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OBJECTIVES: This study aimed to predict individual COVID-19 patient prognosis at hospital admission using artificial intelligence (AI)-based quantification of comput ed tomography (CT) pulmonary involvement. BACKGROUND: Assessing patient prognosis in COVID-19 pneumonia is crucial for patient management and hospital and ICU organization. METHODS: We retrospectively analyzed 559 patients with PCR-verified COVID-19 pneumonia referred to the hospital for a severe disease course. We correlated the CT extent of pulmonary involvement with patient outcome. We also attempted to define cut-off values of pulmonary involvement for predicting different outcomes. RESULTS: CT-based disease extent quantification is an independent predictor of patient morbidity and mortality, with the prognosis being impacted also by age and cardiovascular comorbidities. With the use of explored cut-off values, we divided patients into three groups based on their extent of disease: (1) less than 28 % (sensitivity 65.4 %; specificity 89.1 %), (2) ranging from 28 % (31 %) to 47 % (sensitivity 87.1 %; specificity 62.7 %), and (3) above 47 % (sensitivity 87.1 %; specificity, 62.7 %), representing low risk, risk for oxygen therapy and invasive pulmonary ventilation, and risk of death, respectively. CONCLUSION: CT quantification of pulmonary involvement using AI-based software helps predict COVID-19 patient outcomes. [ABSTRACT FROM AUTHOR]

There are few data on international variation in chemotherapy use, despite it being a key treatment type for some patients with cancer. Here, we aimed to examine the presence and size of such variation. This population-based study used data from Norway, the four UK nations (England, Northern Ireland, Scotland, and Wales), eight Canadian provinces (Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, and Saskatchewan), and two Australian states (New South Wales and Victoria). Patients aged 15–99 years diagnosed with cancer in eight different sites (oesophageal, stomach, colon, rectal, liver, pancreatic, lung, or ovarian cancer), with no other primary cancer diagnosis occurring from within the 5 years before to 1 year after the index cancer diagnosis or during the study period were included in the study. We examined variation in chemotherapy use from 31 days before to 365 days after diagnosis and time to its initiation, alongside related variation in patient group differences. Information was obtained from cancer registry records linked to clinical or patient management system data or hospital administration data. Random-effects meta-analyses quantified interjurisdictional variation using 95% prediction intervals (95% PIs). Between Jan 1, 2012, and Dec 31, 2017, of 893 461 patients with a new diagnosis of one of the studied cancers, 111 569 (12·5%) did not meet the inclusion criteria, and 781 892 were included in the analysis. There was large interjurisdictional variation in chemotherapy use for all studied cancers, with wide 95% PIs: 47·5 to 81·2 (pooled estimate 66·4%) for ovarian cancer, 34·9 to 59·8 (47·2%) for oesophageal cancer, 22·3 to 62·3 (40·8%) for rectal cancer, 25·7 to 55·5 (39·6%) for stomach cancer, 17·2 to 56·3 (34·1%) for pancreatic cancer, 17·9 to 49·0 (31·4%) for lung cancer, 18·6 to 43·8 (29·7%) for colon cancer, and 3·5 to 50·7 (16·1%) for liver cancer. For patients with stage 3 colon cancer, the interjurisdictional variation was greater than that for all patients with colon cancer (95% PI 38·5 to 78·4; 60·1%). Patients aged 85–99 years had 20-times lower odds of chemotherapy use than those aged 65–74 years, with very large interjurisdictional variation in this age difference (odds ratio 0·05; 95% PI 0·01 to 0·19). There was large variation in median time to first chemotherapy (from diagnosis date) by cancer site, with substantial interjurisdictional variation, particularly for rectal cancer (95% PI –15·5 to 193·9 days; pooled estimate 89·2 days). Patients aged 85–99 years had slightly shorter median time to first chemotherapy compared with those aged 65–74 years, consistently between jurisdictions (–3·7 days, 95% PI –7·6 to 0·1). Large variation in use and time to chemotherapy initiation were observed between the participating jurisdictions, alongside large and variable age group differences in chemotherapy use. To guide efforts to improve patient outcomes, the underlying reasons for these patterns need to be established. International Cancer Benchmarking Partnership (funded by the Canadian Partnership Against Cancer, Cancer Council Victoria, Cancer Institute New South Wales, Cancer Research UK, Danish Cancer Society, National Cancer Registry Ireland, The Cancer Society of New Zealand, National Health Service England, Norwegian Cancer Society, Public Health Agency Northern Ireland on behalf of the Northern Ireland Cancer Registry, DG Health and Social Care Scottish Government, Western Australia Department of Health, and Public Health Wales NHS Trust). [ABSTRACT FROM AUTHOR]

BACKGROUND: During an outbreak such as COVID-19, hospital staff needs to be in close contact with all types of patients visiting the hospital and the risk of cross-infection is extremely high. Payment and medication pickup is a mandatory part of a patient's hospital visit, with direct contact between healthcare workers and patients, and long waiting times in the hospital area, which can easily lead to the spread of disease infection. OBJECTIVE: This paper designed the prototype of a contactless smart medicine cabinet based on RFID technology and optimized the patient consultation and medication pickup process to address these problems. METHODS: We conducted a 50-day field observation of patients for consultation and medication pickup at the First Hospital in H city, Jiangsu Province, China, and randomly timed 1600 sets of data from Surgery (ophthalmology) and Internal patients, then we designed the prototype of a contactless smart medicine cabinet based on RFID technology, optimized the patient consultation and medication pickup process, comparing the traditional and intelligent models using AnyLogic. RESULTS: The results show that this contactless medicine cabinet was able to reduce the time taken by patients in consultation and medicine pickup by 18.74 minutes, increasing the overall efficiency of the consultation by 32.20%. The simulation revealed that this contactless intelligent medication pickup model was able to reduce the time taken by patients in consultation and medicine pickup, increasing the overall efficiency of the consultation, effectively reducing the frequency of contact between healthcare workers and patients, and reducing the risk of disease infection. CONCLUSION: The proposed technical model provides a new idea to solve the problems of long queues, low efficiency and high risk of infection for patients to consult and get medicine during epidemics. Especially within hospitals it has important theoretical and practical implications for epidemic prevention and control as well as future hospital management. [ABSTRACT FROM AUTHOR]

Protein products in hospitals often have to be compounded before administration to the patient. This may comprise reconstitution of lyophilizates, dilution, storage, and transport. However, the operations for compounding and administration in the hospital may lead to changes in product quality and possibly even impact patient safety. We surveyed healthcare practitioners from three clinical units using a questionnaire and open dialogue to document common procedures and their justification and to document differences in handling procedures. The survey covered dose compounding, transportation, storage and administration. One key observation was that drug vial optimization procedures were used for some products, e.g., use of one single-use vial for several patients. This included the use of spikes and needles or closed system transfer devices (CSTDs). Filters or light protection aids were used only when specified by the manufacturer. A further observation was a different handling of the overfill in pre-filled infusion containers, possibly impacting total dose. Lastly, we documented the complexity of infusion administration setups for administration of multiple drugs. In this case, flushing procedures or the placement and use of filters in the setup vary. Our study has revealed important differences in handling and administration practice. We propose that drug developers and hospitals should collaborate to establish unified handling procedures. [ABSTRACT FROM AUTHOR]

