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1.
J Prim Care Community Health ; 12: 2150132721993631, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33615883

RESUMEN

The onset of the COVID-19 pandemic and subsequent county shelter-in-place order forced the Cardinal Free Clinics (CFCs), Stanford University's 2 student-run free clinics, to close in March 2020. As student-run free clinics adhering to university-guided COVID policies, we have not been able to see patients in person since March of 2020. However, the closure of our in-person operations provided our student management team with an opportunity to innovate. In consultation with Stanford's Telehealth team and educators, we rapidly developed a telehealth clinic model for our patients. We adapted available telehealth guidelines to meet our patient care needs and educational objectives, which manifested in 3 key innovations: reconfigured clinic operations, an evidence-based social needs screen to more effectively assess and address social needs alongside medical needs, and a new telehealth training module for student volunteers. After 6 months of piloting our telehealth services, we believe that these changes have made our services and operations more robust and provided benefit to both our patients and volunteers. Despite an uncertain and evolving public health landscape, we are confident that these developments will strengthen the future operations of the CFCs.


Asunto(s)
/epidemiología , Innovación Organizacional , Pandemias , Clínica Administrada por Estudiantes/organización & administración , California/epidemiología , Humanos
3.
J Am Med Dir Assoc ; 22(2): 253-255.e1, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33406385

RESUMEN

Long-term care facilities (LTCFs), retirement homes (RHs), and other congregate care settings in Canada and worldwide have experienced significant COVID-19 outbreaks. As a health system response, our acute care hospital in Toronto, Ontario, Canada, developed and mobilized an onsite Infection Prevention and Control (IPAC) SWAT team (IPAC-SWAT) to regional settings on outbreak and implemented a strategy of support through education, training, and engagement. Between April 28, 2020, and June 30, 2020, IPAC-SWAT assessed 7 LTCFs and 10 RHs for IPAC preparedness and actively managed 10 of 13 COVID-19 outbreaks (LTCF n=5; RH n=5). IPAC-SWAT strategies were multi-interventional and intended to mitigate further viral transmission or prevent outbreaks. Dedicated training of local "IPAC champions" was facilitated at 7 sites (LTCF = 5; RH = 2) using a "train-the-trainer" approach to promote local knowledge, autonomy, and site-led audits and feedback.


Asunto(s)
/epidemiología , Hogares para Ancianos/organización & administración , Control de Infecciones/organización & administración , Cuidados a Largo Plazo/organización & administración , Innovación Organizacional , Neumonía Viral/virología , Anciano , Femenino , Humanos , Masculino , Ontario/epidemiología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
4.
Monaldi Arch Chest Dis ; 91(1)2021 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-33501822

RESUMEN

COVID 19 pandemic has brought about a sea change in health care practices across the globe. All specialities have changed their way of working during the pandemic. In this study, we evaluated the impact of COVID-19 on the practice of interventional pulmonology at our centre. All interventional pulmonology procedures done during the three months after implementation of lockdown were evaluated retrospectively for patient demographics, clinical diagnosis, indication for procedure and diagnostic accuracy. The changes in practices, additional human resources requirement, the additional cost per procedure and impact on resident training were also assessed. Procedures done during the month of January 2020 were used as controls for comparison. Twenty-two flexible bronchoscopies (75.8%), four semirigid thoracoscopies (13.7%) and three EBUS-TBNAs (10.3%) were carried out during three month lockdown period as compared to 174 during January 2020. Twenty-three of the procedures were for the diagnostic indication (79%), and six were therapeutic (20.6%). The diagnostic yield in suspected neoplasm was 100% while for suspected infections was 58.3%. The percentage of independent procedures being done by residents reduced from 45.4% to 0%. The workforce required per procedure increased from 0.75 to 4-8, and the additional cost per procedure came out to be 135 USD. To conclude, COVID 19 has impacted the interventional pulmonology services in various ways and brought about a need to reorganize the services, while also thinking of innovative ideas to reduce cost without compromising patient safety.


