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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]

Introduction: Antimicrobial resistance (AMR) is a serious health threat, and it has high priority among the European public health agenda. The development and implementation of the National Action Plans (NAPs) with a One-Health perspective to fight AMR was supported in 2017 by the European Union (EU) through a Joint Action on Antimicrobial Resistance and Healthcare Associated Infections (EU-JAMRAI). The Italian National Institute of Health (Istituto Superiore di Sanità), supported by the University of Udine, and the University of Foggia were among the 44 partners involved. This paper describes the results of EU-JAMRAI relevant to Italy and its impact on national policies. Methods: The activities involved national and international experts who worked in groups, either in virtual or face-to-face meetings. Country-to-country visits were organized to assess and compare the national strategies to counteract AMR and to exchange best practices. In addition, qualitative research methods, particularly focus groups (FGs) and structured interviews, were carried out to collect information and opinions from the experts. Results: The Italian team of experts from the Ministry of Health and the University of Foggia visited the Netherlands and hosted the Polish expert team in Italy. In two FG, stakeholders' opinions from different organizations were collected and analyzed to identify critical areas and provide recommendations to ensure implementation of the NAP and effective One-Health integration. In addition, attitudes of medical professionals toward antimicrobial stewardship were evaluated in a medium/large Italian hospital. Strengths were identified in the multidisciplinary approach and the hospital management's proactive involvement. As for the veterinary sector, Italy was among the 10 EU countries that did not have any national AMR surveillance in place for animal bacterial pathogens. Consequently, a European surveillance system was proposed with the adhesion of Italy. Regarding research and innovation to fight AMR and healthcare-associated infection, Italy worked with the other European partners to identify national research gaps and opportunities. As a result, recommendations were issued to the authorities to promote research and innovation with a One-Health approach. Conclusions: The Italian participation in the EU JAMRAI provided experience and examples to the Italian government for implementing the NAP and planning the roadmap to fight AMR and helped point out the system's criticalities. It also supported the promotion of the One-Health integrated vision that was included in the updated NAP. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify the most significant issues for the effective performance management of hospitals. Methods: Accordingly, seven indicators were selected based on the literature review results. An analysis was carried out using the Spherical fuzzy TOP-DEMATEL method to determine the most important ones among these criteria. Results: The main contribution of this study was that the prior indicators of effective performance management in the hospitals were identified. With the help of this issue, hospitals can take actions to improve performance without having too much costs. Moreover, the main methodological originality of this study is that a new decision-making model is proposed by the name of TOPDEMATEL. Conclusion: Effective supply chain is found as the best factor that affects the performance of the hospitals. Additionally, advanced technology also plays a key role in this framework. Nevertheless, qualified personnel criterion is on the last rank. Supply network refers to the process of providing medical supplies, medicines, equipment, and other resources for healthcare institutions. These resources are of great importance for the performance of hospitals as they are needed to deliver the service. [ABSTRACT FROM AUTHOR]

Research is an essential element in the practice of healthcare, and hospitals play a fundamental role in its promotion. Research in hospitals can improve the quality of care, knowledge of diseases and the discovery of new therapies. Hospitals can conduct research in various fields, including basic research, clinical research, population-based research and even hospital management research. The findings of hospital research can be directly applied to clinical practice and management, thereby enhancing the quality of patient care, a central paradigm in translational health. This article details the experience of the National Cancer Institute of Chile over the past 8 years in its role as a high-complexity public hospital, specialised institute, healthcare centre, teaching institution, and research facility. It reviews the work of generating and strengthening its institutional research model since its redesign in 2018, the key elements that underpin it, and discusses the challenges the institute faces in its growth amidst the increasing cancer epidemiology in Chile, the recent enactment of a National Cancer Law, the post-pandemic scenario that has left a significant waiting list of oncology patients, and the initiation of the design and construction process for the new institute building. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic limitation has led to a variety of psychiatric manifestations in humans. These effects were brought about by insufficient planning and a lack of awareness of the epidemic. Infrastructure, human resources, and steady supply are all important, as is the transportation of medications, food, and surgical supplies for the patients. Managing biomedical waste, which includes collecting and segregating it, comes last, includes its storage and transit. Including the challenges, they face with regards to the disposal of dead bodies. [ABSTRACT FROM AUTHOR]

Introduction: The legalization of cannabis in the United States (US) is increasing. Similarly, published literature indicates that pediatric cannabis exposures have increased, including in Texas, where the recreational use of cannabis is illegal, but certain physicians can prescribe cannabis for patients with certain conditions. Adverse effects associated with pediatric cannabis exposure include drowsiness or lethargy, ataxia, tachycardia, mydriasis, hypotonia, muscle rigidity, seizures, and agitation or irritability. The objective of this study was to characterize trends in cannabis exposures by young children treated at US hospital emergency departments (EDs). Methods: Data were obtained from the National Electronic Injury Surveillance System (NEISS), a database of consumer product-related injuries and all poisonings among children 0-4 years collected from a sample of approximately 100 US hospital EDs. National estimates can be calculated from database records. Cannabis exposures involving patients age 0-4 years reported during 2000-2022 were identified and analyzed. Results: A total of 270 cannabis exposures involving patients age 0-4 years treated at a sample of US hospital EDs during 2000-2022 were identified, resulting in a national estimate of 5,504 such exposures. The annual estimated number of exposures ranged between 0 and 175 during 2000-2017 and was 415 in 2018, 416 in 2019, 757 in 2020, 1,429 in 2021, and 1,440 in 2022. The distribution by disposition was 43.3% treated or examined and released from the ED, 40.7% treated and admitted for hospitalization, 6.6% held for observation, 7.9% treated and transferred to another hospital, and 4.5% left without being seen/left against medical advice. Conclusion: This study found that the number of pediatric cannabis exposures treated at US hospital EDs increased greatly during 2018-2022 when compared to the prior 18 years. Over half of the patients required hospital management beyond the ED. [ABSTRACT FROM AUTHOR]

Background: Epidemics are threats to communities and their health. The preparedness of makeshift hospitals in epidemics in management, planning, implementation, and structure to provide appropriate and timely services is essential. Studies show that the incidence command system and the operational fact sheet based on task descriptions and instructions in makeshift hospitals are not considered. This study is designed to develop an appropriate organizational structure for makeshift hospitals. Materials and Methods: This was a descriptive-analytical cross-sectional study in two stages, including review and expert panel studies, to develop a national fact sheet guide and the structure of makeshift hospitals. Results: Based on the nature of disasters, makeshift hospitals should have specific structures. In the structure designed for a makeshift hospital, according to the center's services and time of activation, it is necessary to have a manager, management, and executive staff. A medical specialist, such as an infectious or pulmonary specialist, is essential, depending on the situation. Considering the limited resources in developing countries and the importance of managing resources (financial, human, and equipment) and improving the quality of health services, it will be helpful to formulate a management structure and implement operational worksheets in the least possible time. Conclusion: The use of command and management structure will improve decision-making in critical situations, especially in cases of epidemics, the need for quarantine, and the provision of services to injured patients. [ABSTRACT FROM AUTHOR]