Purpose: This article aims to identify the benefits and difficulties managers perceive regarding implementing digital transformation (DT) in hospital bed management. Originality/value: The article contributes to academia by analyzing a relevant topic, DT of health, that is scarcely explored in the multifactorial perspective of its technological, organizational, and social elements. No similar study was identified with application in a large private hospital located in a developing country. By analyzing managerial perceptions about implementing DT applied to hospital bed management, the study allows a better understanding and potential strengthening of this DT process by the professionals involved, which can contribute to expanding access to hospital care. Design/methodology/approach: A single case study was carried out to investigate the implementation of DT for managing hospital beds in a private general hospital in São Paulo, Brazil. We interviewed 19 managers responsible for hospital bed management. The interviews were analyzed using two methods: content analysis and data mining, and they were classified according to their technological, organizational, and social elements (Reis et al., 2018). Findings: DT's most cited potential benefits were efficiency gains, realtime information, and employee and patient satisfaction. The main dificulties reported were systems integration, data availability in realtime, instituting new processes, and challenges related to organizational culture and the necessary changes. DT can positively impact bed flow management, but it is crucial to consider the technological, organizational, and social elements involved in its success. [ABSTRACT FROM AUTHOR]

Aim: To identify the various diagnoses associated with extremely elevated C‐reactive protein (CRP) (>30 mg/dL) among immunocompetent children and to evaluate its clinical implications during emergency department (ED) workup and hospital management. Methods: Children (3 months–18 years) with fever in ED were included, retrospectively. The cohort was divided into two groups—'extremely elevated CRP' (>30 mg/dL) and 'highly elevated CRP' (15–30 mg/dL). Results: Included were 1173 patients with CRP 15–30 mg/dL and 221 with CRP > 30 mg/dL. Bacterial infection was more prevalent among the extremely elevated CRP group (94.1% vs. 78.5%, respectively, p = 0.002). Specifically, bacterial pneumonia (52%), cellulitis (7.2%) and sepsis (4.1%) were more prevalent among this group. More of these patients were reported as 'Ill appearing' [78 (35.3%) vs. 166 (17.4%), p < 0.001]. They were more often treated with fluids [33 (14.9%) vs. 50 (5.3%), p < 0.001] and a higher portion of them required admission to an intensive care unit [11 (5.0%) vs. 16 (1.7%), p = 0.007]. Conclusion: Febrile children with extremely elevated CRP showed greater illness severity (haemodynamic instability, PICU admissions), thus careful clinical attention is desirable in these cases. More than half of them had bacterial pneumonia, which reinforces the importance of relevant investigation when diagnosis is unclear. [ABSTRACT FROM AUTHOR]

Background. Registrars in specialisation training programmes encounter numerous difficulties in completing the research component of the Master of Medicine degree. Poor patient record-keeping hinders the research process. Objectives. To investigate current types of medical patient record-keeping systems (electronic v. paper) in training health facilities, and the effect data accessibility has on specialist training and research. Methods. This was a mixed-methods study that included both descriptive and analytical components. Of 610 postgraduate students enrolled in the University of KwaZulu-Natal College of Health Sciences Master of Medicine programme, 168 completed a cross-sectional survey to collect data and 11 did follow-up interviews. The survey and interviews explored issues related to medical record-keeping in the participants' department or hospital, emphasising their experiences with data access while conducting research. The quantitative data were analysed using descriptive statistics, and the qualitative data were analysed thematically. Ethical approval was obtained from the institution's Biomedical Research Ethics Committee. Results. Of the 168 participants, 94 (56%) reported that problems with data access hindered their research, while 56 (33%) indicated that data access did not affect their research. Only 30 participants (18%) had no difficulty in obtaining data for their research, while the rest (n=138; 82%) experienced varying degrees of difficulty. A total of 110 participants (65%) indicated that paper-based record-keeping was mainly being used in their department or hospital, while electronic record-keeping was reported by the rest (n=58; 35%). Many (n=125; 74%) expressed the need to improve hospital data management practices, and 39 (23%) reported that plans were being implemented to improve these practices. Participants expressed frustration with regard to accessing data even in departments that used electronic systems, and they raised concerns regarding data security. Conclusion. The migration to electronic patient record-keeping has not yet been implemented in many hospitals, with poor patient record-keeping affecting training and research. [ABSTRACT FROM AUTHOR]

Introduction Exposure to e-cigarette liquids, whether intentional or accidental, might lead to adverse events. This study aimed to describe the prevalence and characteristics of exposures to e-liquids reported to French Poison Control Centers. Methods All e-liquids exposure cases reported to French Poison Control Centers from July 1, 2019, to December 31, 2020, were reviewed. Information was collected about the patient's characteristics, exposure circumstances, management and outcome. Results About 919 cases of exposure to e-liquids were reported. Ages ranged from one month to 89 years, with a mean age of 16.6 ± 18.6 years and a median age of 4 years. The highest number of exposures—50.7%—concerned infants (0–4 years), 3.1% children (5–11 years), 5.9% adolescents (12–17 years), and 40.1% of cases concerned adults. The majority of cases were accidental (95.0%). Intentional exposures (4.9%) were mainly observed in patients older than 12 years of age (P < 0.001). The route of exposure was ingestion in 73.7% of the cases. A total of 455 exposures showed no symptoms or signs related to poisoning. High nicotine concentration in e-liquids was associated with an increase in hospital management (Odds-ratio from 1.77 to 2.60). Conclusion Involuntary exposures to e-liquids occurred more often in children under the age of five, mainly by ingestion. Unlike intentional ingestions, unintentional ingestions rarely resulted in severe adverse events. These findings highlight the importance of ongoing surveillance to prevent such exposures and associated injuries, emphasizing the need for effective regulation of these products. [ABSTRACT FROM AUTHOR]

• The MIP bi-objective model can reduce food waste by 19.70 % and cost by 32.66 %. • On average, children waste 35.43 % of their meals, and eat 41.32 g less than adults. • The pediatric ward has the most food waste per meal, leading to a 20 % reduction. • The vegetarian diet exhibits the highest food waste and meal-building cost. • In areas of greatest waste and cost, the models achieved the greatest improvements. Food waste contributes significantly to greenhouse emissions and represents a substantial portion of overall waste within hospital facilities. Furthermore, uneaten food leads to a diminished nutritional intake for patients, that typically are vulnerable and ill. Therefore, this study developed mathematical models for constructing patient meals in a 1000-bed hospital located in Florida. The objective is to minimize food waste and meal-building costs while ensuring that the prepared meals meet the required nutrients and caloric content for patients. To accomplish these objectives, four mixed-integer programming models were employed, incorporating binary and continuous variables. The first model establishes a baseline for how the system currently works. This model generates the meals without minimizing waste or cost. The second model minimizes food waste, reducing waste up to 22.53 % compared to the baseline. The third model focuses on minimizing meal-building costs and achieves a substantial reduction of 37 %. Finally, a multi-objective optimization model was employed to simultaneously reduce both food waste and cost, resulting in reductions of 19.70 % in food waste and 32.66 % in meal-building costs. The results demonstrate the effectiveness of multi-objective optimization in reducing waste and costs within large-scale food service operations. [ABSTRACT FROM AUTHOR]

