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Background: Patient no-show behavior is a critical factor complicating hospital resource optimization and causing waste. The inefficiency caused by patients' no-shows and the resulting increased operating costs negatively affect the hospitals' financial structure and service quality. For this reason, health managers must make accurate predictions about whether patients will attend an appointment and plan the appointment system within the framework of these predictions. This research aims to optimize the hospital appointment system by making accurate predictions regarding the no-show behavior of the patients, based on recorded data. Methods: An artificial intelligence-based appointment system has been developed according to patients' demographics and past behavior patterns. The forecast results and realized performance results were compared. The artificial intelligence we have developed continuously improves appointment assignments by learning from past and current data. Results: According to the findings, the artificial intelligence-based appointment system increased the rate of patients attending appointments by 10% per month. Likewise, the hospital capacity utilization rate increased by 6%. Conclusions: Findings from the study confirmed that no-show risks could be managed in the appointment process through artificial intelligence. This artificial intelligence-based design for appointment systems significantly decreases hospital costs and improves service quality performance. [ABSTRACT FROM AUTHOR]

Background: The establishment of a resuscitation room management for nontraumatic critically ill children appears to make sense. This study collected data of pediatric patients suffering from nontraumatic critically ill conditions treated in a resuscitation room. Methods: The retrospective OBSERvE-DUS-PED study (November 2019–October 2022) recorded pediatric patients (age < 18 years) who were admitted to the emergency department (ED) for resuscitation room care. The routinely documented data on treatment were taken from the hospital information system MEDICO® and the patient data management system COPRA® in accordance with the OBSERvE dataset. The study was approved by the Ethics Committee of the Medical Faculty of the Heinrich Heine University (2023-2377). Results: The study included 52 pediatric resuscitation room patients. Adolescents aged 14–17 years were the most frequent in the cohort representing 37% of the total and neonates/infants (0–1 year) were lowest at 8%. The most common symptoms categorized according to ABCDE problems were disturbance of consciousness (D) at 61%, cardiovascular failure (C) at 25%, respiratory insufficiency (B) at 6%, airway obstruction (A) and exposure/environment (E) problems each at 4%. The out-of-hospital and in-hospital emergency procedures were performed with the following frequencies: venous (58% vs. 65%), intraosseous (14% vs. 2%) and central venous access (0% vs. 12%), invasive airway management (35% vs. 8%), cardiopulmonary resuscitation (21% vs. 10%), vasopressors (15% vs. 17%), and intra-arterial pressure measurement (0% vs. 17%). The mean duration of resuscitation room management was 70 ± 43 min. The 30-day mortality was 17%. Conclusion: The OBSERvE-DUS-PED study demonstrates the major challenges in the care of critically ill nontraumatic pediatric patients, both in out-of-hospital and in-hospital management. The variety and complexity of the referral diagnoses as well as the immediate vital threat to the patients make it appear sensible to treat such patients primarily in a resuscitation room of the ED due to the available material, infrastructural and personnel resources. [ABSTRACT FROM AUTHOR]

GNU Health, an open-source clinical information system, offers a comprehensive solution for managing health records, hospital information, and laboratory data. Despite its robust functionality and cost-effective nature, GNU Health remains underutilized in the European healthcare context. This paper explores the potential benefits of implementing GNU Health in European healthcare systems, emphasizing its capacity for customization, integration, and scalability. We also examine the barriers to its widespread adoption, including regulatory challenges, interoperability issues, and resistance to change from established proprietary systems. Through one case study and expert interviews, we provide insights into why these obstacles can hardly be overcome. [ABSTRACT FROM AUTHOR]

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: This study aims to design and test a platform of key performance indicators (KPIs) and indices emphasizing achievements and improvement and helping decision-making. Methods: An operations research study was designed to analyze data from the Hospital Management Information System (HMIS) from July 2017 to June 2018 at the Research Institute of Ophthalmology (RIO), Giza, Egypt. The HMIS data were submitted to reform covering parameters in service delivery and corresponding indicators and indices. Data were grouped into four themes: human resources and outpatient, inpatient, and surgical operations. A total of 14 performance indicators were deployed to four specific indices and total performance indices and applied to six teams of ophthalmologists at RIO. The decision matrices were deliberated to demonstrate achievements and provide recommendations for subsequent improvements. Results: Throughout 1 year, six teams of ophthalmologists (n = 222) at RIO provided the following services: outpatient (n = 116,043), inpatient (n = 8,081), and surgical operations (n = 9,174). Teams 2, 1, and 6 were the top teams in the total performance index. Team 4 had plunges in the outpatient index, and Team 5 faced limitations in the inpatient index. Conclusion: The study provided a model for upgrading the performance of the management information system (MIS) in health organizations. The KPIs and indices were used not only for documenting successful models of efficient service delivery but also as examples of limitations for further support and interventions. [ABSTRACT FROM AUTHOR]

Objective: There is a demand to make hospital management information beyond basic key performance indicators (KPIs) accessible for clinicians. Methods: We developed an interactive application (IAPP) in R Shiny to visualize such information. We provided the IAPP source code online. As a use case, we recorded basic KPIs (numbers of patients (NPs), reimbursed valuation ratios (RVRs), mean length of stay (LOS)), main diagnoses (MDGNs), main procedures (MPRCs), and catchment area (CA) by district from April 2022 to March 2024 at the index department in central Germany, where a neurotrauma and spinal surgery service was resumed on 1 April 2022. Case mix indexes (CMIs) were calculated. We retrieved information about online-reported patient satisfaction (ORPS) from an online physician rating platform between January 2022 and March 2024. Information on longitudes and latitudes of the index department and neighbouring hospitals was collected. We calculated car travelling isochrones (CTIs) of the hospitals as a proxy variable for accessibility. Chi-square and Fisher's exact served as statistical tests. Results: During the observation period, the monthly NPs increased from 26 to 43, the RVR showed a 3.96-fold increase, the CMI showed a 2.41-fold increase, and the LOS reached a steady state in the 2nd year after service resumption. CA (p = 0.03), MDGNs, and MPRCs diversified. ORPS trended towards better overall evaluation after service resumption (p = 0.09). CTI mapping identified a unique market position of the index department. Conclusions: The IAPP makes extended hospital management data accessible to clinicians, can inform other stakeholders in healthcare, and can be tailored to local conditions. [ABSTRACT FROM AUTHOR]