This study proposes a critical and reflective analysis of the adhesion of the University Hospital (HU) of the Federal University of Santa Catarina (UFSC) to the Brazilian Hospital Services Company (EBSERH), based on the theory of Organizational Hybridism as a lens of analysis. The methodology used in the research is qualitative, with descriptive and explanatory objectives, carried out through bibliographic and documentary data collection. We argue that Organizational Hybridism has the potential to be adopted as a theory for analyzing phenomena related to the management of university hospitals run by public companies under private law. HU-UFSC/EBSERH is a hybrid organization which, given its organizational specificity and complexity, as well as the multiple institutional logics that make it up, is still in the process of building its organizational identity The integration of the institutional public policies materialized by HU-UFSC with the educational public policies materialized by EBSERH causes inconsistencies and contradictions in the face of contractual, educational and social divergences. The main results show that the work of managers becomes more complex when it comes to giving back to society about the social function that the university hospital performs. Since it combines the characteristics of non-profit organizations with profit-making organizations. HU-UFSC/EBSERH is a dissident hybrid, where the role of organizational governance is crucial to balancing different logical prescriptions. [ABSTRACT FROM AUTHOR]

A critical situation can substantially impact human behavior, resulting in irreversible behavioral changes. Given the interdependence between various economic aspects and public health measures, including lockdowns, national economies have become unstable, signifying a transformation in market dynamics. The authors aimed to gain a deeper understanding of consumer behavior in the context of the COVID-19 pandemic, recognizing that crises often lead to alterations in consumer behavior patterns. We searched eight databases - CINAHL, Cochrane Library, Embase, EmCare, JBI EBP, Medline, Scopus, and PsycInfo. Out of 366 titles and abstracts, twenty-four papers were selected. In an observational study, 11 (45.8%) publications were conducted in hospitals, clinics, and communities. Meanwhile, the rest of the studies were carried out in various other healthcare institutions. Consumer behavior and using technology as marketing tools during the COVID-19 pandemic were the most commonly explored topics. The hospital-at-home model illustrates how healthcare institutions can undertake significant strategic initiatives to usher in comprehensive reforms that prioritize consumers and transform care delivery. The persistent drive to employ digital technology for enhancing the quality of healthcare services and reducing costs serves as a constant motivation. This implies that the consistent effort to harness digital technology to enhance healthcare service quality and reduce expenses has been a steady impetus. Further research is required to ascertain the long-term effectiveness and suitable strategies for optimizing advantages while mitigating risks in the COVID-19 pandemic. A more comprehensive approach would include taking patients' perspectives on using digital health technologies and addressing specific challenges, ethical considerations, and drawbacks highlighted in the existing literature. [ABSTRACT FROM AUTHOR]

Aims and objectives: (1) To investigate the vulnerability of nurses to experiencing professional burnout and low fulfilment across 5 months of the COVID‐19 pandemic. (2) To identify modifiable variables in hospital leadership and individual vulnerabilities that may mitigate these effects. Background: Nurses were at increased risk for burnout and low fulfilment prior to the COVID‐19 pandemic. Hospital leadership factors such as organisational structure and open communication and consideration of employee opinions are known to have positive impacts on work attitudes. Personal risk factors for burnout include symptoms of depression and anxiety. Methods: Healthcare workers (n = 406 at baseline, n = 234 longitudinal), including doctors (n = 102), nurses (n = 94), technicians (n = 90) and non‐clinical administrative staff (n = 120), completed 5 online questionnaires, once per month, for 5 months. Participants completed self‐report questionnaires on professional fulfilment and burnout, perceptions of healthcare leadership, and symptoms of anxiety and depression. Participants were recruited from various healthcare settings in the southeastern United States. The STROBE checklist was used to report the present study. Results: Both at baseline and across the 5 months, nurses working during the COVID‐19 pandemic reported increased burnout and decreased fulfilment relative to doctors. For all participants, burnout remained largely steady and fulfilment decreased slightly. The strongest predictors of both burnout and fulfilment were organisational structure and depressive symptoms. Leadership consideration and anxiety symptoms had smaller, yet significant, relationships to burnout and fulfilment in longitudinal analyses. Conclusions: Burnout and reduced fulfilment remain a problem for healthcare workers, especially nurses. Leadership styles and employee symptoms of depression and anxiety are appropriate targets for intervention. Relevance to clinical practice: Leadership wishing to reduce burnout and increase fulfilment among employees should increase levels of organisational support and consideration and expand supports to employees seeking treatment for depression and anxiety. [ABSTRACT FROM AUTHOR]

To analyze the Patient Safety Culture in nine Emergency Care Units (UPAs) managed by the Institute of Health and Hospital Management in the year 2023. This is a descriptive, cross-sectional study with a quantitative approach. The instrument used was a questionnaire adapted from the Hospital Survey on Patient Safety Culture (HSOPSC) instrument. Its structure is divided into 12 dimensions. Regarding completion, a total of 77% responses were obtained from all employees. Thus, "Organizational learning/continuous improvement" stood out with the greatest potential, in which the professionals' responses obtained an average of 87.44%, followed by "Expectations and actions of the management/supervision of the unit/service that favor safety (85,19%) and "Unit/service teamwork" (78,02%). Therefore, it is concluded that the HSOPSC technological instrument gained responses from employees along the path it took, achieving results to reinforce the organization's safety culture, bringing positive impacts on the life of society. [ABSTRACT FROM AUTHOR]

To present the experience of building and maintaining a pediatric palliative care service (PPC) in a hospital under the administration of the Health Department of the State of Ceará, Brazil. This is an experience report. The service began at the institution in 2017, with a minimal advisory team, including medical professionals, a nurse, a psychologist and a social worker. The growing recognition of the importance of palliation has required a reassessment of paradigms. These setbacks were faced not only with the patients' families, but also with the care teams. Despite progress, early referral remains a challenge in everyday life. Setting up a service dedicated to pediatric palliative care is a process that requires consideration of different elements. Discussing the structuring of such a specific service aims to share learnings and encourage the continuous evolution of the area, promoting a multidimensional approach to care. [ABSTRACT FROM AUTHOR]

