Previsões do número de cirurgias suspensas utilizando o software Power BI® em um hospital universitário / Predictions of the number of suspended surgeries using software Power BI® in a university hospital / Predicciones del número de cirugías suspendidas utilizando software Power BI® en un hospital universitario

Objetivo: analisar as cirurgias suspensas, realizando previsões futuras de três meses, a partir de outubro de 2022, através de um gráfico de linhas utilizando o software Power BI®. Método: se utilizou a técnica de médias moveis ponderada, alisamento exponencial simples, utilizando a ferramenta gráfico de linhas do Power BI®, com intervalo de confiança de 95% e previsões de três meses. Resultados: os resultados demostraram que existem diferentes etapas para construir previsões e alguns pré-requisitos devem ser preenchidos, foram encontradas as seguintes previsões com seus respectivos intervalos de confiança novembro 134(97,172), dezembro 141(102,180), janeiro 147(106.188). Conclusão: a utilização de previsões pode ser uma ferramenta útil para a tomada de decisão, prever problemas e sempre necessário na gestão de um hospital, podendo até suprimir gastos se antecipando a uma variedade de problemas.

Objective: to analyze the suspended surgeries, making future predictions of three months, starting in October 2022, through a line graph using the Power BI software. Method: we used the technique of weighted moving averages, simple exponential smoothing, using the Power BI® line graph tool, with a confidence interval of 95% and predictions of three months. Results: the results showed that there are different steps to construct predictions and some prerequisites must be fulfilled, the following predictions were found with their respective confidence intervals: November 134 (97,172), December 141 (102,180), January 147 (106,188). Conclusion: the use of forecasts can be a useful tool for decision making, predicting problems and always necessary in the management of a hospital, and can even suppress expenses in anticipation of a variety of problems.

Objetivos:analizar las cirugías suspendidas, haciendo predicciones futuras de tres meses, a partir de octubre de 2022, a través de un gráfico lineal utilizando el software Power BI®. Método: se utilizó la técnica de medias móviles ponderadas, suavizado exponencial simple, utilizando la herramienta de gráfico de líneas de Power BI®, con un intervalo de confianza del 95% y predicciones de tres meses. Resultados: los resultados mostraron que existen diferentes pasos para construir predicciones y se deben cumplir algunos requisitos previos, se encontraron las siguientes predicciones con sus respectivos intervalos de confianza: noviembre 134 (97,172), diciembre 141 (102,180), enero 147 (106,188). Conclusión: el uso de pronósticos puede ser una herramienta útil para la toma de decisiones, predicción de problemas y siempre necesaria en la gestión de un hospital, e incluso puede suprimir gastos en previsión de una variedad de problemas.

Avaliação da satisfação profissional dos enfermeiros num Centro Hospitalar da Região Lisboa / Assessment of nurses' professional satisfaction in a Hospital in the Lisbon Region

A satisfação profissional (SP) tem sido alvo de um crescente interesse por parte dos investigadores, motivados pelas consequências que pode ter na saúde e na qualidade de vida dos trabalhadores e na qualidade de cuidados prestados aos doentes. É assim, uma condição importante para o bom funcionamento das organizações, servindo como indicador para os gestores iniciarem estratégias que promovam a satisfação profissional. Realizou-se um estudo observacional e transversal, seguindo um modelo de análise descritivo - correlacional, num hospital da região de Lisboa, com vista a satisfação profissional dos enfermeiros. A partir deste, pretendeu-se, também, a relação entre a satisfação profissional, os fatores sociodemográficos e os profissionais nos diferentes serviços hospitalares estudados. Para a recolha de dados foi utilizado o Instrumento de Avaliação de Satisfação Profissional (IASP), desenvolvido e adaptado pelo CEISUC de preenchimento via intranet. Utilizou-se o programa informático Statistical Package for the Social Sciences (SPSS) para o tratamento de dados, recorrendo a medidas estatísticas descritivas e de comparação. A amostra ficou constituída por 136 profissionais de saúde, que traduz uma taxa de adesão de 43%. A maioria da amostra é do gênero feminino com 82,6%. O nível médio de satisfação profissional dos enfermeiros nos serviços estudados, foi de 57,1%. Quanto à relação da satisfação com os fatores sociodemográficos e profissionais, apenas nos fatores género e na acumulação de funções evidenciaram-se significâncias estatística, em que os homens se sentem mais satisfeitos que as mulheres e os que acumulam funções em outros locais expressam-se menos satisfeitos. Existem diferenças na satisfação entre as várias áreas de cuidados tendo-se apurado valores médios mais baixos no serviço de medicina e os mais elevados nas unidades de cuidados intensivos. Apesar dos valores baixos obtidos, maioritariamente, os enfermeiros optariam pela mesma profissão, o que significa que se identificam com a profissão e reconhecem na Enfermagem enquanto disciplina científica e profissional, o cuidar do outro, o principal motivo para trabalharem. Os resultados evidenciam necessidade de implementação de medidas que visem a melhoria da satisfação profissional dos enfermeiros.

