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Background Aims Study Design Results Conclusions Relevance to Clinical Practice Evidence suggests that 8%–10% of ICU patients receive renal replacement therapy. However, there is a high rate of unplanned CRRT interruption, ranging between 17% and 74%. Studies on unplanned interruption of CRRT mainly focused on the retrospective investigation of related risk factors and conclusions have been diverse.This article aims to clarify the main influencing factors related to unplanned interruption of continuous renal replacement therapy (CRRT) in adult patients in intensive care units (ICUs).A literature review and meta‐analysis were undertaken. Following the application of the Newcastle–Ottawa Scale (NOS), a total of 15 articles were included in a total of 2132 patients who underwent 3690 CRRT procedures and 2181 unplanned interruption times. The methodological guideline of a scoping review was applied for the evidence synthesis while applying the meta‐analysis quantitative methodological guideline to identify and clarify main influencing factors related to unplanned interruption of CRRT. The reporting Prisma Protocol was followed.Longer filter life and prothrombin activation time, higher red blood cell count, greater transmembrane pressure, faster blood flow rate, intermittent saline irrigation, lower creatinine level, low prothrombin activity and pre‐dilution are factors identified to potentially affect unplanned CRRT in ICU patients.Available evidence suggests four clinical challenges associated with unplanned CRRT interruption, namely: (a) effects of red blood cell count, filter life, cross‐mode pressure, blood flow velocity, prothrombin activity and activated partial thrombin time on unplanned interruption; (b) influence of dilution mode on unplanned interruption; (c) influence of intermittent saline irrigation on unplanned interruption; (d) influence of Scr level on unplanned interruption.The potential to increase the ability to better manage unplanned CRRT in ICUs has been identified in this article and constitutes a relevant potential health care management contribution that can be implemented by nurses. [ABSTRACT FROM AUTHOR]

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With the improvement of economic conditions and the increase in living standards, people's attention in regard to health is also continuously increasing. They are beginning to place their hopes on machines, expecting artificial intelligence (AI) to provide a more humanized medical environment and personalized services, thus greatly expanding the supply and bridging the gap between resource supply and demand. With the development of IoT technology, the arrival of the 5G and 6G communication era, and the enhancement of computing capabilities in particular, the development and application of AI-assisted healthcare have been further promoted. Currently, research on and the application of artificial intelligence in the field of medical assistance are continuously deepening and expanding. AI holds immense economic value and has many potential applications in regard to medical institutions, patients, and healthcare professionals. It has the ability to enhance medical efficiency, reduce healthcare costs, improve the quality of healthcare services, and provide a more intelligent and humanized service experience for healthcare professionals and patients. This study elaborates on AI development history and development timelines in the medical field, types of AI technologies in healthcare informatics, the application of AI in the medical field, and opportunities and challenges of AI in the field of medicine. The combination of healthcare and artificial intelligence has a profound impact on human life, improving human health levels and quality of life and changing human lifestyles. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Health care professionals often generate novel solutions to solve problems during day‐to‐day patient care. However, less is known about generating novel and useful (i.e., creative) ideas in the face of health care system failure. System failures are high‐impact and increasingly frequent events in health care organizations, and front‐line professionals may have uniquely valuable expertise to address such occurrences.Our interdisciplinary team, blending expertise in health care management, economics, psychology, and clinical practice, reviewed the literature on creativity and system failures in health care to generate a conceptual model that describes this process. Drawing on appraisal theory, we iteratively refined the model by integrating various theories with key concepts of system failures, creativity, and health care worker's well‐being.The SFC model provides a conceptualization of creativity from front‐line care professionals as it emerges in situations of failure or crisis. It describes the pathways by which professionals respond proactively to a systems failure with creative ideas to effectively address the situation and affect these workers' well‐being.Our conceptual model guides health care managers and leaders to use managerial practices to shape their systems and support creativity, especially when facing system failures. It introduces a framework for examining system‐failing creativity (SFC) and general creativity, aiming to improve health care quality, health care workers' well‐being, and organizational outcomes. [ABSTRACT FROM AUTHOR]

