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6. Medical operational AI: artificial intelligence in routine medical operations

Author

Berns Fabian, Heilig Niclas, Stumpe Florian, and Kirchhoff Jan

Subjects
explainable artificial intelligence, medical diagnostics, system design, Medical technology, R855-855.5
Abstract

Despite substantial gains facilitated by Artificial Intelligence (AI) in recent years, it has to be applied very cautiously in sensitive domains like medicine due to the lack of explainability of many methods in this field. We aim to provide a system to overcome these issues of medical AI applications by means of our concept of medical operational AI detailed in this paper. We make use of various methods of AI and utilize knowledge graphs in particular. The latter is continuously updated by medical experts based on medical literature such as peer-reviewed papers and standard online sources such as UpToDate. We thoroughly derive a multi-level system tackling the corresponding challenges. In particular, its design encompasses (i) holistic diagnostic assistance on a macro level, (ii) predicitions and detailed suggestions for specific medical domains on a micro level, as well as (iii) AI-based optimizations of the overall system on a meta level. We detail practical merits of medical operational AI and discuss the state of the art beyond our solution.

Published
2023
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7. Insights into Tropical Tropospheric Ozone from the 1998-2000 SHADOZ (Southern Hemisphere Additional Ozonesondes) Data Record

Author

Thompson, Anne M, Witte, Jacquelyn C, Oltmans, Samuel J, Schmidlin, Francis J, Volker, W, Kirchhoff, J. H, Posny, Franaoise, Gert, J, Coetzee, R, Hoegger, Bruno, and Bhartia, P. K

Subjects
Environment Pollution
Abstract

We describe the first overview of total, stratospheric and tropospheric ozone in the southern hemisphere tropics based on a three year, ten site record of ozone soundings from the Southern Hemisphere Additional Ozonesondes (SHADOZ) network. Observations covering 1998-2000 were made over Ascension Island; Nairobi, Kenya; Irene, South Africa; Reunion Island; Watukosek, Java; Fiji; Tahiti; American Samoa; San Cristobal, Galapagos; Natal, Brazil. The ozone data, with simultaneous temperature profiles to approximately 7 hPa and relative humidity to approximately 200 hPa, are at an archive: http://code9l6. gsfc.nasa.gov/Data_services/shadoz. Prominent features are highly variable tropospheric ozone, a zonal wave-one pattern in total (and tropospheric) column ozone, and signatures of the Quasi-Biennial Oscillation (QBO) in stratospheric ozone. Total, stratospheric and tropospheric column ozone amounts usually peak between August and November and are lowest in the first half of the year. Tropospheric ozone variability over the Indian and Pacific Ocean displays influences of the waning 1997-1998 Indian Ocean Dipole and ENSO (El Nino / Southern Oscillation), seasonal convection and pollution transport from Africa. Tropospheric ozone over the Atlantic Basin reflects regional subsidence and recirculation as well as pollution ozone from biomass burning.

Published
2002

11. Tactical Router Interoperability: Concepts and Experiments

Author

Holtzer, A.C.G., Velt, R. in 't, Drijver, F.B., Rogge, H., Kirchhoff, J., Barz, C., Adrichem, N.L.M. van, and Hauge, M.

Subjects
Infostructures, Tactical Routing, FIB, Mobile Tactical Networks, ComputerApplications_COMPUTERSINOTHERSYSTEMS, MANET, FMN, Information Society, Interoperability, CWIX, Experimentation, DLEP
Abstract

Interoperability on the lower tactical levels, e.g. in a multinational battalion or team, poses challenges because of the high degree of mobility and limited data capacity at the tactical edge. Enabling such multi-national teams with direct connectivity can be beneficial since it allows the combination of capabilities from multiple nations and shortens reaction times compared to traditional hierarchical communication models. One target approach for interoperability on these levels is the realization of an IP-based tactical coalition network, in which nations can use different radio equipment, as well as different tactical routers. This paper provides an overview of routing architecture approaches to create heterogeneous tactical networks and focuses on tests and experiments that have been carried out during CWIX 2018 for one of these approaches. In these tests The Netherlands and Germany have shown that multiple national routing domains can be connected via both an embedded and an external route redistribution interface to create IP connectivity between units at the lower tactical level. This approach requires a connected coalition routing domain to which national routing domains connect. The results of the tests can provide input for discussion towards an FMN specification for mobile tactical networks.