Objectives: This research aims to assess the prevalence of microbial contamination related to the usage of eye drops in hospital settings and identify strategies to manage such undesirable incidents. Research Methodology: A systematic literature review was conducted, followed by a planned analysis to see if sufficient data were available. Subsequently, research and development were undertaken to innovate a solution for detecting or preventing microbial contamination of eye drops before usage. Research Findings: Six selected studies met the inclusion criteria, displaying internal validity and practical applicability. However, there is a moderate to low level of bias present. The studies collectively suggest that current management practices in hospitals lack effective measures to address the microbial contamination risks associated with eye drops. Contamination can occur both externally in the packaging and within the eye drop solution, leading to ongoing risks during continuous usage. Analytical challenges arise due to the substantial methodological differences and biases in each study, preventing comprehensive data synthesis. In the research and development phase, it was found that determining whether eye drops are contaminated before use is more beneficial than using them without this knowledge. A simple chemical method involving a reaction between silver nanoparticles and microorganisms, resulting in a visible color change, was proposed for contamination detection. Conclusion: This research provides insights into the prevalence of microbial contamination in eye drops, indicating a continual risk. The lack of standardized methodologies and biases in existing studies hinder comprehensive analysis. The innovation introduced involves a straightforward method for detecting contamination before eye drop usage, offering a practical preventive measure for undesirable incidents. [ABSTRACT FROM AUTHOR]

Innovation is considered a competitive mechanism for organizational performance and success, and is considered an important instrument for adapting to the ever-changing business environment. This research aims to analyze the influence of Organizational Culture and Group Climate on Innovation Readiness at Hasanuddin University Hospital. The type of research carried out was quantitative research using an observational study with a cross sectional study design. The sample in this study was employees at the hospital, totaling 123 respondents. The research results show that there is a direct influence of organizational culture on innovation readiness, there is a direct influence of group climate on innovation readiness. It is recommended that hospital management be open to new ideas and encourage their employees to be more open and accept input from other employees. This will greatly encourage the emergence of innovation, improve the climate in positive work teams, such as participative, open and safe, will motivate employees to show Innovative and improving behavior creates or adopts new ideas, products, services, programs, technologies, policies, structures or new administrative systems. [ABSTRACT FROM AUTHOR]

The article aims to analyze the contexts of influence and text production of the Urgent and Emergency Care Networks (RUE) policy in Brazil through the Policy Cycle Approach. Qualitative research was carried out through document analysis of legal texts, technical, and academic publications to analyze the contexts of influence and production of RUE texts, not being the object of this study the context of practice. The context of influences evidenced the dispute for the legitimacy of the SUS, neoliberalism, underfunding, managerialism, the hospital crisis, and the predominance of the health care network model. The texts, on the other hand, express values of citizenship, access, quality and comprehensiveness; purposes of nationalization and improvement of response time; influences from the previous policy of urgency and humanization, the area of hospital administration and concepts from the field of collective health. The plural and multifaceted character of the policy can bring challenges in the context of practice, to be researched in future studies, due to the need to develop and articulate different ideas and practices identified in the texts and resulting from multiple and diverse influences. Still, these can be resignified and crossed by vectors and disputes in fields of unique practices of decentralized and diverse management in the country, in the different services, municipalities and health regions. [ABSTRACT FROM AUTHOR]

The paper focused on the assessment of secondary healthcare administration in Lagos with respect to examined the administrative structure put in place in secondary healthcare facilities and evaluated the effects of administrative structure on secondary healthcare service in Lagos as well as analysed the challenges confronting the administration of secondary healthcare service in Lagos. The paper employed descriptive research design and quantitative research approach. The data were gathered through administration of structured questionnaire. The paper used 20% of the study population 1341, making 268 sample size for questionnaire which consisted of both medical and non-medical staff of three selected General Hospital in Lagos i.e. one from each senatorial district in Lagos State. Data collected were analysed using frequency distribution, percentages, tables, and t-test. The study revealed that sustainability of administrative structure put in place in Lagos State to manage the secondary healthcare service are impactful and has significant effects on the services rendered. Therefore, the paper recommended that hospital administration should provide up to date medical technology and infrastructure need to easy the work of health workers and promote service delivery and that government should be an increase in the financial commitment and budget allocation of the government to the health care sector to address the existing financial challenges. The paper concluded that sustainability of administrative structure has direct effect on secondary healthcare on service delivery in Lagos, Nigeria. [ABSTRACT FROM AUTHOR]

Background: Internet hospitals (IHs) have rapidly developed as a promising strategy to address supply-demand imbalances in China's medical industry, with their capabilities directly dependent on information platform functionality. Furthermore, a novel theory of "Trinity" smart hospital has provided advanced guidelines on IH constructions. Objective: This study aimed to explore the construction experience, construction models, and development prospects based on operational data from IHs. Methods: Based on existing information systems and internet service functionalities, our hospital has built a "Smart Hospital Internet Information Platform (SHIIP)" for IH operations, actively to expand online services, digitalize traditional health care, and explore health care services modes throughout the entire process and lifecycle. This article encompasses the platform architecture design, technological applications, patient service content and processes, health care professional support features, administrative management tools, and associated operational data. Results: Our platform has presented a set of data, including 82,279,669 visits, 420,120 online medical consultations, 124,422 electronic prescriptions, 92,285 medication deliveries, 6,965,566 prediagnosis triages, 4,995,824 offline outpatient appointments, 2025 medical education articles with a total of 15,148,310 views, and so on. These data demonstrate the significant role of IH as an indispensable component of our physical hospital services, with deep integration between online and offline health care systems. Conclusions: The upward trends in various data metrics indicate that our IH has gained significant recognition and usage among both the public and healthcare workers, and may have promising development prospects. Additionally, the platform construction approach, which prioritizes comprehensive service digitization and the 'Trinity' of the public, healthcare workers, and managers, serves as an effective means of promoting the development of Internet Hospitals. Such insights may prove invaluable in guiding the development of IH and facilitating the continued evolution of the Internet healthcare sector. [ABSTRACT FROM AUTHOR]