ob satisfaction (SP) has been the subject of growing interest on the part of researchers, motivated by the consequences it can have on the health and quality of life of workers and on the quality of care provided to users. It is thus an important condition for the proper functioning of organizations, serving as an indicator for managers to initiate strategies that promote job satisfaction. An observational and cross-sectional study was carried out, following a descriptive - correlational analysis model, in a hospital in the Lisbon region, with a view to the professional satisfaction of nurses. From this, it was also intended to establish a relationship between professional satisfaction, sociodemographic factors and professional factors and in the different hospital services studied. For data collection, the Professional Satisfaction Assessment Instrument (IASP) was used, developed and adapted by CEISUC by via intranet. The Statistical Package for the Social Sciences (SPSS) computer program was used for data processing, using descriptive and comparative statistical measures. The sample consisted of 136 health professionals, which translates into a rate. Most of the sample is female with 82.6%. The average level of professional satisfaction of nurses in the services studied was 57.1%. As for the relationship of satisfaction with sociodemographic and professional factors, only the gender factors and the accumulation of functions showed statistical significance, in which men feel more satisfied than women and those who accumulate functions in other places express themselves less satisfied. There are differences in satisfaction between the various areas of care, with the lowest mean values being found in the medical service and the highest in the intensive care units. Despite the low values obtained, most of the nurses would opt for the same profession, which means that they identify with the profession and recognize Nursing as a scientific and professional discipline, caring for others, the main reason for working. The results show the need to implement measures aimed at improving the professional satisfaction of nurses.

Classificação do nível de complexidade assistencial dos pacientes em hospital oncológico / Clasificación del nivel de complejidad asistencial de los pacientes en un hospital oncológico / Levels of care complexity classification of patients in an oncology hospital

RESUMO Objetivo Classificar o nível de complexidade assistencial requerido da Enfermagem por pacientes oncológicos internados. Método Estudo observacional, seccional, de abordagem quantitativa, realizado diariamente com pacientes oncológicos em unidades de internação de Oncologia Clínica e Cirúrgica de um hospital de referência ao tratamento de câncer durante o período de três meses. A coleta foi realizada por meio da aplicação de um questionário semiestruturado e instrumento de classificação de pacientes de Fugulin et al. (2007). Resultados Foram entrevistados 242 pacientes e realizadas 1309 avaliações com maior quantidade de indivíduos do sexo masculino e que possuíam o Ensino Fundamental incompleto. Houve maior ocorrência de câncer no sistema gastrintestinal e sistema reprodutor feminino, respectivamente, na internação de Oncologia Clínica e Cirúrgica, com maior taxa de ocupação nos meses de junho e de maio, nessa ordem. O comportamento observado foi bastante similar em ambas as internações, correspondendo, respectivamente, a pacientes que se enquadravam nos cuidados mínimos (33,1%; 35,1%) e intermediários (30,2%; 37,5%). Conclusão e implicações para a prática O sistema de classificação de pacientes e dimensionamento em Enfermagem na área oncológica merece maiores discussões e carece de instrumentos validados capazes de representar a real situação do cuidado.