KEY CLINICAL MESSAGE: Even in the era of technology‐guided medicine, the clinician must integrate into his daily practice a careful anamnesis and physical examination to be conducted within a close doctor–patient relationship. All these elements, together with tools such as teleconsultation and digitalized medical records, are able to significantly increase the effectiveness of health care action. [ABSTRACT FROM AUTHOR]

Problem definition: The Centers for Medicare & Medicaid Services launched the Primary Care First (PCF) initiative in January 2021. The initiative builds upon prior innovative payment models and aims at incentivizing a redesign of primary care delivery, including new modes of delivery, such as remote care. To achieve this goal, the initiative blends capitation and fee-for-service (FFS) payments and includes performance-based adjustments linked to service quality and health outcomes. We analyze a model motivated by this new payment system, and its impact on the different stakeholders, and derive insights on how to design it to reach the best possible outcome. Methodology/results: We propose an analytical model that captures patient heterogeneity in terms of health complexity, provider choice of care-delivery mode (referral to a specialist, in-person visit, or remote care), and quality of service (health outcomes and wait time). We analyze the provider decision on the mode of care delivery under both FFS and PCF and study whether PCF can be designed to yield a socially optimal outcome. We characterize analytically when patients, payer, and providers are better off under PCF and show that, in many cases, PCF can be designed to yield a socially optimal outcome. We numerically calibrate our model for 14 states in the United States. We observe that the average health status in a state is a source of heterogeneity that crucially drives the performance of PCF. We find that the model motivated by the current PCF implementation results in too much adoption of referral care and too little adoption of remote care. In addition, states with poor average health status may use more in-person care than socially optimal under a baseline (low) level of capitation. Moreover, relying on high levels of capitation leads to low adoption of in-person care. Managerial implications: Our results have health policy implications by shedding light on how PCF might impact patients, payer, and providers. Under the current performance-based adjustments, low levels of capitation should be preferred. PCF has the potential to be designed to achieve socially optimal outcomes. However, the fee per visit may need to be tailored to the local population’s health status. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.1207 .

Abstract Background The Covid-19 pandemic has tested health care organizations worldwide. Responses have demonstrated great variation and Sweden has been an outlier in terms of both strategy and how it was enacted, making it an interesting case for further study. The aim of this study was to explore how health care leaders experienced the challenges and responses that emerged during the initial wave of the Covid-19 pandemic, and to analyze these experiences through an organizational resilience lens. Methods A qualitative interview study with 12 senior staff members who worked directly with or supervised pandemic efforts. Transcripts were analyzed using traditional content analysis and the codes directed to the Integrated Resilience Attributes Framework to understand what contributed to or hindered organizational resilience, i.e. how organizations achieve their goals by utilizing existing resources during crises. Results/Findings Organizational resilience was found at the micro (situated) and meso (structural) system levels as individuals and organizations dealt with acute shortages and were forced to rapidly adapt through individual sacrifices, resource management, process management, and communications and relational capacity. Poor systemic resilience related to misaligned responses and a lack of learning from previous experiences, negatively impacted the anticipatory phase and placed greater pressure on individuals and organizations to respond. Conventional crisis leadership could hamper innovation, further cement chronic challenges, and generate a moral tension between centralized directives and clinical microsystem experiences. Conclusions The pandemic tested the resilience of the health care system, placing undue pressure on micro and meso systems responses. With improved learning capabilities, some of this pressure may be mitigated as it could raise the anticipatory resilience potential, i.e. with better health systems learning, we may need fewer heroes. How crisis leadership could better align decision-making with frontline needs and temper short-term acute needs with a longer-term infinite mindset is worth further study.

