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Weng SJ, Tsai MC, Tsai YT, Gotcher DF, Chen CH, Liu SC, Xu YY, Kim SH. Improving the Efficiency of an Emergency Department Based on Activity-Relationship Diagram and Radio Frequency Identification Technology. Int J Environ Res Public Health 2019; 16:E4478. [PMID: 31739429 PMCID: PMC6888262 DOI: 10.3390/ijerph16224478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/06/2019] [Accepted: 11/12/2019] [Indexed: 11/17/2022]
Abstract
Emergency department crowding has been one of the main issues in the health system in Taiwan. Previous studies have usually targeted the process improvement of patient treatment flow due to the difficulty of collecting Emergency Department (ED) staff data. In this study, we have proposed a hybrid model with Discrete Event Simulation, radio frequency identification applications, and activity-relationship diagrams to simulate the nurse movement flows and identify the relationship between different treatment sections. We used the results to formulate four facility layouts. Through comparing four scenarios, the simulation results indicated that 2.2 km of traveling distance or 140 min of traveling time reduction per nurse could be achieved from the best scenario.
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Affiliation(s)
- Shao-Jen Weng
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40704, Taiwan; (S.-J.W.); (C.-H.C.); (S.-C.L.)
- Healthcare Systems Consortium, Tunghai University, Taichung 40704, Taiwan
| | - Ming-Che Tsai
- Institute of Medicine and School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Emergency Department of Chung Shan medical university hospital, Taichung 40201, Taiwan
| | - Yao-Te Tsai
- Department of International Business, Feng Chia University, Taichung 40724, Taiwan
| | - Donald F. Gotcher
- Department of International Business, Tunghai University, Taichung 40704, Taiwan;
| | - Chih-Hao Chen
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40704, Taiwan; (S.-J.W.); (C.-H.C.); (S.-C.L.)
| | - Shih-Chia Liu
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40704, Taiwan; (S.-J.W.); (C.-H.C.); (S.-C.L.)
| | - Yeong-Yuh Xu
- Department of Computer Science and Information Engineering, Hungkuang University, Taichung 43302, Taiwan;
| | - Seung-Hwan Kim
- Department of Business Administration, Ajou University, Suwon 443-749, Korea;
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Abstract
BACKGROUND Bedside rounding involving both nurses and physicians has numerous benefits for patients and staff. However, precise quantitative data on the current extent of physician-nurse (MD-RN) overlap at the patient bedside are lacking. OBJECTIVE This study aimed to examine the frequency of nurse and physician overlap at the patient beside and what factors affect this frequency. DESIGN This is a prospective, observational study of time-motion data generated from wearable radio frequency identification (RFID)-based locator technology. SETTING Single-institution academic hospital. MEASUREMENTS The length of physician rounds, frequency of rounds that include nurses simultaneously at the bedside, and length of MD-RN overlap were measured and analyzed by ward, day of week, and distance between patient room and nursing station. RESULTS A total of 739 MD rounding events were captured over 90 consecutive days. Of these events, 267 took place in single-bed patient rooms. The frequency of MD-RN overlap was 30.0%, and there was no statistical difference between the three wards studied. Overall, the average length of all MD rounds was 7.31 ± 0.58 minutes, but rounding involving a bedside nurse lasted longer than rounds with MDs alone (9.56 vs 5.68 minutes, P < .05). There was no difference in either the length of rounds or the frequency of MD-RN overlap between weekdays and weekends. Finally, patient rooms located farther away from the nursing station had a lower likelihood of MD-RN overlap (Pearson's r = -0.67, P < .05). CONCLUSION RFID-based technology provides precise, automated, and high-throughput time-motion data to capture nurse and physician activity. At our institution, 30.0% of rounds involve a bedside nurse, highlighting a potential barrier to bedside interdisciplinary rounding.