Published
2018

12. Self-propagating reactions in Al/Zr multilayers: Anomalous dependence of reaction velocity on bilayer thickness.

Author

Barron, S. C., Kelly, S. T., Kirchhoff, J., Knepper, R., Fisher, K., Livi, K. J. T., Dufresne, E. M., Fezzaa, K., Barbee, T. W., Hufnagel, T. C., and Weihs, T. P.

Subjects
STOICHIOMETRY, ALUMINUM-zirconium alloys, HIGH temperatures, PHASE transitions, CHEMICAL research
Abstract

High temperature, self-propagating reactions are observed in vapor-deposited Al/Zr multilayered foils of overall atomic ratios 3 Al:1 Zr and 2 Al:1 Zr and nanoscale layer thicknesses; however, the reaction velocities do not exhibit the inverse dependence on bilayer thickness that is expected based on changes in the average diffusion distance. Instead, for bilayer thicknesses of 20-30 nm, the velocity is essentially constant at ∼7.7 m/s. We explore several possible explanations for this anomalous behavior, including microstructural factors, changes in the phase evolution, and phase transformations in the reactant layers, but find no conclusive explanations. We determine that the phase evolution during self-propagating reactions in foils with a 3 Al:1 Zr stoichiometry is a rapid transformation from Al/Zr multilayers to the equilibrium intermetallic Al3Zr compound with no intermediate crystalline phases. This phase evolution is the same for foils of 90 nm bilayer thicknesses and foils of bilayer thicknesses in the range of 27 nm to 35 nm. Further, for foils with a bilayer thickness of 90 nm and a 3 Al:1 Zr overall chemistry, the propagation front is planar and steady, in contrast to unsteady reaction fronts in foils with 1 Al:1 Zr overall chemistry and similar bilayer thicknesses. [ABSTRACT FROM AUTHOR]

Published
2013
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15. SK channel inhibition did not increase short-term variability of the QT intervals in atrial tachypaced pigs with left ventricular dysfunction in contrast to the positive control dofetilide

Author

Citerni, C., Kirchhoff, J., Olsen, L., Gentilini, F., Forni, M., Zannoni, A., Edvardsson, N., Bentzen, B., Grunnet, M., Diness, J., Citerni, C., Kirchhoff, J., Olsen, L., Gentilini, F., Forni, M., Zannoni, A., Edvardsson, N., Bentzen, B., Grunnet, M., and Diness, J.

Abstract

ackground: Small conductance Ca2+ activated K+ (SK) channel inhibition has generating conflicting results in the setting of left ventricular dysfunction (LVD). Objective: To evaluate the effect of the SK channel inhibitor AP14145 compared to dofetilide in LVD induced by atrial tachypacing (ATP) in pigs. Methods: A total of 18 pigs were divided into an atrial fibrillation (AF) group and a control group. AF pigs were atrially tachypaced for 4–8 weeks until sustained vernakalant-resistant AF developed. Signs of remodeling were investigated by echocardiography (after cardioversion), biomarkers and tissue analysis. Effect of 20 mg/kg AP14145, given alone or before 0.1 mg/kg dofetilide, or vice versa, were compared in terms of short term variability (STV) of the QT and RR intervals. Results: ATP resulted in a reduced ejection fraction (EF) (52±4 vs. 69±3%, p=0.003, AF vs. controls). This was accompanied by increased end diastolic and systolic LA volumes (50±8 vs. 29±2 ml, p=0.03 and 36±8 vs. 11±0.5 ml, p=0.0007) and LA area (18±2 vs. 11±0.5 cm2, p=0.0006). In pigs with AF, the STV of QT did not change when AP14145 was given alone or before dofetilide, but increased when dofetilide was given alone or after AP14145 (from 0.02±0.07 to 0.55±0.11, n=4, p=0.02). The baseline STV of RR was significantly reduced by AP14145 (from 0.31±0.14 to -0.33±0.11, n=4, p=0.01) and increased by dofetilide (1.5±0.16, n=4, p=0.04 and 0.01). Conclusions: Atrial tachypacing induced AF with concomitantly lowered EF and increased LA volume and area. These findings show that structural remodeling developed, yet SK inhibition by AP14145 did not induce any pro-arrhythmic effects in the ventricles, in contrast to the positive control dofetilide. Acknowledgement/Funding: Innovation Fund Denmark, the Carlsberg Foundation, the Wellcome Trust European Union's Horizon 2020 research and innovation programme

