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Jakl M, Berkova J, Veleta T, Palicka V, Polcarova P, Smetana J, Grenar P, Cermakova M, Vanek J, Horacek JM, Koci J. Rapid triage and transfer system for patients with proven Covid-19 at emergency department. J Appl Biomed 2024; 22:59-65. [PMID: 38505971 DOI: 10.32725/jab.2024.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND COVID-19 is a viral disease notorious for frequent worldwide outbreaks. It is difficult to control, thereby resulting in overload of the healthcare system. A possible solution to prevent overcrowding is rapid triage of patients, which makes it possible to focus care on the high-risk patients and minimize the impact of crowding on patient prognosis. METHODS The triage algorithm assessed self-sufficiency, oximetry, systolic blood pressure, and the Glasgow coma scale. Compliance with the triage protocol was defined as fulfillment of all protocol steps, including assignment of the correct level of care. Triage was considered successful if there was no change in the scope of care (e.g., unscheduled hospital admission, transfer to different level of care) or if there was unexpected death within 48 hours. RESULTS A total of 929 patients were enrolled in the study. Triage criteria were fulfilled in 825 (88.8%) patients. Within 48 hours, unscheduled hospital admission, transfer to different level of care, or unexpected death occurred in 56 (6.0%), 6 (0.6%), and 5 (0.5%) patients, respectively. The risk of unscheduled hospital admission or transfer to different level of care was significantly increased if triage criteria were not fulfilled [13.1% vs. 76.1%, RR 5.8 (3.8-8.3), p < 0.001; 0.5% vs. 5.2%, RR 11.4 (2.3-57.7), p = 0.036, respectively]. CONCLUSION The proposed algorithm for triage of patients with proven COVID-19 is a simple, fast, and reliable tool for rapid sorting for outpatient treatment, hospitalization on a standard ward, or assignment to an intensive care unit.
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Affiliation(s)
- Martin Jakl
- University Hospital Hradec Kralove, Department of Emergency Medicine, Hradec Kralove, Czech Republic
- University of Defence, Military Faculty of Medicine, Department of Military Internal Medicine and Military Hygiene, Hradec Kralove, Czech Republic
| | - Jana Berkova
- University Hospital Hradec Kralove, Department of Emergency Medicine, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Tomas Veleta
- University Hospital Hradec Kralove, Department of Emergency Medicine, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Vladimir Palicka
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Department of Clinical Biochemistry and Diagnostics, Hradec Kralove, Czech Republic
| | - Petra Polcarova
- University of Defence, Military Faculty of Medicine, Department of Epidemiology, Hradec Kralove, Czech Republic
| | - Jan Smetana
- University of Defence, Military Faculty of Medicine, Department of Epidemiology, Hradec Kralove, Czech Republic
| | - Petr Grenar
- University Hospital Hradec Kralove, Department of Emergency Medicine, Hradec Kralove, Czech Republic
- University of Defence, Military Faculty of Medicine, Department of Military Internal Medicine and Military Hygiene, Hradec Kralove, Czech Republic
| | - Martina Cermakova
- University Hospital Hradec Kralove, Department of Emergency Medicine, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jan Vanek
- University of Hradec Kralove, Faculty of Science, Centre of Advanced Technology, Hradec Kralove, Czech Republic
| | - Jan M Horacek
- University of Defence, Military Faculty of Medicine, Department of Military Internal Medicine and Military Hygiene, Hradec Kralove, Czech Republic
| | - Jaromir Koci
- University Hospital Hradec Kralove, Department of Emergency Medicine, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
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Rambaud S, Gavoille A, Economos G, Tazarourte K, Douplat M. Decision-making process of withholding or withdrawing life-sustaining treatments in French emergency departments during COVID-19 outbreak. Eur J Emerg Med 2023; 30:371-373. [PMID: 37650740 DOI: 10.1097/mej.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Severin Rambaud
- Emergency Department, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Bénite
| | - Antoine Gavoille
- Service de Biostatistique, Hospices Civils de Lyon, Lyon
- Université de Lyon Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne
| | - Guillaume Economos
- Palliative Care Center, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Bénite
- Université Claude Bernard Lyon 1, EA 3738 - CICLy, Centre d'Innovation en Cancérologie de Lyon, UFR Faculté de Médecin Lyon-Sud-Charles Mérieux BP1
| | - Karim Tazarourte
- Emergency Department, Edouard Herriot Hospital, Hospices Civils de Lyon
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon
| | - Marion Douplat
- Emergency Department, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Bénite
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon
- UMR ADéS 7268, Aix-Marseille University/EFS/CNRS, Espace éthique méditerranéen, Marseille, France
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Saleem SG, Ali S, Akhtar A, Khatri A, Ashraf N, Jamal I, Maroof Q, Aziz T, Mukhtar S. Impact of sequential capacity building on emergency department organisational flow during COVID-19 pandemic: a quasi-experimental study in a low-resource, tertiary care centre. BMJ Open 2023; 13:e063413. [PMID: 37474172 PMCID: PMC10360418 DOI: 10.1136/bmjopen-2022-063413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION A quasi-experimental study was conducted to estimate the impact of sequential emergency department (ED) capacity building interventions on key performance indicators such as patients' length of stay (LOS) and wait time (WT) during the COVID-19 pandemic. This was achieved through augmenting personnel education and head count, space restructuring and workflow reorganisation. SETTING AND PARTICIPANTS This study included 268 352 patients presenting from January 2019 to December 2020 at Indus Hospital and Health network Karachi, a philanthropic tertiary healthcare facility in a city of 20 million residents. A follow-up study was undertaken from January to December 2021 with 123 938 participants. PRIMARY AND SECONDARY OUTCOME MEASURES These included mean and median ED-LOS and WT for participants presenting in different cohorts. The results of the pre-COVID-19 year 2019 (phase 0) were compared with that of the COVID-19 year, 2020 (phases 1-3 corresponding to peaks, and phase 4 corresponding to reduction in caseloads). The follow-up was conducted in 2021 to see the sustainability of the sequential capacity building. RESULTS Phases 1, 2 and 3 had a lower mean adjusted LOS (4.42, 3.92 and 4.40 hours) compared with phase 0 (4.78 hours, p<0.05) with the lowest numbers seen in phase 2. The same held true for WT with 45.1, 23.8 and 30.4 min in phases 1-3 compared with 49.9 in phase 0. However, phase 4 had a higher LOS but a lower WT when compared with phase 0 with a p<0.05. CONCLUSION Sequential capacity building and improving the operational flow through stage appropriate interventions can be used to off-load ED patients and improve process flow metrics. This shows that models created during COVID-19 can be used to develop sustainable solutions and investment is needed in ideas such as ED-based telehealth to improve patient satisfaction and outcomes.
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Affiliation(s)
| | - Saima Ali
- Indus Hospital & Health Network, Karachi, Pakistan
| | - Ahwaz Akhtar
- Indus Hospital & Health Network, Karachi, Pakistan
| | - Adeel Khatri
- Indus Hospital & Health Network, Karachi, Pakistan
| | | | - Imran Jamal
- Indus Hospital & Health Network, Karachi, Pakistan
| | | | - Tariq Aziz
- Indus Hospital & Health Network, Karachi, Pakistan
| | - Sama Mukhtar
- Indus Hospital & Health Network, Karachi, Pakistan
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Huang LY, Shiau WM, Chou PC. Factors influencing loyalty to online health consultation platform: a cross-strait cultural perspective. BMC Health Serv Res 2023; 23:522. [PMID: 37221562 DOI: 10.1186/s12913-023-09518-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The geographical, cultural, and linguistic proximity between Taiwan and Mainland China has facilitated rapid growth of cross-strait interactions. Both countries have developed online health consultation platforms on the Internet for the public to access healthcare related information. This study examines factors that influence loyalty to a specific online health consultation platform (OHCP) from a cross-strait perspective. METHODS Based on the Expectation Confirmation Theory and the combined Trust, Perceived Health Risks and Culture, we examine factors that influence loyalty to OHCPs among cross-strait users by investigating the roles of trust, perceived health risks, and culture. Data was collected through a questionnaire survey. RESULTS The research models used provide a high-power explanation of loyalty to OHCPs. Results generally align with those of previous studies, with the exception of the relationships between Perceived Health Risks and Perceived Usefulness, Perceived Usefulness and Loyalty, Confirmation and Satisfaction, and Trust and Loyalty. In other words, culture may have moderated these relationships. CONCLUSIONS Findings can help promote OHCPs among cross-strait users to make things easier for patients, and further reduce the load on the emergency department, especially in view of the still ongoing issues related to global outbreak of Coronavirus disease by facilitating early detection of potential cases.
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Affiliation(s)
- Li-Yun Huang
- Division of Dermatology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Wen-Ming Shiau
- Institute of Information Management, National Chung Cheng University, Chia-Yi, Taiwan
| | - Pei Chin Chou
- Department of Respiratory Therapy, Fu Jen Catholic University, No.510, Zhongzheng Rd., Xinzhuang Dist, New Taipei City, 242062, Taiwan.
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Hosseini-Motlagh SM, Samani MRG, Karimi B. Resilient and social health service network design to reduce the effect of COVID-19 outbreak. ANNALS OF OPERATIONS RESEARCH 2023; 328:1-73. [PMID: 37361086 PMCID: PMC10169215 DOI: 10.1007/s10479-023-05363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 06/28/2023]
Abstract
With the severe outbreak of the novel coronavirus (COVID-19), researchers are motivated to develop efficient methods to face related issues. The present study aims to design a resilient health system to offer medical services to COVID-19 patients and prevent further disease outbreaks by social distancing, resiliency, cost, and commuting distance as decisive factors. It incorporated three novel resiliency measures (i.e., health facility criticality, patient dissatisfaction level, and dispersion of suspicious people) to promote the designed health network against potential infectious disease threats. Also, it introduced a novel hybrid uncertainty programming to resolve a mixed degree of the inherent uncertainty in the multi-objective problem, and it adopted an interactive fuzzy approach to address it. The actual data obtained from a case study in Tehran province in Iran proved the strong performance of the presented model. The findings show that the optimum use of medical centers' potential and the corresponding decisions result in a more resilient health system and cost reduction. A further outbreak of the COVID-19 pandemic is also prevented by shortening the commuting distance for patients and avoiding the increasing congestion in the medical centers. Also, the managerial insights show that establishing and evenly distributing camps and quarantine stations within the community and designing an efficient network for patients with different symptoms result in the optimum use of the potential capacity of medical centers and a decrease in the rate of bed shortage in the hospitals. Another insight drawn is that an efficient allocation of the suspect and definite cases to the nearest screening and care centers makes it possible to prevent the disease carriers from commuting within the community and increase the coronavirus transmission rate.
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Affiliation(s)
- Seyyed-Mahdi Hosseini-Motlagh
- School of Industrial Engineering, Iran University of Science and Technology, University Ave, Narmak, Tehran, 16846 Iran
| | - Mohammad Reza Ghatreh Samani
- School of Industrial Engineering, Iran University of Science and Technology, University Ave, Narmak, Tehran, 16846 Iran
| | - Behnam Karimi
- School of Industrial Engineering, Iran University of Science and Technology, University Ave, Narmak, Tehran, 16846 Iran
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Choo EK, Strehlow M, Del Rios M, Oral E, Pobee R, Nugent A, Lim S, Hext C, Newhall S, Ko D, Chari SV, Wilson A, Baugh JJ, Callaway D, Delgado MK, Glick Z, Graulty CJ, Hall N, Jemal A, Kc M, Mahadevan A, Mehta M, Meltzer AC, Pozhidayeva D, Resnick-Ault D, Schulz C, Shen S, Southerland L, Du Pont D, McCarthy DM. Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic. BMJ Open 2023; 13:e067986. [PMID: 37156578 PMCID: PMC10410813 DOI: 10.1136/bmjopen-2022-067986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/14/2023] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to the COVID-19 pandemic. DESIGN, SETTING AND PARTICIPANTS This was a prospective observational study of 17 geographically diverse US hospitals from February 2020 to February 2021. OUTCOMES AND ANALYSIS We identified 42 potential pandemic-related strategies and obtained week-to-week data about their use. We calculated descriptive statistics for use of each strategy and plotted percent uptake and weeks used. We assessed the relationship between strategy use and hospital type, geographic region and phase of the pandemic using generalised estimating equations (GEEs), adjusting for weekly county case counts. RESULTS We found heterogeneity in strategy uptake over time, some of which was associated with geographic region and phase of pandemic. We identified a body of strategies that were both commonly used and sustained over time, for example, limiting staff in COVID-19 rooms and increasing telehealth capacity, as well as those that were rarely used and/or not sustained, for example, increasing hospital bed capacity. CONCLUSIONS Hospital strategies during the COVID-19 pandemic varied in resource intensity, uptake and duration of use. Such information may be valuable to health systems during the ongoing pandemic and future ones.