Purpose The public hospitals are not-for-profit entities, and their purpose is not to generate and distribute profits as a result of business activities. Therefore, in the context of hospital management, where many hospitals are running into losses and improving profitability has become a major issue, it is necessary to study the relationship between operational performance and profitability. Design/Methodology/Approach: In this study, targeting public hospitals, an empirical study was attempted on the correlation between operational performance and profitability. The 303 hospitals were analyzed for the financial years 2022 and 2023. To confirm the validity of the results for the entire group of public hospitals (population), including hospitals other than those subject to this analysis, an uncorrelated test was conducted. Findings: As a result, there was a positive correlation between the volume of surgeries performed and profitability. On the other hand, the shortening of the average length of hospital stay did not lead to an improvement in profitability. Profitability improved as the number of inpatients per physician increased, but there was no correlation between the number of outpatients per physician and profitability. Conclusion: The results of this study suggest the importance of index correction. [ABSTRACT FROM AUTHOR]

At present, Ontario, like most other jurisdictions in Canada, uses a syndromic-based surveillance definition for acute respiratory infection (ARI) outbreaks in institutions and public hospitals. Confirmed outbreaks are defined as either two or more ARIs in 48 hours with any common epidemiological link and at least one that is laboratory-confirmed; or three cases of ARIs occurring within 48 hours with any common epidemiological link, and not necessarily with lab confirmation. However, with the adoption of broader test-based approaches for sick patients/residents throughout the pandemic, new challenges have surfaced regarding the declaration and management of ARI outbreaks with a variety of scenarios in respiratory testing results. Decisions, including the determination of epidemiological linkage when there are discordant/negative test results, have become more complicated with the addition of virusspecific test results for every sick individual. The ARI outbreak case definition and management guidance was updated in 2018. The purpose of this commentary is to highlight epidemiological trends in ARI outbreaks in Ontario over the 2022-2023 season compared to the 2018-2019 and 2019-2020 pre-pandemic seasons. This is followed by a discussion around some of the benefits and challenges of implementing a test-based versus syndromic-based approach to ARI outbreaks. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the physical environmental problems of two Thai community hospitals' outpatient departments (OPDs) during the COVID-19 outbreak and to provide design guidelines for respiratory disease prevention. Design/methodology/approach: A three-step method was used. The first step involved walk-through observations at Mae Wang Hospital and Doi Saket Hospital to assess the physical environment. The second step consisted of interviews with 22 medical staff working in the two hospitals. Third, the observation and interview data were used to develop a preliminary design guideline, which was evaluated by two focus groups comprising the same interview participants. Findings: The observational findings showed that the two hospitals had difficulties following the COVID-19 prevention protocol due to physical environmental problems. Four different themes emerged from the analysis of the medical staff interviews. The preliminary design guidelines that were evaluated through two focus group discussions resulted in design recommendations for four areas (the overall building, clinical, support and staff areas) in the Mae Wang and Doi Saket OPD buildings. Three topics of design recommendations were provided to reduce the spread of COVID-19: improving hospital management, space design and air quality. Originality/value: To the best of the authors' knowledge, this study is the first to provide design guidelines for COVID-19 and respiratory disease prevention in Thai community hospital OPD buildings. [ABSTRACT FROM AUTHOR]

The increase in the volume of medical waste is in line with the improvement of medical waste management performance and compliance with government regulations. Hospitals have another challenge in medical waste management with higher treatment costs that have a direct impact on financial aspects. Based on these problems, this study aims to evaluate medical waste management by comparing the level of hospital compliance with regulations and technical aspects, assessing the generation of medical waste and assessing the financial aspects of recycled medical waste management. The research method is structured observation to collect information and facts in the field so that a systematic description can be accomplished. The results of this study show that X Hospital, Surabaya has complied with the laws and regulations. The results of the study of medical waste generation obtained an average generation in the inpatient room of 88.20 Kg / day and the average waste generation per inpatient patient of 1.15 Kg / day and for outpatients of 0.05 Kg / day. The composition of recycled waste is 18.94%, infectious waste is 57.50%, pharmaceutical packaging waste (Hazardouse waste) is 10.90%, cytotoxic waste is 0,06% and sharps waste is 1.25%. The financial analysis generated from recycling activities on used hazardouse waste packaging, used syringes, used infusion bottles other than blood and/or body fluid infusions, and/or used hemodialysis fluid packaging obtained a NPV value > 0 and BCR value = 1.98 > 1, so this investment is economically feasible and the investment plan is recommended to be implemented. [ABSTRACT FROM AUTHOR]

The healthcare sector is constantly changing due to many different factors, both external and internal, such as regulatory, organizational, technological, personnel, financial, and geopolitical change. Change management methods and tools are useful for effectively planning, implementing and monitoring change. The important issue is in which areas and to what extent change management is utilized in healthcare. The aim of this text is therefore to conduct a scoping literature review on change management in healthcare and to develop, based on the results of this research, a theoretical model of determinants and motives for implementing change management in healthcare. A scoping review of the literature was conducted to determine the extent to which change management is applied in healthcare organizations. Texts meeting the inclusion criteria were searched for in four databases: PubMed, Embase, Scopus, and EBSCO. The search was limited to texts published in English. Of the 247 publications screened, 73 met the inclusion criteria. Additionally, 1021 keywords were selected from the screened publications, of which 137 met the inclusion criteria and were approved for the keyword analysis. The keywords formed seven thematic clusters: human, change management, organization and management, leadership, healthcare delivery, hospital management, and productivity. There are a number of motives for using change management in healthcare, and all centre around a few determinants that can be divided into those directly related to the specifics of the healthcare sector and those directly related to management processes. These determinants and motives were included in the theoretical model. [ABSTRACT FROM AUTHOR]

In this study the method used is descriptive and with a quantitative approach. The sampling technique used in this study is the Slovin formula technique with a sample size of 84 people from the total population of 510 employees. This study aims to determine whether work conflict can significantly affect employee performance, both positively and negatively. The method used is a survey with a questionnaire using a questionnaire as a data collection instrument. The sample of this study amounted to 84 respondents, namely employees who work at Bhayangkara Sartika Asih Bandung Hospital. The data collected will be analyzed using descriptive statistical methods and regression analysis. This research consists of four main stages. The first stage is primary data collection through a questionnaire distributed through Google Form to employees at the hospital. This questionnaire includes variables related to work conflict and employee performance. The second stage is data processing, where the collected data will be analyzed using descriptive statistical methods to get an overview of the level of work conflict and employee performance in the hospital. Furthermore, regression analysis will be conducted to examine the relationship between work conflict and employee performance. The third stage is the interpretation of the analysis results, where the findings from the data analysis will be explained and analyzed in depth. These results will provide a better understanding of the relationship between work conflict and employee performance at Bhayangkara Sartika Asih Bandung Hospital. The final stage is the preparation of the research report, in which the findings and recommendations will be presented in a systematic and comprehensive manner. The results of this study are expected to provide a better understanding of the relationship between work conflict and employee performance in the hospital. In addition, this research is also expected to provide recommendations to hospital management in managing work conflict in order to improve employee performance. [ABSTRACT FROM AUTHOR]

