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2.
Singapore Med J ; 65(2): 61-67, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38343123

RESUMO

INTRODUCTION: Modern magnetic resonance imaging (MRI) scanners utilise superconducting magnets that are permanently active. Patients and healthcare professionals have been known to unintentionally introduce ferromagnetic objects into the scanning room. In this study, we evaluated the projectile risk of Singapore coinage as well as some common healthcare equipment within a 3 T MRI scanner. METHODS: A rig termed 'Object eNtry Guidance and Linear Acceleration Instrument' (ONG LAI) was custom-built to facilitate safe trajectory of the putative ferromagnetic objects. A ballistic gel target was utilised as a human tissue surrogate to estimate tissue penetration. The point at which objects would self-propel towards the scanner was named 'Huge Unintended Acceleration Towards Actual Harm (HUAT AH)'. RESULTS: Singapore third-series coins (10-cent to 1-dollar coins) are highly ferromagnetic and would accelerate towards the MRI scanner from more than one metre away. Cannulas with their needles are ferromagnetic and would self-propel towards the scanner from a distance of 20 cm. Standard surgical masks are ferromagnetic and may lose their sealing efficacy when they are worn too close to the magnet. Among the tested objects, a can of pineapple drink (Lee Pineapple Juice) had the highest HUAT AH at a distance of more than 1.5 m. CONCLUSION: Some local coinage and commonly found objects within a healthcare setting demonstrate ferromagnetic activity with projectile potential from a distance of more than 1 m. Patients and healthcare professionals should be cognisant of the risk associated with introducing these objects into the MRI scanning room.


Assuntos
Equipamentos e Provisões Hospitalares , Imageamento por Ressonância Magnética , Humanos , Singapura , Imageamento por Ressonância Magnética/métodos , Desenho de Equipamento
3.
J Am Coll Surg ; 238(4): 404-413, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38224109

RESUMO

BACKGROUND: Variability in operating room supply cost is a modifiable cause of suboptimal resource use and low value of care (outcomes vs cost). This study describes implementation of a quality improvement intervention to decrease operating room supply costs. STUDY DESIGN: An automated electronic health record data pipeline harmonized operating room supply cost data with patient and case characteristics and outcomes. For inpatient procedures, predicted mortality and length of stay were used to calculate observed-to-expected ratios and value of care using validated equations. For commonly performed (1 or more per week) procedures, the pipeline generated figures illustrating individual surgeon performance vs peers, costs for each surgeon performing each case type, and control charts identifying out-of-control cases and surgeons with more than 90th percentile costs, which were shared with surgeons and division chiefs alongside guidance for modifying case-specific supply instructions to operating room nurses and technicians. RESULTS: Preintervention control (1,064 cases for 7 months) and postintervention (307 cases for 2 months) cohorts had similar baseline characteristics across all 16 commonly performed procedures. Median costs per case were lower in the intervention cohort ($811 [$525 to $1,367] vs controls: $1,080 [$603 to $1,574], p < 0.001), as was the incidence of out-of-control cases (19 (6.2%) vs 110 (10.3%), p = 0.03). Duration of surgery, length of stay, discharge disposition, and 30-day mortality and readmission rates were similar between cohorts. Value of care was higher in the intervention cohort (1.1 [0.1 to 1.5] vs 1.0 [0.2 to 1.4], p = 0.04). Pipeline runtime was 16:07. CONCLUSIONS: An automated, sustainable quality improvement intervention was associated with decreased operating room supply costs and increased value of care.