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Affiliation(s)
- Esther K Choo
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Matthew Strehlow
- Department of Emergency Medicine, Stanford University, Stanford, California, USA
| | - Marina Del Rios
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Evrim Oral
- Department of Biostatistics, School of Public Health LSU Health Sciences Center, New Orleans, Louisiana, USA
| | - Ruth Pobee
- Department of Emergency Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Andrew Nugent
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Stephen Lim
- Section of Emergency Medicine, Department of Medicine, University Medical Center New Orleans, LSU Health Sciences Center New Orleans, New Orleans, Louisiana, USA
| | - Christian Hext
- Department of Emergency Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Sarah Newhall
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Diana Ko
- Department of Radiology, Stanford University, Palo Alto, California, USA
| | - Srihari V Chari
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amy Wilson
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health & Science University, Portland, Oregon, USA
| | - Joshua J Baugh
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David Callaway
- Department of Emergency Medicine, Atrium Health, Charlotte, North Carolina, USA
| | - Mucio Kit Delgado
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Zoe Glick
- Department of Emergency Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Christian J Graulty
- Department of Emergency Medicine, NYU Langone School of Medicine, New York, New York, USA
| | - Nicholas Hall
- Department of Emergency Medicine, Stanford University, Stanford, California, USA
| | - Abdusebur Jemal
- Department of Internal Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Madhav Kc
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER) Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Aditya Mahadevan
- Department of Emergency Medicine, Stanford University, Stanford, California, USA
| | - Milap Mehta
- Department of Emergency Medicine, Ohio State University, Columbus, Ohio, USA
| | - Andrew C Meltzer
- Department of Emergency Medicine, George Washington University School of Medicine, Washington, DC, USA
| | - Dar'ya Pozhidayeva
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health & Science University, Portland, Oregon, USA
| | - Daniel Resnick-Ault
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christian Schulz
- Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Sam Shen
- Department of Emergency Medicine Medicine, Stanford University, Palo Alto, California, USA
| | - Lauren Southerland
- Department of Emergency Medicine, Ohio State University, Columbus, Ohio, USA
| | - Daniel Du Pont
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Danielle M McCarthy
- Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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Greene GJ, Thomson CS, Donnelly D, Chung D, Bhatti L, Gavin AT, Lawler M, Huws DW, Rolles MJ, Bennée F, Morrison DS. Whole-population trends in pathology-confirmed cancer incidence in Northern Ireland, Scotland and Wales during the SARS-CoV-2 pandemic: A retrospective observational study. Cancer Epidemiol 2023; 84:102367. [PMID: 37119604 PMCID: PMC10121133 DOI: 10.1016/j.canep.2023.102367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
INTRODUCTION The COVID-19 epidemic interrupted normal cancer diagnosis procedures. Population-based cancer registries report incidence at least 18 months after it happens. Our goal was to make more timely estimates by using pathologically confirmed cancers (PDC) as a proxy for incidence. We compared the 2020 and 2021 PDC with the 2019 pre-pandemic baseline in Scotland, Wales, and Northern Ireland (NI). METHODS Numbers of female breast (ICD-10 C50), lung (C33-34), colorectal (C18-20), gynaecological (C51-58), prostate (C61), head and neck (C00-C14, C30-32), upper gastro-intestinal (C15-16), urological (C64-68), malignant melanoma (C43), and non-melanoma skin (NMSC) (C44) cancers were counted. Multiple pairwise comparisons generated incidence rate ratios (IRR). RESULTS Data were accessible within 5 months of the pathological diagnosis date. Between 2019 and 2020, the number of pathologically confirmed malignancies (excluding NMSC) decreased by 7315 (14.1 %). Scotland experienced early monthly declines of up to 64 % (colorectal cancers, April 2020 versus April 2019). Wales experienced the greatest overall change in 2020, but Northern Ireland experienced the quickest recovery. The pandemic's effects varied by cancer type, with no significant change in lung cancer diagnoses in Wales in 2020 (IRR 0.97 (95 % CI 0.90-1.05)), followed by an increase in 2021 (IRR 1.11 (1.03-1.20). CONCLUSION PDC are useful in reporting cancer incidence quicker than cancer registrations. Temporal and geographical differences between participating countries mirrored differences in responses to the COVID-19 pandemic, indicating face validity and the potential for quick cancer diagnosis assessment. To verify their sensitivity and specificity against the gold standard of cancer registrations, however, additional research is required.
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Affiliation(s)
- Giles J Greene
- Welsh Cancer Intelligence & Surveillance Unit, Public Health Wales Knowledge Directorate, Floor 5, Capital Quarter 2, Tyndall Street, Cardiff CF10 4BZ, UK.
| | - Catherine S Thomson
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK
| | - David Donnelly
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast UK
| | - David Chung
- Welsh Cancer Intelligence & Surveillance Unit, Public Health Wales Knowledge Directorate, Floor 5, Capital Quarter 2, Tyndall Street, Cardiff CF10 4BZ, UK
| | - Lesley Bhatti
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK
| | - Anna T Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast UK
| | - Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast UK; DATA-CAN, the UK's Health Data Research Hub for Cancer, UK
| | - Dyfed Wyn Huws
- Welsh Cancer Intelligence & Surveillance Unit, Public Health Wales Knowledge Directorate, Floor 5, Capital Quarter 2, Tyndall Street, Cardiff CF10 4BZ, UK
| | - Martin J Rolles
- South West Wales Cancer Centre, Swansea Bay University Health Board, Swansea SA2 8QA, UK
| | - Felicity Bennée
- Welsh Cancer Intelligence & Surveillance Unit, Public Health Wales Knowledge Directorate, Floor 5, Capital Quarter 2, Tyndall Street, Cardiff CF10 4BZ, UK
| | - David S Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK
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Zhang R, You C, Wang L, Jiang Y, He L, Wang C, Chen F, Huang Y, Han H. A practice-based nursing emergency management system model for public health emergencies: A descriptive qualitative study. Nurs Open 2023; 10:3774-3786. [PMID: 36747470 PMCID: PMC10170909 DOI: 10.1002/nop2.1635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 02/08/2023] Open
Abstract
AIM This study aims to explore nursing emergency management system under public health emergencies. DESIGN A descriptive qualitative study. METHOD Semi-structured interviews were conducted during March-November 2020 with 11 nursing emergency management administrators from 11 COVID-19 designated hospitals and infectious disease hospitals under four administrative divisions in China, who were recruited through convenience and purposive sampling. Interviews were audio-recorded and transcribed. Data were analysed with Braun and Clarke's inductive thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research. RESULTS Three main themes emerged from data analysis: (1) Five core elements of nursing emergency management system: Structure, Staff, System, Setting, and Supply (5S); (2) Four phases of nursing emergency management system: Reduction, Readiness, Response and Recovery (4R); and (3) operational process of nursing emergency management system (5S*4R). The findings generated a conceptual model of a nursing emergency management system. PUBLIC CONTRIBUTION This study provides a theoretical basis for nursing emergency management system for public health emergencies in the future. Nurse administrators could refer to this model to either review or develop their system and develop viable interventions to prepare for future public health emergencies.
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Affiliation(s)
- Ruixue Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Congyu You
- Office of Performance Management, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lei Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Lingxiao He
- Trauma Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Cong Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Fengjiao Chen
- Department of Hematology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yujia Huang
- Department of Neurological Comprehensive Ward, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hui Han
- Department of Neurological Comprehensive Ward, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Juang WC, Chiou SMJ, Chen HC, Li YC. Differences in Characteristics and Length of Stay of Elderly Emergency Patients before and after the Outbreak of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1162. [PMID: 36673917 PMCID: PMC9859462 DOI: 10.3390/ijerph20021162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: COVID-19 has spread worldwide and affected Taiwan's medical system and people's lives. This study aimed to explore the impact of medical utilization on the characteristics and length of stay (LOS) of elderly emergency department (ED) patients before and after COVID-19; (2) Methods: We gathered ED visits from January to September 2019 (pre-pandemic group) and from January to September 2020 (pandemic group). The data analysis methods included descriptive statistics, the Pearson's chi-square test, the independent sample t-test, and binary logistic regression; (3) Results: In 2020, during COVID-19, a significant decrease in ED monthly visits occurred from January; the maximum decrease was 32% in March. The average LOS during COVID-19 was shortened, with a significant reduction in diagnoses compared with the pre-pandemic period; (4) Conclusions: The threat of COVID-19 has changed the elderly's behavior in ED visits and shortened the LOS of ED. The study's results emphasize the importance of analyzing the medical utilization of elderly ED patients and understanding the medical quality of healthcare institutions. With Taiwan's rapidly aging society, the demand for healthcare increases from time to time. The overcrowding of medical attention is often a problem. The results recommend that the overcrowding problem has the opportunity to be solved.
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Affiliation(s)
- Wang-Chuan Juang
- Quality Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Sonia Ming-Jiu Chiou
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Hsien-Chih Chen
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Ying-Chun Li
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
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Sheek-Hussein M, Alsuwaidi AR, Davies EA, Abu-Zidan FM. Monkeypox: A current emergency global health threat. Turk J Emerg Med 2023; 23:5-16. [PMID: 36818951 PMCID: PMC9930390 DOI: 10.4103/2452-2473.366487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/03/2022] [Indexed: 02/24/2023] Open
Abstract
Monkeypox (MPXV) is an emerging zoonotic disease carrying a global health threat. Using a multi-disciplinary approach, we review the current MPXV virus infection outbreak including virology, prevention, clinical presentation, and disaster management. MPXV is caused by a double-stranded deoxyribonucleic acid virus. Despite its clinical similarities with smallpox, it is less severe with low mortality. Human-to-human transmission occurs through prolonged direct or close contact, or through blood, body fluids, or mucosal lesions. Risk groups include frontline health workers who care for MPXV patients, household members of an infected patient, and men who have sex with men. Skin lesions are usually, but not always, at the same stage. They may affect the face followed by the distal extremities with fewer lesions on the trunk (centrifugal distribution). Lesions may involve the mouth, genitalia, conjunctiva, and rectum. The majority of cases are mild. Nevertheless, the disease may have long-term effects on the skin, the neurological system, and the eye. Vaccination against MPXV is available but meanwhile should be limited to those who are at high risk. Those vaccinated against smallpox (usually older than 40 years) might be immune against MPXV. Infectious diseases are without borders. If proper action is not taken, there is considerable risk that MPXV will be entrenched worldwide. Our world has a delicate balance between animals, environment, and humans reflecting the need for a "one globe, one health approach" to address this risk. Following the principles of disaster management and using the lessons we have learned from the COVID-19 pandemic will reduce the impact of the MPXV outbreak.
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Affiliation(s)
- Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Ahmed R. Alsuwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Emma A. Davies
- Department of Virology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Fikri M. Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates,Address for correspondence: Prof. Fikri M. Abu-Zidan, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates. E-mail:
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Zhu J, Zhu GP, Weng YM, Zhang Y, Li BX. Clinical Practice and Effectiveness Analysis of the Management of Corona Virus Disease 2019 Infected at Shanghai Fangcang Shelter Hospital: A Descriptive Study. Risk Manag Healthc Policy 2023; 16:337-346. [PMID: 36883054 PMCID: PMC9985874 DOI: 10.2147/rmhp.s403414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Background The Fangcang shelter hospital has gradually become the primary management mode in China's fight against this Corona Virus Disease 2019 (COVID-19) in 2020. In early 2022, the Fangcang shelter hospital management model was successfully applied to the new outbreak of COVID-19 in Shanghai also. Although Fangcang shelter hospitals are no longer the prevailing mode of prevention of COVID-19, the management experience of Shanghai makeshift hospitals is worthy of reference for public health. Methods The authors conducted a descriptive statistical analysis of Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. The whole hall of the Fangcang shelter hospital was managed by the one hospital, and the inclusion of third-party management personnel alleviated the shortage of medical personnel human resources. Through practice, a new procedure for treating batch infected people was introduced. Results By optimizing ward management, 72 on-duty doctors, 360 on-duty nurses, 3 sense-control administrators, and 15 administrators cured 18,574 infected people in 40 days, and created a record of a doctor managing 700 infected people without compromising the quality of treatment. There have been no deaths and no complaints from the infected people located in Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. Conclusion Compared with previous data, the new management mode of Fangcang shelter hospitals provides a reference for the management of the new infectious diseases for public health.
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Affiliation(s)
- Jian Zhu
- Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Guang-Ping Zhu
- Department of Endocrinology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Yan-Ming Weng
- Department of Stomatology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Yong Zhang
- Department of Integrative Medicine, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Bi-Xi Li
- Department of Anesthesiology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, Hubei Province, People's Republic of China
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Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study. J Pers Med 2022; 12:jpm12122085. [PMID: 36556305 PMCID: PMC9787691 DOI: 10.3390/jpm12122085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/21/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Our aim is to describe and compare the profile and outcome of patients attending the ED with a confirmed COVID-19 infection with patients with a suspected COVID-19 infection. Methods: We conducted a multicentric retrospective study including adults who were seen in 21 European emergency departments (ED) with suspected COVID-19 between 9 March and 8 April 2020. Patients with either a clinical suspicion of COVID-19 or confirmed COVID-19, detected using either a RT-PCR or a chest CT scan, formed the C+ group. Patients with non-confirmed COVID-19 (C− group) were defined as patients with a clinical presentation in the ED suggestive of COVID-19, but if tests were performed, they showed a negative RT-PCR and/or a negative chest CT scan. Results: A total of 7432 patients were included in the analysis: 1764 (23.7%) in the C+ group and 5668 (76.3%) in the C− group. The population was older (63.8 y.o. ±17.5 vs. 51.8 y.o. +/− 21.1, p < 0.01), with more males (54.6% vs. 46.1%, p < 0.01) in the C+ group. Patients in the C+ group had more chronic diseases. Half of the patients (n = 998, 56.6%) in the C+ group needed oxygen, compared to only 15% in the C− group (n = 877). Two-thirds of patients from the C+ group were hospitalized in ward (n = 1128, 63.9%), whereas two-thirds of patients in the C− group were discharged after their ED visit (n = 3883, 68.5%). Conclusion: Our study was the first in Europe to examine the emergency department’s perspective on the management of patients with a suspected COVID-19 infection. We showed an overall more critical clinical situation group of patients with a confirmed COVID-19 infection.