Background: Tertiary hospitals in China are confronted with significant challenges due to limited spatial capacity and workforce constraints, leading to saturated allocation of medical resources and restricted growth in medical service provision. The incorporation of digital health into medical service process reengineering (MSPR) marks a pivotal transformation and restructuring of conventional health service delivery models. Specifically, the application of MSPR to blood sampling services processes reengineering (BSSPR) holds promise for substantially enhancing the efficiency and quality of medical services through streamlining and optimizing these procedures. However, the comprehensive impact of BSSPR has been infrequently quantified in existing research. Objective: This study aims to investigate the influence of BSSPR on the efficiency and quality of medical services and to elucidate the key informative technological support points underpinning BSSPR. Methods: Data were collected from both the new and old laboratory information systems from August 1, 2019, to December 31, 2021. A combination of statistical description, chi-square test, and t test was used to compare check-in time and waiting time of outpatients before and after the implementation of BSSPR. An interrupted time-series design was used to analyze the impact of BSSPR on medical service efficiency and quality, enabling the control of confounding variables, including changes in medical human resources and both long- and short-term temporal trends. Results: BSSPR had an impact on the efficiency and quality of medical services. Notably, there was a significant increase in the number of patients receiving blood sampling services, with a daily service volume increase of ~150 individuals (P =.04). The average waiting time for patients decreased substantially from 29 (SD 36) to 11 (SD 11) minutes, indicating a marked improvement in patient experience. During the peak period, the number of patients receiving blood sampling services per working hour statistically increased from 9.56 to 16.77 (P <.001). The interrupted time-series model results demonstrated a reduction in patients' waiting time by an average of 26.1 (SD 3.8; 95% CI –33.64 to –18.57) minutes. Although there was an initial decline in the number of outpatients admitted following BSSPR implementation, an upward trend was observed over time (β=1.13, 95% CI 0.91-1.36). Conclusions: BSSPR implementation for outpatients not only reduced waiting time and improved patients' experience but also augmented the hospital's capacity to provide medical services. This study's findings offer valuable insights into the potential advantages of BSSPR and underscore the significance of harnessing digital technologies to optimize medical service processes. This research serves as a foundational basis and provides scientific support for the promotion and application of BSSPR in other health care contexts. By continuing to explore and refine the integration of digital technologies in health care, we can further enhance patient outcomes and elevate the overall quality of medical services. [ABSTRACT FROM AUTHOR]

Background: Early warning scores (EWS) are routinely used in hospitals to assess a patient's risk of deterioration. EWS are traditionally recorded on paper observation charts but are increasingly recorded digitally. In either case, evidence for the clinical effectiveness of such scores is mixed, and previous studies have not considered whether EWS leads to changes in how deteriorating patients are managed. Objective: This study aims to examine whether the introduction of a digital EWS system was associated with more frequent observation of patients with abnormal vital signs, a precursor to earlier clinical intervention. Methods: We conducted a 2-armed stepped-wedge study from February 2015 to December 2016, over 4 hospitals in 1 UK hospital trust. In the control arm, vital signs were recorded using paper observation charts. In the intervention arm, a digital EWS system was used. The primary outcome measure was time to next observation (TTNO), defined as the time between a patient's first elevated EWS (EWS ≥3) and subsequent observations set. Secondary outcomes were time to death in the hospital, length of stay, and time to unplanned intensive care unit admission. Differences between the 2 arms were analyzed using a mixed-effects Cox model. The usability of the system was assessed using the system usability score survey. Results: We included 12,802 admissions, 1084 in the paper (control) arm and 11,718 in the digital EWS (intervention) arm. The system usability score was 77.6, indicating good usability. The median TTNO in the control and intervention arms were 128 (IQR 73-218) minutes and 131 (IQR 73-223) minutes, respectively. The corresponding hazard ratio for TTNO was 0.99 (95% CI 0.91-1.07; P =.73). Conclusions: We demonstrated strong clinical engagement with the system. We found no difference in any of the predefined patient outcomes, suggesting that the introduction of a highly usable electronic system can be achieved without impacting clinical care. Our findings contrast with previous claims that digital EWS systems are associated with improvement in clinical outcomes. Future research should investigate how digital EWS systems can be integrated with new clinical pathways adjusting staff behaviors to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Effective management of hospital maintenance units is crucial for the upkeep and repair of medical and general equipment, ensuring uninterrupted, high-quality healthcare services. The National Hospital of Sri Lanka (NHSL), established in the 1970s, relies on a vast array of equipment, making the efficiency of its maintenance unit vital. This study examines strategies to enhance operational efficiency in hospital maintenance units, drawing lessons from NHSL. Objectives included evaluating the efficiency of NHSL’s current maintenance processes, identifying areas for improvement, and developing recommendations for enhancing the unit. A qualitative approach was employed, involving observation visits and semi-structured key informant interviews with administrative and technical officers, ward in-charges, storekeeper, maintenance workers, and public works department workers. Data were coded and analyzed using NVivo software to identify common themes and challenges. Findings revealed several critical issues: persistent delays in repairs and frequent equipment breakdowns, a lack of skilled staff, gaps in technical and supervisory skills, delays in recruitment, poor communication, and lack of recognition for maintenance staff contributions, inadequate technical training opportunities, limited repair and storage space, insufficient sanitary facilities, and delays in spare parts supply. The study underscores the need for strategic improvements in NHSL’s maintenance unit. Key recommendations include conducting training programs, establishing a central maintenance unit, providing new machinery and tools, regular vocational training, improving communication channels, and enhancing sanitary facilities. Addressing these challenges can significantly improve the maintenance unit’s operational efficiency and the overall quality of healthcare services at NHSL. [ABSTRACT FROM AUTHOR]

Purpose: Improving the quality of medical services is one of the key focus areas of hospital management. The search for opportunities for improvement, addressing real problems and meeting the needs of customers becomes particularly important in the face of such challenges as technological, especially the development of digitization and e-medicine, demographic changes, including, among others, aging societies, political and financial. The study was conducted to identify and analyze staff attributes that determine the achievement of a level of patient satisfaction with the quality of hospital services. Design/methodology/approach: Based on desk research and interviews with patients of a sample hospital, six key staff attributes important for achieving satisfaction with the quality of hospital services were identified. These attributes were subjected to empirical studies conducted in accordance with the methodology of the Kano model (first stage) and the survey method (second stage). The results of the studies made it possible to identify gaps between the highest desired degree of satisfaction and the level resulting from the patients' actual evaluation. Subsequently, the authors formulated their own recommendations for strengthening human capital for increasing the quality of hospital services. Findings: Based on the research, the map of key staff attributes affecting patient satisfaction with the quality of hospital services was developed. The attributes with the greatest importance and strength of influence on the quality of services, characteristic of the three professional groups studied, were then identified. Among them were: professionalism, kindness and politeness towards the patient and his family members, individualized approach to the patient. Recognizing the opinions of patients of a particular hospital, the attributes that were important but at the same time rated lowest were identified. On this basis, gaps between the expected and actual state were identified, and suggestions were made for improvement in the areas of knowledge, communication and cooperation. Research limitations/implications: Some limitations were recognized in the research process, primarily due to the size of the research sample and the scope and scale of empirical research. It seems desirable to expand the research field to include the international environment. Conclusions made against the background of other cultural or systemic conditions of health care in a given country could enrich the conducted comparative analysis with interesting insights. In addition, the study of correlations between an expanded set of factors influencing the quality of hospital services and the level of patient satisfaction could provide a direction for further research. Practical implications: The results of the study may be of interest to stakeholders in the health care industry. Identifying the key personnel attributes of greatest importance and power to influence service quality seems important for designing changes that strengthen a hospital's human capital. The presented suggestions for improvement in the areas of knowledge, communication and cooperation based on the results of patient satisfaction surveys of a specific hospital have application value. Social implications: Implementation of changes designed on the basis of the research results presented and suggestions for improvement in the areas of knowledge, communication and cooperation can realistically improve patient satisfaction with the quality of hospital services. In addition, hospitals' interest in improving the quality of services in response to patients' needs and expectations demonstrates social responsibility. Originality/value: The paper identifies key staff attributes important for achieving patient satisfaction with the quality of hospital services. It also provides practical recommendations for improvement in the areas of knowledge, communication and cooperation. The article is dedicated to academic and healthcare professionals, including hospital managers, as well as local government administration. [ABSTRACT FROM AUTHOR]