Copyright of OPUS Journal of Society Research is the property of OPUS - International Journal of Society Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study aimed to develop prognostic models for predicting the need for invasive mechanical ventilation (IMV) in intensive care unit (ICU) patients with COVID-19 and compare their performance with the Respiratory rate-OXygenation (ROX) index. Methods: A retrospective cohort study was conducted using data collected between March 2020 and August 2021 at three hospitals in Rio de Janeiro, Brazil. ICU patients aged 18 years and older with a diagnosis of COVID-19 were screened. The exclusion criteria were patients who received IMV within the first 24 h of ICU admission, pregnancy, clinical decision for minimal end-of-life care and missing primary outcome data. Clinical and laboratory variables were collected. Multiple logistic regression analysis was performed to select predictor variables. Models were based on the lowest Akaike Information Criteria (AIC) and lowest AIC with significant p values. Assessment of predictive performance was done for discrimination and calibration. Areas under the curves (AUC)s were compared using DeLong's algorithm. Models were validated externally using an international database. Results: Of 656 patients screened, 346 patients were included; 155 required IMV (44.8%), 191 did not (55.2%), and 207 patients were male (59.8%). According to the lowest AIC, arterial hypertension, diabetes mellitus, obesity, Sequential Organ Failure Assessment (SOFA) score, heart rate, respiratory rate, peripheral oxygen saturation (SpO2), temperature, respiratory effort signals, and leukocytes were identified as predictors of IMV at hospital admission. According to AIC with significant p values, SOFA score, SpO2, and respiratory effort signals were the best predictors of IMV; odds ratios (95% confidence interval): 1.46 (1.07–2.05), 0.81 (0.72–0.90), 9.13 (3.29–28.67), respectively. The ROX index at admission was lower in the IMV group than in the non-IMV group (7.3 [5.2–9.8] versus 9.6 [6.8–12.9], p < 0.001, respectively). In the external validation population, the area under the curve (AUC) of the ROX index was 0.683 (accuracy 63%), the AIC model showed an AUC of 0.703 (accuracy 69%), and the lowest AIC model with significant p values had an AUC of 0.725 (accuracy 79%). Conclusions: In the development population of ICU patients with COVID-19, SOFA score, SpO2, and respiratory effort signals predicted the need for IMV better than the ROX index. In the external validation population, although the AUCs did not differ significantly, the accuracy was higher when using SOFA score, SpO2, and respiratory effort signals compared to the ROX index. This suggests that these variables may be more useful in predicting the need for IMV in ICU patients with COVID-19. ClinicalTrials.gov identifier: NCT05663528. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the current state and challenges of managing electronic quick payment methods within the financial settlement processes of general hospitals, specifically in the context of sports medicine departments. Additionally, it proposes specific optimization strategies to enhance efficiency and security. Methods: The study analyzed the advantages of electronic payment systems within the financial operations of sports medicine services in general hospitals, clarifying the value of quick payment methods in this specialized field. It then delved into the application status, existing problems, and challenges associated with electronic quick payments, focusing on issues pertinent to sports medicine. Based on these insights, targeted optimization paths were developed. Results: The implementation of electronic payment methods in sports medicine departments of general hospitals revealed several issues, including departmental information silos, mismatches between settlement processes and electronic payment systems, and security risks. Moreover, the study identified challenges such as the need for higher levels of hospital information management and robust internal controls. The proposed optimization strategies include enhancing the functionality of hospital medical cards to enable a seamless "one-card" system, optimizing settlement processes within sports medicine departments, strengthening electronic payment security, improving hospital information systems, and reinforcing internal controls. Conclusion: Despite the benefits of electronic quick payments, there are still significant risks and challenges in their application within the financial settlements of sports medicine departments in general hospitals. Strengthening the management of these systems can facilitate their effective use and ensure the financial security of hospital operations, particularly in the specialized area of sports medicine. [ABSTRACT FROM AUTHOR]

Introduction: Digitalization in medicine is steadily increasing. Complex treatments, scarce personnel resources and a high level of documentation are a constant burden on healthcare systems. The balancing between correct manual documentation in the digital records and limited staff resources is rarely successful. The aim of this study is to evaluate the adherence between documentation and lack of documentation in the treatment of critical care patients. Material and Methods: For the evaluation, data from the hospital information system (HIS) of several intensive care units (ICU) were examined in conjunction with data collected from a checklist. All boluses of sedatives, analgesics and catecholamines were documented paper based across all shifts and all weekdays and compared with corresponding digital data from the HIS (2019–2022) of previous years. Results: 939 complete digital patient records revealed a massive under-documentation of the medication administration compared to that applied according to the checklist. Only 12% of all administered catecholamines, 11% of α2-agonists, 33% of propofol, 92% of midazolam and 46% of opioids were found in the digital recordings. In comparison, the effect was more pronounced on weekdays compared to weekends. In addition, the highest documentation gap was found in the comparison of early shifts. Comparing neurosurgical vs. internal vs. anesthesiologic ICUs there was a highly significant difference between anesthesiologic ICUs compared with other disciplines (p < 0.0001). Discussion: Our data shows that there is a remarkable documentation gap and incongruence in the area of applied boli. Automated documentation by connecting syringe pumps that enter data directly into the HIS can not only reduce the workload, but also lead to comprehensive and legally required documentation of all administered medication. [ABSTRACT FROM AUTHOR]

Objective: The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized. Background: Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction. Methods: A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts' suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA. Results: The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%–50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important. Conclusions: Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally. [ABSTRACT FROM AUTHOR]

