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So EHK, Cheung VKL, Leung ASH, So SS, Hung JLK, Yau TML, Chia NH, Ng GWY. Specialised crew resource management programme for non-locally trained healthcare professionals: expediting healthcare cultural adaptation. Hong Kong Med J 2024; 30:80-81. [PMID: 38327161 DOI: 10.12809/hkmj2311287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Affiliation(s)
- E H K So
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
- Department of Anaesthesiology and Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - V K L Cheung
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - A S H Leung
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - S S So
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - J L K Hung
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - T M L Yau
- Central Nursing Division, Kowloon Central Cluster, Hospital Authority, Hong Kong SAR, China
| | - N H Chia
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
- Department of Surgery, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - G W Y Ng
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong SAR, China
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong SAR, China
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Cheung VKL, Chia NH, So SS, Ng GWY, So EHK. Expanding scope of Kirkpatrick model from training effectiveness review to evidence-informed prioritization management for cricothyroidotomy simulation. Heliyon 2023; 9:e18268. [PMID: 37560697 PMCID: PMC10407669 DOI: 10.1016/j.heliyon.2023.e18268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/21/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023] Open
Abstract
Modified Kirkpatrick model has been adopted to evaluate training effectiveness by 6 categories, including activity accounting (training objectives/success in organization change) at Level-0, reaction (satisfaction) at Level-1, learning (acquisition of surgical airway skills) at Level-2, behavior (post-training change in personal strengths) at Level-3, result (organizational or clinical outcomes) at Level-4, and Return on Investment (ROI) or Expectation (ROE) (monetary and societal values following training and other quality and safety related measures) at Level-5. The purpose of this hospital-based prospective observational study was twofold: i) To evaluate potential impacts on monetary and societal values and successful organization change following implementation of advanced Cricothyroidotomy simulator and standardized curriculum in healthcare simulation training, ii) To inform decisions of resource allocation by reviewing overall values and prioritization strategies for i) general surgeon/emergency physician ii) with seniority >5 years and iii) prior porcine training experience based on findings at Kirkpatrick Level-0, Level-4, and Level-5. Seventy doctors and 10 nurses completed Cricothyroidotomy training and follow-up questionnaires within 2021/22. All training usability scoring measured by Scales of Emergency Surgical Airway Simulator (SESAS-17) achieved over 4 out of 5 (Level-4) with effects in favor of emergency physicians or general surgeons (p < .5), regardless of seniority and prior training experience. Success in organization change (Level-0) and cost-effectiveness (Level-5) were hypothetically established using theoretical framework of Gleicher's formula and Roger's Diffusion of Innovation Theory. Overall training effectiveness, in terms of advantage in usability, cost-benefits and successful organizational changes, provided sound evidence to support continuous investment of new curriculum and innovative simulator and "Surgeon-and-emergency-physician-first" policy when it comes to resources allocation strategies for Cricothyroidotomy training. [ACGME competencies: Practice Based Learning and Improvement, Systems Based Practice.].
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Affiliation(s)
- Victor Kai-Lam Cheung
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK
| | - Nam-Hung Chia
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
- Department of Surgery, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - Sze-Sze So
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - George Wing-Yiu Ng
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - Eric Hang-Kwong So
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
- Department of Anaesthesiology & Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
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Lodato I, Iyer AV, To IZ, Lai ZY, Chan HSY, Leung WSW, Tang THC, Cheung VKL, Wu TC, Ng GWY. Prognostic Model of COVID-19 Severity and Survival among Hospitalized Patients Using Machine Learning Techniques. Diagnostics (Basel) 2022; 12:2728. [PMID: 36359571 PMCID: PMC9689804 DOI: 10.3390/diagnostics12112728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 08/22/2023] Open
Abstract
We conducted a statistical study and developed a machine learning model to triage COVID-19 patients affected during the height of the COVID-19 pandemic in Hong Kong based on their medical records and test results (features) collected during their hospitalization. The correlation between the values of these features is studied against discharge status and disease severity as a preliminary step to identify those features with a more pronounced effect on the patient outcome. Once identified, they constitute the inputs of four machine learning models, Decision Tree, Random Forest, Gradient and RUSBoosting, which predict both the Mortality and Severity associated with the disease. We test the accuracy of the models when the number of input features is varied, demonstrating their stability; i.e., the models are already highly predictive when run over a core set of (6) features. We show that Random Forest and Gradient Boosting classifiers are highly accurate in predicting patients' Mortality (average accuracy ∼99%) as well as categorize patients (average accuracy ∼91%) into four distinct risk classes (Severity of COVID-19 infection). Our methodical and broad approach combines statistical insights with various machine learning models, which paves the way forward in the AI-assisted triage and prognosis of COVID-19 cases, which is potentially generalizable to other seasonal flus.