This article explores the intersection of healthcare AI and project management for CEOs and hospital administrators. It discusses the challenges and benefits of integrating AI into healthcare settings, including improved efficiency, diagnostic precision, and patient care experiences. The article highlights the importance of balancing innovative AI solutions with healthcare regulations and ethical considerations, as well as managing data privacy. It also addresses the varying levels of AI adoption in hospitals and the goals of healthcare AI projects, such as patient safety, cost reduction, community health support, and research promotion. The article emphasizes the need for tailored project management methodologies, clear communication, and change management strategies to successfully integrate AI technology in healthcare settings. [Extracted from the article]

Introduction: The coronavirus disease 2019 (COVID‐19) pandemic generated considerable upheaval in all sectors of the US health care system, including maternity care. We focused this inquiry on midwifery practice leaders' experiences and perspectives on changes that occurred in their practices early in the pandemic. Methods: This was a qualitative descriptive study using thematic analysis. The data were responses to an open‐ended question in a survey of pandemic‐related employment and clinical practice changes. Findings are presented from a constructivist perspective, describing the experiences and perspectives of a group of US midwifery practice leaders during the initial phase of the COVID‐19 pandemic. Results: Two main themes emerged from the analysis: demands on midwives and driving forces. Demands on midwives were 3‐fold: clients' needs, modification of care, and midwives' needs. These encompassed the psychological, physical, and emotional toll that caring for women during the pandemic placed on midwives. Driving forces were those entities that spurred and directed change and included regulations, institutions, financial logistics, and team dynamics. Survey respondents in community (home and birth center) practices reported substantial increases in inquiries and client volume, and many respondents expressed concern about withdrawal of students from clinical placements. Discussion: Midwifery practices experienced profound changes in their work environments during the COVID‐19 pandemic, with both positive and negative characteristics. These challenges in providing birth care were similar to those reported in other countries. Results indicated existing guidance for maternity care during emergencies did not meet clients' needs. Coordinated planning for maternity care in future prolonged health emergencies should incorporate best practices and include midwives in the process. [ABSTRACT FROM AUTHOR]

Research background: Deep and machine learning-based algorithms can assist in COVID-19 image-based medical diagnosis and symptom tracing, optimize intensive care unit admission, and use clinical data to determine patient prioritization and mortality risk, being pivotal in qualitative care provision, reducing medical errors, and increasing patient survival rates, thus diminishing the massive healthcare system burden in relation to severe COVID-19 inpatient stay duration, while increasing operational costs throughout the organizational management of hospitals. Data-driven financial and scenario-based contingency planning, predictive modelling tools, and risk pooling mechanisms should be deployed for additional medical equipment and unforeseen healthcare demand expenses. Purpose of the article: We show that deep and machine learning-based and clinical decision making systems can optimize patient survival likelihood and treatment outcomes with regard to susceptible, infected, and recovered individuals, performing accurate analyses by data modeling based on vital and clinical signs, surveillance data, and infection-related biomarkers, and furthering hospital facility optimization in terms of intensive care unit bed allocation. Methods: The review software systems employed for article screening and quality evaluation were: AMSTAR, AXIS, DistillerSR, Eppi-Reviewer, MMAT, PICO Portal, Rayyan, ROBIS, and SRDR. Findings & value added: Deep and machine learning-based clinical decision support tools can forecast COVID-19 spread, confirmed cases, and infection and mortality rates for data-driven appropriate treatment and resource allocations in effective therapeutic and diagnosis protocol development, by determining suitable measures and regulations and by using symptoms and comorbidities, vital signs, clinical and laboratory data and medical records across intensive care units, impacting the healthcare financing infrastructure. As a result of heightened use of personal protective equipment, hospital pharmacy and medication, outpatient treatment, and medical supplies, revenue loss and financial vulnerability occur, also due to expenses related to hiring additional staff and to critical resource expenditures. Hospital costs for COVID-19 medical care, screening, treatment capacity expansion, and personal protective equipment can lead to further financial losses while affecting COVID-19 frontline hospital workers and patients. [ABSTRACT FROM AUTHOR]

To investigate the current nursing practice environment in Jinan, Shandong Province, and to identify the factors influencing the practice environment. Methods: This study is a cross-sectional study for nurses. From October to December 2022, using the clustering and stratified sampling methods, 2426 nurses from internal Medicine, Surgery, Obstetrics and Gynecology, Outpatient Department and Intensive Care Department of the Provincial Hospital of Shandong Medical University were selected and then investigated and analyzed using the revised Nurse Practice Environment Assessment Scale. Results: The overall mean evaluation of the practice environment scored 75.13± 19.87, with a minimum value of 59.74 and a maximum value of 95.82. The items with higher scores were "the hospital has systematic training for new nurses", "the work system is perfect", and "the hospital can provide continuing education for nurses in accordance with the needs of their positions". The items with lower scores were "nurses enjoy legal benefits", "nurses have the opportunity to participate in hospital management decisions", and "nurses have the opportunity to participate in hospital internal management". The results of the multiple linear regression analysis of the factors influencing nurses' practice environment showed that gender, education, position, and years of work were independent influences on nurses' practice environment scores (p < 0.05), and they explained 48.127% of the variation in the total scores of the nurses' practice environment scale. The estimated values (β) of sex, education, cheif nurse, nurses staff, work experience (year), and whether the only child variables were 3.141, 3.237, 2.713, 5.471, 2.074 and 0.732, respectively. Conclusion: The nurse practice environment still needs to be improved, mainly in terms of hospital management participation, human resource allocation and salary distribution system. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives: to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care. Methods: a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument. Results: an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation. Conclusions: the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.

ObjectiveTo identify organizational complementarities of adoption and use of electronic health records (EHRs) and assess what organizational strategies were associated with more advanced EHR use.Data sourcesPrimary survey data of US hospitals combined with secondary data from the American Hospital Association Annual Survey and IT Supplement.Study designIn this cross-sectional study, we describe hospital organizational practices around EHR adoption and use and identify how these practices coalesce into distinct strategies. We then assess the association between those organizational strategies and adoption of advanced EHR functions.Data collectionPrimary data collection consisted of surveys sent to 797 US acute care hospitals in 2018-2019, with 451 complete respondents.Principal findingsThere was significant variation in hospital organizational practices for EHR adoption and use. Factor analysis identified practices in three domains: leadership engagement, human capital, and systems integration. Hospitals in the top quartile of the leadership engagement factor were 14 percentage points more likely to have adopted patient engagement EHR functions (P = 0.01) while hospitals in the top quartile of human capital were 14 percentage points less likely to have adopted these functions (P = 0.02). Hospitals in the top quartile of systems integration were 12 percentage points more likely to have adopted patient engagement functions (P = 0.02) and 14 percentage points more likely to have adopted EHR data analytics functions (P = 0.02).ConclusionsOur findings suggest that specific organizational strategies are associated with more advanced EHR adoption. Hospital leaders interested in realizing more value from their EHR investment may find it useful to know that there is an association between adoption of more advanced EHR functions, and engaging senior leadership as well as building connectivity between clinical and administrative systems.