In this Perspective, we contend bold action is needed to improve transitions from hospitals to home for aging patients and their family caregivers living in rural and underserved areas. The Caregiver Advise, Record, Enable (CARE) Act, passed in over 40 US states, is intended to provide family caregivers of hospitalized patients with the knowledge and skills needed for safe and efficient transitions. It has broken important ground for family caregivers who assist with transitions in patient care. It may fall short, however, in addressing the unique needs of family caregivers living in rural and underserved areas. We contend that to realize the intended safety, cost, and care quality benefits of the CARE Act, especially for those living in rural and underserved areas, states need to expand the Act's scope. We provide three recommendations: 1) modify hospital information systems to support the care provided by family caregivers; 2) require assessments of family caregivers that reflect the challenges of family caregiving in rural and underserved areas; and 3) identify local resources to improve discharge planning. We describe the rationale for each recommendation and the potential ways that an expanded CARE Act could reduce the risks associated with transitions in care for aging patients. Key Points: 1. Recent state laws aim to support family caregivers of hospitalized patients. 2. These laws do not account for the unique needs of rural caregivers. 3. Expanding laws to address rural caregiver needs may improve patient outcomes [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed unprecedented demands on hospitals around the globe, making timely crisis response critical for organizational success. One mechanism that has played an effective role in health care service management during large-scale crises is the Hospital Incident Command System. Purpose: The aim of this article was to understand the role of HICS in the management of a large academic medical center and its impact on relationships and communication among providers in the delivery of services during a crisis. Methodology: This mixed methods study was based on meeting observations, document reviews, semistructured interviews, and two measures of team performance within an academic medical center in the Northeast during the COVID-19 pandemic. Descriptive and bivariate analyses were applied, and qualitative data were coded and analyzed for themes. Results: HICS provided a systematic information-sharing and decision-making process that increased communication and coordination among team members. Analyses indicate a correlation between dimensions of relational coordination and organizational mindfulness. Qualitative data revealed the importance of shared meetings and huddles and the evolution of HICS across multiple waves of the crisis. Conclusion: HICS facilitated organizational improvements during the crisis response and generated opportunities to maintain specific coordination practices beyond the crisis. The prolonged implementation of HICS during the COVID-19 pandemic created challenges, including the disruption of the routine leadership structure. Practical Implications: Applying relational coordination and organizational mindfulness frameworks may allow hospitals to leverage communications and relationships within a high-stakes environment to improve service delivery. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Academics / Sağlık Akademisyenleri Dergisi is the property of Journal of Health Academics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Woo-Youn Kim,1,2 Anna Baek,1 Yoonhee Kim,1 Yewon Suh,1,2 Eunsook Lee,1 Eunkyung Euni Lee,1,2 Ju-Yeun Lee,1,2 Jongchan Lee,3– 5 Hee Sun Park,3– 5 Eun Sun Kim,3– 5 Yejee Lim,3– 5 Nak-Hyun Kim,3– 5 Jung Hun Ohn,3– 5 Sun-wook Kim,3– 5 Jiwon Ryu,3– 5 Hye Won Kim3– 5 1Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, South Korea; 2College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea; 3Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; 4Hospital Medicine Center, Seoul National University Bundang Hospital, Seongnam, South Korea; 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaCorrespondence: Hye Won Kim, Email kimhwhw@gmail.comBackground: Transitional medication safety is crucial, as miscommunication about medication changes can lead to significant risks. Unclear or incomplete documentation during care transitions can result in outdated or incorrect medication lists at discharge, potentially causing medication errors, adverse drug events, and inadequate patient education. These issues are exacerbated by extended hospital stays and multiple care events, making accurate medication recall challenging at discharge.Objective: Thus, we aimed to investigate how real-time documentation of in-hospital medication changes prevents undocumented medication changes at discharge and improves physician-pharmacist communication.Methods: We conducted a retrospective cohort study in a tertiary hospital. Two pharmacists reviewed medical records of patients admitted to the acute medical unit from April to June 2020. In-hospital medication discrepancies were determined by comparing preadmission and hospitalization medication lists and it was verified whether the physician’s intent of medication changes was clarified by documentation. By a documentation rate of medication changes of 100% and < 100%, respectively, fully documented (FD) and partially documented (PD) groups were defined. Any undocumented medication changes at discharge were considered a “documentation error at discharge”. Pharmacists’ survey was conducted to assess the impact of appropriate documentation on the pharmacists.Results: After reviewing 400 medication records, patients were categorized into FD (61.3%) and PD (38.8%) groups. Documentation errors at discharge were significantly higher in the PD than in the FD group. Factors associated with documentation errors at discharge included belonging to the PD group, discharge from a non-hospitalist-managed ward, and having three or more intentional discrepancies. Pharmacists showed favorable attitudes towards physician’s documentation.Conclusion: Appropriate documentation of in-hospital medication changes, facilitated by free-text communication, significantly decreased documentation errors at discharge. This analysis underlines the importance of communication between pharmacists and hospitalists in improving patient safety during transitions of care.Plain language summary: During transitions of care, communication failures among healthcare professionals can lead to medication errors. Therefore, effective sharing of information is essential, especially when intentional changes in prescription orders are made. Documenting medication changes facilitates real-time communication, potentially improving medication reconciliation and reducing discrepancies. However, inadequate documentation of medication changes is common in clinical practice. This retrospective cohort study underlines the importance of real-time documentation of in-hospital medication changes. There was a significant reduction in documentation errors at discharge in fully documented group, where real-time documentation of medication changes was more prevalent. Pharmacists showed favorable attitudes toward the physician’s real-time documenting of medication changes because it provided valuable information on understanding the physician’s intent and improving communication and also saved time for pharmacists. This study concludes that physicians’ documentation on medication changes may reduce documentation errors at discharge, meaning that proper documentation of medication changes could enhance patient safety through effective communication.Keywords: medication reconciliation, medication safety, transitions in care, hospital information systems, hospital discharge, quality audit

The early administration of appropriate antibiotic therapy is crucial for the survival of patients with bacteremia. Current research focuses on improving analytical times through technology, whereas there have been very few efforts to improve postanalytical times even though they represent 40% of the time between blood taking and appropriate treatment administration. One of the clues is the efficiency and appropriateness of the result communication system. Here, we review all delays in the entire process with the aim of improving time to appropriate treatment administration. We discuss causes for long times to adjust treatment once microbiological results are released. We argue that the pervasive health information system in this organization serves as both a bottleneck and a rigid framework. Finally, we explore how next-generation hospital information systems should be designed to effectively assist the doctors in treating patients with bacteremia. [ABSTRACT FROM AUTHOR]