RESUMEN Objetivo Clasificar el nivel de complejidad asistencial requerido en Enfermería por pacientes oncológicos hospitalizados. Método Estudio observacional, seccional, con enfoque cuantitativo, realizado diariamente con pacientes oncológicos en unidades de internación de Oncología Clínica y Quirúrgica de un hospital de referencia para el tratamiento del cáncer durante un período de tres meses. La recolección de datos se realizó mediante la aplicación de un cuestionario semiestructurado y un instrumento de clasificación de pacientes de Fugulin et al. (2007). Resultados Se entrevistaron 242 pacientes y se realizaron 1309 evaluaciones con mayor número de individuos del sexo masculino que tenían la Enseñanza Básica incompleta. Hubo mayor ocurrencia de cáncer en el aparato digestivo y aparato reproductor femenino, respectivamente, en el ingreso de Oncología Clínica y Quirúrgica, con la mayor tasa de ocupación en los meses de junio y mayo, en ese orden. El comportamiento observado fue bastante similar en ambas hospitalizaciones, correspondiendo, respectivamente, a pacientes que se encontraban en cuidados mínimos (33,1%; 35,1%) e intermedios (30,2%; 37,5%). Conclusión e implicaciones para la práctica El sistema de clasificación y dimensionamiento de pacientes en Enfermería en el área de oncología merece mayor discusión y carece de instrumentos validados capaces de representar la situación real del cuidado.

ABSTRACT Objective To classify the level of complexity of care required from Nursing by hospitalized oncology patients. Methods This is an observational, sectional, quantitative study, carried out daily with oncology patients in the Clinical and Surgical Oncology inpatient units of a cancer treatment reference hospital during a three-month period. The collection was carried out through the application of a semi-structured questionnaire and an instrument of patient classification by Fugulin et al. (2007). Results 242 patients were interviewed and 1309 evaluations were performed, with a greater number of males and those with incomplete elementary school education. There was a higher occurrence of cancer in the gastrointestinal system and female reproductive system, respectively, in the admission of Clinical and Surgical Oncology, with higher occupancy rate in the months of June and May, in that order. The behavior observed was quite similar in both admissions, corresponding, respectively, to patients who fell into minimal (33.1%; 35.1%) and intermediate care (30.2%; 37.5%). Conclusion and implications for practice The patient classification and dimensioning system in Nursing in oncology deserves further discussion and lacks validated instruments capable of representing the real situation of care.

[Adapting to the SARS-CoV2 pandemic: Experience of the Curie Institute]. / S'adapter face à la pandémie SARS-CoV2 : l'expérience de l'Institut Curie.

The Curie Institute exclusively cares for cancer patients, who were considered particularly "vulnerable" from the start of the SARS-CoV 2 pandemic. This pandemic, which took the medical world by surprise, suddenly required the Institute's hospital to undergo rapid and multimodal restructuring, while having an impact on everyone to varying degrees. We will examine here how this hospital has coped, with the concern for a new benefit-risk balance, in times of greater medical uncertainty and scarcity of certain resources, for these "vulnerable" patients but also for their relatives and staff. We will highlight by theme the positive aspects and difficulties encountered, and then what could be useful for other hospitals as the pandemic is ongoing.

Health Professional Redeployment and Cross-Training in Response to the COVID-19 Pandemic.

The onset of the COVID-19 pandemic in March 2020 required hospitals to respond quickly and effectively to ensure the availability of healthcare professionals to care for patients. The Ottawa Hospital in Ottawa, ON, used a five-step process to ensure organizational readiness for redeployment of regulated health professionals as and when necessary: (1) define current scopes of practice; (2) obtain discipline-specific input; (3) develop strategies based on literature review and government dictates; (4) identify potential duties; and (5) ensure support for staff. With hospital management support, this plan was readily implemented. Results are discussed in terms of operational outcomes (e.g., number and type of deployments) and staff experience. Outcomes were positive and led to recommendations for improved organizational readiness.

The worldwide coronavirus disease 2019 outbreak: Advice and recommendation on radiology management and infection control from makeshift hospitals in Wuhan.