Hospital-acquired infections (HAIs) are nosocomially acquired infections, typically not present on admission, but manifest rapidly after hospitalization, and have recently assumed an increasingly global problem. A case study of a healthy male patient, though 93 year old is presented here to demonstrate how human lives can be lost as a result of negligence in developing nations. Though there are many clear-cut criteria for preventing hospital-acquired infections, it is still unclear how many of these are followed in majority of hospitals. There is definitely a sponsored nexus of economic growth and hospitals at the cost of human lives, specially where health care has been a major blockade in sustainable development. In order to eliminate HAIs, targeted prevention initiatives along with compliance of research-based hospital treatment modalities should be strictly implemented, under strict independent monitoring. Programmatic recording and reporting of actual hospital inspections should be strengthened, delivering genuine hospital data from district to state, and then to national levels, through a transparent public system. Use of honest hospital metrics, state of the art data collection and its correct scientific interpretation for improving the malady of HAI in our health care systems is recommended. Appointment of specifically qualified hospital managers must be made mandatory, instead of clinical doctors donning the mantle of management specialists, resulting in deficiency in services. [ABSTRACT FROM AUTHOR]

Japan has approved the weight-loss drug semaglutide, known as Wegovy, for chronic weight management. The drug is covered by Japan's national universal health insurance, but there are stringent prescription restrictions. Semaglutide is indicated for adult patients with hypertension, hyperlipidemia, or type 2 diabetes who cannot achieve sufficient effect through dietary therapy and physical activity. However, there are concerns about limited patient access to the drug due to restrictions on prescribing physicians and the requirement for patients to undergo dietary therapy and physical activity for six months prior to receiving the drug. Other Asian countries, such as China, are expected to introduce the drug soon. [Extracted from the article]

Abstract Background Mental disorders are one of the costliest conditions to treat in Norway, and research into the costs of specialist mental healthcare are needed. The purpose of this article is to present a cost structure and to investigate the variables that have the greatest impact on high-cost episodes. Methods Patient-level cost data and clinic information during 2018–2021 were analyzed (N = 180,220). Cost structure was examined using two accounting approaches. A generalized linear model was used to explain major cost drivers of the 1%, 5%, and 10% most expensive episodes, adjusting for patients’ demographic characteristics [gender, age], clinical factors [length of stay (LOS), admission type, care type, diagnosis], and administrative information [number of planned consultations, first hospital visits, interval between two hospital episode]. Results One percent of episodes utilized 57% of total resources. Labor costs accounted for 87% of total costs. The more expensive an episode was, the greater the ratio of the inpatient (ward) cost was. Among the top-10%, 5%, and 1% most expensive groups, ward costs accounted for, respectively, 89%, 93%, and 99% of the total cost, whereas the overall average was 67%. Longer LOS, ambulatory services, surgical interventions, organic disorders, and schizophrenia were identified as the major cost drivers of the total cost, in general. In particular, LOS, ambulatory services, and schizophrenia were the factors that increased costs in expensive subgroups. The “first hospital visit” and “a very short hospital re-visit” were associated with a cost increase, whereas “the number of planned consultations” was associated with a cost decrease. Conclusions The specialist mental healthcare division has a unique cost structure. Given that resources are utilized intensively at the early stage of care, improving the initial flow of hospital care can contribute to efficient resource utilization. Our study found empirical evidence that planned outpatient consultations may be associated with a reduced health care burden in the long-term.

La administración eficiente del capital humano y la efectividad institucional de los centros hospitalarios es fundamental para la efectividad institucional. El objetivo del estudio fue correlacionar la influencia de la gestión eficaz de los recursos humanos y eficacia institucional en el Hospital Dos de Mayo en Lima metropolitana, durante el periodo de agosto de 2021 y agosto de 2022. Metodología: tipo correlacional, diseño no experimental, transversal. La muestra estuvo conformada por 100 trabajadores. Resultados: la efectividad institucional está correlacionada significativamente con administración eficiente (rho=,9022; p=0,0410) planeación eficiente del capital humano (rho=,9032; p=0,0308), organización eficiente del capital humano (rho=,9041; p=0,0397), dirección eficiente del capital humano (rho=,9031; p=0,0397), control eficiente del capital humano (rho=,9211; p=0,0455), responsabilidad social institucional (rho=,9233; p=0,0413). Conclusiones: la efectividad institucional de los hospitales está correlacionada con la administración eficiente del capital humano.

Context: Though many arrangements had been made during the first wave, multiple complaints were reported regarding the arrangements made for COVID patients. The control room was set up as a 24 × 7 administrative coordination center to attend to issues after the initial setup of COVID units. Aim: To identify the major problems reported to the control room during the second wave of COVID-19 and find the related cause for the same. Methods and Materials: Issues reported to the control room were recorded from April to June (2021). The control room residents were asked to allocate each problem into six categories. Next, the residents allotted a frequency score to each of the problems depending on how regularly it was reported. Secondary data from various reports were also considered. Statistical Analysis Used: Data were analyzed using MS Excel software. Results: Various administrative issues were identified to be due to issues in communication and coordination (23%), policy and procedures (22%), human resource and training (16%), administration and implementation (15%), infrastructure (14%), and HMIS and IT (10%). Conclusion: Most frequent problems reported to the control room were related to infrastructure, policy implementation, and manpower training. After the initial implementation of new processes, there was a requirement for regular follow-up and coordination. This model of setting up an administrative control room and evidence-based approach will serve as a template for public hospitals to ensure coordination of hospital operations.

Background and Objectives: The Goal of National Health Mission has been to enhance the availability and access of good quality health care for vulnerable population. The study evaluates the compliance of a neonatal intensive care unit (NICU) in a tertiary care government teaching hospital with national quality assurance standards (NQAS). Materials and Methods: A descriptive, observational, cross-sectional study was conducted using validated checklist adopted from NQAS. The data were collected by utilizing data collection techniques such as observation, staff interview, and record review. Results: The NICU has achieved a total score of 65% in service provision. Major gaps n = 126 (29%) were identified. The number of checkpoints which needed to be fulfilled at the departmental level was n = 137 (80%), to be fulfilled at the institutional level was n = 34 (19.2%), and those to be fulfilled at the top-level administration was n = 1 (0.8%); recommendations were made accordingly for improvement. Conclusion: The study concludes that there were n = 126 (29%) noncompliant checkpoints/major gaps, particularly with respect to the quality management and outcome. Based on the findings of the study, the author recommends the development of a dedicated checklist with new checkpoints that need to be incorporated for medical college hospitals and institutes in the country to ensure quality patient care, which will consecutively improve the medical education and research.