Prescribers often face the challenge of predicting creatinine clearance (CrCl) in elderly patients who are 65 years or older and have serum creatinine (SCr) concentrations below 1 mg/dL. Studies have shown that utilizing rounded SCr would underestimate CrCl in this population, which could lead to the under-dosing of some medications like vancomycin. The current study aimed to compare the accuracy of vancomycin dosing using actual SCr versus rounded SCr to 1 mg/dL in elderly patients. A total of 245 patients were included. The therapeutic trough level (10–20 mg/L) was achieved in 138 (56.3%) patients using actual SCr. Sub-therapeutic (<10 mg/L) and supra-therapeutic (>20 mg/L) trough levels were observed in 32 (13.1%) and 75 (30.6%) patients, respectively. The predictive performance of different vancomycin doses based on actual SCr and rounded SCr compared to the targeted maintenance dose (TMD) showed a stronger correlation of dosing based on actual SCr with TMD (r = 0.55 vs. 0.31) compared to rounded SCr dosing; both doses showed similar precision, with ranges of ±552 mg/day for the dosing based on actual SCr and ±691 mg/day for the dosing based on rounded SCr. Furthermore, the dosing based on actual SCr showed a lower error percentage (69%) and a higher accuracy rate (57.6%) within ±10% of the TMD compared to the dosing based on rounded SCr, which had an error percentage of (92.3%) and an accuracy rate of (40%). The prevalence of vancomycin-associated nephrotoxicity (VAN) was seen in 44 (18%) patients. Patients between 75 and 84 years of age, those who were bedridden, and those with vancomycin trough concentrations greater than 20 mg/L had a higher risk of developing VAN. In conclusion, in elderly patients, estimating vancomycin dosing based on actual SCr was more accurate compared to rounded SCr to 1 mg/dL. The efficacy of vancomycin could be negatively affected by rounding up SCr, which could underestimate CrCl and result in the under-dosing of vancomycin. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to identify and analyze the factors significantly influencing long‐term insulin medication adherence among outpatients and to evaluate whether pharmaceutical interventions targeting these factors can improve patient medication adherence and glycemic control. Methods. A cohort of 180 patients was recruited from a tertiary hospital in Nanjing, China. Factors potentially influencing insulin adherence were scrutinized employing the KAP (knowledge, attitude/belief, and practice) health behavior model. Baseline characteristics were extracted from the hospital information system, while patient knowledge of the disease and medication, medication adherence, medication beliefs, and management self‐efficacy were assessed, respectively, using self‐developed questionnaires, MMAS‐8, C‐DMSES, and BMQ scales. Univariate and multivariate analyses were conducted to determine the impact of these factors on insulin adherence. Following this, participants were randomly allocated to either the intervention or control group. The intervention group received three months of weekly telephone sessions and educational interventions targeting facets such as medication knowledge and beliefs, while the control group received standard care. After the intervention, insulin adherence and glycemic control conditions of both groups were collected and re‐evaluated. Results. After excluding lost‐to‐follow‐up patients, 152 individuals were analyzed (intervention: 75 and control: 77). Multivariate analyses revealed factors influencing insulin adherence, including age, diabetes duration, health insurance status, HbA1c level, disease and medication knowledge, diabetes management self‐efficacy, and medication beliefs (P < 0.05). Before targeted pharmaceutical care, no significant differences existed in insulin adherence, HbA1c levels, management self‐efficacy, knowledge, or medication beliefs between intervention and control groups (P > 0.05). However, subsequent pharmaceutical intervention notably improved adherence, HbA1c levels, self‐efficacy, knowledge, and medication beliefs (P < 0.05). Conclusion. This study examines the impact of glycemic control, health insurance status, management self‐efficacy, level of knowledge, and medication beliefs on improving insulin medication adherence in patients with type 2 diabetes mellitus. Targeted pharmaceutical intervention can enhance medication adherence, improve glucose control, and promote rational insulin use. This trial is registered with ChiCTR2300074444. [ABSTRACT FROM AUTHOR]

Background: It was aimed to examine the sociodemographic and clinical characteristics of 638 children who applied to Şanlıurfa Training and Research Hospital for Special Needs Report for Children (SNRC) and to contribute to new studies in the field of mental health with the results obtained. Materials and Methods: In our study, children and young people who applied to Şanlıurfa Training and Research Hospital for the purpose of a special needs report for children in the 6-month period between 01.10.2023 and 31.03.2024 were included. Participants' information was scanned retrospectively through the hospital information system. Results: The gender distribution of the cases was 261 (40.9%) females and 377 (59.1%) males with a male/female ratio of 1.44. The median age of the patients was 94.5 months (IQR 25/75: 51/134 months). When the distribution of the diagnoses of the cases was analyzed, it was observed that the problems in the cognitive domain were in the first place. In the cognitive domain, the most frequently reported condition was mental capacity at a level requiring an HSN (has special needs) rate. Speech sound disorder and ASD (autism spectrum disorder) were found to be statistically significantly higher in males. The level of need for HSN was found to be more frequent in males. In the diagnoses of delayed milestone, delayed development of receptive or expressive language, and speech disorder (all diagnoses within speech sound disorder within the scope of SNRC), it was found that the group with a statistically significant diagnosis had a lower average age than those without a diagnosis. In the diagnoses of childhood-onset speech fluency disorder and specific learning disability, the mean age of individuals with a diagnosis was statistically significantly higher than that of individuals without a diagnosis. Conclusions: Child and adolescent mental health and illness specialists and all health professionals who care for children should have the necessary knowledge to make appropriate referrals to ensure the educational and social rights of children and young people with special needs. In this context, it is important that physicians working with children and adolescents in our country have sufficient knowledge about SNRC and that their awareness on this issue is increased. [ABSTRACT FROM AUTHOR]

Context: Access to real-time data that provide accurate and timely information about the status and extent of disease spread could assist management of the COVID-19 pandemic and inform decision-making. Aim: To demonstrate our experience with regard to implementation of technical and architectural infrastructure for a near real-time electronic health record-based surveillance system for COVID-19 in Iran. Method: This COVID-19 surveillance system was developed from hospital information and electronic health record (EHR) systems available in the study hospitals in conjunction with a set of open-source solutions; and designed to integrate data from multiple resources to provide near real-time access to COVID-19 patients' data, as well as a pool of health data for analytical and decision-making purposes. Outcomes: Using this surveillance system, we were able to monitor confirmed and suspected cases of COVID-19 in our population and to automatically notify stakeholders. Based on aggregated data collected, this surveillance system was able to facilitate many activities, such as resource allocation for hospitals, including managing bed allocations, providing and distributing equipment and funding, and setting up isolation centres. Conclusion: Electronic health record systems and an integrated data analytics infrastructure are effective tools to enable policymakers to make better decisions, and for epidemiologists to conduct improved analyses regarding COVID-19. Implications: Improved quality of clinical coding for better case finding, improved quality of health information in data sources, data-sharing agreements, and increased EHR coverage in the population can empower EHR-based COVID-19 surveillance systems. [ABSTRACT FROM AUTHOR]

Background: Sepsis is the world's leading cause of death and its detection from a range of data and coding sources, consistent with consensus clinical definition, is desirable. Objective: To evaluate the performance of three coding definitions (explicit, implicit, and newly proposed synchronous method) for sepsis derived from administrative data compared to a clinical reference standard. Method: Extraction of administrative coded data from Australian metropolitan teaching hospital with 25,000 annual overnight admissions compared to clinical review of medical records; 313 (27.9%) randomly selected adult multi-day stay hospital separations from 1,123 separations with acute infection during July 2019. Estimated prevalence and performance metrics, including positive (PPV) and negative predictive values (NPV), and area under the receiver operator characteristic curve (ROC). Results: Clinical prevalence of sepsis was estimated at 10.7 (95% CI = 10.3–11.3) per 100 separations, and mortality rate of 11.6 (95% CI = 10.3–13.0) per 100 sepsis separations. Explicit method for case detection had high PPV (93.2%) but low NPV (55.8%) compared to the standard implicit method (74.1 and 66.3%, respectively) and proposed synchronous method (80.4% and 80.0%) compared to a standard clinical case definition. ROC for each method: 0.618 (95% CI = 0.538–0.654), 0.698 (95% CI = 0.648–0.748), and 0.802 (95% CI = 0.757–0.846), respectively. Conclusion: In hospitalised Australian patients with community-onset sepsis, the explicit method for sepsis case detection underestimated prevalence. Implicit methods were consistent with consensus definition for sepsis, and proposed synchronous method had better performance. [ABSTRACT FROM AUTHOR]