ABSTRACT: To describe and advise on management protocols and infection-protection experience of the radiology department in makeshift hospitals in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak.Based on the literature review and the experience in the frontline, we retrospectively reviewed the configuration of the radiology department, human resource, personal protection, examination procedures for patients confirmed with COVID-19 in Wuhan fangcang shelter hospital.From February 11, 2020 to March 10, 2020, 2730 and 510 CT examinations were performed in the Hanjiang shelter hospital and Hanyang Sports School shelter hospital, respectively, including initial examinations and re-examinations. The maximum number of daily CT examinations reached 289. The CT scanned a patient approximately once every 13 mins.Fangcang shelter radiology department could be powerful components of both global and national responses to the COVID-19 pandemic.

Passagem de turno: Contributo para a qualidade na gestão da informação / Shift change: Contribution to quality in information management

A passagem de turno (PT) é um momento de transmissão da informação para a continuidade dos cuidados e de reflexão sobre as práticas. Contudo, faltam modelos consistentes que orientem esta prática, no sentido de uma melhor qualidade na gestão da informação. Realizou-se um estudo de âmbito institucional, descritivo-exploratório e correlacional, com abordagem quantitativa e qualitativa, usando amostragem aleatória estratificada dos serviços de internamento do Centro Hospitalar e Universitário de Coimbra, cujos principais objetivos foram identificar o modelo em uso na PT nos serviços de internamento e identificar áreas de melhoria da qualidade da PT. Colhidos dados em 24 serviços por gravação de duas PT por serviço, usando duas grelhas de observação e dois questionários, construídos para este estudo. Os aspetos mais valorizados foram Diagnósticos Médicos (68,5%), Atitudes Terapêuticas (70.7%) e Prescrições Médicas (58.9) e «outros dados¼ (66%); os mais desvalorizados reportam-se à Avaliação Inicial (19.4%), Atividade Diagnóstica (36.8%), Diagnósticos de Enfermagem (41.8%) e Intervenções de Enfermagem (30.7%) em linguagem classificada. O enfermeiro gestor adotou uma intervenção promotora do pensamento de enfermagem em 13.0% dos casos. Verificou-se a existência de uma correlação positiva entre a prevalência dos referenciais teóricos nas auditorias realizadas aos sistemas de informação e documentação em enfermagem e a valorização dos Diagnósticos de Enfermagem e da área autónoma e concetual (global) na PT. Não se verificou a existência de relação entre a duração da PT e a quantidade de erros/inconsistências. Os Diagnósticos de Enfermagem tendem a ser mais valorizados nos serviços em que a intervenção do enfermeiro gestor é promotora do pensamento em enfermagem. As sugestões de melhoria que emergiram foram nas áreas da gestão da informação, explicitação da tomada de decisão clínica em enfermagem, interrupções da PT, condições físicas/espaço, organização da PT e dotação de pessoal. Prevalece ainda uma conceção de cuidados centrada numa lógica executiva em detrimento duma lógica concetual. Importando que o enfermeiro gestor adote uma liderança promotora do pensamento de enfermagem e da utilização do processo informatizado como suporte à transmissão da informação na PT.

Boas práticas de liderança do enfermeiro no contexto hospitalar / Good nurse leadership practices in the hospital context

Objetivo: Descrever as boas práticas de liderança em enfermagem, realizadas pelos enfermeiros no contexto de um hospital público de Belém-Pará. Especificamente, levantar práticas de liderança no contexto hospitalar. Método: Pesquisa de campo do tipo descritiva com abordagem qualitativa, realizado em um hospital de urgência emergência do município de Belém. Os participantes foram dez enfermeiros gestores e coordenadores em unidade clínica e Unidade de Terapia Intensiva. A coleta de dados foi por meio de questionário autoaplicável. A análise de conteúdo ocorreu de forma qualitativa a partir da identificação de categorias temáticas. Resultados: Emergiram três temas centrais: as boas práticas de liderança sob a ótica dos enfermeiros; o enfermeiro e a tomada de decisão, na prática hospitalar; lidando com erros e conflitos. Conclusão: As boas práticas de liderança estão relacionadas às dimensões assistenciais, gerenciais e atitudinais, nas quais se destaca a tomada de decisão e gestão de conflitos e erros.(AU)