Objective To study the characteristics and advantages of the tight trusteeship mode, and to provide expe-rience and suggestions for promoting the sinking of high-quality medical resources. Methods By literature analysis, the process and characteristics of hospital trusteeship reforms in China were summarized. Based on the “structure-process-results” theory, the tight, semi-tight, and loose trusteeship modes were compared using comparative research methods to summarize the main characteristics and advantages of the tight trusteeship mode. Through analyzing a case of tight trusteeship of a large provincial tertiary public hospital in Shandong Province, the specific practical measures, effectiveness, and existing problems of the tight trusteeship mode were discussed. Results The tight trusteeship mode is usually a comprehensive government trusteeship, where the trustee hospital provides a unified leadership to manage the entrusted hospital as a campus, integrating and homogenizing personnel ma-nagement, financial management, business management, informationization, and other aspects, achieving more stable collaboration and better performance. Conclusion The tight trusteeship mode is more conducive to channeling large public hospitals’ high-quality medical resources including brand, workforce, technology, and information towards primary medical institutions, which is an effective way to promote the expansion and sinking and regional balance of high-quality medical resources in the new era.

This study aims to develop web-based hospital management software. Several previous studies discovered some lack, such as manual queue calling, limited patient registration, difficult access to medical records, and the absence of reminders. In this study, we developed queue, reservation, medical record, reminder, and medical action modules. We expected that facilities could improve the operational efficiency of hospital services. The research stage starts with problem formulation, literature study, design determination, system development with five main modules, system testing, and the creation of research articles. Some limitations were identified, including responsive design and the expense of API system. [ABSTRACT FROM AUTHOR]

Background: Inpatient hospitalization has the potential to disrupt buprenorphine therapy. Objective: Among patients receiving outpatient buprenorphine prior to admission, we determined the rate of discontinuation during medical and surgical admissions to VA hospitals and its association with subsequent post-discharge continuation of buprenorphine therapy. Design and Main Measures: We conducted an observational study using Veterans Administration data from 10/1/2018 to 3/31/2020 for all medical and surgical admissions where Veterans had active buprenorphine prescriptions at the time of admission. Pre-admission buprenorphine prescriptions were categorized as either sublingual (presumed indication for opioid use disorder (OUD)) or buccal/topical (presumed indication for pain). The primary measure of post-discharge buprenorphine receipt was any outpatient buprenorphine prescription dispensed between 1 day prior to discharge and 60 days following discharge. Key Results: A total of 830 unique inpatient hospitalizations to medical or surgical services occurred among Veterans receiving sublingual (48.3%) or buccal/topical (51.7%) buprenorphine prior to admission. Fewer than half (43.9%) of these patients received buprenorphine at some point during the medical or surgical portion of their hospital stay. Among the 766 patients discharged from a medical or surgical unit, 74.3% received an outpatient buprenorphine prescription within the 60 days following discharge (80.2% sublingual and 69.1% buccal/topical). Among patients who had received buprenorphine during the final 36 h prior to discharge, subsequent outpatient buprenorphine receipt was observed in 94.0%, compared to only 63.7% among those not receiving buprenorphine during the final 36 h (χ2 = 83.5, p < 0.001). Conclusion: Inpatient buprenorphine administrations near the time of discharge were highly predictive of continued outpatient therapy and a significant subset of patients did not continue or reinitiate buprenorphine therapy following discharge. As recommendations for perioperative and inpatient management of buprenorphine coalescence around continuation, efforts are needed to optimize hospital-based buprenorphine practices. [ABSTRACT FROM AUTHOR]

Objective To understand the characteristics and hospital management procedures of mass casualty incidents in Jinshan District and to provide clinical suggestions for standardizing the management of mass casualty incidents. Methods A retrospective analysis of mass casualty incidents handled by the Affiliated Jinshan Hospital of Fudan University from January 1, 2010 to December 31, 2021 was conducted, and the characteristics and hospital treatment procedures of mass casualty incidents were analyzed. Results The hospital handled 197 mass casualty incidents in 12 years, with a total of 1 430 injured persons. The primary cause of injury was traffic accidents, accounting for 100 cases (50.9%), followed by chemical injuries, accounting for 25 cases (12.7% ). The most common age distribution of the injured population was between 21 and 50 years old, with 995 people (69.5%); 964 (67.4%) were male and 466 (32.6%) were female; 23 (1.6%) were dead on arrival; 73 (5.1%) were admitted to the ICU, and 106 (7.4%) were hospitalized. The frequency of mass casualty incidents was similar in March to May (spring) with 60 cases (30.5%), June to August (summer) with 52 cases (26.4%), and September to November (autumn) with 54 cases (27.4%), while the frequency decreased in December to next February (winter) with 31 cases (15.7%). The highest frequency of occurrence was from 8:00 to 16:00, with 186 cases (94.4%), followed by 16:00 to 24:00, with 11 cases (5.6%), and no mass casualty incidents occurred from 0:00 to 8:00. After the new treatment procedure was implemented in 2016, the forewarning rate increased significantly (P < 0.05), the forewarning content increased (P < 0.01), and the allocation time of treatment materials was significantly shortened (P < 0.01); the accuracy rate of secondary injury assessment increased (P < 0.01), and the retention time was significantly reduced (P < 0.01). Conclusions In Jinshan District of Shanghai, the primary cause of mass casualty incidents was traffic accidents, followed by chemical injuries. The age group with the most mass casualties was between 20 and 50 years old, with males significantly outnumbering females. The key points of mass casualty incident treatment include forewarning, timely initiation of treatment procedures, zone and hierarchical treatment, secondary damage control, timely diversion, experienced commanders, summary, and drills. [ABSTRACT FROM AUTHOR]

Introduction Initiation of medications for opioid use disorder (MOUD) within the hospital setting may improve outcomes for people who inject drugs (PWID) hospitalized because of an infection. Many studies used International Classification of Diseases (ICD) codes to identify PWID, although these may be misclassified and thus, inaccurate. We hypothesized that bias from misclassification of PWID using ICD codes may impact analyses of MOUD outcomes. Methods We analyzed a cohort of 36 868 cases of patients diagnosed with Staphylococcus aureus bacteremia at 124 US Veterans Health Administration hospitals between 2003 and 2014. To identify PWID, we implemented an ICD code–based algorithm and a natural language processing (NLP) algorithm for classification of admission notes. We analyzed outcomes of prescribing MOUD as an inpatient using both approaches. Our primary outcome was 365-day all-cause mortality. We fit mixed-effects Cox regression models with receipt or not of MOUD during the index hospitalization as the primary predictor and 365-day mortality as the outcome. Results NLP identified 2389 cases as PWID, whereas ICD codes identified 6804 cases as PWID. In the cohort identified by NLP, receipt of inpatient MOUD was associated with a protective effect on 365-day survival (adjusted hazard ratio, 0.48; 95% confidence interval,.29–.81; P <.01) compared with those not receiving MOUD. There was no significant effect of MOUD receipt in the cohort identified by ICD codes (adjusted hazard ratio, 1.00; 95% confidence interval,.77–1.30; P =.99). Conclusions MOUD was protective of all-cause mortality when NLP was used to identify PWID, but not significant when ICD codes were used to identify the analytic subjects. [ABSTRACT FROM AUTHOR]