Objective: The diagnostic method used in cutaneous leishmaniasis (CL) often depends not on the accuracy of the diagnosis but on the existing infrastructure and resources of the diagnostic facility. It is important to apply a practical and sensitive method in regions where diagnostic possibilities are limited. This study aims to examine the cases diagnosed with CL and the diagnosis method in Batman between July 2021 and July 2023. Methods: Totally 17 patients were referred to the Microbiology Laboratory with a prediagnosis of CL. Demographic data of the patients were obtained from the Hospital Information Management System. The fine needle aspiration method was preferred as the diagnostic method in 2021, the samples were taken by partial removal of the suspected crust of scar/ulcer in 2022 and 2023. Result: With the suspicion of Leishmaniasis lesion, 5 patients in 2021, 8 patients in 2022 and 4 patients in 2023 were referred to our laboratory. Samples were taken with the fine needle aspiration method in 2021 and Leishmania sp. amastigotes were detected in one of five patients. In the samples taken in 2022 and 2023, the sample was taken by partial removal of the crust. Leishmania sp. amastigotes were detected in 6 of 8 suspected patients in 2022 and in 3 of 4 suspected patients in 2023. Conclusion: In this study, 10 CLs were diagnosed and it was observed that taking samples by removing the wound/ulcer crust made it easier to detect the agent. All the cases were local and were thought to be independent of Syrian migration. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: D-dimer is a marker of coagulation and fibrinolysis widely used in clinical practice for assessing thrombotic activity. While it is commonly ordered in the Emergency Department (ED) for suspected venous thromboembolism (VTE), elevated D-dimer levels can occur due to various other disorders. The aim of this study was to find out the causes of elevated D-dimer in patients presenting to a large ED in Saudi Arabia and evaluate the accuracy of D-dimer in diagnosing these conditions. Methods: Data was collected from an electronic hospital information system of patients who visited the ED from January 2016 to December 2022. Demographic information, comorbidities, D-dimer levels, and diagnoses were analyzed. Statistical analysis was performed using the SPSS software. The different diagnoses associated with D-dimer levels were analyzed by plotting the median D-dimer levels for each diagnosis category and their interquartile ranges (IQR). The receiver operating characteristic (ROC) curves were calculated and their area under the curve (AUC) values were demonstrated. The optimal cut-off points for specific diseases were determined based on the ROC analysis, along with their corresponding sensitivities and specificities. Results: A total of 19,258 patients with D-dimer results were included in the study. The mean age of the participants was 50 years with a standard deviation of ± 18. Of the patients, 66% were female and 21.2% were aged 65 or above. Additionally, 21% had diabetes mellitus, 20.4% were hypertensive, and 15.1% had been diagnosed with dyslipidemia. The median D-dimer levels varied across different diagnoses, with the highest level observed in aortic aneurysm 5.46 g/L. Pulmonary embolism (PE) and deep vein thrombosis (DVT) were found in 729 patients (3.8%) of our study population and their median D-dimer levels 3.07 g/L (IQR: 1.35–7.05 g/L) and 3.36 g/L (IQR: 1.06–8.38 g/L) respectively. On the other hand, 1767 patients (9.2%) were diagnosed with respiratory infections and 936 patients (4.9%) were diagnosed with shortness of breath (not specified) with median D-dimer levels of 0.76 g/L (IQR: 0.40–1.47 g/L) and 0.51 g/L (IQR: 0.29–1.06 g/L), respectively. D-dimer levels showed superior or excellent discrimination for PE (AUC = 0.844), leukemia (AUC = 0.848), and aortic aneurysm (AUC = 0.963). DVT and aortic dissection demonstrated acceptable discrimination, with AUC values of 0.795 and 0.737, respectively. D-dimer levels in respiratory infections and shortness of breath (not specified) exhibited poor to discriminatory performance. Conclusion: This is the first paper to identify multiple causes of elevated D-dimer levels in Saudi Arabia population within the ED and it clearly highlights their accurate and diagnostic values. These findings draw attention to the importance of considering the specific clinical context and utilizing additional diagnostic tools when evaluating patients with elevated D-dimer levels. [ABSTRACT FROM AUTHOR]

Introduction: Due to the risk of thrombosis, nearly all children supported by extracorporeal membrane oxygenation (ECMO) receive systemic anticoagulation. While heparin has traditionally been used, there are reports of increased use of direct thrombin inhibitors. We sought to describe the use of anticoagulation in children supported by ECMO in the United States using a large administrative database. Methods: We performed a retrospective cohort study of children supported by ECMO within the Pediatric Health Information System (PHIS) database. Pediatric encounters involving ECMO from 2012 to 2020 were identified. Data regarding demographics, diagnoses, anticoagulation, complications, and outcomes were extracted for eligible encounters. Results: Eleven thousand five hundred ninety-five encounters that involved ECMO were identified. Fifty-four percent were male with an age range of 0–17 years and a median (IQR) age of 0 (0–2) years. Unfractionated heparin (UFH) only was used in 94% (95% CI: 93.6–94.5%) of encounters and UFH followed by bivalirudin in 5% (95% CI: 4.3–5.1%) of cases. There was a significant difference in the use of bivalirudin from 2012 to 2020 (p < 0.001). Differences in anticoagulation regimens were observed between infants and children (p = 0.004) and between those with and without cardiac indications for ECMO (p < 0.001). Four percent (95% CI: 4.1–4.8%) of encounters were associated with diagnostic coding for thrombosis and differences in occurrence of thrombosis were observed between different anticoagulant regimens (p < 0.001). Conclusions: Though the majority of children on ECMO in the United States receive heparin anticoagulation, there is an increase in use of direct thrombin inhibitors. Prospective studies must evaluate the efficacy of different anticoagulants in this patient population. [ABSTRACT FROM AUTHOR]

Hospitals must timely provide qualified health services to the community, so pharmaceutical supply management is very important. Appropriate drug supply control has a major impact on service quality to the patients. This study aimed to analyze the drug inventory control system in the planning and procurement stages by analyzing ABC, VEN, and ABC-VEN combinations. This study is an observational descriptive study using retrospective data collected at the pharmaceutical installation of X Private Hospital in Waru, Sidoarjo Regency, in 2019-2020. The drugs analyzed were orals, injections, and infusions, and the inventory control was analyzed using ABC, VEN, and ABC-VEN Analysis in 2019-2020. This study showed differences in ABC-VEN drug class, changes in the parenteral multivitamin group from C-N to A-V, and antibiotics (Ceftriaxone) from B-E to A-V groups. Group changes caused changes in priorities in procurement and inventory control, which happened due to the Covid-19 pandemic occurring in Indonesia and throughout the world. Based on SWOT analysis, strategic development is to develop a Hospital Information System and increase the competence and skills of pharmaceutical staff. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the risk factors associated with surgical site infection (SSI) after percutaneous endoscopic lumbar discectomy (PELD) in patients with lumbar disc herniation (LDH). A retrospective analysis was performed on a cohort of 335 patients who underwent PELD between January 2016 and January 2023. Data were derived from the Hospital Information System (HIS), and a comprehensive statistical assessment was performed using IBM SPSS Statistics version 25.0. Both univariate and multivariate logistic regression analyses assessed a range of risk determinants, such as age, body mass index (BMI), comorbidities, laboratory test parameters and surgery‐related variables. The incidence of SSI after PELD was 2.7% (9/335). Univariate analysis highlighted BMI, diabetes mellitus, long‐term corticosteroid consumption, surgical time and cerebrospinal fluid leakage as significant predictors of SSI. Multivariate logistic regression identified BMI, diabetes mellitus, long‐term corticosteroid consumption, surgical time and cerebrospinal fluid leakage as significant risk factors for SSI after PELD. High BMI, diabetes mellitus, long‐term corticosteroid consumption, long surgical time and postoperative cerebrospinal fluid leakage are predisposing factors for SSI in patients undergoing PELD. Precise interventions focused on such risk components, including careful preoperative assessment and strategic postoperative care, are essential to reduce the incidence of SSI and improve surgical efficacy. [ABSTRACT FROM AUTHOR]