Previous studies of healthcare organizations' workforces and their performance have focused on burnout and its impact on care. The aim of this research is to expand on this and examine the association of positive organizational states, engagement and recommendation of employer as a place to work, in comparison to burnout on Hospital performance. Methods: This was a panel study of the respondents to the 2012-2019 yearly Staff Surveys of the English National Health Service (NHS) hospital Trusts with hospital performance measured by the adjusted inpatient Summary Hospital-level Mortality Indicator (SHMI). Results: In univariable regression, all three organizational states significantly and negatively correlated with SHMI, with recommendation and engagement showing a nonlinear effect. In multivariable analysis, all three states remained significant predictors of SHMI. Engagement and recommendation showed mutual correlation, with engagement being a more prevalent state than recommendation. Conclusion: Our study indicates that organizations could benefit from monitoring multiple workforce variables to preserve or enhance workforce well-being, while optimizing organizational performance. The surprising finding that higher burnout was associated with improved short-term performance requires further investigation, as does the finding of less frequent staff recommendation of work compared to staff engagement with their work. [ABSTRACT FROM AUTHOR]

Background: The Covid-19 pandemic has tested health care organizations worldwide. Responses have demonstrated great variation and Sweden has been an outlier in terms of both strategy and how it was enacted, making it an interesting case for further study. The aim of this study was to explore how health care leaders experienced the challenges and responses that emerged during the initial wave of the Covid-19 pandemic, and to analyze these experiences through an organizational resilience lens. Methods: A qualitative interview study with 12 senior staff members who worked directly with or supervised pandemic efforts. Transcripts were analyzed using traditional content analysis and the codes directed to the Integrated Resilience Attributes Framework to understand what contributed to or hindered organizational resilience, i.e. how organizations achieve their goals by utilizing existing resources during crises. Results/Findings: Organizational resilience was found at the micro (situated) and meso (structural) system levels as individuals and organizations dealt with acute shortages and were forced to rapidly adapt through individual sacrifices, resource management, process management, and communications and relational capacity. Poor systemic resilience related to misaligned responses and a lack of learning from previous experiences, negatively impacted the anticipatory phase and placed greater pressure on individuals and organizations to respond. Conventional crisis leadership could hamper innovation, further cement chronic challenges, and generate a moral tension between centralized directives and clinical microsystem experiences. Conclusions: The pandemic tested the resilience of the health care system, placing undue pressure on micro and meso systems responses. With improved learning capabilities, some of this pressure may be mitigated as it could raise the anticipatory resilience potential, i.e. with better health systems learning, we may need fewer heroes. How crisis leadership could better align decision-making with frontline needs and temper short-term acute needs with a longer-term infinite mindset is worth further study. [ABSTRACT FROM AUTHOR]

Mobile dental clinics (MDCs) are suitable solutions for servicing people living in rural and urban areas that require dental healthcare. MDCs can provide dental care to the most vulnerable high-school students. However, scheduling MDCs to visit patients is critical to developing efficient dental programs. Here, we study a mobile dental clinic scheduling problem that arises from the real-life logistics management challenge faced by a school-based mobile dental care program in Southern Chile. This problem involves scheduling MDCs to treat high-school students at public schools while considering a fairness constraint among districts. Schools are circumscribed into districts, and by program regulations, at least 50% of the students in each district must receive dental care during the first semester. Fairness prevents some districts from waiting more time to receive dental care than others. We model the problem as a parallel machine scheduling problem with sequence-dependent setup costs and batch due dates and propose a mathematical model and a genetic algorithm-based solution to solve the problem. Our computational results demonstrate the effectiveness of our approaches in obtaining near-optimal solutions. Finally, dental program managers can use the methodologies presented in this work to schedule mobile dental clinics and improve their operations. [ABSTRACT FROM AUTHOR]

KEY CLINICAL MESSAGE Even in the era of technology‐guided medicine, the clinician must integrate into his daily practice a careful anamnesis and physical examination to be conducted within a close doctor–patient relationship. All these elements, together with tools such as teleconsultation and digitalized medical records, are able to significantly increase the effectiveness of health care action.