Published
2018

21. Photoconductivity parameters in lithium niobate.

Author

Gerson, Robert, Kirchhoff, J. F., Halliburton, L. E., and Bryan, D. A.

Subjects
*LITHIUM niobate, *ARRHENIUS equation, *PHOTOCONDUCTIVITY
Abstract

Presents a study that conducted measurements on a variety of doped and undoped lithium niobate crystals in the oxidized state. Arrhenius dependence of dark conductivity on reciprocal temperature; Conductivity of the crystals; Cause of the enhanced photoconductivity of magnesium-doped lithium niobate.

Published
1986
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25. The Impact of Information and Communication Technology on Doctors’ and Registered Nurses’ Working Conditions and Clinical Work – A Cross-Sectional Study in a Norwegian Hospital

Author

Kirchhoff JW, Marks A, Helgesen AK, Andersen KL, Andreassen HM, and Grøndahl VA

Subjects
health care professionals, information and communication technology, job discretion, job content, working conditions, Medicine (General), R5-920
Abstract

Jörg W Kirchhoff,1 Abigail Marks,2 Ann Karin Helgesen,1 Kirsti Lauvli Andersen,1 Hilde Marie Andreassen,1 Vigdis Abrahamsen Grøndahl1 1Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway; 2Author Affiliations Newcastle University Business School, Newcastle University, Newcastle Upon Tyne, UKCorrespondence: Jörg W KirchhoffFaculty of Health, Welfare and Organisation, Østfold University College, Halden, NorwayTel +47 47 69 60 86 99Email jorg.kirchhoff@hiof.noPurpose: Previous studies indicate that the introduction of information and communication technology (ICT) in health care organizations impairs health care professional’s working conditions and diminishes job discretion. Most of these studies, however, were designed to explore the influence of ICT exclusively on a single group of health care professionals and thereby did not consider the influence of the same technology on other groups of health care professionals. The aim of this article is to explore the influence of a fully integrated ICT system on both doctors and registered nurses within the same working environment: a high-tech hospital.Methods: This is a cross-sectional study conducted in a high-tech Norwegian hospital. Data were collected in 2016. In total, 264 registered nurses and 172 doctors responded to a questionnaire on their working conditions and experiences with ICT in clinical work. Descriptive statistics, compare means, cross-tables, Chi-square and bivariate correlation analysis were used to analyze the data. Statistical significance was set at p < 0.05.Results: The findings revealed differences in doctors’ and registered nurses’ working conditions. Registered nurses reported a statistically significant higher workload and better job content than doctors. There was no difference in job discretion between doctors and registered nurses. Both occupational groups experienced that the ICT system impairs patient contact and the quality of health services. We found statistically significant correlations between registered nurses’ and doctors’ experiences with ICT in clinical work and working conditions, whereof the strongest correlation was related to job discretion in clinical work.Conclusion: This study concludes that the impact of ICT on doctors’ and registered nurses’ working conditions in a hospital depends on the experiences of ICT in clinical work. In consequence, it is recommended to involve doctors and registered nurses in the implementation of ICT in hospitals.Keywords: health care professionals, information and communication technology, job discretion, job content, working conditions

Published
2021

26. Angular Resolved Scattering Measurements as Quality Control Tool for Texture-Etched ZnO:Al Front Contacts

Author

Jost, G., Merdzhanova, T., Zimmermann, T., Kirchhoff, J., and Hüpkes, J.

