Applying Microsoft Power Platform to Improve Primary Medical Equipment Maintenance Processes.

Post-COVID, our hospital shifted to online systems using Microsoft Power Platform to mitigate errors and delays. SharePoint and Power Apps manage equipment maintenance records and submissions, enhancing immediacy and transparency. Power Automate automates report generation and reminders, improving task completion rates. Power BI visualizes data for streamlined management. Adjustments to real-time reporting enhanced efficiency, reducing manual efforts and improving completion rates.

The financial and environmental impact of unopened medical supplies discarded in the emergency department.

BACKGROUND: Inefficient supply chain management within the US healthcare industry results in significant financial and environmental impact. Unopened medical supplies may routinely be discarded in the Emergency Department (ED), contributing as a source of unnecessary medical waste. OBJECTIVES: Quantify the financial and environmental impact of unopened medical supplies that are routinely discarded in two EDs. METHODS: The study utilized a waste audit of collection bins targeting unopened medical supplies that would have otherwise been discarded. Associated financial cost was calculated using data from the purchasing department and from an online search. End-of-life (EOL) environmental impact was calculated using the M+ Wastecare calculator. A lifecycle analysis was performed on a supplier-packaged intubation kit, which the study identified as a significant source of waste. RESULTS: High volumes of unused, unopened supplies (143.48 kg) were collected during the study period with a yearly extrapolated value of 1337 kg. Purchasing costs over 44 days at Hospital A and 37 days at Hospital B for these items amounted to $16,159.71 across both sites with a yearly extrapolated value of $150,631.73. Yearly extrapolated EOL impact yielded 5.79 tons per year of CO2eq. Components from supplier-packaged intubation kits were found to contribute to 45.2% of collected items at one site which purchased them. Lifecycle analysis of an intubation kit yields 23.6 kg of CO2eq. CONCLUSION: This study demonstrates that the disposal of unopened medical supplies contributes a significant source of financial and environmental waste in the ED setting. The results continue to support the trend of procedure kits generating significant environmental and financial waste.

[Medical Equipment Management System Based on the Concept of Whole Life Cycle].

Objective: Strengthen the legal, compliant, and rational use of medical equipment and further guide the rationalization of medical behaviors. Methods: By utilizing the Internet of Things (IoT) and image analysis technology, collect real-time operation data of the equipment, establish a real-time running database for medical equipment, and cooperate with the 12 key links of the "whole life" of the equipment and the 8+6 management system framework to implement lean management of the efficiency, benefit, and effectiveness of medical equipment usage. Results: It realizes the improvement of the quality and efficiency of medical equipment, cost reduction and cost control, and provides data support for scientific decision-making. Conclusion: This study innovates the management model for the entire life cycle of medical equipment, providing a scientific approach to the management of hospital equipment.

Confirmation of a measurement model for hospital supply chain resilience.

Background: The hospital supply chain has revealed increasing vulnerabilities and disruptions in the wake of the COVID-19 pandemic, threatening the healthcare services and patient safety. The resilience of hospital supply chains has emerged as a paramount concern within the healthcare system. However, there is a lack of systematic research to develop an instrument tailored to the healthcare industry that is both valid and reliable for measuring hospital supply chain resilience. Therefore, this study aims to construct and validate a comprehensive scale for assessing hospital supply chain resilience, based on dynamic capability theory. Methods: This study followed rigorous scale development steps, starting with a literature review and 15 semi-structured interviews to generate initial items. These items were then refined through expert panel feedback and three rounds of Delphi studies. Using data from 387 hospitals in Province S, mainland China, the scale underwent rigorous testing and validation using structural equation modeling. To ensure the most effective model, five alternative models were examined to determine the most suitable parsimonious model. Results: The study produced a 26-item scale that captures five dimensions of resilience in line with dynamic capability theory: anticipation, adaptation, response, recovery, and learning, all showing satisfactory consistency, reliability and validity. Conclusion: The multi-dimensional scale offers hospital managers a valuable tool to identify areas needing attention and improvement, benchmark resilience against their counterparts, and ultimately strengthen their supply chains against unexpected risks.

Availability of Pediatric Services and Equipment in Emergency Departments: A Multicenter Study in Resource-Limited Settings.

