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The nursing schedule generation is an important activity that takes a considerable amount of time for managers to prepare and amend. It involves the optimal allocation of nurses to shifts, factoring various constraints like shift timings, holidays, leaves, and emergencies. This paper provides the design and development details for an automated nurse scheduling system called "ROTA," implemented for a 2032 bed multi-specialty tertiary teaching hospital, having 1800 staff nurses and 98 wards. The system generates daily, weekly, monthly schedules, nurse face sheets, duty allocation charts, swapping schedules, and training details for nurses. The system improved managerial control and saved a considerable amount of time for nurses to prepare the schedule. A survey conducted to gauge the system's satisfaction level showed that 91% of nurses were satisfied with ROTA. Overall, the system saved 78% of nurse scheduling time, resulting in a 3% cost reduction for the hospital. [ABSTRACT FROM AUTHOR]

Clinical pathways are used to support the management of patients in emergency departments. An existing document-based clinical pathway was used as the foundation on which to design and build a digital clinical pathway for acute chest pain, with the aim of improving clinical calculations, clinician decision-making, documentation, and data collection. Established principles of decision support system design were used to build an application within the existing electronic health record, before testing with a multidisciplinary team of doctors using a think-aloud protocol. Technical authoring was successful, however, usability testing revealed that the user experience and the flexibility of workflow within the application were critical barriers to implementation. Emergency medicine and acute care decision support systems face particular challenges to existing models of linear workflow that should be deliberately addressed in digital pathway design. We make key recommendations regarding digital pathway design in emergency medicine. [ABSTRACT FROM AUTHOR]