Subjects
Thin Film Solar Cells, Amorphous and Microcrystalline Silicon Solar Cells
Abstract

27th European Photovoltaic Solar Energy Conference and Exhibition; 2543-2547, The texture of the transparent front contact is of major importance with respect to the optical performance of a thin-film silicon solar cell. In this study we address the method of angular resolved scattering as a tool to characterize the transparent conductive oxide surface texture. Using variously etched sputter-deposited aluminum doped zinc oxide films correlations between the scattering characteristics of the front contacts and the current generation of different solar cells are investigated. In order to simplify the characterization only discrete angles are used as a fingerprint. Thus, correlations between the front contact scattering and current of a-Si:H and μc- Si:H single junction solar cells as well as a-Si:H/μc-Si:H tandem junction solar cells are established. It is well known that the texture does not only influence the optical performance of the device but also the growth processes of the successive layers. Especially the growth of the μc-Si:H absorber is very sensitive to the front contact texture. Therefore the correlation between the light scattering based texture fingerprint of the front contact and the crystalline volume fraction of the μc-Si-H absorber layer is investigated.

Published
2012
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27. Textured Glass for Silicon Thin Film Solar Cells

Author

Bunte, E., Zhang, W., Worbs, J., Siekmann, H., Kirchhoff, J., Gordijn, A., and Hüpkes, J.

Subjects
Thin Films Solar Cells, Amorphous and Microcrystalline Silicon Solar Cells
Abstract

24th European Photovoltaic Solar Energy Conference, 21-25 September 2009, Hamburg, Germany; 2789-2792, Textured glass is prepared by ion beam treatment using wet chemically etched aluminium doped zinc oxide films as three dimensional etching masks. The shape and rms roughness of the textured glass can be adjusted by changing the initial ZnO thickness, wet chemical etching duration and ion beam etching parameters. The maximum rms roughness we achieved is 228 nm, with lateral feature size larger than 2 m. Microcrystalline silicon thin film solar cells grown on the textured glass show certain light trapping effect (Jsc = 20 mA/cm2). This proves that the textured glass prepared by this method is suitable as an alternative substrate for thin film solar cells.

Published
2009
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28. Ultra-Short Deposition Times for a-Si/µc-Si Tandem Cells on Texture-Etched ZnO:Al

Author

Gordijn, A., Schicho, S., Kirchhoff, J., Reetz, W., Kilper, T., Zhu, H., Bunte, E., and Hüpkes, J.

Subjects
Thin Films Solar Cells, Amorphous and Microcrystalline Silicon Solar Cells
Abstract

24th European Photovoltaic Solar Energy Conference, 21-25 September 2009, Hamburg, Germany; 2835-2838, In this paper we explore the efficiency potential of a-Si/μc-Si tandem cells that are produced under conditions that lead to a considerable production cost reduction. On standard lab-type texture-etched ZnO:Al, 1 cm² a-Si:H/μc-Si:H tandem test cells on a deposition area of 30 x 30 cm² were made that showed an initial efficiency of 9.9%, whereas the total deposition time of intrinsic layers was only 22 minutes. The silicon thickness is only 600 nm. On high-rate texture-etched ZnO:Al an efficiency of 9.4% initial was reached. Standard light-induced degradation experiments showed a degradation rate of only 5 to 8% after 1000 hours. The regime of very short preparation times and relatively high stabilized efficiencies is relevant for production.