Background: Leaders are tasked with making decisions that have substantial impact on an organization's well-being. Decision making requires critical thinking. Clinical environments are becoming more complex and demanding nowadays. Acquisition of critical thinking skills seems crucial in order to provide effective and safe services in these climates. There are various general definitions regarding critical thinking in the context of health care management which mostly have no positive correlation with clinical performance. The aim of this study is to provide an evolved perspective on critical thinking in health care managers. Methods: Eight-step Rodgers’ concept analysis approach was adopted in this analysis to provide a clear definition about critical thinking in health care managers as well as searching and analyzing online databases. The inclusion criterion included articles published during 2005-2022 in English and Persian languages (just in English or in Persian). Finally, 57 articles, 3 dissertations, were included in the analysis. Results: The extracted attributes of critical thinking were as follows: responsibility for strategic planning and thinking, making accurate and hesitant decisions and problem solving skills, using professional and inter professional communication skills, applying knowledge in managing clinical settings, organizing human and financial resources, growing of mindsets and disposition for better performances in health care managers, and supervision for insurance of health quality. Provision of critical thinking leads to positive outcomes such as effective and patient-centered care, creativity, evidence-based practices, and professionalism. Conclusion: A clear and comprehensive definition of critical thinking in health care management context was developed. This definition can correct many misconceptions and conceptual misuses about critical thinking in health care managers.

Abstract Objectives The main objective of this manuscript was to identify the methods used to create process maps for care pathways that utilized the time-driven activity-based costing method. Methods This is a systematic mapping review. Searches were performed in the Embase, PubMed, CINAHL, Scopus, and Web of Science electronic literature databases from 2004 to September 25, 2022. The included studies reported practical cases from healthcare institutions in all medical fields as long as the time-driven activity-based costing method was employed. We used the time-driven activity-based costing method and analyzed the created process maps and a qualitative approach to identify the main fields. Results A total of 412 studies were retrieved, and 70 articles were included. Most of the articles are related to the fields of orthopedics and childbirth-related to hospital surgical procedures. We also identified various studies in the field of oncology and telemedicine services. The main methods for creating the process maps were direct observational practices, complemented by the involvement of multidisciplinary teams through surveys and interviews. Only 33% of the studies used hospital documents or healthcare data records to integrate with the process maps, and in 67% of the studies, the created maps were not validated by specialists. Conclusions The application of process mining techniques effectively automates models generated through clinical pathways. They are applied to the time-driven activity-based costing method, making the process more agile and contributing to the visualization of high degrees of variations encountered in processes, thereby making it possible to enhance and achieve continual improvements in processes.

BACKGROUND: Telemedicine refers to using electronic information and telecommunication technologies to support numerous aspects of healthcare, including clinical care, patient and professional education and training, public health, and health administration. However, many challenges hinder the widespread adoption of telemedicine by healthcare providers. This study aimed to assess the perspectives and barriers in telemedicine and information technology in health care management among nursing students. MATERIALS AND METHODS: A cross-sectional study was conducted among 60 nursing students enrolled in the third and fourth years. The sample was selected using a nonprobability purposive sampling technique from students studying at the Applied Medical Science Colleges for Females, University of Bisha. Data collection was facilitated through a structured questionnaire, and the gathered data were analyzed using SPSS version 22. The study was conducted between August 15, 2022 and November 20, 2022. RESULTS: 61% of students believe that telemedicine will lead to a reduction in travel time, costs, and effort. Approximately two-fourths of the sample’s perspectives revolve around concerns regarding privacy, medical errors, and camera comfort. However, more than 30% of participants agree that telemedicine will improve the quality of patient care, decrease waiting times, be beneficial for patient care in remote areas, and assist in providing appropriate information during emergency. 59% of respondents identified the lack of time or busy schedules as the most frequently reported barrier to using telemedicine. Following this, concerns regarding privacy, confidentiality, unreliable Internet connections, and inadequate knowledge about computer technology and Information Management Systems were also commonly cited as barriers. These factors were identified as the primary obstacles hindering the progress of telemedicine. CONCLUSION: This study concluded that telemedicine is a critical tool to address the challenges of limited medical resources in healthcare facilities. However, reduced healthcare costs and waiting time and improved patient access to healthcare in remote areas all helped promote telemedicine implementation. In these remote areas, telemedicine has the potential to bridge this distance and facilitate healthcare.