Purpose: Identification of infrastructure attributes that are crucial for achieving patient satisfaction. Design/methodology/approach: Based on a literature review, an initial set of infrastructure elements (attributes) determining the level of patient satisfaction with hospitalization was identified. In the empirical part, these attributes were verified in two ways: through surveys conducted in a selected hospital and through research based on the Kano methodology (CAWI method). Findings: It was found that the availability and cleanliness of sanitary rooms, markings of hospital units and communication routes, and facilities for people with disabilities significantly influence the level of satisfaction with hospitalization. There were indicated some areas in which the managers of the studied hospital could make some improvements. For example, an attribute where changes could be recommended is I5 - facilities for people with disabilities. Research limitations/implications: The publication presents the results of the literature review, which can be expanded in further research on the topic discussed. However, this study is limited to the relatively small group of patients and respondents who participated in surveys. These limitations concern also the geographical area and the number of hospital facilities, which suggest possible directions for future research. Practical implications: The results of the study may have practical applications in the area of hospital management. Satisfaction surveys completed by patients from various hospitals will identify the infrastructure elements with the lowest patient satisfaction. Therefore, they may constitute the basis for developing guidelines to improve satisfaction with hospitalization. Additionally, the Kano methodology indicates which attributes are most important to patients. Social implications: Introducing changes in the areas of infrastructure elements indicated in the study may result not only in increased patient satisfaction with the hospitalization process, but also in a real improvement in the conditions in which patients stay. This may be important for their well-being and could influence the recovery process. Originality/value: The article presents two-track research conducted among the public and actual patients of a provincial public hospital. The methodology prepared in this way can be helpful for hospital managers because it provides insight into social expectations and the actual assessment of the examined infrastructure attributes. [ABSTRACT FROM AUTHOR]

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Patient flow simulation and analysis is one of the oldest IT-based methods used to optimize patient care processes and hospital management. During the pandemic, interest in this domain suddenly increased due to the various constraints and recommendations to reduce the likelihood of further infections in the hospital. Suddenly, metrics such as the number of patients waiting in the same area, the maximum time a patient could stay in a single room, and the minimum distance between patients became important issues to monitor and optimize. Using data and modelling concepts from various hospitals, our team developed a simulation tool that used bpmn models to define an emergency department. We then modified a single day's usual patient flow with various real-world inspired edge cases to evaluate how the simulated flow would change and which stations would become bottlenecks, where the quality of patient care would deteriorate and rooms would become overcrowded. To execute the models, we developed our own tool based on the open-source Camunda modeling tool and the Business Process Model Notation (BPMN) file format. To execute the generated models, we use our own Python-based execution environment based on the SpiffWorkow library, which permits extensive logging and extensive customization of the attributes analysed. In addition, the modelling toolkit of Camunda was narrowed down and compiled so that it could be easily used by researchers who are not programmers. In the paper, we present both the modeling process and the scenario design process, as well as the results obtained through the runs, including the maximum waiting times during the model runs and the maximum number of patients waiting at once, which allowed us to validate the effectiveness of the framework. [ABSTRACT FROM AUTHOR]

“Multiple Disease Prediction” is a system based on predictive modeling that will predict the user's disease based on the given symptoms. We have considered four diseases for now, that is Heart disease, Liver disease, Chronic Kidney Disease, and Diabetes. There are existing systems that can predict one disease at a time and perhaps with lower accuracy, which puts a patient’s health in danger. In this project, we aim to design a multiple disease prediction system by applying principles of machine learning, where our application incorporates two ways of predicting diseases for two different categories of users. For single users, the user must enter various parameters of the disease, and the system would display the output whether she/he has the disease or not. The project makes it easier for a multitude of users, such as a hospital management system, to anticipate diseases from the results of laboratory blood test reports. Blood analysis is a crucial disease indicator since it comprises several factors that are symptoms of diseases. This project not only emphasizes prediction precision but also opens the possibility of easily introducing new diseases. [ABSTRACT FROM AUTHOR]

Background and purpose: Artificial intelligence (AI) plays a crucial role in the optimal management of hospital waste, particularly in predicting the volume and type of waste generated. This study aims to identify and rank the risks associated with the use of AI systems in hospital waste management by employing a multi-criteria decision-making approach. Methods: This descriptive, cross-sectional study was conducted in 2023 (1402 in the Iranian calendar) at two hospitals, Ali Ibn Abitaleb and Khatam al-Anbiah, in Zahedan. Ten hospital staff members were selected as expert participants for the Delphi panel. The Shannon entropy method was utilized for risk weighting, and the TOPSIS method was applied to rank the identified risks. Results: Kendall's coordination coefficient was used to assess the level of consensus among the Delphi panel members, with the coefficient values for the first, second, and third Delphi rounds being 6.3, 7.1, and 7.3, respectively. The indicators were weighted using the Shannon entropy method, based on three criteria: impact intensity (0.3), probability of occurrence (0.4), and detection probability (0.32). The TOPSIS method was then employed to rank the identified risks, with the most significant risks being the need for necessary infrastructure (0.847), the requirement for accurate and complete data (0.751), and budget constraints (0.749.) Conclusion: By applying multi-criteria decision-making methods, healthcare managers can effectively identify and prioritize the risks associated with using AI systems in hospital waste management, enabling them to focus on strengthening waste management practices based on these priorities. [ABSTRACT FROM AUTHOR]