Published
2009
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29. High-Rate Deposited Amorphous and Microcrystalline Silicon Based Tandem Cells and Modules

Author

Kilper, T., Hrunski, D., Kirchhoff, J., Kroll, J., Muthmann, S., Noll, J., Reetz, W., Schicho, S., Schöpe, G., Zahren, C., and Gordijn, A.

Subjects
Thin Films Solar Cells, Amorphous and Microcrystalline Silicon Solar Cells
Abstract

24th European Photovoltaic Solar Energy Conference, 21-25 September 2009, Hamburg, Germany; 2320-2323, Tandem thin-film solar cells based on amorphous (a-Si:H) and microcrystalline silicon (μc-Si:H) were prepared in a 30×30 cm² PECVD reactor. Applying 40.68 MHz μc-Si:H high-rate processes at 10 Å/s for bottom i-layer deposition initial tandem cell efficiencies up to 11.5 % were realized. In combination with a 40.68 MHz a-Si:H rate process for top i-layer deposition at 5 Å/s initial tandem cell efficiencies up to 11.0/10.7 % (50/32 min total i-layer deposition time on SnO2:F/ZnO:Al as front TCO) were achieved. A first tandem module with bottom i-layer deposition at 10 Å/s had an initial efficiency of 10.0 % (aperture area 64 cm²). Also the stability properties of high-rate deposited 40.68 MHz μc-Si:H solar cells (RD = 10-25 Å/s) were investigated. Particularly samples that were deposited at 10 Å/s showed an excellent stability. After 4 years storage in ambient atmosphere and 1000 h light soaking the cell efficiency was 9.0 % corresponding with a relative degradation of only 1.9 % compared to the initial cell efficiency.

Published
2009
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30. A Novel Method of Optimization at a Constant Desposition Rate: Application to Thin-Film Amorphous Silicon Solar Cells

Author

Hrunski, D., Rech, B., Repmann, T., Kirchhoff, J., Gordijn, A., Hüpkes, J., and Appenzeller, W.

Subjects
Thin Films, Amorphous and Microcrystalline Silicon
Abstract

23rd European Photovoltaic Solar Energy Conference and Exhibition, 1-5 September 2008, Valencia, Spain; 2292-2296, To reduce the production cost for thin-film amorphous silicon solar cells, a high deposition rate must be achieved without a decline in the cell efficiency. Over the last few decades, evidence was collected on the deposition rate (Rd) as an additional technological parameter: Y. Hishikawa et al. have demonstrated that when substrate temperature (Ts) is fixed, amorphous silicon material properties appear to depend only on Rd, regardless of the gas pressure, rf power, or reactor dimensions. High-efficiency amorphous single-junction solar cells deposited at a higher deposition rate with no further frequency increases is a goal of the present work. To find a technological optimum, the compared cells should have the same deposition rate and thickness. The novel optimization method of a constant deposition rate (CDR) is proposed. This method means that two technological parameters could be varied during optimization in order to keep the deposition rate constant. Here, the discharge power as the second technological parameter was changed in order to ensure a constant deposition rate. When CDR is applied for two different deposition pressures areas (“low-pressure regime” is 0.5 Torr and “high-pressure regime” is 8 Torr), it allows evidence to be obtained which clearly indicates that solar cells of an almost similar quality could be achieved under rather different technological conditions. Based on this fact, an updated view is presented of the role of silane concentration in plasma as a technological parameter. High initial efficiencies of 10.4 % are achieved by CDR for 1 cm2 amorphous silicon single-junction p-i-n solar cells deposited on Asahi-U-type TCO at a deposition rate of 5 Å/s (i-layer). The optimized solar cells show a stabilized efficiency of 8 %.

