Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2012
Early discharge and its effect on ED length of stay and access block.
Effecting early discharge is a widely recommended strategy for improving patient flow in acute hospitals. This paper analyses the impact of inpatient discharge timing on Emergency Department (ED) flow parameters such as access block and length of stay, while comparing this to the effect on hospital occupancy, to arrive at an understanding of a 'whole of hospital' response to discharge timing. ⋯ The analysis reveals that, on days when the discharge peak lags the peak in inpatient admissions, hospitals of all sizes exhibit increased levels of occupancy, inpatient and ED length of stay, and access block. The findings corroborate the efficacy of early discharge initiatives and 'whole of hospital' flow improvement initiatives for addressing overcrowding and efficiency issues in hospitals.
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Stud Health Technol Inform · Jan 2012
Envisioning electronic health record systems as change management: the experience of an English hospital joining the National Programme for Information Technology.
The historical National Programme for Information Technology (NPfIT) in England was the most expensive (~$20billion) and ambitious politically-driven IT-based transformations of public services ever undertaken. Nation-wide implementation of integrated electronic health record (EHR) systems in hospitals was at the heart of the NPfIT (~$10billion). We conducted the first longitudinal, prospective, and sociotechnical case study implementation and adoption of national EHRs implementations in 12 'early adopter' hospitals across England. ⋯ This led to greater local configuration and high sense of ownership among users, which transformed work practices towards overall better performance of the hospital. Contrary to painful and turbulent experiences of EHR implementation via NPfIT route in the English hospitals, this in-depth case study revealed the importance of vision (change management) and insightful leadership in 'working out' EHR. We advocate envisioning EHRs as change management endeavors to enhance their complex, multi-dimensional, and sociotechnical adoption in healthcare settings.
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Stud Health Technol Inform · Jan 2012
Quality of life and stress level in adolescents with idiopathic scoliosis subjected to conservative treatment.
Quality of life (QoL) and stress level of adolescents with idiopathic scoliosis is under growing consideration by physicians, physiotherapists and other specialists (psychologist, nurses). The aim of the study was to evaluate the quality of life and stress level in adolescents with idiopathic scoliosis who are under brace treatment. It involved 45 adolescents, ages ranging between 10.0 and 15.0 years, all with Adolescent Idiopathic Scoliosis (AIS) with Cobb angle between 20-45 degrees. ⋯ Adolescents revealed higher score with BSSQ Deformity (median = 15) comparing to BSSQ Brace (median = 12). Conservative treatment does not severely impact on the quality of life of scoliotic adolescents. The adolescents who were under brace treatment suffered moderate level of stress from the deformity.
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Stud Health Technol Inform · Jan 2012
Nasotracheal intubation in a difficult airway using the Storz C-MAC Videolaryngoscope, the Boedeker Bougie endotracheal introducer, and the Boedeker curved forceps.
Airway management has multiple indications for nasotracheal intubation. In this study, we focus on its indication in difficult airways. This work describes a modified procedure of nasotracheal intubation using the new Storz CMAC® Videolaryngoscope, the malleable Boedeker Bougie and the curved Boedeker Forceps in the intubation of a difficult airway manikin.
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Stud Health Technol Inform · Jan 2012
Rate of surgery in a sample of patients fulfilling the SRS inclusion criteria treated with a Chêneau brace of actual standard.
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. Prospective cohort studies are available using the SRS inclusion criteria for studies on bracing. This seems to provide a great advantage to compare different strategies of bracing against each other. As we have gathered all data of the patients treated with a Chêneau light TM between June 2005 and November 2007 it was possible to identify the sample of patients fulfilling the SRS inclusion criteria from the whole sample. ⋯ Rate of surgery can be reduced with the help of Chêneau braces of the latest standard and satisfactory in-brace correction. Brace treatment with the Chêneau brace seems effective and therefore clearly is indicated. Clinical outcomes may be more important for the patient than radiologic outcomes.