PURPOSE: To perform an environmental scan of the current status of reimbursement for obstetric and gynecology services and identify problematic issues and opportunities for change. The areas that were evaluated include the American Medical Association (AMA) relative value unit assignment process, payer rates (where available), and trends in employment and salary determination for obstetrician-gynecologists (ob-gyns). METHODS: This report was developed by members of the American College of Obstetricians and Gynecologists' (ACOG) Committee on Health Economics and Coding using public-facing payment data from the Medicare Physician Fee Schedule and state Medicaid programs, as well as published research and commentary on payment for physicians, maternal health, and gynecologic surgery. Data from the Centers for Disease Control and Prevention were used to describe typical patient characteristics, and practice survey reports from the AMA were analyzed. Finally, an anonymous online survey was distributed to 27,854 members of ACOG in March 2022, with a response rate of 10.8% (3,018 members) and a CI of ±1.7%. FINDINGS: The evaluation found that payment for ob-gyns is heavily influenced by the values and rates set by third-party payers, a patient case-mix that includes a higher-than-average number of patients with Medicaid insurance, and the increase of employed physicians reliant on salary contracts that include productivity requirements and bonuses. RECOMMENDATIONS: The Committee identified action items, including payment reform for obstetric services; advocating for gynecologic surgery time as a priority for hospital administration; developing resources to assist employed physicians with payment, practice, and business management; developing a business and coding curriculum for students and early-career physicians; and continued advocacy with private and public policymakers who influence physician payment. [ABSTRACT FROM AUTHOR]

Lay summary: Malignant ureteric obstruction (MUO) is frequently encountered in patients with advanced cancers. In the largest study to date, assessing 852 patients from across Scotland, the authors demonstrated the presence of MUO as a marker of advanced disease across cancer types, with poor survival for many patients, even with intervention. There is uncertainty in optimal management of this condition, with marked differences in management between hospitals. Treatment to relieve the obstruction does not guarantee either improvement in kidney function or progression to further oncological treatment. The authors have developed a prognostic tool to estimate outcomes after intervention for MUO, and advocate its use for clinicians along with other data presented for patient counselling. [ABSTRACT FROM AUTHOR]

Purpose: The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities. Design/methodology/approach: This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies. Findings: The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies. Research limitations/implications: The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region. Originality/value: The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities. [ABSTRACT FROM AUTHOR]

Hospitals are increasingly faced with the challenge of providing quality services to patients, having to meet accreditation requirement, patient needs and expectations, social and ethical values, demands for continuous improvement in the quality of health services, as well as reducing costs, so that local people continue to use health services and facilities in that country. The aim of the research is to determine the readiness of the (RSUD) Rumah Sakit Umum Daerah Kabupaten Karanganyar infrastructure in implementing standard national health insurance inpatient classes. Qualitative research with a case study approach. The population in this study was Hospital Management. Sampling uses purposive sampling. The results of research on the application of KRIS are generally known, but do not know specifically because they have never received direct socialization and there are no regulations that specifically guide KRIS sufficient to face the current situation, and management and work realization have attempted to provide the best infrastructure for patients and in accordance with established standards [ABSTRACT FROM AUTHOR]

Although, strengthening patient safety competencies in nursing has been emphasized for enhancing quality care and patient safety. However, little is known about the association of nurses' perceptions of patient safety competency with adverse nurse outcomes in Iranian hospitals. This study aimed to measure nurses' levels of patient safety competency in the hospitals of Iran and examines the relationship between patient safety competency with the occurrence and reporting of adverse events (AEs). This cross-sectional research was applied in eight teaching hospitals in Tehran, Iran, between August and December 2021. A sample of 511 nurses was randomly selected using the table of random numbers. The validated Patient Safety Competency Self-Evaluation questionnaire was used. Furthermore, two questions were used to measure the incidence and reporting of AEs. Data analysis was performed using descriptive statistics, independent t-tests, and two binary logistic regression models through SPSS version 24.0. The mean patient safety competency score was 3.34 (SD = 0.74) out of 5.0; 41.5% of nurses rated their patient safety competency as less than 3. Among subscales, "skills of patient safety" scores were the highest, and "knowledge of patient safety" scores were the lowest. Nurses with higher Knowledge and Attitude scores were less likely to experience the occurrence of AEs (OR = 1.50 and OR = 0.58, respectively). Regarding AEs reporting, nurses with higher Skill and Attitude scores were 2.84 and 1.67 times, respectively, more likely to report AEs (OR = 2.84 and OR = 3.44, respectively). Our results provide evidence that enhancing PSC leads to reduced incidence of AEs and increased nurses' performance in reporting. Therefore, it is recommended that managers of hospitals should enhance the patient safety competency of nurses in incidents and reporting of patient safety adverse outcomes through quality expansion and training. Additionally, researchers should carry out further research to confirm the findings of the current study and identify interventions that would strengthen patient safety competencies and reduce the occurrence of AEs, and rise their reporting among nurses. [ABSTRACT FROM AUTHOR]

Background: This research depicts the linkage of public leadership on public health delivery (PHD) and collaborative administration. The research is also focused to examine the effect of public leadership on public health delivery through the intervening variable of collaborative administration by using both social information processing theory and collaboration theory. Methods: This research is based on quantitative method. Data was collected from 464 public hospital administration in the context of Pakistan. This study evaluated data using SPSS, AMOS, and PROCESS Macro. Results: Public leadership has a positive profound effect on public health delivery and collaborative administration, and that collaborative administration significantly promotes public health delivery. The outcomes also exposed that public leadership has substantial influence on public health delivery through intervening collaborative administration. Conclusions: Whilst public leadership demonstrated positive outcomes on public health delivery and collaborative administration, there is a need for more rigor studies on collaborative governance leadership, collaborative ethics and collaborative norms in the public health service. [ABSTRACT FROM AUTHOR]

Background: Hospital chief financial officer (CFO) contributes to improving health system performance. However, how to become an excellent hospital CFO has rarely been considered from a holistic perspective. This paper aims to identify competencies required by hospital CFO to fulfil the position's responsibilities and explore effective implementation pathways to generate high performance and improve healthcare service. Methods: We conducted 61 semi-structured interviews with individuals in key leadership positions in China's hospitals and researchers focusing on healthcare system management to identify core competencies necessary for hospital CFO. Interviews were analysed through a multi-stage review process and modified via expert vetting using a national panel of 23 professors. Subsequently, interviews were conducted with 32 hospital CFOs from 14 provinces throughout September 2021 to May 2022. We scored the performance of 32 hospital CFOs in various aspects of competency and used the fuzzy-set qualitative comparative analysis to explore the competency configurations of excellent CFOs. Results: We identify seven core competencies necessary for a hospital CFO to fulfil management practices, including personal morality, resource management, strategy management, learning ability, negotiating skill, leadership skill, and financial management. The findings indicate that a single competency factor is not a necessary condition to become an excellent hospital CFO. The results of qualitative comparative analysis then make it possible to propose four configurational paths, namely, supportive, interpersonal, all-around development, and technical, to become an excellent hospital CFO and achieve effective managerial performance. Conclusions: The responsibilities of hospital CFOs are complex and varied, hence, a better understanding of competencies required by CFO is essential to implement their responsibilities effectively. The identification in this study of the four effective implementation pathways to becoming an excellent hospital CFO enriches the literature on hospital management and provides implications for China's hospitals and their CFOs. [ABSTRACT FROM AUTHOR]