Despite significant advancements in antiretroviral therapy (ART) for HIV, adherence remains a challenge. While Brazil has validated scales for treatment adherence, few assess treatment adherence barriers. This underscores the necessity for validated questionnaires on adherence barriers to identify patient-specific challenges and enhance strategies for ART adherence. This study aimed to adapt and validate the Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV), a 17-item questionnaire assessing the adherence barriers to ART, for the Brazilian context and to evaluate its psychometric properties in HIV patients. A methodological study on the psychometric properties and factorial structure of ABQ-HIV was conducted. The study followed seven steps: consent of the original authors, two translations, synthesis of the translations, expert committee, back-translation, pre-test, and reliability test. A high content validity index (0.93) was achieved with the expert committee. The study sample consisted of 230 adults with HIV, with 37.0 (29.3-45.0) years as the median age (IQR), and 52.2% were male. The exploratory factor analysis with a three subscales structure of 17 items showed good interpretability (Bartlett’s sphericity (1167.2 [136]; p < 0.001) and Kaiser-Meyer-Olkin = 0.602) and internal consistency (α = 0.76; Ω = 0.76). The fit indicators were satisfactory (χ2 = 89.931; df = 88; p > 0.005; RMSEA = 0.010; RMSR = 0.07; CFI = 0.996; GFI = 0.940; AGFI = 0.907; NNFI = 0.995). The Brazilian version of ABQ-HIV is a potential instrument for identifying specific barriers to adherence to ART in adults living with HIV in Brazil.

ABSTRACT Objective To validate the Brazilian National Health System Hospital Information System (SIH/SUS) for maternal morbidity surveillance. Methods This was a cross-sectional study conducted in 2021/2022, taking as its reference a national study on maternal morbidity (MMG) conducted in 50 public and 28 private hospitals; we compared SIH/SUS and MMG data for hospitalization frequency, reason and type of discharge and calculated sensitivity, specificity, positive and negative likelihood ratios for seven diagnoses and four procedures. Results Hospitalizations identified on SIH/SUS (32,212) corresponded to 95.1% of hospitalizations assessed by MMG (33,867), with lower recording on SIH/SUS (85.5%) for private hospitals [10,036 (SIH/SUS)]; 11,742 (MMG)]; compared to MMG, SIH/SUS had a lower proportion of hospitalizations due to “complications during pregnancy” (9.7% versus 16.5%) as well as under-recording of all diagnoses and procedures assessed, except “ectopic pregnancy”. Conclusion Better recording of diagnoses and procedures on SIH/SUS is essential for its use in maternal morbidity surveillance.

Background: Trauma can lead to significant complications and mortality for victims of accidents.Objectives: The present study was conducted to determine the mortality caused by trauma and its related factors.Methods: The present study was conducted using the data available in the Isfahan Trauma Registration System (ITR) and Hospital Information Systems (HIS). The number of 1266 deceased trauma patients who were registered in this system over 18 months (between September 2020 and March 2022) were included in the study and analyzed.Results: Out of 1266 patients who died from trauma, 604 (47.7%) patients experienced early death, 427 (33.7%) delayed mortality, and 235 (18.6%) late mortality. The mechanism and type of trauma, and the pre-impact conditions were significantly different between the three death categories (P

Anesthesiologists have a significant responsibility to provide care at all hours of the day, including nights, weekends, and holidays. This call burden carries a significant lifestyle constraint that can impact relationships, affect provider wellbeing, and has been associated with provider burnout. This quality improvement study analyzes the effects of a dynamic call marketplace, which allows anesthesiologists to specify how much call they would like to take across a spectrum of hypothetical compensation levels, from very low to very high. The system then determines the market equilibrium price such that every anesthesiologist gets exactly the amount of desired call. A retrospective analysis compared percentage participation in adjusting call burden both pre- and post-implementation of a dynamic marketplace during the years of 2017 to 2023. Additionally, a 2023 post-implementation survey was sent out assessing various aspects of anesthesiologist perception of the new system including work-life balance and job satisfaction. The dynamic call marketplace in this study enabled a more effective platform for adjusting call levels, as there was a statistically significant increase in the percentage of anesthesiologists participating in call exchanged during post- compared to pre-implementation (p < 0.0001). The satisfaction survey suggested agreement among anesthesiologists that the dynamic call marketplace positively affected professional satisfaction and work-life balance. Further, the level of agreement with these statements was most prevalent among middle career stage anesthesiologists (11–20 years as attending physician). The present system may target elements with the capacity to increase satisfaction, particularly among physicians most at risk of burnout within the anesthesia workforce. [ABSTRACT FROM AUTHOR]