Asunto(s)
Broncoscopía , Prestación de Atención de Salud , Control de Infecciones , Enfermedades Pulmonares , Broncoscopía/métodos , Broncoscopía/estadística & datos numéricos , /prevención & control , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/tendencias , Técnicas de Diagnóstico del Sistema Respiratorio/estadística & datos numéricos , Femenino , Humanos , India/epidemiología , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/epidemiología , Enfermedades Pulmonares/terapia , Masculino , Persona de Mediana Edad , Innovación Organizacional , Estudios Retrospectivos , Centros de Atención Terciaria/estadística & datos numéricos
7.
J Ambul Care Manage ; 44(1): 78-84, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33234870

RESUMEN

COVID-19 restructured the health care delivery process, catapulting telemedicine to the mainstream. The Johns Hopkins After Care Clinic (JHACC) continued transprofessional health care delivery in the telemedicine space by shifting to remote, asynchronous collaboration and a triage system. In 1 month after starting telemedicine, the JHACC had 907 encounters for 376 unique patients. Most patients reported satisfaction with their visits. Telemedicine lengthened visit completion times. Providers encountered many failed call attempts and limited access to videoconferencing. Barriers to sustainable interprofessional telemedicine include poor social determinants of health, limited reimbursement for nonphysician health professionals, and increased clinical and administrative time.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Prestación de Atención de Salud/organización & administración , Telemedicina/tendencias , Humanos , Innovación Organizacional , Pandemias , Estados Unidos
8.
J Environ Manage ; 280: 111833, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33360391

RESUMEN

Integrated reporting is a voluntary reporting approach that has the potential to transform corporate reporting. This reporting approach involves integrating financial information with sustainability information and requires a coordinated approach by all organisational departments to address social and environmental issues affecting an organisation, a process referred to as integrated thinking. This paper builds on existing research on public sector organisations and explores the current status and motivations for integrated reporting by Australian local councils and the resulting potential organisational change leading to integrated thinking. The findings reveal that while integrated reporting is emerging in Australian local councils, the external motivations for integrated reporting have led to a limited level of organisational change, leading to a low level of integrated thinking in councils. To enable integrated reporting practices to transform and drive change in organisational practices, this paper considers top level managerial support and a strategic vision for this approach is required.


Asunto(s)
Organizaciones , Sector Público , Australia , Innovación Organizacional
10.
J Nurs Adm ; 51(1): 6-8, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33278194

RESUMEN

This article describes the formation of a Regulatory Advisory Council to address regulatory preparedness. The council used quality improvement methods to address data and findings from previous mock surveys and created 2 categories of work, an environment of care and clinical standards group, with checklists and work streams to improve organizational success with regulatory readiness.


Asunto(s)
Mejoramiento de la Calidad/legislación & jurisprudencia , Control Social Formal/métodos , Humanos , Innovación Organizacional , Mejoramiento de la Calidad/normas , Mejoramiento de la Calidad/tendencias , Encuestas y Cuestionarios
12.
J Invasive Cardiol ; 33(2): E71-E76, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33348314

RESUMEN

In Spring 2020, the United States epicenter of COVID-19 was New York City, in which the borough of the Bronx was particularly affected. This Fall, there has been a resurgence of COVID-19 in Europe and the Midwestern United States. We describe our experience transforming our cardiac catheterization laboratories to accommodate an influx of COVID-19 patients so as to provide other hospitals with a potential blueprint. We transformed our pre/postprocedural patient care areas into COVID-19 intensive care and step-down units and maintained emergent invasive care for ST-segment elevation myocardial infarction using existing space and personnel.