Assuntos
Salas Cirúrgicas , Cirurgiões , Humanos , Equipamentos e Provisões Hospitalares , Melhoria de Qualidade , Redução de Custos , Tempo de Internação
4.
Sci Rep ; 13(1): 21321, 2023 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-38044369

RESUMO

Accurate forecasting of hospital bed demand is crucial during infectious disease epidemics to avoid overwhelming healthcare facilities. To address this, we developed an intuitive online tool for individual hospitals to forecast COVID-19 bed demand. The tool utilizes local data, including incidence, vaccination, and bed occupancy data, at customizable geographical resolutions. Users can specify their hospital's catchment area and adjust the initial number of COVID-19 occupied beds. We assessed the model's performance by forecasting ICU bed occupancy for several university hospitals and regions in Germany. The model achieves optimal results when the selected catchment area aligns with the hospital's local catchment. While expanding the catchment area reduces accuracy, it improves precision. However, forecasting performance diminishes during epidemic turning points. Incorporating variants of concern slightly decreases precision around turning points but does not significantly impact overall bed occupancy results. Our study highlights the significance of using local data for epidemic forecasts. Forecasts based on the hospital's specific catchment area outperform those relying on national or state-level data, striking a better balance between accuracy and precision. These hospital-specific bed demand forecasts offer valuable insights for hospital planning, such as adjusting elective surgeries to create additional bed capacity promptly.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Ocupação de Leitos , Previsões , Equipamentos e Provisões Hospitalares , Hospitais Universitários
5.
Int J Equity Health ; 22(1): 177, 2023 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-37660026

RESUMO

OBJECTIVE: The study aimed to analyze the efficiency and equity of bed utilization in Please check if the section headings are assigned to appropriate levels.China's healthcare institutions and to compare and analyze the overall health resource utilization efficiency in recent years and some specific utilization conditions in 2021, to provide empirical experience for the allocation of health care resources in epidemic China. METHODS: To compare and analyze the overall health resource utilization efficiency of the whole country with that of the East, middle, and West in 2021, and to analyze the bed utilization efficiency of different types of healthcare institutions in China and the bed utilization efficiency of various types of specialist hospitals in the country in 2021 by using the rank-sum ratio method. RESULTS: In 2021, the bed utilization rate of China's health institutions was 69.82%, and the number of bed turnover times was 27.65 times; the bed utilization rate of hospitals was 74.6%, and the number of bed turnover times was 26.08 times. The number of hospital bed turnovers was highest in the western region, lowest in the central region, and close to the national average in the eastern region. The average length of stay for discharged patients was the highest in the central region, the lowest in the eastern region, and the same as the national average in the western region. The analysis of rank-sum ratio method shows that among different types of health institutions' bed utilization efficiency (r = 0.935, P = 0.000), general hospitals and traditional Chinese medicine hospitals have the best bed utilization rate, and the bed utilization rate of community health service centers (stations) needs to be improved; while among various types of specialized hospitals' bed utilization efficiency (r = 0.959, P = 0.000), oncology hospitals, thoracic hospitals, and hematology hospitals, children's hospitals have high bed utilization efficiency; leprosy hospitals, cosmetic hospitals, and stomatology hospitals have low bed utilization efficiency. Health technicians per 1,000 population are highest in the western region, lowest in the central region, and lower in the eastern region than in the western region but slightly higher than the national average. The number of beds in health institutions per 1,000 population is the highest in the central region, the lowest in the eastern region, and slightly lower in the northwest than in the central region but higher than the national average. CONCLUSION: China's investment in health funding in the field of health care has been on the rise in recent years. However, there still exists the situation of uneven investment in health expenses and inconsistent medical efficiency among regions. And change such a status quo can be further improved in terms of government, capital, human resources, technology, information system, and so on.


Assuntos
Equipamentos e Provisões Hospitalares , Instalações de Saúde , Criança , Humanos , China , Centros Comunitários de Saúde , Hospitais Pediátricos
6.
Zhongguo Yi Liao Qi Xie Za Zhi ; 47(5): 587-590, 2023 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-37753903

RESUMO

OBJECTIVE: To study the effective method of comprehensive evaluation and analysis of hospital valuable medical equipment performance. METHODS: The operation performance of 6 valuable equipment was evaluated by cost-benefit method, comprehensive index method and public evaluation method. RESULTS: Utilize equipment information management methods for data collection and evaluation, and construct an assessment data model based on evaluation indicators from three aspects: equipment operation status, profitability status, and scientific research contribution. CONCLUSIONS: Through the performance analysis of different types of valuable medical equipment, a more real and comprehensive quantitative analysis is carried out, which plays a key role in the reasonable purchase, efficient operation and avoiding idling.