Published
2008
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36. Implementation of minimally invasive and objective humane endpoints in the study of murine Plasmodium infections

Author

Dellavalle, B, Kirchhoff, J, Maretty, L, Castberg, F C, Kurtzhals, J A L, Dellavalle, B, Kirchhoff, J, Maretty, L, Castberg, F C, and Kurtzhals, J A L

Abstract

SUMMARY Defining appropriate and objective endpoints for animal research can be difficult. Previously we evaluated and implemented a body temperature (BT) of <32 °C as an endpoint for experimental cerebral malaria (ECM) and were interested in a similar endpoint for a model of severe malarial anaemia (SMA). Furthermore, we investigate the potential of a minimally invasive, non-contact infrared thermometer for repeated BT measurement. ECM was induced with Plasmodium berghei ANKA infection in C57Bl/6 mice. SMA was induced with Plasmodium chabaudi AS infection in A/J mice. Our previous published endpoint was applied in ECM and 30 °C was pre-determined as the lowest permitted limit for termination in SMA according to consultation with the Danish Animal Inspectorate. Infrared thermometer was compared with the rectal probe after cervical dislocation, ECM and SMA. Linear regression analysis of rectal versus infrared thermometry: cervical dislocation: Pearson R = 0·99, R 2 = 0·98, slope = 1·01, y-intercept = 0·55; ECM: 0·99, 0·98, 1·06, -2·4; and SMA: 0·98, 0·97, 1·14, -5·6. Implementation of the 30 °C endpoint captured all lethal infections. However, some animals with BT below 30 °C were not deemed clinically moribund. This study supports repeated measurement infrared thermometry. A humane endpoint of 30 °C was sensitive in capturing terminal animals but might overestimate lethality in this SMA model.

Published
2014

37. The mGlu5 receptor regulates extinction of cocaine-driven behaviours

Author

Bird, MK, Lohmann, P, West, B, Brown, RM, Kirchhoff, J, Raymond, CR, Lawrence, AJ, Bird, MK, Lohmann, P, West, B, Brown, RM, Kirchhoff, J, Raymond, CR, and Lawrence, AJ

Abstract

BACKGROUND: There is extensive evidence implicating the metabotropic glutamate 5 (mGlu5) receptor in aspects of addiction-related behaviours. METHODS: Here, we used a well-characterized line of mGlu5-deficient mice to further examine the role of this receptor in cocaine-driven behaviours. We confirmed the previously reported deficit in hippocampal long-term potentiation and associated spatial learning impairment. RESULTS: Despite a spatial learning deficit, mGlu5-deficient mice developed and maintained a conditioned place preference to cocaine, suggesting cocaine reward and Pavlovian conditioning are intact in these animals. Notably, however, mGlu5-deficient mice exhibited a marked deficit in the extinction of a cocaine-conditioned place preference compared to wild type littermates. Moreover, in a fixed ratio operant intravenous self-administration paradigm, both genotypes showed similar responding for cocaine over two different doses, while mGlu5-deficient mice displayed enhanced responding on a progressive ratio schedule. In addition, cue-induced drug-seeking after abstinence was exaggerated in mGlu5-deficient mice. CONCLUSION: Collectively, these findings suggest that while the mGlu5 receptor may be involved in mediating the rewarding effects of cocaine, it appears necessary for the extinction of cocaine-driven behaviours.

Published
2014

39. Metabotropic glutamate 5 receptors regulate sensitivity to ethanol in mice

Author

Bird, MK, Kirchhoff, J, Djouma, E, Lawrence, AJ, Bird, MK, Kirchhoff, J, Djouma, E, and Lawrence, AJ

Abstract

The metabotropic glutamate receptor 5 (mGlu5) has been implicated in ethanol- and drug-seeking behaviours in rodent studies. Here we examine a number of ethanol-related behavioural assays in mice lacking mGlu5 and wild-type littermates. In a two-bottle free-choice paradigm, mGlu5-deficient mice consumed less ethanol with a reduced preference compared to wild-type mice. Indeed, mGlu5-deficienct mice were ethanol-avoiding at both concentrations of ethanol proffered (5% and 10% v/v). However, there was no difference in the rate of hepatic ethanol and acetaldehyde metabolism between genotypes and consumption of saccharin was similar. In a conditioned place preference study, mGlu5-deficient mice displayed a place preference for ethanol when conditioned with a low dose (1g/kg) of ethanol. Thus, while mGlu5-deficient mice consume less ethanol (with a reduced preference) than wild-type mice, this is not apparently related to impaired hepatic metabolism or a lack of reward from ethanol. Rather, we provide evidence that deletion of the mGlu5 receptor increases sensitivity to centrally mediated effects of ethanol.

