contributed more significantly to discharge readiness than system changes during COVID-19. Participant interviews demonstrated agreement, as most participants were discharged home and identified strong personal feelings of readiness for discharge.<i>Clinical trials registration</i>: ClinicalTrials.gov ID NCT04248738, https://clinicaltrials.gov/ct2/show/NCT04248738.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44250-023-00060-8.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"45"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479713","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}

{"title":"Regional anesthesia in the intensive care unit: a single center's experience and a narrative literature review.","authors":"Emanuele Russo, Marina Latta, Domenico Pietro Santonastaso, Daniele Bellantonio, Alessio Cittadini, Dario Pietrantozzi, Alessandro Circelli, Emiliano Gamberini, Costanza Martino, Martina Spiga, Vanni Agnoletti","doi":"10.1007/s44250-023-00018-w","DOIUrl":"10.1007/s44250-023-00018-w","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9906757","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}