Background and Purpose: Organizational commitment among nurses, a critical aspect of hospital workforce management, is influenced by various factors, including job attachment. This attachment fosters motivation and commitment, which ultimately enhances the quality of healthcare services. This study investigates the relationship between organizational commitment and job attachment among nurses working in selected teaching hospitals affiliated with Shahid Sadoughi University of Medical Sciences in Yazd in 2022. Methods: This descriptive-analytical study involved all nurses at Shahid Sadoughi Hospital in Yazd. A sample size of 298 nurses was determined using Cochran's formula. Data collection was conducted using the Job Descriptive Index (JDI) by Edwards and Kilpatrick (1984) and the Organizational Commitment Questionnaire (OCQ) by Allen and Meyer (1990). The data were analyzed using the Chi-square test with SPSS version 21 software and structural equation modeling via LISREL software. Results: Among the nurses surveyed, 43.17% reported being satisfied with their jobs, while 40.17% exhibited organizational commitment. The findings revealed a significant relationship between job attachment and organizational commitment (P<0.001). The average scores were 3.75 ± 0.76 for the affective dimension, 3.97 ± 0.26 for the continuance dimension, 3.65 ± 0.36 for the normative dimension, and 3.74 ± 0.93 for overall job attachment. Conclusion: The significant direct relationship between job satisfaction and organizational commitment highlights the importance of managerial focus on enhancing job satisfaction to increase employee responsibility and commitment. Managers should prioritize factors that improve job satisfaction as a means to strengthen organizational commitment. [ABSTRACT FROM AUTHOR]

Aim: Health data is considered to be highly sensitive and the protection of health data is an ethical and legal responsibility for all health data managing structures. Healthcare organizations use various security measures and techniques to adopt a secure electronic health data recording system in which, in addition, they keep log data. Hospital Information System (HIS) developers had been keeping the log records according to their needs by making the necessary coding for the "changedelete" triggers. Therefore, there was a dire need to develop a common standard for keeping diaries in health information systems. This new standard was considered to be a guide for software developers and was named as Minimum Log Standards in Health (SAMILOG). This study explains the development process of SAMILOG. Method: Focus group meetings were held with seven developer companies. Several scenarios of unauthorized access or data breaches in a health information system were created. The participants discussed each scenario and they evaluated the best methods for keeping logs and which data should be kept as log in each case. Previously, a standard called Minimum Data Model- Minimum Veri Modeli (VEM) was developed to assist data migration to a new HIS software when the hospital administration decides to go for a change. The data field names of VEM standard were also used in this new SAMILOG standard. Results: In SAMILOG 1.0, which of the data elements in each VEM set should be logged was determined, it required an update for SAMILOG as the VEM was updated. Conclusion: SAMILOG v1.0 was announced in 2016 and since then in case of a security breach of health data of public hospitals in Turkey, it is primarily the data logged within the scope of SAMILOG which is examined. [ABSTRACT FROM AUTHOR]

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Económicas CUC is the property of Corporacion Universidad de la Costa, CUC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Espirales Revista Multidisciplinaria de Investigación is the property of Grupo Compas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study examined owners-based exogenous factors that could hamper adequate management and treatment of Biomedical Waste (BMW) at the Federal and State governments owned tertiary health facilities located in Ekiti State, Nigeria. Failure to address these impediments has been identified as bane of inadequate BMW management, capable of escalating insurgence of epidemics. The study employed survey research design using a well-structured five-item based questionnaire to elicit primary data from 103 purposively selected health officers from the two healthcare facilities. Evidence from relative importance index and One-way Contingency Chi-Square tests unveil that the five factors examined possess latency to impede adequate BMW management, but more for lack of modern medical waste management equipment and less for the health workers salary and allowances while the factors are found to be statistically significant in obstructing proper management of biomedical waste. The study concludes that failure to ensure that these factors are put in place can lead to inappropriate handling of medical waste which in turn can worsen disease outbreak in the environment. Thus, as a proactive measure to curb epidemics, it is recommended that government and hospital management boards should provide adequate fund to support this course in line with global best practices. [ABSTRACT FROM AUTHOR]

Objectives Compared with first-tier cities in China that are of abundant funds and resources like legions of high-level hospitals, the degree of nurses' disaster nursing preparedness in non-first-tier cities (inland) is relatively lower. For example, nurses' knowledge reserve of specific disasters is not comprehensive enough. And nurses are diffident when it comes to the skills of handling disaster rescue. Furthermore, their understanding of the roles to take in disaster coordination management is ambiguous. Conquering these challenges could be conducive to the improvement of local medical staffs' confidence and capabilities in disaster relief. Consequently, the objective of this research is to probe for approaches of improving the strategies of disaster nursing in Chinese small cities. Methods In order to ascertain the factors that influence disaster preparedness, a cross-sectional study with SPSS 25.0 data analysis method is adopted. The sample of the study is nursing personnel from 4 comprehensive hospitals at or above the second level in Yongcheng, Henan Province, China, as nurses are first-line responders in disasters and pandemics and the largest group in disaster rescue. Results From 813 distributed questionnaires, 784 completed questionnaires were returned, for a response rate of 96.43%. The total average score of the Disaster Preparedness Evaluation Tool is 146.76 ± 34.98, and the average score of all the entries is 3.26 ± 0.45, indicating moderate performance. The results indicate that age affects post disaster management (P < 0.05), meaning that as age increases, the scores also tend to be higher. Work experience, professional titles, disaster relief experience, and disaster training significantly differ in terms of knowledge, skills, post disaster management, and total scores (P < 0.01). The result of multivariate analysis indicates that titles, disaster relief experiences, and disaster training are the main factors affecting the disaster preparedness of nurses in Chinese non-first-tier (inland) cities(P < 0.05). Conclusions For the sake of upgrading the efficiency of disaster nursing preparedness in Chinese non-first-tier (inland) cities with limited funds and resources, it is very important to formulate training and education methods that are suitable for the local area, conduct characteristic simulation exercises, and expand experience exchange between hospitals. It's certain that the local government will also play an important role in coordinating and organizing the division of labor, resource allocation, and management of hospitals at all levels in different phases of disasters, which can help nursing staff have a clearer understanding of their roles when preparing for disasters. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Health Management Review is the property of International Journal of Health Management Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Globally, healthcare systems encounter significant challenges during disasters, necessitating healthcare professionals to react with readiness and efficiency. Among these professionals, nurses assume a crucial role in disaster preparedness and response, often positioned at the forefront of delivering healthcare amid such events. Methods: The study employed a quantitative descriptive design by the respondents who were registered nurses who had worked under the Nursing Services Department in different units such as ER, ICU, OR, Inpatients, OPD, and nursing administration at a tertiary hospital, utilizing a self-formulated questionnaire. Result: The evidence-based practice helps nurses in their disaster preparedness in the workplace. Conclusion: Hospitals can cultivate a culture of evidence-based practice among nurses in the area of disaster preparation by putting into action this structure for an innovative program. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AIM: A centralised Coordination Hub was implemented at a large tertiary health service in Queensland, Australia to address problems associated with a fragmented, reactive and manual approach to patient flow. APPROACH: The Hub was developed through challenging traditional ways of working, breaking down divisional silos, and developing technological enablers to manage patient flow as a whole-system issue. The Hub is a centralised space within the health service, where staff involved in patient flow are co-located and provided with real-time visibility of end-to-end data. CONTEXT: This case study describes the implementation and early operation of the Hub, outlining the critical design features and some of the early challenges and how they are being addressed. MAIN FINDINGS: This approach was designed to manage patient flow as a whole-system issue - co-locating staff, providing them with visibility of real time data, and accountability for decision-making to address flow blockages. CONCLUSIONS: Greater visibility of data and co-location of staff is not sufficient to manage long-standing patient flow challenges. This must be accompanied by appropriate accountability and authority to ensure that those who see and understand emergent flow issues are equipped with the authority to act and respond. [ABSTRACT FROM AUTHOR]

