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Journal of Healthcare Engineering 2018Increased healthcare costs are pushing hospitals to reduce costs and increase the quality of care. Operating rooms are the most important source of income and expense... (Review)
Review
Increased healthcare costs are pushing hospitals to reduce costs and increase the quality of care. Operating rooms are the most important source of income and expense for hospitals. Therefore, the hospital management focuses on the effectiveness of schedules and plans. This study includes analyses of recent research on operating room scheduling and planning. Most studies in the literature, from 2000 to the present day, were evaluated according to patient characteristics, performance measures, solution techniques used in the research, the uncertainty of the problem, applicability of the research, and the planning strategy to be dealt within the solution. One hundred seventy studies were examined in detail, after scanning the Emerald, Science Direct, JSTOR, Springer, Taylor and Francis, and Google Scholar databases. To facilitate the identification of these studies, they are grouped according to the different criteria of concern and then, a detailed overview is presented.
Topics: Appointments and Schedules; Efficiency, Organizational; Humans; Operating Rooms; Personnel Staffing and Scheduling; Research Design
PubMed: 30008991
DOI: 10.1155/2018/5341394 -
Trials Apr 2022Clinical trial managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist...
Clinical trial managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist role due to a complex set of factors, most likely to have come to a head due to the COVID-19 pandemic. Academic clinical trial units and departments are struggling to recruit trial managers to vacant positions, and multiple influences are affecting the retention of this highly skilled workforce. Without tackling this issue, we face major challenges in the delivery on the Department of Health and Social Care's Future of UK Clinical Research Delivery implementation plan. This article, led by a leading network of and for UK Trial Managers, presents some of the issues and ways in which national stakeholders may be able to address this.
Topics: COVID-19; Clinical Trials as Topic; Humans; Pandemics; Research Design; Workforce
PubMed: 35477835
DOI: 10.1186/s13063-022-06315-8 -
The Journal of Thoracic and... Oct 2021
Topics: Benchmarking; Biomedical Research; Data Science; Databases as Topic; Humans; Information Storage and Retrieval; Management Information Systems; Medical Informatics; Quality Assurance, Health Care; Quality Improvement; Research Design; Thoracic Surgery
PubMed: 32680635
DOI: 10.1016/j.jtcvs.2020.06.019 -
Journal of Occupational Rehabilitation Dec 2016Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant... (Review)
Review
Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.
Topics: Disabled Persons; Humans; Occupational Injuries; Program Development; Research Design; Workplace
PubMed: 27796914
DOI: 10.1007/s10926-016-9677-7 -
The Milbank Quarterly Mar 2017
Topics: Biomedical Research; Clinical Trials as Topic; Female; Humans; Male; National Institutes of Health (U.S.); Patient Selection; Public Health; Registries; Research Subjects; United States
PubMed: 28266074
DOI: 10.1111/1468-0009.12244 -
GMS Journal For Medical Education 2019
Topics: Education, Medical, Undergraduate; Evidence-Based Practice; Humans; Patient Selection; Schools, Medical; Waiting Lists
PubMed: 30828610
DOI: 10.3205/zma001218 -
Journal of Internal Medicine Dec 2013Clinical research is on the threshold of a new era in which electronic health records (EHRs) are gaining an important novel supporting role. Whilst EHRs used for routine... (Review)
Review
Clinical research is on the threshold of a new era in which electronic health records (EHRs) are gaining an important novel supporting role. Whilst EHRs used for routine clinical care have some limitations at present, as discussed in this review, new improved systems and emerging research infrastructures are being developed to ensure that EHRs can be used for secondary purposes such as clinical research, including the design and execution of clinical trials for new medicines. EHR systems should be able to exchange information through the use of recently published international standards for their interoperability and clinically validated information structures (such as archetypes and international health terminologies), to ensure consistent and more complete recording and sharing of data for various patient groups. Such systems will counteract the obstacles of differing clinical languages and styles of documentation as well as the recognized incompleteness of routine records. Here, we discuss some of the legal and ethical concerns of clinical research data reuse and technical security measures that can enable such research while protecting privacy. In the emerging research landscape, cooperation infrastructures are being built where research projects can utilize the availability of patient data from federated EHR systems from many different sites, as well as in international multilingual settings. Amongst several initiatives described, the EHR4CR project offers a promising method for clinical research. One of the first achievements of this project was the development of a protocol feasibility prototype which is used for finding patients eligible for clinical trials from multiple sources.