E-prescription, introduced on February 16, 2018, as part of a pilot program in two cities, initially met many barriers (resistance and doubts of medical staff, incompatibility of IT systems and inappropriate computer equipment or its lack in medical offices), and is currently one of the most well-known and the most frequently used e-tools in medical services. The usage of e-prescribing was crucial during the COVID-19 pandemic, when forced isolation made contacts with medical staff difficult or even impossible. Patients, left without medical care, could use health care services to a very limited extent. Then, teleconsultations and digital prescriptions turned out to be an excellent remedy for such a problematic situation. In fact, we owe the development of many e-tools and the spread of their use to the COVID-19 pandemic. The importance of e-prescription for the system and medical service providers cannot be overestimated. Through it, the system and health care entities receive reliable and accurate information (e.g. about the number of prescribed drugs, the health condition of Polish patients, or the amount of reimbursement). An e-prescription is not only a record of what medicine the patient should take, but a set of data that, when used in an appropriate manner, can constitute a guide for the further development of medical services, preventive programs and directions of changes in the health care system. The article presents information on the implementation and use of e-prescriptions by medical staff in Poland in 2018-2022. The information contained in the article may constitute the basis for subsequent studies in Poland and abroad, for international comparative analyses, due to their timeliness and detail. The aim of the article is to present the degree of use of e-prescriptions by medical staff in health care entities. To achieve the goal, the fol-lowing research methods were used: critical analysis of literature and websites presenting digital solutions for the health care system, analysis of source materials and numerical data from the e-Health Center (CeZ).

Abstract Background A significant and growing portion of the global burden of diseases is caused by neurological disorders. Tele-neurology has the potential to improve access to health care services and the quality of care, particularly in rural and underserved areas. The economic evaluation of the stepped wedge randomised controlled trial NeTKoH aims to ascertain the cost-effectiveness and cost-utility regarding the effects of a tele-neurologic intervention in primary care in a rural area in Germany. Methods This protocol outlines the methods used when conducting the trial-based economic evaluation of NeTKoH. The outcomes used in our economic analysis are all prespecified endpoints of the NeTKoH trial. Outcomes considered for the cost-utility and cost-effectiveness analyses will be quality-adjusted life years (QALYs) derived from the EQ-5D-5L, proportion of neurologic problems being solved at the GP’s office (primary outcome), hospital length-of-stay and number of hospital stays. Costs will be prospectively collected during the trial by the participating statutory health insurances, and will be analysed from a statutory health insurance perspective within the German health care system. This economic evaluation will be reported complying with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Discussion This within-trial economic evaluation relaying the costs and outcomes of an interdisciplinary tele-consulting intervention will provide high-quality evidence for cost-effectiveness and policy implications of a tele-neurological programme, including the potential for application in other rural areas in Germany or other jurisdictions with a comparable health system. Trial registration German Clinical Trials Register (DRKS00024492), date registered: September 28, 2021.

With the improvement of economic conditions and the increase in living standards, people’s attention in regard to health is also continuously increasing. They are beginning to place their hopes on machines, expecting artificial intelligence (AI) to provide a more humanized medical environment and personalized services, thus greatly expanding the supply and bridging the gap between resource supply and demand. With the development of IoT technology, the arrival of the 5G and 6G communication era, and the enhancement of computing capabilities in particular, the development and application of AI-assisted healthcare have been further promoted. Currently, research on and the application of artificial intelligence in the field of medical assistance are continuously deepening and expanding. AI holds immense economic value and has many potential applications in regard to medical institutions, patients, and healthcare professionals. It has the ability to enhance medical efficiency, reduce healthcare costs, improve the quality of healthcare services, and provide a more intelligent and humanized service experience for healthcare professionals and patients. This study elaborates on AI development history and development timelines in the medical field, types of AI technologies in healthcare informatics, the application of AI in the medical field, and opportunities and challenges of AI in the field of medicine. The combination of healthcare and artificial intelligence has a profound impact on human life, improving human health levels and quality of life and changing human lifestyles.