Published
2008

49. SiO[sub 2] thickness determination by x-ray photoelectron spectroscopy, Auger electron spectroscopy, secondary ion mass spectrometry, Rutherford backscattering, transmission electron microscopy, and ellipsometry

Author

Cole, D. A., primary, Shallenberger, J. R., additional, Novak, S. W., additional, Moore, R. L., additional, Edgell, M. J., additional, Smith, S. P., additional, Hitzman, C. J., additional, Kirchhoff, J. F., additional, Principe, E., additional, Nieveen, W., additional, Huang, F. K., additional, Biswas, S., additional, Bleiler, R. J., additional, and Jones, K., additional

Published
2000
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50. Health care quality from the patients’ perspective: a comparative study between an old and a new, high-tech hospital

Author

Grøndahl VA, Kirchhoff JW, Andersen KL, Sørby LA, Andreassen HM, Skaug EA, Roos AK, Tvete LS, and Helgesen AK

Subjects
High-tech hospital, patients’ subjective importance, patients’ perceived reality, quality of care, QPP-questionnaire, Medicine (General), R5-920
Abstract

Vigdis Abrahamsen Grøndahl,1 Jörg W Kirchhoff,1 Kirsti Lauvli Andersen,1 Lise Aagaard Sørby,2 Hilde Marie Andreassen,1 Eli-Anne Skaug,1 Anne Karine Roos,2 Liv Solveig Tvete,1 Ann Karin Helgesen1 1Faculty of Health and Welfare, Østfold University College, Halden, Norway; 2Østfold Hospital Trust, Grålum, Norway Purpose: Previous studies show that the hospital environment and the behavior of health care personnel may predict patients’ perceptions of care quality. The aim of the study was to explore changes in perceived care quality from the patients’ perspective (QPP) when hospital services are relocated from an old to a new high-tech hospital and to describe what is important for patients in the high-tech hospital.Patients and methods: A comparative cross-sectional design was used. The questionnaire QPP, which is based on a theoretical model of the quality of care comprising four quality dimensions, was used. Data were collected in 2015 (old hospital) and 2016 (new hospital), with 253 and 324 respondents, respectively, by consecutive sampling. Comparative statistics was used to test differences between patients’ care quality perceptions (perceived reality [PR] and subjective importance [SI]) (P≤0.05).Results: The patients rated PR of all four quality dimensions (the care organization’s physical-technical conditions and sociocultural approach and the caregivers’ medical-technical competence and identity-oriented approach) higher in the new hospital. However, only the two quality dimensions concerning the care organization were rated significantly more highly. On an item level, five of the 27 items scored significantly higher on patients’ SI than on patients’ PR of the care in the new hospital, indicating a quality deficiency from the patients’ perspective. This comprised receiving effective pain relief, receiving examination and treatment within an acceptable waiting time, receiving useful information on self-care, receiving useful information on which doctors were responsible for their medical care, and having a comfortable bed.Conclusion: The increase in care QPP was associated with improved environmental conditions, and no significant improvement in care quality was associated with the health care personnel. The results indicate that being in a high-tech environment does not improve patients’ perceptions of care quality provided by health care personnel. The results gave valuable information for quality improvement in clinical practice, based on the patients’ perspective. Keywords: high-tech hospital, patients’ subjective importance, patients’ perceived reality, quality of care, QPP questionnaire

Published
2018

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