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Jia P, Wang Y, Yang M, Wang L, Yang X, Shi X, Yang L, Wen J, Liu Y, Yang M, Xin J, Zhang F, Jiang L, Chi C, Zhang L, Ma X, Ma X, Zhao L, Li W. Inequalities of spatial primary healthcare accessibility in China. Soc Sci Med 2022; 314:115458. [PMID: 36279792 DOI: 10.1016/j.socscimed.2022.115458] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 07/15/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
Abstract
A key step to the establishment of a tiered healthcare system is equitable access to basic primary healthcare services for all. However, no quantitative research on the national status quo of primary healthcare accessibility in China exists. We filled this gap by estimating spatial accessibility to primary healthcare centers (PHCs) and mapping its inequality across the mainland China. Four national datasets during 2015-2018, including administrative boundaries, residential communities, points-of-interest (including PHCs), and road networks, were collected to calculate the distance to the nearest PHC for each community. Five other national datasets including census, elevation, land use, vegetation, and nightlight, were collected to model 100m × 100 m population grids, based on which geographical modeling was used to calculate PHC accessibility of each community. Inequalities in PHC accessibility across China were described with concentration indices. About 44% of communities across China representing approximately 30% of the overall population had no access to PHCs within their 6-km catchment areas; about 78% of communities across China representing approximately 68.4% of the overall population had no access to PHCs within their 1.5-km catchment areas. Some municipalities/provinces like Shanghai, Beijing, Tianjin, Jiangsu, Shandong, and Zhejiang generally had higher proximity to the nearest PHCs, while others like Tibet, Guizhou, and Guangxi had lower proximity to the nearest PHCs. However, assuming similar basic service capacity across all PHCs, Shanghai, Tianjin, and Chongqing showed the lowest PHC accessibility due to high population density. Variations in PHC accessibility existed, with more inequalities observed in the north and northeastern provinces and less inequalities in southwestern and south-central provinces. This study demonstrates primary healthcare accessibility and inequality at province and city levels, and identifies communities with lower proximity and accessibility to PHCs in China. It would serve as a starting point to facilitate precise healthcare planning and preparedness for health emergencies in China.
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Affiliation(s)
- Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, Hubei, China; School of Public Health, Wuhan University, Wuhan, Hubei, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, Hubei, China.
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Min Yang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan, Zhejiang, China
| | - Xinyu Shi
- University College Twente, University of Twente, Enschede, the Netherlands
| | - Lijian Yang
- Center for Statistical Science, Tsinghua University, Beijing, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Liu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Maokang Yang
- Division of Rural Health, Sichuan Hospital Association, Chengdu, Sichuan, China
| | - Junguo Xin
- School of Public Health, Chengdu Medical College, Chengdu, Sichuan, China
| | - Fengying Zhang
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lihua Jiang
- Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunhua Chi
- Department of General Practice, Peking University Health Sciences Center, Beijing, China; Health Management Center, Peking University First Hospital, Beijing, China
| | - Luxia Zhang
- National Institute of Health Data Science, Peking University, Beijing, China; Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
| | - Xudong Ma
- Bureau of Medical Administration, National Health Commission of the People's Republic of China, Beijing, China
| | - Xiao Ma
- Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Weimin Li
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Healthcare design to improve safe doffing of personal protective equipment for care of patients with COVID-19. Infect Control Hosp Epidemiol 2022; 43:1796-1805. [PMID: 35156598 PMCID: PMC8914142 DOI: 10.1017/ice.2021.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Understand how the built environment can affect safety and efficiency outcomes during doffing of personal protective equipment (PPE) in the context of coronavirus disease 2019 (COVID-19) patient care. STUDY DESIGN We conducted (1) field observations and surveys administered to healthcare workers (HCWs) performing PPE doffing, (2) focus groups with HCWs and infection prevention experts, and (3) a with healthcare design experts. SETTINGS This study was conducted in 4 inpatient units treating patients with COVID-19, in 3 hospitals of a single healthcare system. PARTICIPANTS The study included 24 nurses, 2 physicians, 1 respiratory therapist, and 2 infection preventionists. RESULTS The doffing task sequence and the layout of doffing spaces varied considerably across sites, with field observations showing most doffing tasks occurring around the patient room door and PPE support stations. Behaviors perceived as most risky included touching contaminated items and inadequate hand hygiene. Doffing space layout and types of PPE storage and work surfaces were often associated with inadequate cleaning and improper storage of PPE. Focus groups and the design charrette provided insights on how design affording standardization, accessibility, and flexibility can support PPE doffing safety and efficiency in this context. CONCLUSIONS There is a need to define, organize and standardize PPE doffing spaces in healthcare settings and to understand the environmental implications of COVID-19-specific issues related to supply shortage and staff workload. Low-effort and low-cost design adaptations of the layout and design of PPE doffing spaces may improve HCW safety and efficiency in existing healthcare facilities.
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Torres M, Corona M, Rodríguez-Mora S, Casado-Fernández G, Zurdo-Castronuño A, Mateos E, Ramos-Martín F, Sánchez-Menéndez C, Murciano-Antón MA, García-Pérez J, Alcamí J, Pérez-Olmeda M, Coiras M, López-Jiménez J, García-Gutiérrez V. Strong Humoral but Not Cellular Immune Responses against SARS-CoV-2 in Individuals with Oncohematological Disease Who Were Treated with Rituximab before Receiving a Vaccine Booster. Cancers (Basel) 2022; 14:5537. [PMID: 36428631 PMCID: PMC9688562 DOI: 10.3390/cancers14225537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/12/2022] Open
Abstract
The humoral immune response developed after receiving the full vaccination schedule against COVID-19 is impaired in individuals who received anti-CD20 therapy 6-9 months before vaccination. However, there is little information about the cellular immune responses elicited in these individuals. In this study, we analyzed the humoral and cellular immune responses in 18 individuals with hematological disease who received the last dose of rituximab 13.8 months (IQR 9.4-19) before the booster dose. One month after receiving the booster dose, the seroconversion rate in the rituximab-treated cohort increased from 83.3% to 88.9% and titers of specific IgGs against SARS-CoV-2 increased 1.53-fold (p = 0.0098), while the levels of neutralizing antibodies increased 3.03-fold (p = 0.0381). However, the cytotoxic activity of peripheral blood mononuclear cells (PBMCs) from rituximab-treated individuals remained unchanged, and both antibody-dependent cellular cytotoxicity (ADCC) and direct cellular cytotoxicity (CDD) were reduced 1.7-fold (p = 0.0047) and 2.0-fold (p = 0.0086), respectively, in comparison with healthy donors. Breakthrough infections rate was higher in our cohort of rituximab-treated individuals (33.33%), although most of the infected patients (83.4%) developed a mild form of COVID-19. In conclusion, our findings confirm a benefit in the humoral, but not in the cellular, immune response in rituximab-treated individuals after receiving a booster dose of an mRNA-based vaccine against COVID-19.
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Affiliation(s)
- Montserrat Torres
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Magdalena Corona
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
- Faculty of Sciences, Universidad de Alcalá, 28871 Alcalá de Henares, Spain
| | - Sara Rodríguez-Mora
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Guiomar Casado-Fernández
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Faculty of Sciences, Universidad de Alcalá, 28871 Alcalá de Henares, Spain
| | - Alejandro Zurdo-Castronuño
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Elena Mateos
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Fernando Ramos-Martín
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Clara Sánchez-Menéndez
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | | | - Javier García-Pérez
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- AIDS Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - José Alcamí
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- AIDS Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Mayte Pérez-Olmeda
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Serology Service, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mayte Coiras
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Javier López-Jiménez
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Valentín García-Gutiérrez
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
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Tabatabaee SS, Vatandoost V, Saghi FK, Daghighbin E. Explaining the challenges of hospitals admitting COVID-19 patients from the perspective of managers (a qualitative study). JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:334. [PMID: 36567989 PMCID: PMC9768733 DOI: 10.4103/jehp.jehp_377_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/24/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Crises are often unavoidable events that occur around the world. Hospitals play an important role in treating patients and preventing extensive injuries in times of crisis, requiring adequate preparedness. In order to design a proper planning system, it is essential to be aware of the challenges of hospitals during a crisis. The purpose of this study was to explain the challenges of hospitals admitting COVID-19 patients in the city of Mashhad, Iran, from the perspective of their managers. MATERIALS AND METHODS This study employed a qualitative approach, using the method of conventional content analysis and was conducted from May to July 2020. A purposive sampling method was used to recruit the senior managers of hospitals admitting COVID-19 patients in Mashhad. The interviews were conducted face to face, with open-ended questions following an interview guide based on semi-structured questions, and continued until data saturation was reached. Data were analyzed using Atlas Ti software. RESULTS After the implementation of the interviews, first 665 initial codes were extracted from the data, and after removing the overlapping sequences, a total of 115 codes were obtained. Three categories (organizational challenges, extra organizational challenges, and challenges related to information domain), 13 sub-categories, and 33 codes were extracted from the content analysis of the interviews. The main themes propounded in the field of challenges of COVID-19 referral hospitals in Mashhad were organizational challenges, extra organizational challenges, and information domain challenges. DISCUSSION The results of this study showed that the hospitals admitting COVID-19 patients in Mashhad faced many challenges. To improve the quality of services in postcrisis phase, replacing hospitals' equipment, revising curriculums at medical universities, staff retraining, recruiting skilled human resources, and creating a supportive community context are necessary. CONCLUSION For sure, the COVID-19 crisis will not be the last one, we have to be prepared for the bigger health crisis.
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Affiliation(s)
- Seyed Saeed Tabatabaee
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Economic and Management Sciences, Health School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Vatandoost
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Health Care Management, Health Policy and Health Economic Department, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Kokabi Saghi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Economic and Management Sciences, Health School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Daghighbin
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Economic and Management Sciences, Health School, Mashhad University of Medical Sciences, Mashhad, Iran
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Douplat M, Gavoille A, Subtil F, Haesebaert J, Jacquin L, Durand G, Lega JC, Perpoint T, Potinet V, Berthiller J, Perreton N, Tazarourte K. Management and Outcome of COVID-19 Positive and Negative Patients in French Emergency Departments During the First COVID-19 Outbreak: A Prospective Controlled Cohort Study. West J Emerg Med 2022; 23:897-906. [DOI: 10.5811/westjem.2022.7.57135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/19/2022] [Indexed: 11/15/2022] Open
Abstract
ntroduction: Few studies have investigated the management of COVID-19 cases from the operational perspective of the emergency department (ED), We sought to compare the management and outcome of COVID-19 positive and negative patients who presented to French EDs.
Methods: We conducted a prospective, multicenter, observational study in four EDs. Included in the study were adult patients (≥18 years) between March 6–May 10, 2020, were hospitalized, and whose presenting symptoms were evocative of COVID-19. We compared the clinical features, management, and prognosis of patients according to their confirmed COVID-19 status.
Results: Of the 2,686 patients included in this study, 760 (28.3%) were COVID-19 positive. Among them, 364 (48.0%) had hypertension, 228 (30.0%) had chronic cardiac disease, 186 (24.5%) had diabetes, 126 (16.6%) were obese, and 114 (15.0%) had chronic respiratory disease. The proportion of patients admitted to intensive care units (ICU) was higher among COVID-19 positive patients (185/760, 24.3%) compared to COVID-19 negative patients (206/1,926, 10.7%; P <0.001), and they required mechanical ventilation (89, 11.9% vs 37, 1.9%; P <0.001) and high-flow nasal cannula oxygen therapy (135, 18.1% vs 41, 2.2%; P < 0.001) more frequently. The in-hospital mortality was significantly higher among COVID-19 positive patients (139, 18.3% vs 149, 7.7%; P <0.001).
Conclusion: Emergency departments were on the frontline during the COVID-19 pandemic and had to manage potential COVID-19 patients. Understanding what happened in the ED during this first outbreak is crucial to underline the importance of flexible organizations that can quickly adapt the bed capacities to the incoming flow of COVID-19 positive patients.
