Impact of the Automation of Inpatient Bed Management to Reduce the Emergency Service Waiting Time.

The patient waiting time to be transferred for hospitalization is the time that the patient waits between the decision to hospitalize and the actual admission to an inpatient hospital bed. One of the difficulties encountered in qualifying waiting time for inpatient bed is the inability of hospital information systems to measure it. Hospitals in France have a specialized bed allocation team. This team must manage the bed allocation problem between different hospital departments using phone communication to assign patients to the adapted service. This kind of communication represents a lengthy additional workload in which effectiveness is uncertain. This paper presents a new approach to automate bed management in downstream service. For that, we have implemented algorithms based on artificial intelligent integrated in an inpatient web platform using IoT-Beacons, which is implemented to improve and facilitate the exchange of availability information of downstream beds within the Lille university hospital center (LUHC).

Ontology for Overcrowding Management in Emergency Department.

Emergency department (ED) overcrowding is an ongoing problem worldwide. Scoring systems are available for the detection of this problem. This study aims to combine a model that allows the detection and management of overcrowding. Therefore, it is crucial to implement a system that can reason model, rank ED resources and ED performance indicators based on environmental factors. Thus, we propose in this paper a new domain ontology (EDOMO) based on a new overcrowding estimation score (OES) to detect critical situations, specify the level of overcrowding and propose solutions to deal with these situations. Our approach is based on a real database created during more than four years from the Lille University Hospital Center (LUHC) in France. The resulting ontology is capable of modeling complete domain knowledge to enable semantic reasoning based on SWRL rules. The evaluation results show that the EDOMO is complete that can enhance the functioning of the ED.

Acute coronary syndromes: is there a place for a real pre-hospital treatment for patients "en route" to the coronary intensive care unit?

Acute initial management of patients with acute coronary syndrome (ACS) is based on a precise clinical and electrocardiographic diagnosis. Initial risk stratification in the pre-hospital phase is the key step. The last step, adequate patient routing, is decided based on emergency level and reperfusion strategies, considered right from the pre-hospital phase. The management of a patient with an ACS requires close collaboration between emergency physicians and cardiologists, according to simplified protocols for easier access to catheterisation. The next challenges for the pre-hospital management of ACS are based on: - precise knowledge of new antiplatelet and anticoagulant drugs by the emergency physicians, in order to adjust their prescriptions to the patient profile; - developing co-operation between hospitals, according to regional specificities (geographic considerations and distribution of PCI centres) in order to reduce access time to catheterisation rooms; - organising the healthcare network, where the SAMU has an essential role in coordinating the different medical actors; - regular analysis of the evolution of our professional practices, considering, e.g., the guidelines of the "HAS" (French official healthcare guidelines institute);- integrating pre-hospital medicine in health prevention programmes; - improving our understanding of the population's presentations of coronary artery disease, in order to encourage the patients and their families to call the EMS as soon as possible. The challenge of the emergency physician is to adapt the strategies to the patient's needs.