Asunto(s)
Cateterismo Cardíaco/métodos , Servicio de Cardiología en Hospital , Unidades de Cuidados Coronarios , Cuidados Críticos , Control de Infecciones , Laboratorios de Hospital/organización & administración , Innovación Organizacional , Infarto del Miocardio con Elevación del ST , /epidemiología , Servicio de Cardiología en Hospital/organización & administración , Servicio de Cardiología en Hospital/tendencias , Unidades de Cuidados Coronarios/métodos , Unidades de Cuidados Coronarios/organización & administración , Cuidados Críticos/métodos , Cuidados Críticos/organización & administración , Cuidados Críticos/tendencias , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Ciudad de Nueva York/epidemiología , Grupo de Atención al Paciente/organización & administración , Atención Perioperativa/métodos , Infarto del Miocardio con Elevación del ST/epidemiología , Infarto del Miocardio con Elevación del ST/terapia
13.
Br J Radiol ; 94(1117): 20200613, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33090919

RESUMEN

OBJECTIVE: The improvement of radiotherapy depends largely on the implementation of innovations, of which effectivity varies widely. The aim of this study is to develop a prediction model for successful innovation implementation in radiotherapy to improve effective management of innovation projects. METHODS: A literature review was performed to identify success factors for innovation implementation. Subsequently, in two large academic radiotherapy centres in the Netherlands, an inventory was made of all innovation projects executed between 2011 and 2017. Semi-structured interviews were performed to record the presence/absence of the success factors found in the review for each project. Successful implementation was defined as timely implementation, yes/no. Cross-tables, Χ2 tests, t-tests and Benjamin-Hochberg correction were used for analysing the data. A multivariate logistic regression technique was used to build a prediction model. RESULTS: From the 163 identified innovation projects, only 54% were successfully implemented. We found 31 success factors in literature of which 14 were significantly related to successful implementation in the innovation projects in our study. The prediction model contained the following determinants: (1) sufficient and competent employees, (2) complexity, (3) understanding/awareness of the project goals and process by employees, (4) feasibility and desirability. The area Under the curve (AUC) of the prediction model was 0.86 (0.8-0.92, 95% CI). CONCLUSION: A prediction model was developed for successful implementation of innovation in radiotherapy. ADVANCES IN KNOWLEDGE: This prediction model is the first of its kind and, after external validation, could be widely applicable to predict the timely implementation of radiotherapy innovations.


Asunto(s)
Difusión de Innovaciones , Innovación Organizacional , Oncología por Radiación/métodos , Oncología por Radiación/organización & administración , Humanos , Modelos Organizacionales , Países Bajos
14.
Medicine (Baltimore) ; 99(51): e23516, 2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33371073

RESUMEN

ABSTRACT: The clinical management assistant (CMA) is an innovative and practical way to help manage a hospital, so the selection of CMA is important. This research is to find the influencing factors on the competency of CMA and help to select proper candidate of CMA.Based on the items of competency theory using the structural equation model, the data of 600 hospital managers from Shanghai, Guangzhou and Wuhan were identified by exploratory factor analysis and confirmatory factor analysis. In further analysis, the interactions among the factors were evaluated.A total of 20 items were identified as critical to CMA capability, which were further tested and divided into 3 factors: (1) personal characteristics; (2) competence; (3) thinking. The subsequent analysis showed that all factors had significant impact on CMA's ability, and competence contributed the most to the formation of CMA's ability, while the intermediary role of personal characteristics and thinking could not be ignored in practice. The results showed that the competency model contained these 3 factors and had the same structure as the classic competency model.This study presented a tentative approach for assessing CMA's competency, as well as provided the criteria to find and evaluate a CMA.


Asunto(s)
Administración Hospitalaria/normas , Modelos Organizacionales , Competencia Profesional/normas , China , Competencia Clínica , Comunicación , Análisis Factorial , Procesos de Grupo , Humanos , Aprendizaje , Innovación Organizacional , Identificación Social , Factores de Tiempo
15.
S Afr Med J ; 0(0): 13182, 2020 12 14.
Artículo en Inglés | MEDLINE | ID: mdl-33334391

RESUMEN

BACKGROUND: The COVID-19 pandemic has led to the implementation of restrictive policies on theatre procedures, with profound impacts on service delivery and theatre output. OBJECTIVES: To quantify these effects at a tertiary hospital in KwaZulu-Natal Province, South Africa. METHODS: A retrospective review of morbidity and mortality data was conducted. The effects on emergency and elective caseload, intensive care unit (ICU) admissions from theatre, theatre cancellations and regional techniques were noted. RESULTS: Theatre caseload decreased by 30% from January to April 2020 (p=0.02), ICU admissions remained constant, and theatre cancellations were proportionally reduced, as were the absolute number of regional techniques. CONCLUSIONS: The resulting theatre case deficit was 1 260 cases. It will take 315 days to clear this deficit if four additional surgeries are performed per day.