Assuntos
Equipamentos e Provisões Hospitalares , Hospitais , Coleta de Dados , Gestão da Informação , Equipamentos Cirúrgicos
8.
Zhongguo Yi Liao Qi Xie Za Zhi ; 47(2): 158-162, 2023 Feb 08.
Artigo em Chinês | MEDLINE | ID: mdl-37096469

RESUMO

OBJECTIVE: In order to solve the problems of equipment comprehensive management in grade A hospitals, such as complicated work, low maintenance efficiency, error-prone, non-standard management process, et al. A set of efficient information-based medical management equipment platform was designed to serve the concept of medical departments. METHODS: B/S (browser and server) architecture and WeChat official accounts technology were adopted to construct the application end and WeChat official accounts client developed by Web technology, and MySQL server was selected as the system database technology. RESULTS: Asset management, equipment maintenance, quality control management, equipment leasing, data statistical analysis and other modules were integrated into the system, which optimized and standardized the medical equipment management process, improved the work efficiency of equipment management personnel, and improved the opening rate of medical equipment. CONCLUSIONS: Intelligent management by means of computer technology can effectively improve the utilization rate of hospital equipment, improve the level of hospital informatization and fine management, and contribute to the informatization development of medical engineering department.


Assuntos
Equipamentos e Provisões Hospitalares , Hospitais , Humanos , Controle de Qualidade , Gestão da Informação
9.
Am J Nurs ; 123(4): 10, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36951323
10.
BMJ ; 380: 712, 2023 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-36990504
12.
PLoS One ; 18(2): e0282331, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36848360

RESUMO

Hospital bed demand forecast is a first-order concern for public health action to avoid healthcare systems to be overwhelmed. Predictions are usually performed by estimating patients flow, that is, lengths of stay and branching probabilities. In most approaches in the literature, estimations rely on not updated published information or historical data. This may lead to unreliable estimates and biased forecasts during new or non-stationary situations. In this paper, we introduce a flexible adaptive procedure using only near-real-time information. Such method requires handling censored information from patients still in hospital. This approach allows the efficient estimation of the distributions of lengths of stay and probabilities used to represent the patient pathways. This is very relevant at the first stages of a pandemic, when there is much uncertainty and too few patients have completely observed pathways. Furthermore, the performance of the proposed method is assessed in an extensive simulation study in which the patient flow in a hospital during a pandemic wave is modelled. We further discuss the advantages and limitations of the method, as well as potential extensions.


Assuntos
Hospitais , Pandemias , Humanos , Equipamentos e Provisões Hospitalares , Simulação por Computador , Pacientes
13.
Am J Nurs ; 123(2): 14, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36698342

RESUMO

Regionalization of pediatric services has created geographic gaps in access to care.


Assuntos
Equipamentos e Provisões Hospitalares , Hospitais , Humanos , Criança
14.
Jt Comm J Qual Patient Saf ; 49(4): 181-188, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36476954

RESUMO

BACKGROUND: Hospitals have sought to increase pre-noon discharges to improve capacity, although evidence is mixed on the impact of these initiatives. Past interventions have not quantified the daily gap between morning bed supply and demand. The authors quantified this gap and applied the pre-noon data to target a pre-noon discharge initiative. METHODS: The study was conducted at a large hospital and included adult and pediatric medical/surgical wards. The researchers calculated the difference between the average cumulative bed requests and transfers in for each hour of the day in 2018, the year prior to the intervention. In 2019 an intervention on six adult general medical and two surgical wards was implemented. Eight intervention and 14 nonintervention wards were compared to determine the change in average cumulative pre-noon discharges. The change in average hospital length of stay (LOS) and 30-day readmissions was also calculated. RESULTS: The average daily cumulative gap by noon between bed supply and demand across all general care wards was 32.1 beds (per ward average, 1.3 beds). On intervention wards, mean pre-noon discharges increased from 4.7 to 6.7 (p < 0.0000) compared with the nonintervention wards 14.0 vs. 14.6 (p = 0.19877). On intervention wards, average LOS decreased from 6.9 to 6.4 days (p < 0.001) and readmission rates were 14.3% vs 13.9% (p = 0.3490). CONCLUSION: The gap between daily hospital bed supply and demand can be quantified and applied to create pre-noon discharge targets. In an intervention using these targets, researchers observed an increase in morning discharges, a decrease in LOS, and no significant change in readmissions.