Abstract Background Neurological disorders account for a large and increasing proportion of the global burden of disease. Therefore, it is important to strengthen the management of neurologic care, particularly in rural areas. The use of tele-neurology in primary care in rural areas is internationally considered to have the potential to increase access to health care services and improve the quality of care in these underserved areas. NeTKoH aims to address the existing knowledge gap regarding the effects of a tele-neurologic intervention in primary care under real-world conditions in a rural area in Germany. Methods NeTKoH is a cluster-randomized controlled trial with a stepped-wedge design involving 33 outpatient general practitioner’s (GP) offices (clusters) in a rural area in Northeast Germany. During 11 predetermined steps, all clusters are randomized before they cross over into groups from the control to the intervention arm. The targeted sample size is 1,089 patients with neurologic symptoms that are continuously being recruited. In the intervention arm, tele-neurologic consultations will be provided via a face-to-face video conferencing system with a neurologic expert at a university hospital. The control arm will receive usual care. The primary outcome is the proportion of neurologic problems being solved at the GP’s office. Secondary outcomes will comprise hospital stays and days, time until neurologic specialist appointments and diagnostics, patients’ health status and quality of life, outpatient and inpatient referrals. A concurrent observational study, together with a process, implementation, and health economic evaluation, will also be conducted. Discussion Using a stepped-wedge cluster design in a real-life situation can help with logistic challenges and enhance the motivation of the participating GPs, as all, at some point, will be in the intervention phase. With the additional implementation evaluation pertaining to external validity, an observational study, and a health economic evaluation, NeTKoH will be able to provide an extensive evaluation for health policy decision-makers regarding the uptake into standard care. Trial registration German Clinical Trials Register (DRKS00024492). Date registered: September 28, 2021. Date and protocol version: June 2023, version 1.

This study evaluates the management capacity ability and profitable capacity of eight public-private partnership hospitals in Taiwan from 2015 to 2020. By conducting various ratio analyses of the financial statement, this study found these hospitals have achieved a balance between management efficiency and profitability, thereby confirming the viability of the PPP model for hospital management. In addition, the subject hospitals play a vital role as isolation hospitals during the COVID-19 pandemic. Beyond offering medical assistance to infected individuals, these hospitals contribute to the integrity of Taiwan's medical network, mitigating the impact of the pandemic. Overall, establishing and managing hospitals with PPP partnership is a feasible solution as it alleviates governmental financial burdens related to medical welfare and achieves profitability. [ABSTRACT FROM AUTHOR]

Aims: To investigate which work‐related factors are associated with work–family conflict of care workers in nursing homes, this study aimed to: (a) describe the prevalence of work–family conflict of care workers in nursing homes and (b) assess the association of work‐related factors with work–family conflict. Design: Cross‐sectional multicentre sub‐study based on data from the Swiss Nursing Homes Human Resources Project 2018. Methods: Data were collected between September 2018 and October 2019. Work–family conflict of care workers was assessed with the Work–Family Conflict Scale (range 1–5). Prevalence was described in percentages. We used multilevel linear regression to assess the association of time‐based factors (working overtime or during one's free time, employment percentage, presenteeism, shift working) and strain‐based factors (staffing adequacy, leadership support) with work–family conflict. Results: Our study sample consisted of 4324 care workers working in a total of 114 nursing homes. Overall, 31.2% of respondents stated to have experienced work–family conflict (>3.0 on the Work–Family Conflict Scale). The overall mean score of the study sample for work–family conflict was 2.5. Care workers experiencing presenteeism 10 or more days per year showed the highest scores for work–family conflict (mean: 3.1). All included predictor variables were significant (p <.05). Conclusion: Work–family conflict is multifactorial. Possible intervention points to tackle work–family conflict could be strengthening care workers' influence in planning work schedules, enabling flexible planning to ensure adequate staffing, lowering presenteeism and implementing a supportive leadership style. Impact: Care workers' jobs become less desirable when workplace demands interfere with family life. This study highlights the multifaceted nature of work–family conflict and suggests intervention options to prevent care workers from experiencing work–family conflict. Action is needed at nursing home and policy level. [ABSTRACT FROM AUTHOR]