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Affiliation(s)
- Marion Douplat
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Lyon Sud Hospital, Department of Emergency Medicine, Pierre Bénite, France
| | - Antoine Gavoille
- Université de Lyon Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France; Service de Biostatistique, Hospices Civils de Lyon, Lyon France
| | - Fabien Subtil
- Université de Lyon Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France; Service de Biostatistique, Hospices Civils de Lyon, Lyon France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Pôle de Santé Publique, Service de Recherche et d’Epidémiologie Cliniques, Hospices Civils de Lyon, France
| | - Laurent Jacquin
- Hospices Civils de Lyon, Edouard Herriot Hospital, Department of Emergency Medicine, Lyon, France
| | - Guillaume Durand
- Villefranche Hospital, Department of Emergency Medicine, Gleize, France
| | - Jean-Christophe Lega
- Hospices Civils de Lyon, Lyon Sud Hospital, Department of Internal and Vascular Medicine, Pierre Bénite, France
| | - Thomas Perpoint
- Service de Maladies Infectieuses et Tropicales, Hôpital Croix-Rousse Hospices Civils de Lyon, Lyon, France
| | - Veronique Potinet
- Hospices Civils de Lyon, Lyon Sud Hospital, Department of Emergency Medicine, Pierre Bénite, France
| | - Julien Berthiller
- Pôle de Santé Publique, Service de Recherche et d’Epidémiologie Cliniques, Hospices Civils de Lyon, France
| | - Nathalie Perreton
- Pôle de Santé Publique, Service de Recherche et d’Epidémiologie Cliniques, Hospices Civils de Lyon, France
| | - Karim Tazarourte
- Hospices Civils de Lyon, Edouard Herriot Hospital, Department of Emergency Medicine, Lyon, France
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Emergency Information Communication Structure by Using Multimodel Fusion and Artificial Intelligence Algorithm. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3029039. [PMID: 36262605 PMCID: PMC9576386 DOI: 10.1155/2022/3029039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
With the development of The Times, social events are increasing, and emergency management has gradually become the main helper to solve the crisis in the public domain. By observing the current situation of many countries and regions, we can find that various types of public crises often occur in many countries and regions in the world, which have severely affected people's daily life, lives, and property. Through long-term research and analysis, it can be known that the emergency management mechanism currently established in China has certain shortcomings. The communication problem of emergency information is likely to cause the emergency work to not proceed smoothly. In addition, problems in the communication channels of emergency information are likely to cause problems in the cooperation of various departments when people carry out emergency management work, and the efficiency of the government in dealing with problems will also be reduced in real scenarios. In order to improve the efficiency of emergency information management, this paper aims at the various problems existing and facing in the construction of emergency management system. On this basis, the integration of various relevant emergency information management plan models is analyzed and sorted out, and based on the research and integration of the development of artificial intelligence algorithms. The main research results of emergency information management at home and abroad are comprehensively studied and evaluated. Finally, a QG algorithm based on more model fusion is developed. In the process of analysis, this article uses artificial intelligence algorithms to build a prediction model of multiple modes and collects the data needed to build the model by random extraction. Through the analysis of different data sets, it is used as the basic training data for prediction. Through comprehensive analysis, the model constructed in this paper can promote the sharing of emergency information among departments to a certain extent.
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Cushman DM, York E, Asay A, Ross B, Teramoto M, McCormick ZL. Changes in clinical practice perceptions and mental health of sports medicine physicians due to the SARS-CoV-2 pandemic. PHYSICIAN SPORTSMED 2022; 50:419-428. [PMID: 34176424 PMCID: PMC8727637 DOI: 10.1080/00913847.2021.1949252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The SARS-CoV-2 pandemic has had an immense impact on healthcare, but little has been published on its impact on sports medicine physicians. This study aimed to assess the perceived impacts of the pandemic on practice changes, financial implications, and mental health of the physician members of the American Medical Society for Sports Medicine (AMSSM). METHODS Online surveys were sent to physician members of the AMSSM, with questions asking about demographic information and personal associations to COVID-19. The main outcome measures included self-reported clinical practice volumes, visit types (telemedicine, face-to-face), Patient Health Questionnaire (PHQ-4) scores, personal finances, clarity of practice guidelines, and personal protective equipment (PPE) availability. RESULTS A total of 825 respondents completed the initial survey, with a subset completing follow-ups. In-person clinical and procedural volumes were reported to be reduced to just 17.9% and 13.7% of the pre-pandemic baseline volumes at the first survey (March 2020), but increased to 81.1% and 77.3% (August 2020), respectively. PHQ-4 anxiety subscores significantly decreased over time (p < 0.001); younger physicians and female physicians were more likely to have higher scores (p < 0.05). Reported physician income significantly increased over time (p < 0.05), and financial concerns steadily decreased (p < 0.001). The perception of having an adequate PPE significantly increased over the study (p < 0.001) but not for having clear practice guidelines (p > 0.05). Physicians have become increasingly aware of others testing positive for the virus, but not themselves or someone they live with. CONCLUSIONS Sports medicine physicians have been heavily impacted by the SARS-CoV-2 pandemic, with some recovery since it started. Sports medicine physicians should be aware of pandemic-related practice changes and resulting mental health and financial implications.
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Affiliation(s)
- Daniel M Cushman
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth York
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, USA
| | - Alexandra Asay
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Brendon Ross
- Department of Orthopedic Surgery & Rehabilitation Medicine, University of Chicago, Chicago, IL, USA
| | - Masaru Teramoto
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, USA
| | - Zachary L McCormick
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, USA
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20
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Mohan Y, Charumathi B, Anantha Eashwar VM, Jain T, Abiramasundari VK. Incidence and Source of COVID-19 Infection Among Health Care Workers in a Tertiary Hospital in South India-A Prospective Cohort Study. Int J Prev Med 2022; 13:108. [PMID: 36247191 PMCID: PMC9564233 DOI: 10.4103/ijpvm.ijpvm_687_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 09/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background Data for COVID-19 incidence and the source of infection among health care workers (HCWs) in Indian population are limited. The main objective of the study was to assess the incidence of COVID-19 infection and identify the source of infection among the HCWs in a tertiary teaching hospital. Methods A prospective cohort study was conducted among the 2134 HCWs recruited by purposive sampling from a tertiary teaching hospital from May to August 2020 (4-month period-123 days). Over the 4-month period, all the HCWs who had symptoms or those were close contacts of COVID positive patients were traced and tested using validated COVID diagnostic test (reverse transcription-polymerase chain reaction [RT-PCR] test). A semi-structured questionnaire was used to interview each positive HCW to identify the source of exposure of the infection. Results Incidence proportion was 9.3% among HCWs and was two times higher among males compared to females. Hazard ratio was found to be higher among males and HCWs working in the non-COVID areas. Test positivity rate was found to highest (around 57.8%) among those aged less than 30 years. The most common source of infection was infected HCW colleagues (40.9%) followed by exposure to patients in non-COVID areas (27.3%). Only 5.1% of total infection was found in HCWs who had worked in COVID zones. Conclusions People working in non-COVID areas, those using shared workplace, dining halls, and staff hostels, must follow strict COVID protocols by using appropriate Personal Protective Equipment (PPE) and following social distancing measures.
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Affiliation(s)
- Yogesh Mohan
- Department of Community Medicine, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - B. Charumathi
- Department of Community Medicine, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - V. M. Anantha Eashwar
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India,Address for correspondence: Dr. V. M. Anantha Eashwar, 158/6 Washer Varadappa Street, New Washermanpet – 81, Chennai, Tamil Nadu, India. E-mail:
| | - Timsi Jain
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | - V. K. Abiramasundari
- Department of Microbiology, Saveetha Medical College and Hospital, Thandalam, Chennai, Tamil Nadu, India
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21
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Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, Dimian M, Savage WK. Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems. J Pers Med 2022; 12:1295. [PMID: 36013244 PMCID: PMC9409667 DOI: 10.3390/jpm12081295] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/21/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022] Open
Abstract
Beginning in December 2019, the world faced a critical new public health stressor with the emergence of SARS-CoV-2. Its spread was extraordinarily rapid, and in a matter of weeks countries across the world were affected, notably in their ability to manage health care needs. While many sectors of public structures were impacted by the pandemic, it particularly highlighted shortcomings in medical care infrastructures around the world that underscored the need to reorganize medical systems, as they were vastly unprepared and ill-equipped to manage a pandemic and simultaneously provide general and specialized medical care. This paper presents modalities in approaches to the pandemic by various countries, and the triaged reorganization of medical sections not considered first-line in the pandemic that was in many cases transformed into wards for treating COVID-19 cases. As new viruses and structural variants emerge, it is important to find solutions to streamline medical care in hospitals, which includes the expansion of digital network medicine (i.e., telemedicine and mobile health apps) for patients to continue to receive appropriate care without risking exposure to contagions. Mobile health app development continues to evolve with specialized diagnostics capabilities via external attachments that can provide rapid information sharing between patients and care providers while eliminating the need for office visits. Telemedicine, still in the early stages of adoption, especially in the developing world, can ensure access to medical information and contact with care providers, with the potential to release emergency rooms from excessive cases, and offer multidisciplinary access for patients and care providers that can also be a means to avoid contact during a pandemic. As this pandemic illustrated, an overhaul to streamline health care is essential, and a move towards greater use of mobile health and telemedicine will greatly benefit public health to control the spread of new variants and future outbreaks.
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Affiliation(s)
- Roxana Filip
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- BK Laboratory, SuceavaCounty Emergency Hospital, 720224 Suceava, Romania
| | - Roxana Gheorghita Puscaselu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Liliana Anchidin-Norocel
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Mihai Dimian
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Department of Computers, Electronics and Automation, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Wesley K. Savage
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
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22
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Wang Q, Liu Z, Jiang P, Luo L. A stochastic programming model for emergency supplies pre-positioning, transshipment and procurement in a regional healthcare coalition. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 82:101279. [PMID: 35281569 PMCID: PMC8896868 DOI: 10.1016/j.seps.2022.101279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/24/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
A regional healthcare coalition enables its member hospitals to conduct an integrated emergency supply management, which is seldom addressed in the existing literature. In this work, we propose a two-stage stochastic emergency supply planning model to facilitate cooperation and coordination in a regional healthcare coalition. Our model integrates pre-disaster emergency supplies pre-positioning and post-disaster emergency supplies transshipment and procurement and considers two planning goals, i.e., minimizing the expected total cost and the maximum supply shortage rate. With some comparison models and a case study on the West China Hospital coalition of Sichuan Province, China, under the background of the COVID-19 epidemic, we demonstrate the effectiveness and benefits of our model and obtain various managerial insights and policy suggestions for practice. We highlight the importance of conducting integrated management of emergency supplies pre-positioning, transshipment and procurement in the regional healthcare coalition for better preparation and responding to future potential disasters.
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Affiliation(s)
- Qingyi Wang
- Business School, Sichuan University, Chengdu, 610064, China
| | - Zhuomeng Liu
- Business School, Sichuan University, Chengdu, 610064, China
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China
| | - Peng Jiang
- Business School, Sichuan University, Chengdu, 610064, China
| | - Li Luo
- Business School, Sichuan University, Chengdu, 610064, China
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23
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Marsilio M, Roldan ET, Salmasi L, Villa S. Operations management solutions to improve ED patient flows: evidence from the Italian NHS. BMC Health Serv Res 2022; 22:974. [PMID: 35908053 PMCID: PMC9338603 DOI: 10.1186/s12913-022-08339-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/11/2022] [Indexed: 11/26/2022] Open
Abstract
Background Overcrowding occurs when the identified need for emergency services outweighs the available resources in the emergency department (ED). Literature shows that ED overcrowding impacts the overall quality of the entire hospital production system, as confirmed by the recent COVID-19 pandemic. This study aims to identify the most relevant variables that cause ED overcrowding using the input-process-output model with the aim of providing managers and policy makers with useful hints for how to effectively redesign ED operations. Methods A mixed-method approach is used, blending qualitative inquiry with quantitative investigation in order to: i) identifying and operationalizing the main components of the model that can be addressed by hospital operation management teams and ii) testing and measuring how these components can influence ED LOS. Results With a dashboard of indicators developed following the input-process-output model, the analysis identifies the most significant variables that have an impact on ED overcrowding: the type (age and complexity) and volume of patients (input), the actual ED structural capacity (in terms of both people and technology) and the ED physician-to-nurse ratio (process), and the hospital discharging process (output). Conclusions The present paper represents an original contribution regarding two different aspects. First, this study combines different research methodologies with the aim of capturing relevant information that by relying on just one research method, may otherwise be missed. Second, this study adopts a hospitalwide approach, adding to our understanding of ED overcrowding, which has thus far focused mainly on single aspects of ED operations.