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The aim of this paper is to attempt to analyze how readiness for change affects effectiveness in the Polish health sector. Theoretical and practical aspects of readiness for change, effectiveness, and determinants of the hospital system will be presented and research results will be published. Design/methodology/approach: The survey study Likerd scale-based with a telephoneassisted was conducted in a group of 100 Polish hospitals. Factor analysis, summary scales and regression calculations were performed. Findings: The level of readiness to change positively influences hospital effectiveness. The level of readiness for change and effectiveness are independent of the level in the hospital network. Research limitations/implications: Questions were provided by heads of medical administration, medical managers, and independent administrative specialists answered questions. The subjective opinions of medical and administrative staff may differ. Originality/value: The article is addressed to researchers interested in the health care sector, as well as those interested in the relationship between readiness for change and effectiveness. For practitioners, hospital management may provide management guidance regarding organizational support. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about the regional anesthesia practice in low resources settings (LRS). The aim of this study was to describe the regional anesthesia capacity, characteristics of regional anesthesia practice, and challenges and solutions of practicing safe regional anesthesia in public hospitals in Botswana. Methods: This was a cross-sectional survey of anesthesia providers working in public hospitals in Botswana. A purposive sampling method of public hospitals was used to achieve representation of different hospital levels across Botswana. Paper-based questionnaires were sent to anesthesia providers from selected hospitals. Descriptive statistics were used for analysis. Results: Questionnaires were distributed to 47 selected anesthesia providers from selected hospitals; 38 (80.9%) were returned. Most participants were nurse anesthetists and medical officers (57.8%). All hospitals perform spinal anesthesia; however, other regional techniques were performed by a small number of participants in one referral hospital. Most hospitals had adequate regional anesthesia drugs and sedation medications, however, most hospitals (except one referral hospital) lacked ultrasound machine and the regional anesthesia kit. The common challenges reported were lack of knowledge and skills, lack of equipment and supplies, and lack of hospital engagement and support. Some solutions were proposed such as regional anesthesia training and engaging the hospital management to get resources. Conclusions: The results of this study suggest that spinal anesthesia is the most common regional anesthesia technique performed by anesthesia providers working in public hospitals in Botswana followed by few upper limb blocks. However, most public hospitals lack enough training capacity, equipment, and supplies for regional anesthesia. More engagement of the hospital management, investment in regional anesthesia resources, and training are needed in order to improve the regional anesthesia capacity and provide safe surgery and anesthesia in Botswana. [ABSTRACT FROM AUTHOR]

This document provides a comprehensive overview of strangulation in cases of intimate partner violence (IPV). It highlights the serious consequences of strangulation, even with minimal force, and the difficulty in identifying cases where survivors do not have visible injuries. The article emphasizes the importance of early identification, appropriate diagnosis, and access to resources for survivors. It also addresses the disproportionate impact on women of color and the increased risk of hanging as a method of self-harm. The document provides information on the physiological consequences, clinical features, and physical examination findings related to strangulation and near hanging. It emphasizes the need for a safe and supportive environment for survivors to disclose their experiences and obtain an accurate history. Healthcare providers are urged to have a high index of suspicion for IPV and to ask direct questions about strangulation. The document also discusses the assessment and management of strangulation and hanging injuries, including diagnostic studies and prehospital and hospital management. It emphasizes the importance of interdisciplinary collaboration and follow-up care due to potential complications. The article also highlights the increased risk of homicide for victims of strangulation and the importance of addressing the social aspects of the patient's situation. [Extracted from the article]

Background: Measuring quality is essential to drive improvement initiatives in hospitals. An instrument that measures healthcare quality multidimensionally and integrates patients', kin's and professionals' perspectives is lacking. We aimed to develop and validate an instrument to measure healthcare quality multidimensionally from a multistakeholder perspective. Methods: A multi-method approach started by establishing content and face validity, followed by a multi-centre study in 17 Flemish (Belgian) hospitals to assess construct validity through confirmatory factor analysis, criterion validity through determining Pearson's correlations and reliability through Cronbach's alpha measurement. The instrument FlaQuM-Quickscan measures 'Healthcare quality for patients and kin' (part 1) and 'Healthcare quality for professionals' (part 2). This bipartite instrument mirrors 15 quality items and 3 general items (the overall quality score, recommendation score and intention-to-stay score). A process evaluation was organised to identify effective strategies in instrument distribution by conducting semi-structured interviews with quality managers. Results: By involving experts in the development of quality items and through pilot testing by a multi-stakeholder group, the content and face validity of instrument items was ensured. In total, 13,615 respondents (5,891 Patients/kin and 7,724 Professionals) completed the FlaQuM-Quickscan. Confirmatory factor analyses showed good to very good fit and correlations supported the associations between the quality items and general items for both instrument parts. Cronbach's alphas supported the internal consistency. The process evaluation revealed that supportive technical structures and approaching respondents individually were effective strategies to distribute the instrument. Conclusions: The FlaQuM-Quickscan is a valid instrument to measure healthcare quality experiences multidimensionally from an integrated multistakeholder perspective. This new instrument offers unique and detailed data to design sustainable quality management systems in hospitals. Based on these data, hospital management and policymakers can set quality priorities for patients', kin's and professionals' care. Future research should investigate the transferability to other healthcare systems and examine between-stakeholders and between-hospitals variation. [ABSTRACT FROM AUTHOR]

At present, people and hospital management are wasting their time and wealth due to a lack of a smart system in the pre-examination process for patients. This paper discusses an approach to designing a healthcare system that collects necessary health condition data using a microcontroller-based smart system, the information from which is referred to an authorized device. The smart Health Care System is an economical healthcare device for a hospital; it obtains measurements of vital signs like temperature using a DS18B20 Digital Temperature Sensor, heartbeat and SpO2 level using pulse oximetry and a health rate sensor, and the height of a patient via an ultrasonic sensor, etc. The system contains a microcontroller, an Arduino UNO, and all the collected information from sensors is sent to the Arduino UNO. The LCD screen coupled with the Arduino UNO displays all measurements from the sensors. This project has an alert system that works according to the patient's condition; if there is an emergency, the RED LED will light up, and the system will generate an alert through a buzzer and send the information to the doctor using a Bluetooth system. This system can be placed before entering triage, used in the intensive care unit, or used as a personal device to monitor the health of a patient. [ABSTRACT FROM AUTHOR]