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Affiliation(s)
- Adam X Sang
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Rebecca L Tisdale
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Derek Nielsen
- Clinical Technology, Stanford Hospital and Clinics, Stanford, California
| | - Silvia Loica-Mersa
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Travis Miller
- Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California
| | - Ian Chong
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Lisa Shieh
- Medical Director for Quality, Department of Medicine, Stanford University School of Medicine, Stanford, California
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Kersten JT, Fethke NB. Radio frequency identification to measure the duration of machine-paced assembly tasks: Agreement with self-reported task duration and application in variance components analyses of upper arm postures and movements recorded over multiple days. Appl Ergon 2019; 75:74-82. [PMID: 30509539 DOI: 10.1016/j.apergo.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 08/31/2018] [Accepted: 09/08/2018] [Indexed: 05/27/2023]
Abstract
Technical advances in inertial measurement units (IMUs) with data logging functionality have enabled multi-day collection of fullshift upper arm postures and movements. Such data are useful for characterizing job-level exposures and, when coupled with task-level information, can inform interventions to mitigate high-exposure tasks. Previously reported methods for capturing task-level information, however, were limited primarily to self-report diaries or direct observation. In this study of machine-paced manufacturing workers (n=6), a low-cost radio frequency identification (RFID) system was used to collect information about when, and for how long, specific assembly tasks were performed during up to 14 consecutive work shifts (76 total work shifts across the six participants). The RFID data were compared to information collected with a self-report diary using Bland-Altman analyses. In addition, the RFID data were paired with IMU data to identify task-level exposures from within full-shift recordings of upper arm postures and movements. These data were then used to estimate the relative contributions of between- and within-worker sources of variance to overall variance in posture and movement summary measures using hierarchical random-effects analysis of variance (ANOVA) techniques. Average estimates of daily task duration based on RFID data were comparable to estimates obtained by self-report (mean bias < ±1 minute) but with substantial variability (limits of agreement > ±100 minutes). In addition, the ANOVA models containing task-level information suggested a substantial amount of the overall exposure variance was attributed to repeated observations of the same task within a work day. These findings (i) suggest that while the RFID system used in this study performed adequately, further refinement, validation, and/or alternative strategies may be needed and (ii) underscore the importance of repeated full-shift and task-based measurement approaches in characterizing physical exposures, even in machine-paced environments.
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Affiliation(s)
- Joshua T Kersten
- University of Iowa, Department of Occupational and Environmental Health, S300 CPHB, 52242, Iowa City, IA, USA.
| | - Nathan B Fethke
- University of Iowa, Department of Occupational and Environmental Health, S347 CPHB, 52242, Iowa City, IA, USA.
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Coustasse A, Cunningham B, Deslich S, Willson E, Meadows P. Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine. Perspect Health Inf Manag 2015; 12:1d. [PMID: 26396555 PMCID: PMC4558481] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption.
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Affiliation(s)
- Alberto Coustasse
- Alberto Coustasse, DrPH, MD, MBA, MPH, is an Associate Professor of the Healthcare Program at Marshall University Graduate College of Business in South Charleston, WV
| | - Brian Cunningham
- Brian Cunningham, MS is an Alumni of the Healthcare Program at Marshall University Graduate College of Business in South Charleston, WV
| | - Stacie Deslich
- Stacie Deslich, MS is an Alumni of the Healthcare Program at Marshall University Graduate College of Business in South Charleston, WV
| | - Eric Willson
- Eric Willson, MBA, MHR, MS is an Alumni of the Healthcare Program at Marshall University Graduate College of Business in South Charleston, WV
| | - Pamela Meadows
- Pamela Meadows is an Assistant Professor of Clinical Lab Sciences at the Health Profession School, in Marshall University in Huntington, WV
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Hong SK, Sung MW. Study of Development for RFID System to Hospital Environment. Stud Health Technol Inform 2015; 216:904. [PMID: 26262206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
RFID/USN develops information systems for anytime, anywhere to anybody access Electronic Medical Records (EMR). The goal of the present study is to develop a RFID/USN-based information system for the hospital environment. First, unable to recognize, second, able to recognize as a pursuit of place and suppose the time of medical examination. A retrospective analysis of 235 RFID monitoring results, from four ENT ambulatory clinics of Seoul National University Hospital were extracted by a reader program and monitoring of RFID tag (2006.11.16~2006.12.16). RFID detection for sensing reader of this study has been put into representing "place" and "spending time" of patients for medical history taking and examination. Through the RFID of detection for specific place and spending time of medical examination, RFID/USN develops information system progressing in the EMR of hospital system.