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Affiliation(s)
- Marta Marsilio
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, Milano, Italy.
| | - Eugenia Tomas Roldan
- CERISMAS (Research Centre in Health Care Management), Università Cattolica del Sacro Cuore, Milano, Italy
| | - Luca Salmasi
- Department of Economics and Finance, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefano Villa
- Department of Management, Università Cattolica del Sacro Cuore, Milano, Italy
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24
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Prasad VK, Bhattacharya P, Bhavsar M, Verma A, Tanwar S, Sharma G, Bokoro PN, Sharma R. ABV-CoViD: An Ensemble Forecasting Model to Predict Availability of Beds and Ventilators for COVID-19 Like Pandemics. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2022; 10:74131-74151. [PMID: 36345376 PMCID: PMC9423030 DOI: 10.1109/access.2022.3190497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/10/2022] [Indexed: 06/16/2023]
Abstract
Recently, healthcare stakeholders have orchestrated steps to strengthen and curb the COVID-19 wave. There has been a surge in vaccinations to curb the virus wave, but it is crucial to strengthen our healthcare resources to fight COVID-19 and like pandemics. Recent researchers have suggested effective forecasting models for COVID-19 transmission rate, spread, and the number of positive cases, but the focus on healthcare resources to meet the current spread is not discussed. Motivated from the gap, in this paper, we propose a scheme, ABV-CoViD (Availibility of Beds and Ventilators for COVID-19 patients), that forms an ensemble forecasting model to predict the availability of beds and ventilators (ABV) for the COVID-19 patients. The scheme considers a region-wise demarcation for the allotment of beds and ventilators (BV), termed resources, based on region-wise ABV and COVID-19 positive patients (inside the hospitals occupying the BV resource). We consider an integration of artificial neural network (ANN) and auto-regressive integrated neural network (ARIMA) model to address both the linear and non-linear dependencies. We also consider the effective wave spread of COVID-19 on external patients (not occupying the BV resources) through a [Formula: see text]- ARNN model, which gives us long-term complex dependencies of BV resources in the future time window. We have considered the COVID-19 healthcare dataset on 3 USA regions (Illinois, Michigan, and Indiana) for testing our ensemble forecasting scheme from January 2021 to May 2022. We evaluated our scheme in terms of statistical performance metrics and validated that ensemble methods have higher accuracy. In simulation, for linear modelling, we considered the [Formula: see text] model, and [Formula: see text] model for ANN modelling. We considered the [Formula: see text](12,6) forecasting. On a population of 2,93,90,897, the obtained mean absolute error (MAE) on average for 3 regions is 170.5514. The average root means square error (RMSE) of [Formula: see text]-ARNN is 333.18, with an accuracy of 98.876%, which shows the scheme's efficacy in ABV measurement over conventional and manual resource allocation schemes.
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Affiliation(s)
- Vivek Kumar Prasad
- Department of Computer Science and EngineeringInstitute of Technology, Nirma UniversityAhmedabadGujarat382481India
| | - Pronaya Bhattacharya
- Department of Computer Science and EngineeringInstitute of Technology, Nirma UniversityAhmedabadGujarat382481India
| | - Madhuri Bhavsar
- Department of Computer Science and EngineeringInstitute of Technology, Nirma UniversityAhmedabadGujarat382481India
| | - Ashwin Verma
- Department of Computer Science and EngineeringInstitute of Technology, Nirma UniversityAhmedabadGujarat382481India
| | - Sudeep Tanwar
- Department of Computer Science and EngineeringInstitute of Technology, Nirma UniversityAhmedabadGujarat382481India
| | - Gulshan Sharma
- Department of Electrical Engineering TechnologyUniversity of JohannesburgJohannesburgGauteng2006South Africa
| | - Pitshou N. Bokoro
- Department of Electrical Engineering TechnologyUniversity of JohannesburgJohannesburgGauteng2006South Africa
| | - Ravi Sharma
- Centre for Inter-Disciplinary Research and InnovationUniversity of Petroleum and Energy StudiesDehradun248001India
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25
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Analysis of Human Reliability in Fever Clinics during the Epidemic Based on the DEMATEL Method. JOURNAL OF ELECTRICAL AND COMPUTER ENGINEERING 2022. [DOI: 10.1155/2022/2351648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To explore the method and process of human reliability analysis in epidemic prevention and control system in the complex environment of fever clinics. Methods. Based on the actual situation in the fever clinic of a level A tertiary hospital in Wenzhou, factors that affect clinical safety are sorted out. The Delphi method is used when evaluating the interrelationship among the contributing factors, and then, the DEMATEL method is used to further sort it out to build an impact model. Finally, the data of the experimental model are analyzed, and the impact of factors on human reliability is summarized. Results. Through the data analysis of 23 factors in the fever clinic of the hospital, the impact, prominence, and relation of each factor are confirmed. It is concluded that layout design, disinfection, and isolation setting and on-the-job training are the core factors impacting the operation of the fever clinic. Conclusion. Conducting a human factor reliability analysis with the help of the DEMATEL method can quantitatively describe the influence and interrelationship of human factors in epidemic prevention and control system and effectively promote the safety enhancement of fever clinics.
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26
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Deveci M, Krishankumar R, Gokasar I, Tuna Deveci R. Prioritization of healthcare systems during pandemics using Cronbach's measure based fuzzy WASPAS approach. ANNALS OF OPERATIONS RESEARCH 2022; 328:1-29. [PMID: 35531560 PMCID: PMC9062871 DOI: 10.1007/s10479-022-04714-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 05/04/2023]
Abstract
Pandemics are well-known as epidemics that spread globally and cause many illnesses and mortality. Because of globalization, the accelerated occurrence and circulation of new microbes, the infection has emerged and the incidence and movement of new microbes have sped up. Using technological devices to minimize the visit durations, specifying days for handling chronic diseases, subsidy for the staff are the alternatives that can help prevent healthcare systems from collapsing during pandemics. The study aims to define the efficient usage of optimization tools during pandemics to prevent healthcare systems from collapsing. In this study, a new integrated framework with fuzzy information is developed, which attempts to prioritize these alternatives for policymakers. First, rating data are assigned respective fuzzy values using the standard singleton grades. Later, criteria weights are determined by extending Cronbach´s measure to fuzzy context. The measure not only understands data consistency comprehensively, but also takes into consideration the attitudinal characteristics of experts. By this approach, a rational weight vector is obtained for decision-making. Further, an improved Weighted Aggregated Sum Product Assessment (WASPAS) algorithm is put forward for ranking alternatives, which is flexibly considering criteria along with personalized ordering and holistic ordering alternatives. The usefulness of the developed framework is tested with the help of a real case study. Rank values of alternatives when unbiased weights are used is given by 0.741, 0.582, 0.640 with ordering asR 1 ≻ R 3 ≻ R 2 . The sensitivity/comparative analysis reveals the impact of the proposed model as useful in selecting the best alternative for the healthcare systems during pandemics.
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Affiliation(s)
- Muhammet Deveci
- Department of Industrial Engineering, Turkish Naval Academy, National Defence University, 34940 Tuzla, Istanbul, Turkey
- Royal School of Mines, Imperial College London, London, SW7 2AZ UK
| | - Raghunathan Krishankumar
- Department of Computer Science and Engineeering, Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore, TN India
| | - Ilgin Gokasar
- Department of Civil Engineering, Bogazici University, 34342 Bebek, Istanbul, Turkey
| | - Rumeysa Tuna Deveci
- Department of Pediatric Hematology-Oncology, Faculty of Medicine, Istanbul University, 34093 Topkapı, Istanbul, Turkey
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27
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Burns SP, Fleming TK, Webb SS, Kam ASH, Fielder JDP, Kim GJ, Hu X, Hill MT, Kringle EA. Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation. Arch Phys Med Rehabil 2022; 103:1874-1882. [PMID: 35533736 PMCID: PMC9072806 DOI: 10.1016/j.apmr.2022.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 12/02/2022]
Abstract
Health care delivery shifted and adapted with the COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus 2. Stroke care was negatively affected across the care continuum and may lead to poor community living outcomes in those who survived a stroke during the ongoing pandemic. For instance, delays in seeking care, changes in length of stays, and shifts in discharge patterns were observed during the pandemic. Those seeking care were younger and had more severe neurologic effects from stroke. Increased strain was placed on caregivers and public health efforts, and community-wide lockdowns, albeit necessary to reduce the spread of COVID-19, had detrimental effects on treatment and recommendations to support community living outcomes. The American Congress of Rehabilitation Medicine Stroke Interdisciplinary Special Interest Group Health and Wellness Task Force convened to (1) discuss international experiences in stroke care and rehabilitation and (2) review recently published literature on stroke care and outcomes during the pandemic. Based on the findings in the literature, the task force proposes recommendations and interdisciplinary approaches at the (1) institutional and societal level; (2) health care delivery level; and (3) individual and interpersonal level spanning across the care continuum and into the community.
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Affiliation(s)
- Suzanne Perea Burns
- Division of Occupational Therapy, University of New Mexico School of Medicine, Albuquerque, New Mexico.
| | - Talya K Fleming
- JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, New Jersey
| | - Sam S Webb
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Alice Sau Han Kam
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada
| | | | - Grace J Kim
- Department of Occupational Therapy, New York University, New York City, New York; Department of Rehabilitation Medicine, NYU Langone Health, New York City, New York
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Mary Thelander Hill
- Division of Occupational Therapy, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Emily A Kringle
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
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28
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Zaki A, Soomar SM, Khan DH, Shaharyar Sheikh H, Iftikhar R, Mir A, Aziz Z, Bano K, Naseer H, Chaudhry QU, Bokhari SWI, Shabbir-Moosajee M. “Outcomes of COVID-19 infection in patients with hematological malignancies- A multicenter analysis from Pakistan”. PLoS One 2022; 17:e0267139. [PMID: 35446898 PMCID: PMC9022796 DOI: 10.1371/journal.pone.0267139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/01/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose COVID-19 infection resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to spread across the globe in early 2020. Patients with hematologic malignancies are supposed to have an increased risk of mortality from coronavirus disease of 2019 (COVID-19) infection. From Pakistan, we report the analysis of the outcome and interaction between patient demographics and tumor subtype and COVID-19 infection and hematological malignancy. Patients and methods This multicenter, retrospective study included adult patients with a history of histologically proven hematological malignancies who were tested positive for COVID-19 via PCR presented at the oncology department of 5 tertiary care hospitals in Pakistan from February to August 2020. A patient with any known hematological malignancy who was positive for COVID-19 on RT-PCR, was included in the study. Chi-square test and Cox-regression hazard regression model was applied considering p ≤ 0.05 significant. Results A total of 107 patients with hematological malignancies were diagnosed with COVID-19, out of which 82 (76.64%) were alive, and 25 (23.36%) were dead. The significant hematological malignancy was B-cell Lymphoma in dead 4 (16.00%) and alive group 21 (25.61%), respectively. The majority of the patients in both the dead and alive group were on active treatment for hematological malignancy while they came positive for COVID-19 [21 (84.00%) & 48 (58.54%) p 0.020]. All patients in the dead group were admitted to the hospital 25 (100.00%), and among these, 14 (56.00%) were admitted in ICU with a median 11 (6–16.5) number of days. Among those who had contact exposure, the hazard of survival or death in patients with hematological malignancies and COVID-19 positive was 2.18 (CI: 1.90–4.44) times and 3.10 (CI: 2.73–4.60) times in patients with travel history compared to no exposure history (p 0.001). Conclusion Taken together, this data supports the emerging consensus that patients with hematologic malignancies experience significant morbidity and mortality resulting from COVID-19 infection.
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Affiliation(s)
- Adeeba Zaki
- Aga Khan University Hospital, Karachi, Pakistan
- Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan
- * E-mail:
| | - Salman Muhammad Soomar
- Aga Khan University Hospital, Karachi, Pakistan
- Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Danish Hasan Khan
- Hangzhou Tigermed, Karachi, Pakistan
- Clinical Project Manager (CPM Pakistan), Hangzhou Tigermed, Karachi, Pakistan
| | - Hasan Shaharyar Sheikh
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Consultant Medical Oncologist, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Raheel Iftikhar
- Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan
| | - Ayaz Mir
- Shifa International Hospital, Islamabad, Pakistan
- Bone Marrow & Stem Cell Transplant, Shifa International Hospital, Karachi, Pakistan
| | - Zeba Aziz
- Hameed Latif Hospital, Lahore, Pakistan
- Medical Oncologist, Hammed Latif Hospital, Lahore, Pakistan
| | - Khadija Bano
- Shifa International Hospital, Islamabad, Pakistan
- Fellow Clinical Hematology Shifa International Hospital, Islamabad, Pakistan
| | - Hafsa Naseer
- Hameed Latif Hospital, Lahore, Pakistan
- Postgraduate Resident, Hameed Latif Hospital, Lahore, Pakistan
| | | | - Syed Waqas Imam Bokhari
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Medical Oncologist, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Munira Shabbir-Moosajee
- Aga Khan University Hospital, Karachi, Pakistan
- Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan
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29
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Resilience development and digitalization of the healthcare supply chain: an exploratory study in emerging economies. INTERNATIONAL JOURNAL OF LOGISTICS MANAGEMENT 2022. [DOI: 10.1108/ijlm-09-2021-0438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeHealthcare supply chains (HSCs) have been adopting Industry 4.0 (I4.0) as a means to boost their resilience. The first objective of this study is to identify the effect of contextual variables of HSCs on resilience development and I4.0 adoption. Second, the paper examines the pervasiveness of the relationship between resilience and I4.0 across different contextual characteristics.Design/methodology/approach179 organizations from the HSC in Brazil and India were surveyed. Responses were analyzed using multivariate data techniques.FindingsLarge HSC agents are more likely to develop resilience abilities and adopt I4.0 technologies when these factors are analyzed independently. However, the joint analysis of resilience and I4.0 displayed a large number of significant correlations among small organizations.Originality/valueFindings provide managers of HSC arguments to enhance resilience through the digitalization. HSC organizations can identify HSC organizations' context to tailor initiatives on resilience and digitalization.