OBJECTIVE: This study was conducted to assess the availability of equipment and supplies in the emergency departments of the hospitals in the West Bank of Palestine. METHODS: This study was conducted in a cross-sectional design using a data collection form that was specifically developed for this study. The standardized data collection form contained a detailed list of all essential pediatric emergency equipment and supplies. RESULTS: This study was conducted in a total of 30 hospitals all across the West Bank of Palestine. The median number of patients visiting the emergency department per day was 115.0, the median number of patients admitted to the hospital per day was 14.5, and the median number of pediatric patients visiting the emergency department per day was 6.0. The median number of pediatricians in the hospital was 4.0, the median number of pediatricians in the emergency department was 1.0, the median number of nurses in the hospital was 75.0, and the median number of nurses in the emergency department was 8.5. Both governmental and private hospitals lacked the equipment and supplies needed for monitoring, gaining vascular access, airway management, resuscitation medications, cervical immobilization equipment, and other equipment and supplies. CONCLUSIONS: Decision and policymakers might use the findings reported in this study to allocate resources to restock and increase the availability of pediatric emergency equipment and supplies. More studies are still needed to compare the outcomes of patients before and after restocking and increasing the availability of pediatric emergency equipment and supplies.

Implementing the Lean 5S process improvement to boost efficiency and cost savings in hospital supply rooms.

ABSTRACT: A strong link exists between adequate supply chain management and nurse efficiency and satisfaction. Implementing Lean methodology, specifically 5S process improvement, staff created a unit-based supply room that was clean, safe, and well organized which led to reduced waste, greater efficiency, and cost savings.

A fair bed allocation during COVID-19 pandemic using TOPSIS technique based on correlation coefficient for interval-valued pythagorean fuzzy hypersoft set.

The relationship between two variables is an essential factor in statistics, and the accuracy of the results depends on the data collected. However, the data collected for statistical analysis can be unclear and difficult to interpret. One way to predict how one variable will change about another is by using the correlation coefficient (CC), but this method is not commonly used in interval-valued Pythagorean fuzzy hypersoft set (IVPFHSS). The IVPFHSS is a more advanced and generalized form of the Pythagorean fuzzy hypersoft set (PFHSS), which allows for more precise and accurate analysis. In this research, we introduce the correlation coefficient (CC) and weighted correlation coefficient (WCC) for IVPFHSS and their essential properties. To demonstrate the applicability of these measures, we use the COVID-19 pandemic as an example and establish a prioritization technique for order preference by similarity to the ideal solution (TOPSIS) model. The technique is used to study the problem of optimizing the allocation of hospital beds during the pandemic. This study provides insights into the importance of utilizing correlation measures for decision-making in uncertain and complex situations like the COVID-19 pandemic. It is a robust multi-attribute decision-making (MADM) methodology with significant importance. Subsequently, it is planned to increase a dynamic bed allocation algorithm based on biogeography to accomplish the superlative decision-making system. Moreover, numerical investigations deliberate the best decision structures and deliver sensitivity analyses. The efficiency of our encouraged algorithm is more consistent than prevalent models, and it can effectively control and determine the optimal configurations for the study.

Achromobacter species (sp.) outbreak caused by hospital equipment containing contaminated water: risk factors for infection.

BACKGROUND: Nosocomial outbreaks of urinary tract infections caused by Achromobacter spp. have been rare in recent decades. AIM: To identify the origin of an Achromobacter sp. outbreak, conduct multi-modal infection control measures, and finally to stop the outbreak. To this end, an epidemiological outbreak investigation and risk factor analysis were performed. METHODS: Achromobacter sp. was detected in 22 patients in our urology wards and six environmental cultures of specimens obtained from the operating rooms. Strains isolated were submitted for antimicrobial susceptibility testing. An on-site epidemiological investigation, evaluation of patient medical records, and environmental sampling were performed to identify the source of the outbreak, and implementation of infection control intervention. A case-control study was performed to analyse the potential risk factors. FINDINGS: Environmental sampling showed that the source of the infection for 22 patients was an ISA-IIIA-type medical pressurizer containing contaminated water. A case-control analysis showed that the risk factors for infection were: diagnosis of kidney/ureteral stones, surgery, placement of a double-J stent, and history of hospitalization in the past three months. CONCLUSION: It was concluded that the outbreak occurred in patients who underwent internal lithotripsy and double-J stent placement, due to contact transmission with the contaminated sensor and connecting tubes of the ISA-IIIA-type medical pressurizer.

Local cOinage and Hospital Equipment Index (Lo Hei): projectile distance of Singapore coinage and healthcare-related equipment in a 3T magnetic resonance imaging scanner.

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.

Operating Room Supply Cost and Value of Care after Implementing a Sustainable Quality Intervention.