Objective: Antimicrobial resistance (AMR) has emerged as a serious global public health crisis. In response, 2016, 14 ministries in China, under the leadership of the National Health Commission, collaboratively issued the National Action Plan (NAP) to Contain Antibacterial Resistance (2016–2020). The NAP outlines strategies for medical institutions to adopt stewardship and implement AMR control. The purpose of this study was to comprehend stakeholders' perceptions of the NAP and explore the factors that influence its implementation in medical institutions. Methods: Semi-structured interviews were conducted with practitioners from medical institution in March and April 2021. Interviews were audio-recorded, transcribed and analyzed using thematic analysis via the framework approach. Results: Twenty practitioners, representing diverse roles (4 administrators, 7 clinicians, 3 microbiologists, 3 pharmacists, 3 nosocomial infection management personnel) from seven institutions, participated in the study. Substantial efforts have been undertaken to regulate the rational use of antibiotics and enhance the management of hospital infections. Participants demonstrated awareness and concern regarding antimicrobial resistance, with widespread support expressed for the NAP. Among all professions, there were varying opinions on whether they felt restricted in their daily work. The tertiary hospitals have established multidisciplinary cooperation mechanisms. Six main themes were identified as both barriers and facilitators to the implementation of the NAP in the medical institutions: individual factors, leadership, multidisciplinary collaboration, patient factors, training and culture. The capacity for administrative attention is constrained or limited, poor enforcement of guidelines, insufficient specialist staff and the liability pressure on clinicians were perceived barriers. To containing AMR in medical institutions, management of hospital infections, the public's knowledge of antibiotics' usage, routine education and multidisciplinary support would be facilitators. Conclusions: Practitioners from medical institutions were highly supportive for the NAP. Consideration of practitioners' perceived barriers and facilitators might enhance implementation of the NAP to contain antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Background: Hospital Examination Reservation System (HERS) was designed for reducing appointment examination waiting time and enhancing patients' medical satisfaction in China, but implementing HERS would encounter many difficulties. This study would investigate the factors that influence patients' utilization of HERS through UTAUT2, and provide valuable insights for hospital managements to drive the effective implementation of HERS. It is helpful for improving patients' medical satisfaction. Methods: We conducted a survey through the Sojump platform, targeting patients were who have already used HERS. We collected questionnaire information related to factors behavior intention, performance expectancy, and effort expectancy. Subsequently, we employed a structural equation model to analyze the factors influencing patients' utilization of HERS. Results: A total of 394 valid questionnaires were collected. Habit was the main direct positive factor influencing the behavioral intention of HERS (β = 0.593; 95%CI: 0.072, 1.944; P = 0.002), followed by patient innovation (β = 0.269; 95%CI: 0.002, 0.443; P < 0.001), effort expectancy (β = 0.239; 95%CI: -0.022, 0.478; P = 0.048). Patient innovation and facilitating conditions also have an indirect effect on behavioral intention. Perceived privacy exposure has a significantly negative effect on behavioral intention (β=-0.138; 95%CI: -0.225, -0.047; P < 0.001). The above variables explained 56.7% of the variation in behavioral intention. Conclusions: When HERS is implemented in hospitals, managements should arrange volunteers to guide patients to bring up the habit and solve the using difficulties, and managements could invite patients with high innovation to recommend HERS to others, what's more, it is a valid way to retain the old form of appointment to pass the transition period to the new system. HERS utilization and patients' medical satisfaction will be enhanced through the guidance of hospital management means. [ABSTRACT FROM AUTHOR]

Background: Hospitals in Japan established the healthcare delivery system from FY 2018 to 2021 by acquiring an additional reimbursement for infection prevention (ARIP) of category 1 or 2. However, research on outcomes of ARIP applications related to the practice of hospital pharmacists is scarce. Methods: This study assessed the activities performed by hospital pharmacists in hospitals with 100 to 299 beds, using ARIP acquirement as an indicator, using data from an annual questionnaire survey conducted in 2020 by the Japanese Society of Hospital Pharmacists on the status of hospital pharmacy departments. Out of the survey items, this study used those related to hospital functions, number of beds, number of pharmacists, whether the hospital is included in the diagnosis procedure combination (DPC) system, average length of stay, and nature of work being performed in the analysis. The relationship between the number of beds per pharmacist and state of implementation of pharmacist services or the average length of hospital stay was considered uncorrelated when the absolute value of the correlation coefficient was within 0–0.2, whereas the relationship was considered to have a weak, moderate, or strong correlation when the absolute value ranged at 0.2–0.4, 0.4–0.7, or 0.7–1, respectively. Results: Responses were received from 3612 (recovery rate: 43.6%) hospitals. Of these, 210 hospitals meeting the criteria for ARIP 1 with 100–299 beds, and 245 hospitals meeting the criteria for ARIP 2 with 100–299 beds, were included in our analysis. There was a significant difference in the number of pharmacists, with a larger number in ARIP 1 hospitals. For the pharmacist services, significant differences were observed, with a more frequency in ARIP 1 hospitals in pharmaceutical management and guidance to pre-hospitalization patients, sterile drug processing of injection drugs and therapeutic drug monitoring. In DPC hospitals with ARIP 1 (173 hospitals) and 2 (105 hospitals), the average number of beds per pharmacist was 21.7 and 24.7, respectively, while the average length of stay was 14.3 and 15.4 d, respectively. Additionally, a weak negative correlation was observed between the number of pharmacist services with "Fairly well" or "Often" and the number of beds per pharmacist for both ARIP 1 (R = -0.207) and ARIP 2 (R = -0.279) DPC hospitals. Furthermore, a weak correlation (R = 0.322) between the average number of beds per pharmacist and the average length of hospital stay was observed for ARIP 2 hospitals. Conclusions: Our results suggest that lower beds per pharmacist might lead to improved pharmacist services in 100–299 beds DPC hospitals with ARIP 1 or 2. The promotion of proactive efforts in hospital pharmacist services and fewer beds per pharmacist may relate to shorter hospital stays especially in small and medium-sized hospitals with ARIP 2 when ARIP acquisition was used as an indicator. These findings may help to accelerate the involvement of hospital pharmacists in infection control in the future. [ABSTRACT FROM AUTHOR]

New Public Management-inspired reforms in the Norwegian hospital sector have introduced several features from the private sector into a predominantly public healthcare system. Since the late 1990s, several reforms have been carried out with the intention of improving the utilization of resources. There is, however, limited knowledge about the long-term, and sector-wide effects of these reforms. In this study, using a panel data set of all public hospital trusts spanning nine years, we provide an analysis of the efficiency of hospital trusts using data envelopment analysis (DEA), as well as a Malmquist productivity index. Thereafter we use the efficiency scores as the dependent variable in a second-stage panel data regression analysis. We show that during the period between 2011 and 2019, on average, efficiency has increased over time. Further, in the second-stage analysis, we show that New Public Management features related to incentivization are associated with the level of hospital efficiency. We find no association between degree of competition and efficiency. [ABSTRACT FROM AUTHOR]