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Gada V, Shegaonkar M, Inamdar M, Dinesh S, Sapariya D, Konde V, Warang M, Mehendale N. Data Analysis of COVID-19 Hospital Records Using Contextual Patient Classification System. ANNALS OF DATA SCIENCE 2022; 9:945-965. [PMID: 38624787 PMCID: PMC8939496 DOI: 10.1007/s40745-022-00378-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/01/2021] [Accepted: 02/19/2022] [Indexed: 12/18/2022]
Abstract
Humanity today is suffering from one of the most dangerous pandemics in history, the Coronavirus Disease of 2019 (COVID-19). Although today there is immense advancement in the medical field with the latest technology, the COVID-19 pandemic has affected us severely. The virus is spreading rapidly, resulting in an escalation in the number of patients admitted. We propose a contextual patient classification system for better analysis of the data from the discharge summary available from the research hospital. The classification was done using the Knuth-Morris-Pratt algorithm. We have also analyzed the data of COVID-19 and non-COVID-19 patients. During the analysis, studies on the medicines, medical services and tests, pulse count, body temperature, and the overall effect of age and gender was done. The death versus survival ratio for the COVID-19 positive patients has also been studied. The classification accuracy of the contextual patient classification system achieved was 97.4%. The combination of data analysis and contextual patient classification will be helpful to all the sectors to be better prepared for any future waves of the COVID-19 pandemic.
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Affiliation(s)
- Vrushabh Gada
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
| | | | - Madhura Inamdar
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
| | - Sharath Dinesh
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
| | - Darshan Sapariya
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
| | - Vedant Konde
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
| | - Mahesh Warang
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
| | - Ninad Mehendale
- K. J. Somaiya College of Engineering, Mumbai, Maharashtra 400077 India
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O’Neal HR, Sheybani R, Caffery TS, Hamer D, Laperouse LM, Musso MW, O’Neal CS, Tse HTK, Shah AM, Thomas CB. Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting. PLoS One 2022; 17:e0264220. [PMID: 35294441 PMCID: PMC8926179 DOI: 10.1371/journal.pone.0264220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/04/2022] [Indexed: 01/08/2023] Open
Abstract
Objective Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic. Methods An observational single-center study of prospective cohort of patients presenting to the ED during the early COVID-19 pandemic with respiratory symptoms and a CBC drawn within 4.5 hours of initial vital signs. A sample of this blood was aliquoted for performance of the ISI, and patients were followed for clinical outcomes. The study required no patient-centered activity beyond standard of care and treating clinicians were unaware of study enrollment and ISI test results. Main findings 282 patients were included. The ISI ranges 0.1 to 10.0, with three interpretation bands indicating risk of adverse outcome: low (green), 0.1–4.9; intermediate (yellow), 5.0–6.2; and high (red), 6.3–10.0. Of 193 (68.4%) tested for SARS-CoV-2, 96 (49.7%) were positive. The ISI resulted in 182 (64.5%) green, 54 (18.1%) yellow, and 46 (15.6%) red band patients. Green band patients had a 1.1% (n = 2) 3-day mortality, while yellow and red band had 3.7% (n = 2, p > .05) and 10.9% (n = 5, p < .05) 3-day mortalities, respectively. Fewer green band patients required admission (96 [52.7%]) vs yellow (44 [81.5%]) and red (43 [93.5%]). Green band patients had more hospital free days (median 23 (Q1-Q3 20–25) than yellow (median 22 [Q1-Q3 0–23], p < 0.05) and red (median 21 [Q1-Q3 0–24], p < 0.01). SOFA increased with interpretation band: green (2, [Q1-Q3 0–4]) vs yellow (4, [Q1-Q3 2–5], p < 0.001) and red (5, [Q1-Q3 3–6]) p < 0.001). Conclusions The ISI rapidly risk-stratifies patients presenting to the ED during the early COVID-19 pandemic with signs or suspicion of respiratory infection.
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Affiliation(s)
- Hollis R. O’Neal
- Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
| | - Roya Sheybani
- Cytovale, Inc., San Francisco, California, United States of America
- * E-mail:
| | - Terrell S. Caffery
- Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
| | - Diana Hamer
- Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
| | - L. Mark Laperouse
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
| | - Mandi W. Musso
- Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
| | - Catherine S. O’Neal
- Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
| | - Henry T. K. Tse
- Cytovale, Inc., San Francisco, California, United States of America
| | - Ajay M. Shah
- Cytovale, Inc., San Francisco, California, United States of America
| | - Christopher B. Thomas
- Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America
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Jmaa MB, Ayed HB, Kassis M, Hmida MB, Trigui M, Maamri H, Ketata N, Yaich S, Trabelsi J, Mejdoub Y, Turki M, Marrakchi C, Kammoun S, Jemaa MB, Feki H, Damak J. Epidemiological profile and performance of triage decision-making process of COVID-19 suspected cases in southern Tunisia. Afr J Emerg Med 2022; 12:1-6. [PMID: 34751240 PMCID: PMC8566344 DOI: 10.1016/j.afjem.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 09/03/2021] [Accepted: 10/09/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction During an epidemic, screening processes can play a crucial role in limiting the spread of the infection. The aim of this study was to describe the epidemiological profile of COVID-19 suspected cases and to evaluate the performance of the triage process in predicting COVID-19 in Southern Tunisia. Methods It was a prospective study including all patients consulting to the Hedi Chaker University Hospital departments from March to June 2020. A clinical triage score (CTS) was used to assess the risk of the infection and to refer patients to the appropriate part of the facility accordingly. Results Overall, 862 patients were enrolled, among whom 505 patients (58.6%) were classified as suspected cases (CTS ≥4). Of these, 46.9% (n = 237) were of mild form. Samples were collected from 215 patients (24.9%), among whom five were COVID-19 positive, representing a positive rate of 2.3%. The in-hospital cumulative incidence rate of COVID-19 was 580/100000 patients. The total daily incidence decreased significantly during the study period (p < 0.001, chi-square for linear trend = 25.6). At a cut-off of four, the CTS had a sensitivity of 40%, a specificity of 32.4%, and negative and positive predictive values of 95.8% and 1.4%, respectively. Discussion Although the triage process based on the CTS was not as performant as the RT-PCR, it was crucial to interrupt virus spread among hospitalized patients in “COVID-19-free departments”.
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Aminoff SR, Mork E, Barrett EA, Simonsen C, ten Velden Hegelstad W, Lagerberg TV, Melle I, Romm KL. Locked out during COVID-19 lockdown—an online survey of relatives of people with psychotic and bipolar disorders in Norway. BMC Public Health 2022; 22:294. [PMID: 35151293 PMCID: PMC8841121 DOI: 10.1186/s12889-022-12625-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many relatives of people with psychotic and bipolar disorders experience a high caregiver burden normally. During the first COVID-19 lockdown, mental health services partly shut down in many countries. The impact on relatives is unknown. Aims Explore how relatives of people with psychotic and bipolar disorders experienced changes in treatment and service availability for their family member during the first COVID-19 pandemic lockdown in the spring of 2020, and to what extent they perceived information and support to be satisfactory. To help guide future contingency plans, we were also interested in what relatives would prioritize in the event of a future crisis. Study setting We distributed an anonymous Norwegian online survey inviting relatives of individuals with psychotic and bipolar disorders. We distributed the survey using social media, through snowball sampling, collecting both quantitative and qualitative data. The survey was available between May and June 2020. We used systematic text condensation to analyse qualitative data. Results Two hundred and seventy-nine respondents replied, mostly mothers and partners. A majority experienced a reduction in health care for their family member. Most respondents did not receive any support during the lockdown. However, most found the information they received from the mental health services regarding their family members’ treatment as sufficient. The qualitative data analysis revealed that relatives experienced three major challenges: reductions in treatment for the family member; reduced organised daily activity for the family member; and an increased caretaker load. In the case of a future lockdown, they would prefer increased access to care compared with a normal situation; increased support for relatives; and enhanced information. Conclusions Mental health services in Norway did not manage to meet the needs of patients with severe mental illness and their relatives during the first COVID-19 lockdown. To be better prepared, Norwegian mental health services should consider prioritising infrastructure to ensure access to care and support for both patients and relatives. Digital tools and telephone calls are generally well accepted as substitutes for face-to-face contact. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12625-y.
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Evaluación de los planes de contingencia en la atención a pacientes en unidades de cuidados intensivos en la pandemia COVID-19. J Healthc Qual Res 2022; 37:291-298. [PMID: 35249860 PMCID: PMC8825313 DOI: 10.1016/j.jhqr.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022]
Abstract
Introducción La expansión de las áreas de cuidados de intensivos ha sido una de las medidas más significativas en esa obligada adaptación a la evolución de las distintas fases de la pandemia por la COVID-19. El objetivo es evaluar el despliegue de los planes de contingencia en la atención a pacientes ingresados en Unidades de Cuidados Intensivos (UCI) durante el periodo del 19 de marzo al 20 de abril de 2020, en un hospital público, referencia para 300.000 habitantes, perteneciente al Servicio Galego de Saúde. Materiales y métodos Investigación cualitativa a partir de grupos focales, con muestreo sistemático. A partir de la adaptación al entorno sanitario de las 10 medidas recomendadas por Deloitte para afrontar una pandemia, se realizó una evaluación por la Unidad de Calidad del Área Sanitaria. Como indicadores de resultados, se evaluaron el número de pacientes con COVID-19, porcentaje de pacientes con ingreso hospitalario, % de pacientes con ingreso en UCI, así como el número de fallecidos por COVID-19, en siete áreas sanitarias en el periodo del 19 marzo al 20 de abril de 2020. Resultados La evaluación cualitativa identificó dos áreas de mejora (comunicación y evaluación de riesgos) de las 10 medidas recomendadas (80%). El área sanitaria presenta la menor tasa relativa (2,6%) y absoluta (16) de pacientes fallecidos, así como la menor tasa relativa (7,9%) y absoluta (24) de pacientes ingresados en servicios de intensivos por COVID-19. La tasa de infección en profesionales ha sido de 4,4%. Conclusiones La simplicidad e identificación de áreas de mejora sumado al escaso consumo de recursos son fortalezas de esta propuesta. Esta autoevaluación puede ser útil para detectar áreas de mejora.
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Alishan S, Ali F, Iqbal Z, Ammar A, Muhammad AS, Farooq F, Mir A, Salahuddin N, Saghir T, Karim M. Home Management of COVID-19 Patients: A Successful Model in Non-severe COVID-19 Patients in the Developing World. Cureus 2022; 14:e21605. [PMID: 35228963 PMCID: PMC8870052 DOI: 10.7759/cureus.21605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 01/10/2023] Open
Abstract
Background Around 80-85% of coronavirus disease 2019 (COVID-19) cases were reported to have mild disease and home treatment of such patients was proved to be effective without significant morbidity or mortality. Therefore, the aim of this study was to assess the outcome of home management of non-severe COVID-19 infection in healthcare providers in the developing world. Methods This observational cohort study was conducted at the National Institute of Cardiovascular Diseases from June 2020 till January 2021. It included health care workers who tested positive for COVID-19 with non-severe infection and received home treatment. The COVID-19 management team monitored their symptoms and oxygen saturation over the phone. Need-based lab tests, X-rays, home proning, steroids, and oxygen were administered along with the standard intuitional management strategies. Study outcomes included duration of recovery, need for hospitalization, and expiry. Results A total of 128 patients were included, out of which 98 (76.6%) were male, and the mean age was 32.9 ± 5.9 years. Fever was the most common symptom, seen in 89.8% of patients. Most of the patients (85.9%) had no pre-existing comorbidities. Five patients received home oxygen therapy, seven received steroid therapy, and one received home pruning. The average time of recovery was 13.8 ± 8.1 days with no mortality; however, 14 (10.9%) patients were hospitalized due to worsening of symptoms. Conclusion Home treatment for COVID-19 patients with mild to moderate disease after appropriate risk assessment can be a safe and effective option to preserve hospital capacities for more needy and severely ill patients.
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Cushman DM, Teramoto M, Babu A, Olafsen N, Onishi K, Asay A, McCormick ZL. Sports Medicine Physician Decision-Making, Practice Changes, and Mental Health During the Early Phase of the SARS-CoV-2 Global Pandemic. Clin J Sport Med 2022; 32:28-39. [PMID: 33675623 PMCID: PMC8663923 DOI: 10.1097/jsm.0000000000000905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/12/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The SARS-CoV-2 pandemic has had a profound effect on the healthcare system. This study aimed to identify its effects on sports medicine physicians during the early phase of this pandemic. DESIGN Survey study. SETTING Sports medicine providers. PARTICIPANTS Physician members of the American Medical Society for Sports Medicine were surveyed between March 25 and April 4, 2020. A total of 810 responses were obtained from 2437 physicians who viewed the survey. INTERVENTIONS The survey consisted of questions examining demographics, prepandemic practice patterns, anxiety and depression screening, and new beliefs and behaviors following government-based medical policy changes resulting from the pandemic. MAIN OUTCOME MEASURES Changes in clinical volume and treatment practices, Patient Health Questionnaire (PHQ-4). RESULTS The mean in-person clinic visits reduced to 17.9%, telephone visits to 24.4%, telemedicine (video) visits to 21.8%, and procedural visits to 13.8% of prepandemic practice volume. The mean PHQ-4 scores for physicians were 2.38 ± 2.40. Clinic and procedural volumes were reduced less by male physicians, as well as more experienced physicians, nonphysical medicine and rehabilitation training background, in government or private practice, and in the Southern region of the United States (P < 0.05). Physicians were more likely to reduce their anti-inflammatory (37.8% decreasing vs 6.8% increasing, P < 0.001) and opioid (10.5% vs 6.8%, P = 0.003) prescriptions rather than increase. CONCLUSIONS During the early phase of the SARS-COV-2 pandemic sports medicine physicians reported reducing in-person evaluation, management, and procedure volume by over 80%. Multiple demographic and geographic factors were associated with practice volume changes.