Topics: Biomedical Research; Electronic Health Records; Humans; Research Design; Systems Integration
PubMed: 23952476
DOI: 10.1111/joim.12119 -
The Journal of the American Academy of... Jun 2020The novel coronavirus pandemic, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed an immense strain on healthcare systems across the... (Review)
Review
The novel coronavirus pandemic, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed an immense strain on healthcare systems across the entire world. Consequently, multiple federal and state governments have placed restrictions on hospitals such as limiting "elective surgery" and recommending social or physical distancing. We review the literature on several areas that have been affected including surgical selection, inpatient care, and physician well-being. These areas affecting inpatient paradigms include surgical priority, physical or social distancing, file sharing for online clinical communications, and physician wellness. During this crisis, it is important that orthopaedic departments place an emphasis on personnel safety and slowing the spread of the virus so that the department can still maintain vital functions. Physical distancing and emerging technologies such as inpatient telemedicine and online file sharing applications can enable orthopaedic programs to still function while attempting to protect medical staff and patients from the novel coronavirus spread. This literature review sought to provide evidence-based guidance to orthopaedic departments during an unprecedented time. Orthopaedic surgeons should follow the Centers for Disease Control and Prevention guidelines, wear personal protective equipment (PPE) when appropriate, have teams created using physical distancing, understand the department's policy on elective surgery, and engage in routines which enhance physician wellness.
Topics: COVID-19; Communicable Disease Control; Coronavirus Infections; Elective Surgical Procedures; Female; Humans; Inpatients; Male; Occupational Health; Orthopedic Procedures; Pandemics; Patient Isolation; Patient Safety; Patient Selection; Personal Protective Equipment; Pneumonia, Viral; Program Development; Program Evaluation; Safety Management; United States
PubMed: 32304401
DOI: 10.5435/JAAOS-D-20-00360 -
Archivio Italiano Di Urologia,... Oct 2017To evaluate the feasibility of performing laparoscopic radical prostatectomy (LRP) as a day case procedure while maintaining patient satisfaction and safety. Herein we...
BACKGROUND
To evaluate the feasibility of performing laparoscopic radical prostatectomy (LRP) as a day case procedure while maintaining patient satisfaction and safety. Herein we report our experience, selection criteria, and discharge criteria for day case LRP.
METHODS
We performed a prospective study with 32 patients undergoing extraperitoneal LRP. These patients were counselled before the procedure that they would go home the same evening of the procedure. Pain scores and quality of life data were recorded day 1 postoperatively via a telephone consultation. The patients underwent routine blood tests on day 2 and an outpatient review on day 7 and regularly thereafter via an assigned key worker. Socio-demographic data, comorbidities, and outcomes were collected for analysis.
RESULTS
All patients were successfully discharged the same day of surgery. Mean patient age was 62 years with a mean body mass index of 25. Mean operative time was 147 minutes, and estimated blood loss was 101 ml. Three patients were treated for post operative urinary tract infections; two patients developed infected lymphoceles which required percutaneous drainage and one patient required re-catheterisation due to a burst catheter balloon. Of these six complications four patients required re-admission. Post-operative pain, nausea and vomiting were low whilst patient satisfaction scores were unanimously high in all patients surveyed.
CONCLUSIONS
The early experience with extraperitoneal LRP as a same day surgery is promising although patients who are at high risk of lymphocele should be excluded. Preoperative patient counselling and selection is paramount. Patient satisfaction is not adversely affected by the shortened stay. Surgeon experience, a well-motivated patient, meticulous attention to detail through an integrated pathway, a multidisciplinary team and adequate postoperative assessment are essential.
Topics: Ambulatory Surgical Procedures; Blood Loss, Surgical; Humans; Laparoscopy; Male; Middle Aged; Operative Time; Pain, Postoperative; Patient Care Team; Patient Readmission; Patient Satisfaction; Patient Selection; Postoperative Complications; Prospective Studies; Prostatectomy; Prostatic Neoplasms; Quality of Life
PubMed: 28969402
DOI: 10.4081/aiua.2017.3.182 -
Academic Emergency Medicine : Official... Apr 1999Publication is a marker of academic success. In academia, appointments and promotions are in many cases strongly linked to the candidate's bibliography. The "publish or... (Review)
Review
Publication is a marker of academic success. In academia, appointments and promotions are in many cases strongly linked to the candidate's bibliography. The "publish or perish" mindset has placed extraordinary pressures on scientists and academic physicians alike. Authorship controversies have received considerable attention in the medical literature. Although guidelines are available to help determine how attribution should be acknowledged, anecdotal experiences with disputes associated with authorship continue to exist. This paper addresses several key problems facing authorship. A discussion of who should be given authorship, the responsibilities of an author, and a method for assigning authorship in a multiauthored publication is provided.
Topics: Authorship; Guidelines as Topic; Humans; Job Description; Periodicals as Topic; Publishing; Research Design; Scientific Misconduct
PubMed: 10230981
DOI: 10.1111/j.1553-2712.1999.tb00393.x