Objective: Describe the good nursing leadership practices performed by nurses in the context of a public hospital in Belém-Pará. Specifically, to raise leadership practices in the hospital context. Method: Descriptive field research with a qualitative approach, carried out in an emergency hospital in the city of Belém. The participants were ten nurse managers and coordinators in the clinical unit and intensive care unit. Data collection was through a self-administered questionnaire. Content analysis occurred qualitatively based on the identification of thematic categories. Results: Three central themes emerged: good leadership practices from the nurses' perspective; nurses and decision-making in hospital practice; dealing with errors and conflicts. Conclusion: Good leadership practices are related to care, management and attitudinal dimensions, in which decision-making and conflict and error management stand out.(AU)

Objetivo: Descrever as boas práticas de liderança em enfermagem, realizadas pelos enfermeiros no contexto de um hospital público de Belém-Pará. Especificamente, levantar práticas de liderança no contexto hospitalar. Método: Pesquisa de campo do tipo descritiva com abordagem qualitativa, realizado em um hospital de urgência emergência do município de Belém. Os participantes foram dez enfermeiros gestores e coordenadores em unidade clínica e Unidade de Terapia Intensiva. A coleta de dados foi por meio de questionário autoaplicável. A análise de conteúdo ocorreu de forma qualitativa a partir da identificação de categorias temáticas. Resultados: Emergiram três temas centrais: as boas práticas de liderança sob a ótica dos enfermeiros; o enfermeiro e a tomada de decisão, na prática hospitalar; lidando com erros e conflitos. Conclusão: As boas práticas de liderança estão relacionadas às dimensões assistenciais, gerenciais e atitudinais, nas quais se destaca a tomada de decisão e gestão de conflitos e erros.(AU)

Hemodialysis shake-up on the front lines of the Covid-19 pandemic: the Treviglio Hospital experience.

The new coronavirus disease (Covid-19) pandemic in Italy formally started on 21st February 2020, when a 38-years old man was established as the first Italian citizen with Covid-19 in Codogno, Lombardy region. In a few days, the deadly coronavirus swept beyond expectations across the city of Bergamo and its province, claiming thousands of lives and putting the hospital in Treviglio under considerable strain. Since designated Covid-dialysis hospitals to centrally manage infected hemodialysis patients were not set up in the epidemic areas, we arranged to treat all our patients. We describe the multiple strategies we had to implement fast to prevent/control Covid-19 infection and spread resources in our Dialysis Unit during the first surge of the pandemic in one of the worst-hit areas in Italy. The recommendations provided by existing guidelines and colleagues with significant experience in dealing with Covid-19 were combined with the practical judgement of our dialysis clinicians, nurses and nurse's aides.

Experiences managing pregnant hospital staff members using an active management policy-A qualitative study.

BACKGROUND AND OBJECTIVE: During pregnancy, absence from work increases significantly. Job adjustments have been shown to decrease absences; however, studies show only half of pregnant women who need job adjustments receive them. Little is known about the viewpoints of managers and possible challenges in the management of pregnant employees. The aim of this study was to investigate the experiences and considerations of managers in relation to managing pregnant hospital staff members and to describe the experiences of an active management policy for pregnant individuals. METHODS: A qualitative study based on five focus group interviews was conducted at five public hospitals in Zealand, Denmark with participation of 19 hospital managers, from 17 different wards, representing six different medical specialties. The interviews took place from February to May 2019. Thematic analysis was used to analyze the data. RESULTS: Four themes were identified: (1) The everyday management, (2) Managerial dilemmas, (3) Acknowledging the workplace culture, and (4) Dialogue as a means for the working relationship. The managers' experiences revolved around investing a lot of effort into the working relationship with pregnant staff members by adjusting job tasks and work schedules while balancing work tasks between all staff members. The dialogue was considered central in order to identify the needs of the individual staff member. CONCLUSIONS: Overall, management dialogue constituted a central tool in order to identify the needs of the individual staff member. A proactive and open approach increased the chances of a fruitful dialogue. The individual staff member, the influence of the workplace culture, and the everyday management of the workplace all shaped the experiences of the managers. The concept of an active management policy for pregnant individuals was perceived to entail useful elements, but also as replicating what managers already did.

