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Introduction: Many patients have unaddressed social needs that significantly impact their health, yet navigating the landscape of available resources and eligibility requirements is complex for both patients and clinicians. Methods: Using an iterative design-thinking approach, our multidisciplinary team built, tested, and deployed a digital decision tool called "Discharge Navigator" (edrive.ucsf.edu/dcnav) that helps emergency clinicians identify targeted social resources for patients upon discharge from the acute care setting. The tool uses each patient's clinical and demographic information to tailor recommended community resources, providing the clinician with action items, pandemic restrictions, and patient handouts for relevant resources in five languages. We implemented two modules at our urban, academic, Level I trauma center. Results: Over the 10-week period following product launch, between 4-81 on-shift emergency clinicians used our tool each week. Anonymously surveyed clinicians (n = 53) reported a significant increase in awareness of homelessness resources (33% pre to 70% post, P<0.0001) and substance use resources (17% to 65%, P<0.0001); confidence in accessing resources (22% to 74%, P<0.0001); knowledge of eligibility criteria (13% to 75%, P<0.0001); and ability to refer patients always or most of the time (11% to 43%, P<0.0001). The average likelihood to recommend the tool was 7.8 of 10. Conclusion: Our design process and low-cost tool may be replicated at other institutions to improve knowledge and referrals to local community resources. [ABSTRACT FROM AUTHOR]

Background: Newly intensified use of personal protective equipment (PPE) in emergency departments presents teamwork challenges affecting the quality and safety of care at the frontlines.Objective: We conducted a qualitative study to categorize and describe barriers to teamwork posed by PPE and distancing in the emergency setting.Methods: We conducted 55 semi-structured interviews between June 2020 and August 2020 with personnel from two emergency departments serving in a variety of roles. We then performed a thematic analysis to identify and construct patterns of teamwork challenges into themes.Results: We discovered two types of challenges to teamwork: material barriers related to wearing masks, gowns and powered air-purifying respirators, and spatial barriers implemented to conserve PPE and limit coronavirus exposure. Both material and spatial barriers resulted in disrupted communication, roles and interpersonal relationships, but they did so in unique ways. Material barriers muffled information flow, impeded team member recognition and role/task division, and reduced belonging and cohesion while increasing interpersonal strain. Spatial barriers resulted in mediated communication and added physical and emotional distance between teammates and patients.Conclusion: Our findings identify specific aspects of how intensified PPE use disrupts teamwork and can inform efforts to ensure care quality and safety in emergency settings as PPE use continues during and, potentially beyond, the coronavirus disease-2019 pandemic. [ABSTRACT FROM AUTHOR]

The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they “agree” or “strongly agree” that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course. [ABSTRACT FROM AUTHOR]

Micromolded carbon paste electrodes are easily fabricated, disposable, and can be integrated into microfluidic devices to fabricate inexpensive sensors and biosensors. In this work, carbon paste microelectrodes were fabricated in poly(dimethylsiloxane) using micromolding techniques and were coupled to a microfluidic channel to fabricate electrogenerated chemiluminescence (ECL) sensors. ECL was generated using both the tris(2,2'‐bipyridyl)ruthenium(II)/tripropylamine system and the hydrogen peroxide/luminol system. For each of these ECL systems, the sensor fabrication method was optimized, along with key experimental parameters (applied voltage, solution flow rate, buffer species and luminol concentration). The limit of detection (S/N=3) for TPrA was approximately 2.4 μM with a linear range of 10–100 μM. For hydrogen peroxide, the LOD was approximately 11 μM and the electrodes gave a linear response between 30 μM and 200 μM hydrogen peroxide. Electrodes containing glucose oxidase were fabricated using this new method, demonstrating that glucose could be indirectly detected via generation of hydrogen peroxide by the enzymatic reaction at the micromolded biosensor. [ABSTRACT FROM AUTHOR]

This research examines student perceptions of foreign born instructors in higher education. Based on the theoretical foundations of country of origin effects, this empirical study operationalizes constructs in classroom settings and student-teacher interactions. A national random sample of student respondents (n=785) is used to ascertain the validity of measures and subsequent analysis. The results indicate that the majority of students do not perceive foreign-born instructors differently from native-born instructors. Most students had a positive attitude towards foreign-born instructors and generally felt that foreign-born instructors were very effective teachers. Students indicated that foreign-born instructors would benefit from pedagogical strategies that reduce reliance on verbal instruction in favor of a hybrid of lectures and visuals. Student perceptions of overall effectiveness of foreign-born instructors are driven by observable instructor characteristics such accent, looks, attire, and skin color. Findings of this preliminary study are useful to foreign born instructors as they contemplate pedagogical strategies to better meet the needs of their students. This study also provides implications for instructors, and faculty development leaders. [ABSTRACT FROM AUTHOR]

This study is based on perceptions of students regarding the integration of laptops in classroom endeavors. Empirical findings are based on data collected from a sample of 392 students in undergraduate and graduate universities in twelve states of the USA. Three key findings related to the integration of laptop technology into classrooms of higher education are reported. First relates to student perceptions and feelings surrounding laptop use in the classroom. Secondly, we report how these perceptions vary depending on personal characteristics of students. Lastly, we examine the role these perceptions play in student learning, as well as student satisfaction. Traditionally, laptop technology has been viewed as tool for facilitating note taking. However, our findings indicate that the learning experience is equal, and in some instances greater, when laptops are used to develop a more interactive learning environment, increase information gathering during class time, and enhance classroom discussion. [ABSTRACT FROM AUTHOR]

Past literature has suggested maximizing customer satisfaction as a strategic choice to increase customer loyalty and ensuring revenues. However, the relationship between increased customer satisfaction and resultant revenue has remained unexamined. This research focuses on optimizing customer satisfaction rather than maximizing it. This optimization of customer satisfaction is based on maximizing profitability. In aiming for higher customer satisfaction levels with no regard to profitability, a company runs the risk of self-annihilation. Based on conceptual foundations of prior research on Return on Quality (ROQ), we propose the construct of Return on Satisfaction (ROS). We review frameworks of customer satisfaction examined by scholars in marketing and then propose a conceptual ROS model. We use empirical data (n=1597) obtained from an institution of higher education to test the conceptual model we propose. Results indicate that the data demonstrates construct validity and points to promising directions for further research. We conclude by underscoring managerial implications as well as the scholarly contributions of this research. [ABSTRACT FROM AUTHOR]