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Affiliation(s)
- Ivano Lodato
- Allos Limited, 1 Hok Cheung Street, Kowloon, Hong Kong, China
| | - Aditya Varna Iyer
- Allos Limited, 1 Hok Cheung Street, Kowloon, Hong Kong, China
- Department of Physics, University of Oxford, Oxford OX1 3PJ, UK
| | | | - Zhong-Yuan Lai
- Allos Limited, 1 Hok Cheung Street, Kowloon, Hong Kong, China
- Department of Physics, Fudan University, Shanghai 200433, China
| | - Helen Shuk-Ying Chan
- Division of Infectious Diseases, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Winnie Suk-Wai Leung
- Division of Integrative Systems and Design, Hong Kong University of Science and Technology, Hong Kong, China
| | - Tommy Hing-Cheung Tang
- Division of Infectious Diseases, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Victor Kai-Lam Cheung
- Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital, Hong Kong, China
| | - Tak-Chiu Wu
- Division of Infectious Diseases, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - George Wing-Yiu Ng
- Intensive Care Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
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Chan AKC, Tsang CF, Chui SF, Wong ECY, Au SY, Ng GWY, Chan KT, Lee MKY. Managing acute myocardial infarction in patients with COVID-19 at a cardiac catheterisation laboratory. Hong Kong Med J 2021; 27:152-153. [PMID: 33824214 DOI: 10.12809/hkmj209046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- A K C Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - C F Tsang
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - S F Chui
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - E C Y Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - S Y Au
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
| | - G W Y Ng
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
| | - K T Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - M K Y Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
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Cheung VKL, So EHK, Ng GWY, So SS, Hung JLK, Chia NH. Investigating effects of healthcare simulation on personal strengths and organizational impacts for healthcare workers during COVID-19 pandemic: A cross-sectional study. Integr Med Res 2020; 9:100476. [PMID: 32802743 PMCID: PMC7365062 DOI: 10.1016/j.imr.2020.100476] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION This cross-sectional study aimed at evaluating impacts of healthcare simulation training, either in-situ or lab-based, on personal strengths of healthcare workers (HCWs) and organizational outcomes during the COVID-19 pandemic. METHODS COVID-19 Taskforce was established to formulate standardized scenario-based simulation training materials in late-January 2020. Post-training questionnaires made up of 5-point Likert scales were distributed to all participants to evaluate their personal strengths, in terms of i) assertiveness, ii) mental preparedness, iii) self-efficacy, iv) internal locus of control, and v) internal locus of responsibility. Independent sample t-tests were used to analyze between-group difference in "In-situ" and "Lab-based" group; and one-sample t-tests were used to compare change in personal strengths with reference point of 3 (Neutral). Kirkpatrick's Model served as the analytical framework for overall training effects. RESULTS Between 05 February and 18 March 2020, 101 sessions of simulation training were conducted in "In-Situ" at either Accident & Emergency Department (20, 20%) or Intensive Care Unit (15, 14%) and "Lab-based" for Isolation (30, 30%) and General Wards (36, 36%). 1,415 hospital staff members, including 1,167 nurses (82%), 163 doctors (12%) and 85 patient care assistants (6%), were trained. All domains of personal strengths were scored 4.24 or above and statistically significantly increased when comparing with reference population (p < .001). However, no significant differences between in-situ and lab-based simulation were found (p > .05), for all domains of personal strengths. CONCLUSION Healthcare simulation training enhanced healthcare workers' personal strengths critical to operational and clinical outcomes during the COVID-19 pandemic.
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Affiliation(s)
- Victor Kai-Lam Cheung
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
- The Department of Neuroscience, Psychology & Behaviour, University of Leicester, UK
| | - Eric Hang-Kwong So
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - George Wing-Yiu Ng
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - Sze-Sze So
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - Jeff Leung-Kit Hung
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - Nam-Hung Chia
- Multi-Disciplinary Simulation & Skills Centre (MDSSC), Queen Elizabeth Hospital, Hong Kong Special Administrative Region
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Au SY, Fong KM, Shek JKC, Yung SK, Ng GWY. A common but often neglected source of emboli. Hong Kong Med J 2020; 26:350.e1-350.e2. [PMID: 32807741 DOI: 10.12809/hkmj198084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- S Y Au
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
| | - K M Fong
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
| | - J K C Shek
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
| | - S K Yung
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
| | - G W Y Ng
- Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
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