This research aims to advance the understanding of gamification in health care management using a systematic review of the literature through a multiphase analysis. To do so, first, we extract the relevant bibliographic data for our research according to a methodology of data generation structured in six stages and a descriptive analysis oriented to the technical characterization of the data. Then, we codify all the information, identify the main attributes with the collaboration of two independent experts and check their validity using the evaluation of two focus groups of professionals in gamification and health care management. We found seven attributes: (1) health care users, (2) psychology, (3) behavior, (4) activities, (5) health field, (6) technology, and (7) gamification elements. Within each of these seven attributes, there are a series of main elements that are detailed in the following for each of them. (1) Health care users: their age and the role they play in the health system. (2) Psychology: cognition, positive and negative emotions. (3) Behavior: healthy behavior encouragement, such as compliance, collaboration and responsibility. (4) Activities: physical activity and food. (5) Health field: preventive medicine and chronic diseases. (6) Technology: cell phones. (7) Gamification elements: different elements, but the number of articles in which these elements and their interactions are studied in depth is limited. Our results point toward a promising present and future research agenda that is in parallel with the development of relevant fields for the sector, such as chronic diseases, health education and preventive medicine. Plain Language Summary: Gamification, Health Care Management and Systematic Literature Review This research aims to advance the knowledge of gamification in healthcare management using a systematic literature review through a multiphase analysis. Our results point to a promising present and future research agenda parallel to developing fields relevant to the sector, such as chronic diseases, health education, and preventive medicine. [ABSTRACT FROM AUTHOR]

Introduction: Emergency Medical Services (EMS) are integrated services involving doctors, paramedics, nurses, and social workers. This research was carried out to synthesize the evidence concerning social work roles for EMS. The aim of this study was to synthesize literature on the social worker's role in EMS settings. Methods: The study was a systematic review. Data were collected through selected databases. The researcher used Scopus, Sociology Database, Social Science Database, and Public Health Database related to EMS and social work settings. English papers were selected, without restrictions on publication time, place, and year. The searched keywords were: "Social Work AND Emergency Medical Services AND Ambulance Services," "Social Worker AND Emergency Medical Systems AND Ambulance Services," "Social Work AND EMS," "Social Worker AND EMS," "Social Work OR Social Worker," "Social Work Role AND EMS," Social Worker AND EMS," "Emergency Medical Services OR/AND Emergency Medical Systems." Results: The study synthesized the literature about the social work role in pre-EMS, during emergency, and post-EMS. The following themes were highlighted: social workers act as cultural liaisons, effective communicators, emergency workers, and mental health practitioners, collaborating with other disciplines and researchers, for this study. In pre-emergency stages, social workers have roles as educators, communicators, advocates, and awareness builders. During an emergency, social workers act as search and rescue workers, advocates, facilitators, networkers, psychosocial assessors, consultants, counselors, and liaisons for referral activities. And in the post-emergency period, social workers have roles as planners, liaisons, interdisciplinary collaborators, researchers, evaluators, and individuals responsible for follow up. Conclusion: This study synthesizes the roles of social workers in EMS settings. It is the first study on this topic, aiming to produce new knowledge, evidence, and an EMS practice framework for the social worker. [ABSTRACT FROM AUTHOR]

Background: A significant and growing portion of the global burden of diseases is caused by neurological disorders. Tele-neurology has the potential to improve access to health care services and the quality of care, particularly in rural and underserved areas. The economic evaluation of the stepped wedge randomised controlled trial NeTKoH aims to ascertain the cost-effectiveness and cost-utility regarding the effects of a tele-neurologic intervention in primary care in a rural area in Germany. Methods: This protocol outlines the methods used when conducting the trial-based economic evaluation of NeTKoH. The outcomes used in our economic analysis are all prespecified endpoints of the NeTKoH trial. Outcomes considered for the cost-utility and cost-effectiveness analyses will be quality-adjusted life years (QALYs) derived from the EQ-5D-5L, proportion of neurologic problems being solved at the GP's office (primary outcome), hospital length-of-stay and number of hospital stays. Costs will be prospectively collected during the trial by the participating statutory health insurances, and will be analysed from a statutory health insurance perspective within the German health care system. This economic evaluation will be reported complying with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Discussion: This within-trial economic evaluation relaying the costs and outcomes of an interdisciplinary tele-consulting intervention will provide high-quality evidence for cost-effectiveness and policy implications of a tele-neurological programme, including the potential for application in other rural areas in Germany or other jurisdictions with a comparable health system. Trial registration: German Clinical Trials Register (DRKS00024492), date registered: September 28, 2021. [ABSTRACT FROM AUTHOR]