Healthcare stakeholders' perceptions and experiences of factors affecting the implementation of critical care telemedicine (CCT): qualitative evidence synthesis.

BACKGROUND: Critical care telemedicine (CCT) has long been advocated for enabling access to scarce critical care expertise in geographically-distant areas. Additional advantages of CCT include the potential for reduced variability in treatment and care through clinical decision support enabled by the analysis of large data sets and the use of predictive tools. Evidence points to health systems investing in telemedicine appearing better prepared to respond to sudden increases in demand, such as during pandemics. However, challenges with how new technologies such as CCT are implemented still remain, and must be carefully considered. OBJECTIVES: This synthesis links to and complements another Cochrane Review assessing the effects of interactive telemedicine in healthcare, by examining the implementation of telemedicine specifically in critical care. Our aim was to identify, appraise and synthesise qualitative research evidence on healthcare stakeholders' perceptions and experiences of factors affecting the implementation of CCT, and to identify factors that are more likely to ensure successful implementation of CCT for subsequent consideration and assessment in telemedicine effectiveness reviews. SEARCH METHODS: We searched MEDLINE, Embase, CINAHL, and Web of Science for eligible studies from inception to 14 October 2019; alongside 'grey' and other literature searches. There were no language, date or geographic restrictions. SELECTION CRITERIA: We included studies that used qualitative methods for data collection and analysis. Studies included views from healthcare stakeholders including bedside and CCT hub critical care personnel, as well as administrative, technical, information technology, and managerial staff, and family members. DATA COLLECTION AND ANALYSIS: We extracted data using a predetermined extraction sheet. We used the Critical Appraisal Skills Programme (CASP) qualitative checklist to assess the methodological rigour of individual studies. We followed the Best-fit framework approach using the Consolidated Framework for Implementation Research (CFIR) to inform our data synthesis.  We classified additional themes not captured by CFIR under a separate theme. We used the GRADE CERQual approach to assess confidence in the findings. MAIN RESULTS: We found 13 relevant studies. Twelve were from the USA and one was from Canada. Where we judged the North American focus of the studies to be a concern for a finding's relevance, we have reflected this in our assessment of confidence in the finding. The studies explored the views and experiences of bedside and hub critical care personnel; administrative, technical, information technology, and managerial staff; and family members. The intensive care units (ICUs) were from tertiary hospitals in urban and rural areas. We identified several factors that could influence the implementation of CCT. We had high confidence in the following findings: Hospital staff and family members described several advantages of CCT. Bedside and hub staff strongly believed that the main advantage of CCT was having access to experts when bedside physicians were not available. Families also valued having access to critical care experts. In addition, hospital staff described how CCT could support clinical decision-making and mentoring of junior staff.  Hospital staff greatly valued the nature and quality of social networks between the bedside and CCT hub teams. Key issues for them were trust, acceptance, teamness, familiarity and effective communication between the two teams. Interactions between some bedside and CCT hub staff were featured with tension, frustration and conflict. Staff on both sides commonly described disrespect of their expertise, resistance and animosity. Hospital staff thought it was important to promote and offer training in the use of CCT before its implementation. This included rehearsing every step in the process, offering staff opportunities to ask questions and disseminating learning resources. Some also complained that experienced staff were taken away from bedside care and re-allocated to the CCT hub team. Hospital staff's attitudes towards, knowledge about and value placed on CCT influenced acceptance of CCT. Staff were positive towards CCT because of its several advantages. But some were concerned that the CCT hub staff were not able to understand the patient's situation through the camera. Some were also concerned about confidentiality of patient data. We also identified other factors that could influence the implementation of CCT, although our confidence in these findings is moderate or low. These factors included the extent to which telemedicine software was adaptable to local needs, and hub staff were aware of local norms; concerns about additional administrative work and cost; patients' and families' desire to stay close to their local community; the type of hospital setting; the extent to which there was support from senior leadership; staff access to information about policies and procedures; individuals' stage of change; staff motivation, competence and values; clear strategies for staff engagement; feedback about progress; and the impact of CCT on staffing levels. AUTHORS' CONCLUSIONS: Our review identified several factors that could influence the acceptance and use of telemedicine in critical care. These include the value that hospital staff and family members place on having access to critical care experts, staff access to sufficient training, and the extent to which healthcare providers at the bedside and the critical care experts supporting them from a distance acknowledge and respect each other's expertise. Further research, especially in contexts other than North America, with different cultures, norms and practices will strengthen the evidence base for the implementation of CCT internationally and our confidence in these findings. Implementation of CCT appears to be growing in importance in the context of global pandemic management, especially in countries with wide geographical dispersion and limited access to critical care expertise. For successful implementation, policymakers and other stakeholders should consider pre-empting and addressing factors that may affect implementation, including strengthening teamness between bedside and hub teams; engaging and supporting frontline staff; training ICU clinicians on the use of CCT prior to its implementation; and ensuring staff have access to information and knowledge about when, why and how to use CCT for maximum benefit.