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Affiliation(s)
- Daniel M Cushman
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah
| | - Masaru Teramoto
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah
| | - Ashwin Babu
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Sports Medicine Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nathan Olafsen
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Kentaro Onishi
- Department of Physical Medicine & Rehabilitation, Department of Orthopedics, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Alexandra Asay
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | - Zachary L McCormick
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah
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Li S, Chai R, Wang Y, Wang J, Dong X, Xu H, Wu H, Binnay IT, Liu Z. A survey of mental health status of obstetric nurses during the novel coronavirus pneumonia pandemic. Medicine (Baltimore) 2021; 100:e28070. [PMID: 34967352 PMCID: PMC8718244 DOI: 10.1097/md.0000000000028070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023] Open
Abstract
To investigate the mental health status of obstetric nurses and its influencing factors during the novel coronavirus epidemic period, so as to provide theoretical reference for hospital decision-makers and managers.From February 25 to March 20, 2020, we conducted a cross-sectional survey through online questionnaire, and selected obstetric nurses from Jilin and Heilongjiang Provinces as the research objects by convenience sampling.Three hundred eighteen valid questionnaires were collected; the results of Symptom Checklist 90 showed that the scores of "obsessive-compulsive", "depression", "anxiety", "hostility", "phobia", and "psychosis" were higher than the Chinese norm (P < .01). There were 107 people whose total score of Symptom Checklist 90 was more than 160, and 83 people whose number of positive items was more than 43. Logistic regression results showed that married, temporary employment, lack of support and communication from family and relatives, onerous task, and unbearable responsibility were independent risk factors for mental disorder.There is a great psychological burden for obstetric nurses during the epidemic period. Decision makers should focus on necessary psychological intervention for those that are married, temporarily employed, and those lacking family supports including communication. At the same time, managers should distribute tasks reasonably to avoid psychological burdens caused by overwork.
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Affiliation(s)
- Shuyue Li
- Changchun Maternity Hospital, Changchun, Jilin, China
| | - Ruiyu Chai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yingshuang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinxin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Han Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Huiyan Wu
- The First Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Isaac T.S. Binnay
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhigang Liu
- Department of Pain Management, The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, Jilin, China
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Sharmin A, Rahman MA, Ahmed S, Ali SM. Addressing critical success factors for improving concurrent emergency management: lessons learned from the COVID-19 pandemic. ANNALS OF OPERATIONS RESEARCH 2021:1-35. [PMID: 34876767 PMCID: PMC8639410 DOI: 10.1007/s10479-021-04447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
The world is witnessing a difficult time trying to circumscribe the spread of COVID-19 pandemic. The situation has become even more challenging as several natural disasters and emergencies coincided with this pandemic and created a situation of concurrent emergency. Effectively managing concurrent emergencies are extremely challenging. Only by utilizing and applying the knowledge gathered while combating a real-life concurrent emergency, one can further be prepared to face such emergencies. Hence, this study intends to identify the critical success factors (CSFs) having a major role in effective management of concurrent emergencies and evaluate the indispensable links among the factors. Twelve CSFs are identified from Pareto analysis, for which feedback from 46 experts involved in the management of emergencies is utilized. In addition, the revised rough-decision making trial and evaluation laboratory (rough-DEMATEL) approach is suggested to analyze the indispensable links among the CSFs and further, these factors are ranked based on the average vector length. The recent case of concurrent emergency in Bangladesh- floods amid a pandemic is considered to establish the applicability of this method. The findings of this research reveal that to handle concurrent emergencies 'Incremental improvement of proactive measures', 'Resilient supply chain and logistics network', and 'Government leadership and military cooperation' are the most critical factors to concurrent emergency management (CEM). These CSFs play a major role in ensuring the effectiveness of CEM. Thus, this study can be a building block in developing an effective CEM plan for the policymakers, managers, and practitioners.
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Affiliation(s)
- Aliza Sharmin
- Department of Mechanical and Production Engineering, Ahsanullah University of Science and Technology, Dhaka, 1208 Bangladesh
| | - Md Adib Rahman
- Department of Mechanical and Production Engineering, Ahsanullah University of Science and Technology, Dhaka, 1208 Bangladesh
| | - Sayem Ahmed
- Department of Mechanical and Production Engineering, Ahsanullah University of Science and Technology, Dhaka, 1208 Bangladesh
| | - Syed Mithun Ali
- Department of Industrial and Production Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1000 Bangladesh
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The Impact of COVID-19 on Levels of Adherence to the Completion of Nursing Records for Inpatients in Isolation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111262. [PMID: 34769780 PMCID: PMC8583626 DOI: 10.3390/ijerph182111262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. AIM To describe the impact of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing pressure ulcers, falling, and social vulnerability among hospitalised patients in isolation. METHODS Observational pre-post comparison study. Comparison between nursing records (the Braden, Downton, and Gijón scales) belonging to 1205 inpatients took place in two phases. Phase 1: 568 patients admitted in February 2020, prior to the COVID-19 pandemic, vs. phase 2: 637 patients hospitalised with COVID-19 in March-April 2020, during the peak of the first wave of the pandemic. This research adheres to the STROBE guidelines for the reporting of observational studies. RESULTS The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 vs. phase 1 (p < 0.001). The mean Downton and Gijón scale scores for patients admitted in phase 1 were higher compared to those of patients admitted in phase 2 (p < 0.001). The mean Braden scale score in phase 2 was higher than in phase 1 (p < 0.05). CONCLUSION During the COVID-19 pandemic, there was a decrease in the completion of nursing records in the clinical records of patients in isolation. The levels of risk of developing PUs, falling, and social vulnerability of patients admitted to hospital were lower during the first wave of the pandemic.
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Zhao S, Duan X, Cheng L, Jiang J. Perspective and experience of newly graduated registered nurses with standardized training in the emergency department: A qualitative study in Shanghai, China. NURSE EDUCATION TODAY 2021; 105:104994. [PMID: 34174510 DOI: 10.1016/j.nedt.2021.104994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/05/2021] [Accepted: 05/25/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The standardized training system for newly graduated registered nurses (NGRNs) in China is different from that of other countries in the world, especially when frequent disasters occur, emergency department (ED) training is particularly important. However, the work experience of new Chinese nurses in standardized training in the emergency department still remained unclear. OBJECTIVES To explore the experience of newly recruited nurses in standardized training in the emergency department. DESIGN Qualitative research. SETTING A 3rd level hospital in Shanghai, China. PARTICIPANTS Fifteen NGRNs undergoing standardized training in the ED. METHODS Semi-structured face-to-face interviews were conducted between August and September 2020. Colaizzi seven-step framework was applied for data analysis. RESULTS Three main themes emerged: high occupational pressure, competency enhancement in ED and high satisfaction with standard training. CONCLUSIONS It is very important and necessary for NGRNs to have a training period in the emergency department. This not only helps NGRNs to improve their abilities in emergency care, but also reserve talents during emergency responses. At the same time, the training methods for NGRNs should be refined and improved, and effective support should be provided. This can help NGRNs relieve from work pressure, better and rapidly adapt to the clinical environment and enter the nursing role.
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Affiliation(s)
- Sijia Zhao
- Emergency Department, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Xia Duan
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200126, China
| | - Lin Cheng
- Emergency Department, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Jinxia Jiang
- Emergency Department, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
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Organization of a Hospital Ward Aimed at Admitting Patients with SARS-CoV-2: An Economic and Epidemiological Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189446. [PMID: 34574370 PMCID: PMC8469759 DOI: 10.3390/ijerph18189446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
The SARS-CoV-2 epidemic requires dynamic action on the part of the entire health care system to provide infected patients whose condition requires hospitalization with access to appropriate medical care and infrastructure, including oxygen devices and ventilators. The demand for specialized inpatient care has increased rapidly and in many areas exceeds the resources available to date. Individual hospitals must make investment and organizational decisions to increase their capacity to handle patients with SARS-CoV-2. The aim of the article is to present the organizational and investment steps taken to establish and maintain an infectious hospital ward as well as the clinical and financial consequences of this decision. The study was conducted in a hospital ward that was launched at the end of October 2020 to care for patients with SARS-CoV-2. A case study method was used. The department was characterized taking into account its importance for: (1) the regional level of health coverage of the population, (2) the organization of the hospital's activities, (3) the financial and economic situation of the hospital.
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[Impact of COVID-19 on oncological surgery of the upper gastrointestinal tract]. Chirurg 2021; 92:929-935. [PMID: 34448904 PMCID: PMC8391856 DOI: 10.1007/s00104-021-01489-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND The outbreak of the coronavirus disease 2019 (COVID-19) pandemic imposed limitations for elective surgery, impacting the associated hospital standards worldwide. As certain treatment windows must be adhered to in oncological surgery, the limited intensive care unit (ICU) capacity had to be critically distributed in order to do justice to both acutely ill and oncology patients. This manuscript summarizes the impact of COVID-19 on the management of oncological surgery of the upper gastrointestinal tract and particularly esophageal surgery in German medical centers. MATERIAL AND METHODS A survey of German centers for esophageal surgery was performed on the impact of COVID-19 on operative management for esophageal surgery during the first lockdown. After inspection, assessment, critical analysis and interpretation, the results were compared to the international literature. RESULTS AND DISCUSSION Initial recommendations of international societies warned for caution and restraint regarding interventions of the upper gastrointestinal tract that were not absolutely necessary. Oncological surgery should be performed under strict restrictions, especially only after negative testing for COVID-19 and only with sufficiently available personal protective equipment for the personnel. Furthermore, minimally invasive procedures were preferably not recommended. In diseases with alternative treatment options, such as definitive chemoradiotherapy of esophageal squamous cell carcinoma, these should be given priority when possible. In the further development of the pandemic, it was shown that due to a high standardization of preoperative management, postoperative results comparable to pre-pandemic times could be achieved particularly with respect to the diagnostics of infections.
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Mosallanezhad B, Chouhan VK, Paydar MM, Hajiaghaei-Keshteli M. Disaster relief supply chain design for personal protection equipment during the COVID-19 pandemic. Appl Soft Comput 2021; 112:107809. [PMID: 34421442 PMCID: PMC8372451 DOI: 10.1016/j.asoc.2021.107809] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 12/23/2022]
Abstract
The global epidemic caused by novel coronavirus continues to be a crisis in the world and a matter of concern. The way the epidemic has wreaked havoc on the international level has become difficult for the healthcare systems to supply adequately personal protection equipment for medical personnel all over the globe. In this paper, considering the COVID-19 outbreak, a multi-objective, multi-product, and multi-period model for the personal protection equipment demands satisfaction aiming to optimize total cost and shortage, simultaneously, is developed. The model is embedded with instances and validated by both modern and classic multi-objective metaheuristic algorithms. Moreover, the Taguchi method is exploited to set the metaheuristic into their best performances by finding their parameters’ optimum level. Furthermore, fifteen test examples are designed to prove the established PPE supply chain model and tuned algorithms’ applicability. Among the test examples, one is related to a real case study in Iran. Finally, metaheuristics are evaluated by a series of related metrics through different statistical analyses. It can be concluded from the obtained results that solution methods are practical and valuable to achieve the efficient shortage level and cost.
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Affiliation(s)
| | - Vivek Kumar Chouhan
- Department of Mechanical Engineering, Indian Institute of Information Technology, Design and Manufacturing, Kancheepuram, Chennai, India
| | - Mohammad Mahdi Paydar
- Department of Industrial Engineering, Babol Noshirvani University of Technology, Babol, Iran
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Mokhtari R, Safdari A, Hekmatpou D, Sahebi A, Moayedi S, Torres M, Golitaleb M. Investigating the Effective Factors of Using Personal Protective Equipment from the Perspective of Nurses Caring for COVID-19 Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157882. [PMID: 34360175 PMCID: PMC8345363 DOI: 10.3390/ijerph18157882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022]
Abstract
Considering the importance of appropriate personal protective equipment (PPE) for preventing COVID-19 transmission, the aim of this study was to investigate the factors affecting the use of PPE from the perspective of the nurses caring for COVID-19 patients. This descriptive cross-sectional study surveyed 240 nurses working in the central COVID-19 hospitals of Arak, Iran. Nurses were enrolled in the study by a convenience sampling method. The data collection tool was a validated questionnaire. Data were analyzed by SPSS 16 software using descriptive statistics, analysis of variance (ANOVA), and independent sample t-test. Environmental (4.24 ± 0.45), personal (4.16 ± 0.42), and organizational (4.04 ± 0.50) factors all contribute significantly to nursing attitudes about PPE use (p < 0.05). The average score, combining all identified factors, was 4.15 ± 0.31. The most influential factor contributing to appropriate use of PPE was environmental, while the least impactful parameters were related to rules and regulations. Environmental factors have the greatest impact on the use of PPE from the perspective of the nurses caring for patients with COVID-19. Managers and healthcare organizations should provide appropriate and adequate PPE to nurses, educate them on proper use, and monitor the process to resolve barriers.