Asunto(s)
Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Control de Infecciones , Servicio de Cirugía en Hospital , Atención Terciaria de Salud , Adulto , /prevención & control , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Política de Salud , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Masculino , Mortalidad , Evaluación de Necesidades , Innovación Organizacional , Administración de la Seguridad/tendencias , Sudáfrica/epidemiología , Servicio de Cirugía en Hospital/organización & administración , Servicio de Cirugía en Hospital/estadística & datos numéricos , Atención Terciaria de Salud/organización & administración , Atención Terciaria de Salud/tendencias
16.
Ann Saudi Med ; 40(6): 491-495, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33307733

RESUMEN

The coronavirus pandemic (COVID-19) has impacted essentially every country's healthcare system in extraordinary ways, fundamentally changing the way we deliver care. The practice of oral and maxillofacial surgery is no exception. In response to this global health crisis, the Saudi Society of Oral and Maxillofacial Surgery has prepared this consensus statement to inform our clinical and other medical colleagues and the public at large on proper procedures during this time. The statement is based on the best scientific evidence available and follows the guidelines put forth by the Saudi Ministry of Health on the COVID-19 response. It explains how to manage and triage oral and maxillofacial patients based on the level of care needed at the time of clinical presentation.


Asunto(s)
Prestación de Atención de Salud , Control de Infecciones , Sociedades Médicas , Cirugía Bucal , /epidemiología , Consenso , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/tendencias , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Innovación Organizacional , Arabia Saudita/epidemiología , Cirugía Bucal/métodos , Cirugía Bucal/tendencias , Triaje/métodos
17.
J Nurs Adm ; 50(12): e12-e13, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33181603

RESUMEN

Innovation has enabled organizations to highlight and engage during the COVID -19 pandemic. The use of virtual site visits to assess the organizations 's culture and sustainability of the Magnet components during initial designation and redesignation allows for ongoing support of nursing excellence.


Asunto(s)
American Nurses' Association/organización & administración , Habilitación Profesional/organización & administración , Servicio de Enfermería en Hospital/normas , Innovación Organizacional , Garantía de la Calidad de Atención de Salud/normas , Infecciones por Coronavirus , Humanos , Personal de Enfermería en Hospital , Pandemias , Neumonía Viral , Estados Unidos
18.
BMC Med Educ ; 20(1): 400, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33138818

RESUMEN

BACKGROUND: COVID - 19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to ensure that the content delivered is satisfactory for student progression. AIM OF THE WORK: This work aims at mapping priorities for post-COVID planning for better balance between distance learning and face to face learning. METHODS: This qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 63-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and action steps to maintain upsides and avoid downsides of each pole. RESULTS: Participants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. They also agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal opportunities to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL are much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks of over focusing on one pole at the expense of the other. Action steps were determined to ensure optimized use of in either method. CONCLUSION: In order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators' decisions to minimize the downsides for the good of the learning process.


Asunto(s)
Competencia Clínica , Infecciones por Coronavirus/prevención & control , Educación a Distancia/métodos , Educación a Distancia/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Estudios Transversales , Curriculum , Educación de Pregrado en Medicina/organización & administración , Femenino , Humanos , Masculino , Innovación Organizacional , Pandemias/estadística & datos numéricos , Investigación Cualitativa , Facultades de Medicina/organización & administración , Estudiantes de Medicina/psicología
19.
Rev Bras Epidemiol ; 23: e200100, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33053093

RESUMEN

OBJECTIVE: The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties. METHODS: Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. RESULTS: Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability. CONCLUSION: The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.


Asunto(s)
Comparación Transcultural , Innovación Organizacional , Psicometría/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Brasil , Estudios Transversales , Humanos , Portugal , Reproducibilidad de los Resultados
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