Introduction: Today, modern technology is used to diagnose and treat cardiovascular disease. These medical devices provide exact measures and raw data such as imaging data or biosignals. So far, the Broad Integration of These Health Data into Hospital Information Technology Structures--Especially in Germany--is Lacking, and if data integration takes place, only non-Evaluable Findings are Usually Integrated into the Hospital Information Technology Structures. A Comprehensive Integration of raw Data and Structured Medical Information has not yet Been Established. The aim of this project was to design and implement an interoperable database (cardio-vascular-information-system, CVIS) for the automated integration of al medical device data (parameters and raw data) in cardio-vascular medicine. Methods: The CVIS serves as a data integration and preparation system at the interface between the various devices and the hospital IT infrastructure. In our project, we were able to establish a database with integration of proprietary device interfaces, which could be integrated into the electronic health record (EHR) with various HL7 and web interfaces. Results: In the period between 1.7.2020 and 30.6.2022, the data integrated into this database were evaluated. During this time, 114,858 patients were automatically included in the database and medical data of 50,295 of them were entered. For technical examinations, more than 4.5 million readings (an average of 28.5 per examination) and 684,696 image data and raw signals (28,935 ECG files, 655,761 structured reports, 91,113 x-ray objects, 559,648 ultrasound objects in 54 different examination types, 5,000 endoscopy objects) were integrated into the database. Over 10.2 million bidirectional HL7 messages (approximately 14,000/day) were successfully processed. 98,458 documents were transferred to the central document management system, 55,154 materials (average 7.77 per order) were recorded and stored in the database, 21,196 diagnoses and 50,353 services/OPS were recorded and transferred. On average, 3.3 examinations per patient were recorded; in addition, there are an average of 13 laboratory examinations. Discussion: Fully automated data integration from medical devices including the raw data is feasible and already creates a comprehensive database for multimodal modern analysis approaches in a short time. This is the basis for national and international projects by extracting research data using FHIR. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to assess the experiences, barriers, and expectations regarding current patient monitoring systems among intensive care unit nurses at one university hospital. Methods: A qualitative exploratory study approach was adopted to test the research questions. Results: Intensive care unit personnel placed a high value on practical criteria such as user friendliness and visualization while assessing the present monitoring system. Poor alarm handling was recognized as possible patient safety hazards. The necessity of high accessibility was highlighted once again for a prospective system; wireless, noninvasive, and interoperability of monitoring devices were requested; and smart phones for distant patient monitoring and alert management improvement were required. Conclusion: Core comments from ICU personnel are included in this qualitative research on patient monitoring. All national healthcare involved parties must focus more on user-derived insights to ensure a speedy and effective introduction of digital health technologies in the ICU. The findings from the alarm control or mobile device studies might be utilized to train ICU personnel to use new technology, minimize alarm fatigue, increase medical device accessibility, and develop interoperability standards in critical care practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: There is a need to increase patient and clinician awareness on the effectiveness of pneumococcal vaccination in at-risk groups. The aim of the study was to evaluate the effect of reminders for physicians and patients using the vaccination tracking system created in the hospital information management system (HIMS) on the vaccination rate, and the effect of pneumococcal vaccination on pneumonia-related hospitalization and mortality over a 12-month period. MATERIAL AND METHODS: This prospective observational cohort study was undertaken during a 2-year period in 3 tertiary care centers. Patients were followed up for 12 months following vaccination, and hospital admissions and mortality were recorded via HIMS. During the campaign, HIMS transmitted pneumococcal immunization reminder messages in accordance with guideline recommendations to physicians' computers and patients' mobile phones. Educational posters on pneumococcal vaccination were posted in outpatient clinics. Regular seminars on the evidence for pneumococcal vaccination were organized. All patients who were hospitalized during the follow-up period for chronic obstructive pulmonary disease (COPD), asthma, lung cancer, or pneumonia were analyzed in relation to their vaccination history regarding clinical outcomes. RESULTS: A total of 29 530 patients were included in the study. During the study period, the annual vaccination rate increased by 74.4% and reached 4.8% in 3 hospitals (P = .001). The rates were 3.9% in patients older than 65 years without comorbidities and 5.2% in those with COPD and asthma (P = .002). In pneumococcal vaccine recipients, pneumonia-related hospital mortality was lower (relative risk (RR) = 0.19, CI 0.09-0.35, P < .001). CONCLUSION: It is possible to raise the rate of pneumococcal vaccination through awareness campaigns. Individuals with COPD and asthma are more willing to receive pneumococcal vaccination. Among patients hospitalized for pneumonia, prior pneumococcal vaccination is associated with lower mortality. [ABSTRACT FROM AUTHOR]

Objective: Hospital information systems (HIS) are meant to manage complex work processes across healthcare organizations. We describe limitations of HIS to address local information requirements and how they are circumvented at different organizational levels. Results can be used to better support collaboration in socio-technical systems. Background: Workarounds describe a mismatch between a technology's purpose and its actual use, whereas shadow systems are unofficial IT systems circumventing limitations of official systems to support workflows. Boundary infrastructures are conceptualized as the entirety of all (in)formal digital and analog systems connecting different communities of practice in a socio-technical system. Methods: An ethnographic study with observations and semi-structured interviews was conducted and analyzed through categorization and iterative coding. Results: Several digital-analog workarounds are employed for documentation and a shared server functions as a shadow system to support workflows in ways the HIS cannot. For collaborative documentation, all (official and informal) information sources were used simultaneously as part of an interconnected boundary infrastructure. Conclusion: Formal and informal IT systems are interconnected across different organizational levels and provide insights into unmet information requirements, effective and problematic work practices, and how to address them to improve system functioning. An integrated perspective on boundary infrastructures, workarounds, and shadow systems may advance system analysis, providing a more comprehensive picture of IT requirements than any concept alone. Application: Workarounds and shadow systems highlight that HIS should support systemic and local needs. Customized interfaces in HIS to support search, access, and exchange of relevant data might help to mitigate current shortcomings. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Patient medical records are records relating to the patient's identity, diagnosis, action, and to the treatment that has been given to the patient. Thus, medical records must be protected from damage, but damage to medical records is still found in every hospital. Purpose: This study attempts to investigate the causes of damage to hospital medical record materials. Methods: this is literature review, and the research was obtained from google scholar and the portal garuda, using full text articles. The measured results were factors that cause damage to medical record documents. Results: The main factor were still officers with a low level of education, namely high school graduates. This has an impact on filing officers to be not disciplined in maintaining medical record documents, and the absence of implementation of training related to management and storage management in the filing section. The machine factor was that there was no medical record rack available in accordance with the number of medical record documents. The method factor was that there was no SOP for maintaining medical records. The material factor was the raw material for the map using thin paper. The media factor, namely the storage space, has not been avoided from the dangers of water, fire, and biological damage. Conclusion: Based on 5M factors, the factors that have the highest influence on damage to medical record documents are the elements of people, machine, and material. While the factor that causes the least damage to medical record documents is the method. [ABSTRACT FROM AUTHOR]

Background. Climatic and geomorphological characteristics of a region are vital factors in the regional spread of diseases. Geographic Information System (GIS) is a useful tool for studying cancer epidemiology. This study was conducted with the aim of investigating the prevalence of childhood leukemia in Khuzestan based on 10-year GIS data of temperature, wind speed and dust level. Methods. The medical characteristics of all cases of leukemia in children admitted to Bagai 2 Ahvaz Hospital, which were diagnosed with leukemia for the first time. We collected what was diagnosed. Results. Five hundred and twelve children had acute lymphoblastic leukemia (ALL) and 100 children had acute myeloblastic leukemia (AML). The year 2015 had the highest and the year 2018 the lowest ALL rate. The peak of AML was in 2013 and the lowest was in 2018. Central cities had the highest mean particulate matter, temperature, wind speed, and the highest rate of leukemia. Conclusion. The results show that dust, temperature and wind speed are related to the prevalence of childhood leukemia in Khuzestan, Iran. Practical Implications. A wide range of environmental and genetic factors can play a role in the occurrence of cancer, so additional studies are needed to confirm the effect of particles and environmental factors such as temperature and dust on the occurrence of cancer. [ABSTRACT FROM AUTHOR]