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Affiliation(s)
- Seung Kwon Hong
- Division for BioMedical Informatics, Department of Family Medicine, School of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital
| | - Myung-Whun Sung
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Hospital
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Lai HM, Lin IC, Tseng LT. High-level managers' considerations for RFID adoption in hospitals: an empirical study in Taiwan. J Med Syst 2014; 38:3. [PMID: 24445396 DOI: 10.1007/s10916-013-0003-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/23/2013] [Indexed: 11/30/2022]
Abstract
Prior researches have indicated that an appropriate adoption of information technology (IT) can help hospitals significantly improve services and operations. Radio Frequency Identification (RFID) is believed to be the next generation innovation technology for automatic data collection and asset/people tracking. Based on the Technology-Organization-Environment (TOE) framework, this study investigated high-level managers' considerations for RFID adoption in hospitals. This research reviewed literature related IT adoption in business and followed the results of a preliminary survey with 37 practical experts in hospitals to theorize a model for the RFID adoption in hospitals. Through a field survey of 102 hospitals and hypotheses testing, this research identified key factors influencing RFID adoption. Follow-up in-depth interviews with three high-level managers of IS department from three case hospitals respectively also presented an insight into the decision of RFID's adoption. Based on the research findings, cost, ubiquity, compatibility, security and privacy risk, top management support, hospital scale, financial readiness and government policy were concluded to be the key factors influencing RFID adoption in hospitals. For practitioners, this study provided a comprehensive overview of government policies able to promote the technology, while helping the RFID solution providers understand how to reduce the IT barriers in order to enhance hospitals' willingness to adopt RFID.
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Affiliation(s)
- Hui-Min Lai
- Department of Information Management, Chienkuo Technology University, No.1, Chiehshou North Road, Changhua, 500, Taiwan, Republic of China
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Isella L, Romano M, Barrat A, Cattuto C, Colizza V, Van den Broeck W, Gesualdo F, Pandolfi E, Ravà L, Rizzo C, Tozzi AE. Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors. PLoS One 2011; 6:e17144. [PMID: 21386902 PMCID: PMC3046133 DOI: 10.1371/journal.pone.0017144] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 01/21/2011] [Indexed: 11/19/2022] Open
Abstract
Background Nosocomial infections place a substantial burden on health care systems and represent one of the major issues in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals. Methods and Findings We used wearable active Radio-Frequency Identification Devices (RFID) to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants, with 51 health care workers, 37 patients, and 31 caregivers. Nearly 16,000 contacts were recorded during the study period, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found. In the setting under study, caregivers do not represent a significant potential for infection spread to a large number of individuals, as their interactions mainly involve the corresponding patient. Nurses would deserve priority in prevention strategies due to their central role in the potential propagation paths of infections. Conclusions Our study shows the feasibility of accurate and reproducible measures of the pattern of contacts in a hospital setting. The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies. Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings.
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Affiliation(s)
- Lorenzo Isella
- Complex Networks and Systems Group, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | | | - Alain Barrat
- Complex Networks and Systems Group, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
- Centre de Physique Théorique de Marseille, CNRS UMR 6207, Marseille, France
| | - Ciro Cattuto
- Complex Networks and Systems Group, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | - Vittoria Colizza
- Complex Networks and Systems Group, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | - Wouter Van den Broeck
- Complex Networks and Systems Group, Institute for Scientific Interchange (ISI) Foundation, Torino, Italy
| | | | | | - Lucilla Ravà
- Epidemiology Unit, Bambino Gesù Hospital, Rome, Italy
| | - Caterina Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità Rome, Rome, Italy
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Affiliation(s)
- Daiki Min
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA.
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