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.

CREAS e covid-19: desafios e perspectivas da psicologia no Norte de Minas / CREAS and covid-19: challenges and perspectives for Northern Minas Gerais psychology / CREAS y covid-19: desafíos y perspectivas de la psicología en el Norte de Minas

Este artigo analisa os desafios e estratégias de atuação de psicólogas(os) nos Centros de Referência Especializados de Assistência Social (CREAS) do norte de Minas Gerais durante a pandemia de covid-19. Trata-se de um estudo descritivo, quanti-qualitativo, de corte transversal e com análise de conteúdo e estatística para a interpretação de dados primários e meio de questionário eletrônico, emergiram os seguintes eixos temáticos: (a) Perfil sociodemográfico das(os) trabalhadoras(es); (b) Medidas de prevenção à contaminação para quem? Impactos da pandemia na práxis da psicologia no CREAS; (c) Chegada das demandas no CREAS; e (d) Tenuidade entre as potencialidades e vicissitudes do uso das tecnologias digitais. Observou-se que a inserção das(os) trabalhadoras(es) nos CREAS é marcada por contratos temporários, altas jornadas de trabalho e baixa remuneração. Além disso, com a pandemia de covid-19, têm enfrentado obstáculos como a falta de equipamentos de proteção individual (EPI) e de prevenção ao vírus. A chegada de demandas aos CREAS também foi afetada pela pandemia, como apontam as análises estatísticas dos registros mensais de atendimento dos municípios. As tecnologias digitais se configuraram como a principal estratégia adotada no ambiente de trabalho dos CREAS. Conclui-se que, se por um lado, a pandemia engendrou e acentuou obstáculos para a práxis da psicologia; por outro, a imprevisibilidade desse cenário e a potência da psicologia norte-mineira possibilitaram diversas estratégias para assistir os usuários.(AU)

This article analyses the challenges and strategies over the psychologists activity at the Specialized Reference Centers for Social Assistance (CREAS), from the north of the state of Minas Gerais during the COVID-19 pandemic. It is a descriptive, quantitative-qualitative study on content and statistics analysis for interpretation of primary and secondary data, with 19 psychologists participating. From interviews made with electronic questionnaires, the following theatrical axes emerged: (a) Social demographic profile of workers; (b) Prevention measures over contamination directed to which public? The impacts of the pandemic over the practice of psychology at CREAS; (c) Demand reception at CREAS; and (d) Tenuity between potentialities and vicissitudes of the use of digital technologies. The workers insertion at CREAS is notably marked by transitory working contracts, long labor journeys, and low wages. Furthermore, the COVID-19 pandemic is causing hindrances such as the lack of personal protection equipment (PPE) and virus prevention. The demands received by CREAS were also affected by the pandemic, as shown in the statistics analysis from monthly county treatment records. The digital technologies were the main strategy enforced by the working environment at CREAS. In conclusion, if on the one hand, the pandemic produced and increased obstacles for the practice of Psychology, on the other hand, the unpredictability of this scenery and the capacity of the psychology of the north of Minas Gerais enabled diverse strategies to attend the users.(AU)

Este artículo analiza los desafíos y las estrategias en la actuación de psicólogas(os) en los Centros de Referencia Especializados de Asistencia Social (CREAS) del norte de Minas Gerais (Brasil) durante la pandemia de la COVID-19. Se trata de un estudio descriptivo, cualicuantitativo, de cohorte transversal, con análisis de contenido y estadísticas para la interpretación de datos primarios y secundarios, en el cual participaron 19 psicólogas(os). De las entrevistas en un cuestionario electrónico surgieron los siguientes ejes temáticos: (a) perfil sociodemográfico de los(as) trabajadores(as); (b) medidas de prevención de la contaminación ¿para quién? Impactos de la pandemia en la praxis de la psicología en CREAS; (c) la llegada de demandas a CREAS y; (d) la tenuidad entre las potencialidades y vicisitudes del uso de tecnologías digitales. Se observó que la inserción de las(os) trabajadoras(es) en el CREAS está marcada por contratos laborales temporales, largas jornadas y baja remuneración. Además, con la pandemia de la COVID-19, se han enfrentado a obstáculos como la falta de equipo de protección personal (EPP) y prevención del virus. La llegada de demandas al CREAS también se vio afectada por la pandemia, como lo demuestran los análisis estadísticos de los registros mensuales de atención de los municipios. Las tecnologías digitales se han convertido en la principal estrategia adoptada en el entorno laboral de los CREAS. Se concluye que si, por un lado, la pandemia engendró y acentuó obstáculos a la praxis de la Psicología, por otro, la imprevisibilidad de este escenario y el poder de la Psicología en el norte de Minas Gerais posibilitaron varias estrategias para asistir a los usuarios.(AU)

Forecasting local hospital bed demand for COVID-19 using on-request simulations.