Assuntos
Alta do Paciente , Readmissão do Paciente , Adulto , Humanos , Criança , Tempo de Internação , Equipamentos e Provisões Hospitalares , Hospitais
19.
BMC Health Serv Res ; 22(1): 864, 2022 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-35790966

RESUMO

BACKGROUND: Shortage of resources, such as hospital beds, needed for health care especially in times of crisis can be a serious challenge for many countries. Currently, there is no suitable model for optimal allocation of beds in different hospital wards. The Data Envelopment Analysis method (DEA) has been used in the present study to examine the evacuation and allocation of hospital beds during the covid-19 pandemic in order to contribute to effective planning for fighting the spread the covid-19 virus. METHODS: The present study was conducted in two stages in hospitals affiliated with Urmia University of Medical Sciences (UUMS) in 2021. First, the number of excess beds was determined by calculating the technical efficiency using the DEA method and Deap2.1 software. To reallocate excess beds to covid-19 patients, the types of hospital wards were considered. As a result of this analysis, the inefficient hospitals with excess beds in different wards, which could be used for covid-19 patients with more serious symptoms, were identified. RESULTS: The results of the study show that the average technical efficiency of the studied hospitals was 0.603. These hospitals did not operate efficiently in 2021 and their current output can be produced with less than 61% of the used input. Also, the potential of these hospitals, over a period of 1 year, for the evacuation of beds and reallocation of them to covid-19 patients was calculated to be 1781 beds, 450 of which belonged to general wards and 1331 belonged to specialized wards. CONCLUSIONS: The DEA method can be used in the allocation of resources in hospitals. Depending on the type of hospital wards and the health condition of patients, this method can help policy-makers identify hospitals with the best potential but less emergency services for the purpose of reallocation of resources, which can help reduce the severe effects of crises on health resources.


Assuntos
COVID-19 , COVID-19/epidemiologia , Equipamentos e Provisões Hospitalares , Hospitais , Humanos , Irã (Geográfico)/epidemiologia , Pandemias
20.
J Environ Public Health ; 2022: 5268887, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35655949

RESUMO

Aiming at the problem that particles cannot realize multidimensional analysis and poor global search ability, a composite particle swarm optimization algorithm is proposed, improving the accuracy of particle swarm optimization. Firstly, k-clustering is used to cluster risk management particle swarm optimization. The advantages of particle swarm optimization have to be given full play, and the risk of hospital equipment management from various aspects has to be controlled. Then, the multidimensional particle swarm is segmented to obtain an ordered multidimensional risk particle swarm set, which provides a basis for later risk prediction. Finally, through the fusion function of multidimensional risk particle swarm, the risk particle swarm set based on the clustering degree is constructed, and the optimal extreme value is obtained, so as to improve the accuracy of management risk calculation results. Through MATLAB simulation analysis, it can be seen that the composite particle swarm optimization algorithm is better than particle swarm optimization algorithm in global search accuracy and search time. Moreover, the calculation time and accuracy are better. Therefore, the composite particle swarm optimization algorithm can be used to analyze the risk of hospital equipment and effectively control the risk of hospital equipment management.


Assuntos
Algoritmos , Equipamentos e Provisões Hospitalares , Análise por Conglomerados , Simulação por Computador , Gestão de Riscos
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