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Affiliation(s)
- Razieh Mokhtari
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak 3819693345, Iran; (R.M.); (D.H.)
| | - Ali Safdari
- Student Research Committee, Arak University of Medical Sciences, Arak 3819693345, Iran;
| | - Davood Hekmatpou
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak 3819693345, Iran; (R.M.); (D.H.)
| | - Ali Sahebi
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam 6931851147, Iran;
| | - Siamak Moayedi
- Department of Emergency Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.M.); (M.T.)
| | - Mercedes Torres
- Department of Emergency Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.M.); (M.T.)
| | - Mohamad Golitaleb
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak 3819693345, Iran; (R.M.); (D.H.)
- Correspondence: or ; Tel.: +98-93-7936-6279
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Richmond JG, Tochkin J, Hertelendy AJ. Canadian health emergency management professionals' perspectives on the prevalence and effectiveness of disaster preparedness activities in response to COVID-19. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2021; 60:102325. [PMID: 36570631 PMCID: PMC9764162 DOI: 10.1016/j.ijdrr.2021.102325] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 06/17/2023]
Abstract
Emergency management (EM) professionals play an integral role in preparing healthcare organizations for disasters but evidence of their pervasiveness in Canadian healthcare is limited. Through an exploratory Canada-wide survey of EM in healthcare organizations, we aim to develop understanding of the prevalence and effectiveness of the disaster preparedness activities enacted in preparation for COVID-19. The online survey generated 161 responses; 150 (93%) had EM responsibility. EM reported that reviewing infectious disease (pandemic) plans and protocols was the most widespread activity (82%), while simulation-based exercises was the least (26%). Organizational incident management response to COVID-19 was led by a sole 'incident commander' 61% of the time, while 39% of 'incident commands' were led by multiple individuals. Of all those assigned to lead IM, only 68% received training in that role. Overall, the prevalence of disaster preparedness activities in healthcare organizations was positively associated with leaders who received training in incident response and having a dedicated EM resource. Meanwhile, the overall effectiveness of activities was positively correlated with having a sole 'incident commander' and was found to improve as the overall prevalence of activities rose. The study provides strong evidence for regional, organizational, and EM resource variation in the delivery of disaster preparedness activities and training for leaders in Canadian healthcare. Hence, we recommend the creation of a national health emergency preparedness system which includes legislated standards and a national training centre to ensure Canadian healthcare is bolstered against future disasters including pandemics.
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Affiliation(s)
- John G Richmond
- School of Health and Related Research, The University of Sheffield, United Kingdom
| | | | - Attila J Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
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Jaffe TA, Hayden E, Uscher‐Pines L, Sousa J, Schwamm LH, Mehrotra A, Zachrison KS. Telehealth use in emergency care during coronavirus disease 2019: a systematic review. J Am Coll Emerg Physicians Open 2021; 2:e12443. [PMID: 33969356 PMCID: PMC8087945 DOI: 10.1002/emp2.12443] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/21/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 pandemic has presented emergency departments (EDs) with many challenges to address the acute care needs of patients. Many EDs have leveraged telehealth to innovatively respond to these challenges. This review describes the landscape of telehealth initiatives in emergency care that have been described during the coronavirus disease 2019 pandemic. METHODS We conducted a comprehensive, systematic review of the literature using PubMed, supplemented by a review of the gray literature (ie, non-peer reviewed), with input from subject matter experts to identify telehealth initiatives in emergency care during coronavirus disease 2019. We categorized types of telehealth use based on purpose and user characteristics. RESULTS We included 27 papers from our review of the medical literature and another 8 sources from gray literature review. The vast majority of studies (32/35) were descriptive in nature, with the additional inclusion of 2 cohort studies and one randomized clinical trial. There were 5 categories of ED telehealth use during the pandemic: (1) pre-ED evaluation and screening, (2) within ED (including as a means of limiting staff and patient exposure and facilitating consultation with specialists), (3) post-ED discharge monitoring and treatment, (4) educating trainees and health care workers, and (5) coordinating resources and patient care. CONCLUSION Telehealth has been used in a variety of manners during the coronavirus disease 2019 pandemic, enabling innovation in emergency care delivery. The findings from this study can be used by institutions to consider how telehealth may address challenges in emergency care during the coronavirus disease 2019 pandemic and beyond. Because few studies included cost data and given the variability in institutional resources, how organizations implement telehealth programs will likely vary. Future work should further explore barriers and facilitators of innovation, and the impact on care delivery and patient outcomes.
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Affiliation(s)
- Todd A. Jaffe
- Harvard Affiliated Emergency Medicine ResidencyMassachusetts General Hospital and Brigham and Women's HospitalBostonMassachusettsUSA
| | - Emily Hayden
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | | | | | - Lee H. Schwamm
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Ateev Mehrotra
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Kori S. Zachrison
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
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Beghi M, Brandolini R, Casolaro I, Beghi E, Cornaggia CM, Fraticelli C, De Paoli G, Ravani C, Castelpietra G, Ferrari S. Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from the AUSL Romagna, Italy. Int J Psychiatry Clin Pract 2021; 25:135-139. [PMID: 33346685 DOI: 10.1080/13651501.2020.1859120] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES An observation of the admissions to the emergency room (ER) requiring psychiatric evaluation during the lockdown and investigation of the demographic and clinical variables. METHODS Retrospective longitudinal observational study of ER accesses for psychiatric evaluation was performed, comparing two periods (9 March-3 May 2020 vs. 9 March-3 May 2019). Data (number of admissions, key baseline demographic and clinical variables) were extracted from the ER databases of referral centres in a well-defined geographic area of North-Eastern Italy (Cesena, Ravenna, Forlì, and Rimini). RESULTS A 15% reduction of psychiatric referrals was observed, together with a 17% reduction in the total number of patients referring to the ER. This reduction was most evident in the first month of the lockdown period (almost 25% reduction of both referrals and patients). Female gender (OR: 1.52: 95%, CI: 1.12-2.06) and being a local resident (OR: 1.54: 95%CI: 1.02-2.34) were factors associated with the decrease. CONCLUSIONS Lockdown changed dramatically health priorities in the local population, including people with mental health. We speculate that our observations do not only refer to the confinement due to the lockdown regime but also to fear of contagion and adoption of different coping strategies, especially in women.Key-pointsDuring lockdown 15% reduction of psychiatric visits and >17% reduction in the number of psychiatric patients referring to the ER was observed.in the first four weeks of the lockdown almost 25% reduction of both visits and patients was observedFemale gender and being a local resident were factors associated with the decrease.
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Affiliation(s)
| | - Riccardo Brandolini
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Ravenna, Italy.,Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum, Bologna, Italy
| | - Ilaria Casolaro
- Department of Mental Health and Addictions, ASST Lariana, Como, Italy
| | - Ettore Beghi
- Department of Neurosciences, IRSST Mario Negri, Milan, Italy
| | | | - Carlo Fraticelli
- Department of Mental Health and Addictions, ASST Lariana, Como, Italy
| | | | | | - Giulio Castelpietra
- Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy.,Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Silvia Ferrari
- Department of Biomedical Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy.,Department of Mental Health, AUSL Modena, Modena, Italy
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Kerstens K, Shen Z. Using COVID-19 mortality to select among hospital plant capacity models: An exploratory empirical application to Hubei province. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2021; 166:120535. [PMID: 33518820 PMCID: PMC7833876 DOI: 10.1016/j.techfore.2020.120535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 05/28/2023]
Abstract
This contribution defines short- and long-run output- and input-oriented plant capacity measures and evaluates them relative to convex and nonconvex technologies. By applying these different plant capacity concepts, the authors seek to measure the use of existing capacities, as well as the evolution and build-up of extra hospital capacity in the Chinese province of Hubei during the outbreak of the COVID-19 epidemic in early 2020. Furthermore, medical literature has established that mortality rates increase with high capacity utilization rates, an insight that this study leverages to select the most plausible of eight plant capacity concepts. The preliminary results indicate that a relatively new, input-oriented plant capacity concept correlates best with mortality.
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Affiliation(s)
- Kristiaan Kerstens
- IESEG School of Management, CNRS, Univ. Lille, UMR 9221-LEM, 3 rue de la Digue, FR-59000 Lille, France
| | - Zhiyang Shen
- School of Management and Economics, Beijing Institute of Technology, 5 ZhongGuanCunNan Street, 100081 Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, 100081 Beijing, China
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Margherita A, Elia G, Klein M. Managing the COVID-19 emergency: A coordination framework to enhance response practices and actions. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2021; 166:120656. [PMID: 33551496 PMCID: PMC7849534 DOI: 10.1016/j.techfore.2021.120656] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 05/28/2023]
Abstract
The global outbreak of the coronavirus pneumonia (COVID-19) showed how epidemics today can spread very rapidly, with potentially ruinous impact on economies and societies. Whereas medical research is crucial to define effective treatment protocols, technology innovation and social research can contribute by defining effective approaches to emergency management, especially to optimize the complex dynamics arising within actors and systems during the outbreak. The purpose of this article is to define a framework for modeling activities, actors and resources coordination in the epidemic management scenario, and to reflect on its use to enhance response practices and actions. We identify 25 types of resources and 8 activities involved in the management of epidemic, and study 29 "flow", "fit", and "share" dependencies among those resources and activities, along with purposeful management criteria. Next, we use a coordination framework to conceptualize an emergency management system encompassing practices and response actions. This study has the potential to impact a broad audience, and can opens avenues for follow up works at the intersection between technology and innovation management and societal challenges. The outcomes can have immediate applicability to an ongoing societal problem, as well as be generalized for application in future (possible although undesired) events.
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Affiliation(s)
- Alessandro Margherita
- Department of Engineering for Innovation, University of Salento, Campus Ecotekne, Via Monteroni s.n., 73100 Lecce, Italy
| | - Gianluca Elia
- Department of Engineering for Innovation, University of Salento, Campus Ecotekne, Via Monteroni s.n., 73100 Lecce, Italy
| | - Mark Klein
- Center for Collective Intelligence, MIT Massachusetts Institute of Technology, 77 Massachusetts Avenue, E94-1505, Cambridge, MA 02139, USA
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Abdulla F, Nain Z, Karimuzzaman M, Hossain MM, Rahman A. A Non-Linear Biostatistical Graphical Modeling of Preventive Actions and Healthcare Factors in Controlling COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4491. [PMID: 33922634 PMCID: PMC8122857 DOI: 10.3390/ijerph18094491] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND With the insurgence of the COVID-19 pandemic, many people died in the past several months, and the situation is ongoing with increasing health, social, and economic panic and vulnerability. As most of the countries relying on different preventive actions to control the outcomes of COVID-19, it is necessary to boost the knowledge about the effectiveness of such actions so that the policymakers take their country-based appropriate actions. This study generates evidence of taking the most impactful actions to combat COVID-19. OBJECTIVE In order to generate community-based scientific evidence, this study analyzed the outcome of COVID-19 in response to different control measures, healthcare facilities, life expectancy, and prevalent diseases. METHODS It used more than a hundred countries' data collected from different databases. We performed a comparative graphical analysis with non-linear correlation estimation using R. RESULTS The reduction of COVID-19 cases is strongly correlated with the earliness of preventive initiation. The apathy of taking nationwide immediate precaution measures has been identified as one of the critical reasons to make the circumstances worse. There is significant non-linear relationship between COVID-19 case fatality and number of physicians (NCC = 0.22; p-value ≤ 0.001), nurses and midwives (NCC = 0.17; p-value ≤ 0.001), hospital beds (NCC = 0.20; p-value ≤ 0.001), life expectancy of both sexes (NCC = 0.22; p-value ≤ 0.001), life expectancy of female (NCC = 0.27; p-value ≤ 0.001), and life expectancy of male (NCC = 0.19; p-value ≤ 0.001). COVID-19 deaths were found to be reduced with increased medical personnel and hospital beds. Interestingly, no association between the comorbidities and severity of COVID-19 was found excluding asthma, cancer, Alzheimer's, and smoking. CONCLUSIONS Enhancing healthcare facilities and early imposing the control measures could be valuable to prevent the COVID-19 pandemic. No association between COVID-19 and other comorbidities warranted further investigation at the pathobiological level.
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Affiliation(s)
- Faruq Abdulla
- Department of Statistics, Faculty of Sciences, Islamic University, Kushtia 7003, Bangladesh;
- Research, Training and Management (RTM) International, Mirpur, Dhaka 1216, Bangladesh
| | - Zulkar Nain
- Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Islamic University, Kushtia 7003, Bangladesh;
| | - Md. Karimuzzaman
- Department of Statistics, Faculty of Mathematical and Physical Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (M.K.); (M.M.H.)
| | - Md. Moyazzem Hossain
- Department of Statistics, Faculty of Mathematical and Physical Sciences, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (M.K.); (M.M.H.)
- School of Mathematics, Statistics & Physics, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Azizur Rahman
- School of Computing and Mathematics, Charles Sturt University, Wagga Wagga, NSW 2650, Australia
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