Background: Emergency departments are important points of intervention, to reduce the risk of further self-harm and suicide. A national programme to standardise the management of people presenting to the emergency department with self-harm and suicidal ideation (NCPSHI) was introduced in Ireland in 2014. The aim of this study was to evaluate the impact of the NCPSHI on patient outcomes and provision of care. Methods: Data on self-harm presentations were obtained from the National Self-Harm Registry Ireland from 2012 to 2017. The impacts of the NCPSHI on study outcomes (3-month self-harm repetition, biopsychosocial assessment provision, admission, post-discharge referral, and self-discharge) were examined at an individual and aggregate (hospital) level, using a before and after study design and interrupted time series analyses, respectively. The 15 hospitals that implemented the programme by January 2015 (of a total of 24 between 2015 and 2017) were included in the analyses. Results: There were 31,970 self-harm presentations during the study period. In hospitals with no service for self-harm (n = 4), risk of patients not being assessed reduced from 31.8 to 24.7% following the introduction of the NCPSHI. Mental health referral in this hospital group increased from 42.2 to 59.0% and medical admission decreased from 27.5 to 24.3%. Signs of a reduction in self-harm repetition were observed for this hospital group, from 35.1 to 30.4% among individuals with a history of self-harm, but statistical evidence was weak. In hospitals with a pre-existing liaison psychiatry service (n = 7), risk of self-discharge was lower post-NCPSHI (17.8% vs. 14.8%). In hospitals with liaison nurse(s) pre-NCPSHI (n = 4), medical admission reduced (27.5% vs. 24.3%) and there was an increase in self-harm repetition (from 5.2 to 7.8%. for those without a self-harm history). Conclusion: The NCPSHI was associated with improvements in the provision of care across hospital groups, particularly those with no prior service for self-harm, highlighting the need to consider pre-existing context in implementation planning. Our evaluation emphasises the need for proper resourcing to support the implementation of clinical guidelines on the provision of care for people presenting to hospital with self-harm. [ABSTRACT FROM AUTHOR]

Intravenous augmentation therapy with human alpha-1 proteinase inhibitor for the management of respiratory disease is recommended for people with alpha-1 antitrypsin deficiency (AATD) who are nonsmokers or former smokers. Augmentation therapy usually requires weekly administration at the hospital or clinic and poses an additional burden for patients due to interference with daily life, including work and social activities. Self-administration is a useful alternative to overcome this limitation, but there is a lack of published information on clinical outcomes. We report two cases of individuals with AATD at different stages of the disease who were successfully managed with self-administered augmentation therapy, with increased satisfaction because of the independence gained, lack of interference with clinical stability, and no relevant safety issues. [ABSTRACT FROM AUTHOR]

This article, titled "A Liberating Breath," recounts the experiences of Elizabeth Dotsenko, a doctor who worked in conflict zones and later established a branch of the NGO STEP-IN in Ukraine during the war with Russia. The article describes the challenges faced by Dotsenko and her team as they provided crisis intervention, medical care, and support to internally displaced persons (IDPs) in Ukraine. The narrative highlights the story of one patient, Lady S, who faced difficulties accessing medical care and underwent surgery with the help of Dotsenko's connections. The article emphasizes the importance of human connections and compassion in providing support to those affected by war. [Extracted from the article]

The efficient management of hospitals is vital to the delivery of high-quality healthcare services and exceptional patient outcomes. This paper aims to explore the significance of health care management, its impact on people's health, and organizational fulfillment. Case studies and empirical research are used to evaluate the influence of numerous management strategies on organizational subculture, teamwork engagement, and patient outcomes. The importance of management in stimulating innovation, and dealing with complicated healthcare structures is also discussed. This paper emphasizes the need for visionary management to achieve organizational excellence and innovation and future developments in patient-targeted care models. [ABSTRACT FROM AUTHOR]

Health and environmental consequences are unavoidable when it comes to management of hospital waste (HW) disposables. In order to eradicate the HW, this study isolated a novel fungus SPF21 from a hospital dumping yard to degrade Polypropylene (PP). We measured the attributes of PP inoculated with fungus using mass loss, Fourier trans‐form infrared (FTIR), contact angle (CA), and scanning electron microscopy (SEM). The weight of PP exposed to SPF21 was reduced by 25% in 90 days. The SEM images reveal that there are pores all over the sample surface; they alsocaused voids during the biodegradation of PP. FTIR analysis indicates that the spectra of treated mask pieces show the absence of peak at 1746 cm−1 and the appearance of a new peak at 1643 cm−1. A period of 90‐day exposure to the fungal isolate SPF21 reduced the CA of PP by 44.8% when compared to the nonexposed PP samples, suggesting that the surface of PP turned more hydrophilic after exposure. Moreover, our study on PP degradation by the fungus Ascotricha sinuosa SPF21 appears to be promising from the perspective of environmental, health, and economic hazards. Our results indicate that biodegradation greatly facilitates fungus deposition and changes PP film morphology and hydrophilicity. [ABSTRACT FROM AUTHOR]

We aimed to determine the epidemiology and clinical management of patients presenting to an Australian tertiary emergency department (ED) with a suspected snake bite. Nepean Hospital covers a geographical area known to harbour venomous elapid snake species. A Retrospective chart review of all patients presenting to Nepean ED from 2011 to 2020 was performed. We searched the electronic medical records (eMR) for triage presentations including search terms of "snakebite", "bite" "envenomation", or "bite-snake" and a discharge or independent diagnosis of "snakebite" or "envenomation". Our review identified 110 patients presenting with snakebite, of whom nine had signs or symptoms indicating envenomation. The most common envenomation syndrome was venom-induced consumption coagulopathy (VICC) and the most commonly suspected culprit snake was the Eastern Brown Snake. Our data broadly agreed with national data on epidemiology and demographics. We noted a satisfactory rate of compliance with local snake bite protocols with evidence of early diagnosis and antivenom administration. We had no cases of anaphylaxis and one case of serum sickness. Our study of a tertiary hospital experience in the management of snake bite demonstrated an appropriate adherence to national guidelines and early clinician recognition of envenomation syndromes. It also demonstrated appropriate antivenom use without obvious time delay. [ABSTRACT FROM AUTHOR]