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.

Reutilización de barrera de tela de algodón estéril en la práctica clínica: estudio observacional longitudinal / Reusing sterile cotton fabric barriers in the clinical practice: an observational and longitudinal study / Reuso de barreira estéril de tecido de algodão na prática clínica: estudo longitudinal observacional

Objetivo: analizar las características de barrera física y biológica de los campos de algodón utilizados como sistema de barrera estéril después de ser sometidos a múltiples usos y procesos en la práctica clínica. Método: estudio observacional longitudinal de seguimiento y evaluación de tela 100% algodón, utilizada como sistema de barrera estéril en un hospital de mediano porte. Se recolectaron muestras antes del uso (después de tres lavados) y después de tres, seis, nueve, 12 y 15 meses de uso y se evaluaron el número, grosor e integridad de los hilos, peso, absorción de agua y penetración húmeda de microorganismos. Resultados: después de 85 lavados, no cambió el número de hilos, aumentó el número de fibras deshilachadas y el volumen de agua absorbida. La prueba microbiológica mediante la metodología estándar alemana obtuvo un resultado negativo y la de penetración húmeda de microorganismos no mostró cambios significativos con el tiempo, a pesar de que una fracción de células microbianas pasó a través de las muestras de doble capa. Conclusión: las propiedades físicas de la tela 100% algodón utilizada como sistema de barrera estéril cambiaron con el uso/procesamiento; sin embargo, no interfirieron significativamente con los resultados obtenidos en las pruebas realizadas a la barrera microbiológica hasta los 85 lavados.

Objective: to analyze the physical and biological barrier characteristics of cotton fields used as a sterile barrier system after multiple use and processing cycles in the clinical practice. Method: an observational and longitudinal study to monitor and evaluate 100% cotton fabric used as a sterile barrier system in a medium-sized hospital. Samples were collected before use (after three washes) and at three, six, nine, 12 and 15 months of use and evaluated for the number, thickness and integrity of threads, weight, water absorption and wet penetration by microorganisms. Results: after 85 washes, the number of threads remained unchanged, and the shredded fibers and the water volume absorbed were increased. The microbiological test using the German standard methodology obtained a negative result and wet penetration by microorganisms did not show significant changes over time, although a percentage of the microbial cells passed through the double-layer samples. Conclusion: the physical properties of 100% cotton used as a sterile barrier system changed with use/processing cycles; however, these alterations did not significantly interfere with the results obtained by the tests performed on the microbiological barrier up to 85 washes.

Objetivo: analisar as características de barreira física e biológica de campos de algodão, que são utilizados como sistema de barreira estéril, após múltiplos usos e processamentos na prática clínica. Método: estudo longitudinal observacional de acompanhamento e de avaliação de tecido 100% algodão que foi utilizado como sistema de barreira estéril em um hospital de médio porte. Amostras foram coletadas antes do uso (após três lavagens) e com três, seis, nove, 12 e 15 meses de uso e avaliadas quanto ao número, à espessura e à integridade dos fios, peso, absorção de água e penetração úmida de micro-organismos. Resultados: após 85 lavagens, o número de fios permaneceu inalterado, porém aumentaram-se as fibras desfiadas e o volume de água absorvido. O teste microbiológico utilizando metodologia padrão alemão obteve resultado negativo; já o de penetração de úmida de micro-organismos não apresentou mudanças significativas ao longo do tempo, embora uma fração das células microbianas tenham passado pelas amostras de dupla camada. Conclusão: as propriedades físicas do tecido 100% algodão, utilizado como sistema de barreira estéril, alteraram com usos/processamentos; entretanto essas não interferiram significativamente nos resultados obtidos pelos testes realizados na barreira microbiológica até 85 lavagens.

[Analysis and Research on Comprehensive Evaluation Method of Operation Performance of Hospital Valuable Equipment].

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.

Efficiency and equity of bed utilization in China's health institutions: based on the rank-sum ratio method.

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.

[Design and Application of Medical Equipment Management System Based on B/S Architecture and WeChat Official Accounts].

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.