Radiology departments face challenges in delivering timely and accurate imaging reports, especially in high-volume, subspecialized settings. In this retrospective cohort study at a tertiary cancer center, we assessed the efficacy of an Automatic Assignment System (AAS) in improving radiology workflow efficiency by analyzing 232,022 CT examinations over a 12-month period post-implementation and compared it to a historical control period. The AAS was integrated with the hospital-wide scheduling system and set up to automatically prioritize and distribute unreported CT examinations to available radiologists based on upcoming patient appointments, coupled with an email notification system. Following this AAS implementation, despite a 9% rise in CT volume, coupled with a concurrent 8% increase in the number of available radiologists, the mean daily urgent radiology report requests (URR) significantly decreased by 60% (25 ± 12 to 10 ± 5, t = -17.6, p < 0.001), and URR during peak days (95th quantile) was reduced by 52.2% from 46 to 22 requests. Additionally, the mean turnaround time (TAT) for reporting was significantly reduced by 440 min for patients without immediate appointments and by 86 min for those with same-day appointments. Lastly, patient waiting time sampled in one of the outpatient clinics was not negatively affected. These results demonstrate that AAS can substantially decrease workflow interruptions and improve reporting efficiency. [ABSTRACT FROM AUTHOR]

Background: Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods: This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results: 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion: The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies. [ABSTRACT FROM AUTHOR]

Background: This study aimed to construct an enteral nutrition evaluation system for critically ill patients using the Delphi method to direct the formulation of enteral nutrition support strategies and reduce interruption to enteral feeding. Methods: We used domestic and foreign databases to obtain and analyze the literature and form "The Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients." The Delphi method was used to conduct two rounds of expert opinion consultation, combined with the suggestions from the research group to finalize the nutrition evaluation content of the system. Results: After two rounds of expert consultation, a nutrition evaluation system was formed around three dimensions: before the start, during, and after the end of nutritional support. The effective recovery rates of the two rounds of expert consultation were 90.0% (18/20) and 100.0% (18/18), respectively. Authority coefficients were 0.865 and 0.908, while Kendall coordination coefficients were 0.108 (P < 0.05) and 0.115 (P < 0.001), respectively. Finally, the full enteral nutrition evaluation system for critically ill patients was constructed based on the Delphi method, including three primary items and seven secondary and 28 tertiary indicators. Conclusion: The established "Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients" has high consistency from expert opinions and reliability, which can provide a practical evaluation tool for the process of enteral nutrition for severe patients. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the influence of case management and its corresponding computer-assisted assessment system on the quality improvement of dementia care. Methods: This observational study enrolled 2029 patients and their caregivers at Changhua Christian Hospital in Taiwan. Physicians who made the diagnosis of dementia would introduce the patient and caregiver dyad to the case manager-centered collaborative care team after obtaining agreement. The achievement rates of 11 quality indicators (QIs) comprising timely diagnostic evaluations, regular screens of cognition and neuropsychiatric symptoms, caregiver support, and proper medication prescriptions were counted. Different timeframes (≤4 months, 4 months–1 year, 1–2 years, 2–3 years, or ≥3 years) from diagnosis of dementia to collaborative care intervention were compared. Results: A significantly higher attainment rate was achieved for patients with earlier entry into the collaborative team model, including QIs about timely diagnosis and regular screening, and caregiver support. The QIs regarding dementia medication prescriptions and documentation of the risk of antipsychotics remained similar regardless of the time of entry into the model. The completion rates of QIs also improved after the information system was launched. Conclusions: Physician-case manager co-management in the setting of a collaborative care model with a computer-assisted assessment system helps improve QI achievement for dementia care. [ABSTRACT FROM AUTHOR]

Background: The Minimum Data Set (MDS) plays a vital role in data exchange, collection and quality improvement. In the context of the COVID-19 pandemic, there is a need for a tailored MDS that aligns with the specific information needs of the Iranian community and integrates seamlessly into the country's Hospital Information Systems (HIS). Objective: The study aimed to develop a comprehensive MDS for COVID-19 patients in Iran, with objectives to identify essential data elements and integrate the MDS into HIS, enhancing data exchange and supporting decision-making. Method: This study employed a comparative-descriptive approach to design COVID-19 patient data elements based on World Health Organisation and Centers for Disease Control and Prevention guidelines. The Delphi technique involved 35 experts in two rounds for checklist refinement. The finalised MDS consisted of 9 main terms and 80 sub-terms, analysed using descriptive statistics and IBM SPSS software. Results: Of 35 experts involved with the study, 69% were male and 31% female, and Health Information Management experts were the majority (34%). The refined MDS for COVID-19 in Iran comprises 50 data elements, while 30 elements were excluded. The MDS includes 8 main terms and 80 sub-terms, with unanimous approval for identity, underlying disease, and treatment sections. Conclusion: The customised MDS for COVID-19 patients in Iran addresses data collection challenges and supports effective disease prevention and management. By providing comprehensive and reliable information, the MDS enhances healthcare quality, facilitates timely access to medical records, and fosters integrated health services. [ABSTRACT FROM AUTHOR]

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Health data is considered to be highly sensitive and the protection of health data is an ethical and legal responsibility for all health data managing structures. Healthcare organizations use various security measures and techniques to adopt a secure electronic health data recording system in which, in addition, they keep log data. Hospital Information System (HIS) developers had been keeping the log records according to their needs by making the necessary coding for the "changedelete" triggers. Therefore, there was a dire need to develop a common standard for keeping diaries in health information systems. This new standard was considered to be a guide for software developers and was named as Minimum Log Standards in Health (SAMILOG). This study explains the development process of SAMILOG. Method: Focus group meetings were held with seven developer companies. Several scenarios of unauthorized access or data breaches in a health information system were created. The participants discussed each scenario and they evaluated the best methods for keeping logs and which data should be kept as log in each case. Previously, a standard called Minimum Data Model- Minimum Veri Modeli (VEM) was developed to assist data migration to a new HIS software when the hospital administration decides to go for a change. The data field names of VEM standard were also used in this new SAMILOG standard. Results: In SAMILOG 1.0, which of the data elements in each VEM set should be logged was determined, it required an update for SAMILOG as the VEM was updated. Conclusion: SAMILOG v1.0 was announced in 2016 and since then in case of a security breach of health data of public hospitals in Turkey, it is primarily the data logged within the scope of SAMILOG which is examined. [ABSTRACT FROM AUTHOR]

Copyright of Lijecnicki Vjesnik is the property of Croatian Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)