Reconfiguring the radiology leadership team for crisis management during the COVID-19 pandemic in a large tertiary hospital in Singapore.

The coronavirus 2019 (COVID-19) outbreak poses a serious public health risk. To date, the disease has affected almost all countries in the world. The enormous scale of the outbreak and the relative lack of knowledge and information regarding a new virus, as well as the unpredictability of events, make it challenging for leadership teams to respond. This paper shares how we have reconfigured our radiology leadership team into a smaller disease outbreak task force (DOTF) to respond and coordinate all related efforts during this ongoing COVID-19 pandemic. The DOTF format is modelled after the military with domain groups looking at manpower, intelligence, operations, and logistics matters on a daily basis so that timely decisions can be made and action plans executed promptly. In managing the DOTF, discipline, flexibility, and teamwork are key principles, and these are built upon a strong foundation of focus on infection prevention and control, and patient and staff safety as well as staff well-being. The DOTF has positioned us well to confront the many challenges to date. We believe it will also help us navigate the complex issues that will arise with future surges in cases and in formulating strategies to manage exit from the present and future lockdowns. KEY POINTS: • In a pandemic, regular and directed meetings by a smaller leadership core group are required, for prompt decision making and execution of action plans. • The military format, with domain groups to look at manpower, intelligence, operations, and logistics matters, is useful in managing a pandemic. • Discipline, flexibility, and teamwork with strong focus on infection prevention and control, and patient and staff safety as well as staff well-being are key principles for leadership teams managing a pandemic.

COVID-19: lessons for junior doctors redeployed to critical care.

Approximately 4% of patients with coronavirus disease 2019 (COVID-19) will require admission to an intensive care unit (ICU). Governments have cancelled elective procedures, ordered new ventilators and built new hospitals to meet this unprecedented challenge. However, intensive care ultimately relies on human resources. To enhance surge capacity, many junior doctors have been redeployed to ICU despite a relative lack of training and experience. The COVID-19 pandemic poses additional challenges to new ICU recruits, from the practicalities of using personal protective equipment to higher risks of burnout and moral injury. In this article, we describe lessons for junior doctors responsible for managing patients who are critically ill with COVID-19 based on our experiences at an urban teaching hospital.

Trainee Wellness and Safety in the Context of COVID-19: The Experience of One Institution.

The COVID-19 pandemic has had significant ramifications for provider well-being. During these unprecedented and challenging times, one institution's Department of Surgery put in place several important initiatives for promoting the well-being of trainees as they were redeployed to provide care to COVID-19 patients. In this article, the authors describe these initiatives, which fall into 3 broad categories: redeploying faculty and trainees, ensuring provider safety, and promoting trainee wellness. The redeployment initiatives are the following: reframing the team mindset, creating a culture of grace and forgiveness, establishing a multidisciplinary wellness committee, promoting centralized leadership, providing clear communication, coordinating between departments and programs, implementing phased restructuring of the department's services, establishing scheduling flexibility and redundancy, adhering to training regulations, designating a trainee ombudsperson, assessing physical health risks for high-risk individuals, and planning for structured deimplementation. Initiatives specific to promoting provider safety are appointing a trainee safety advocate, guaranteeing personal protective equipment and relevant information about these materials, providing guidance regarding safe practices at home, and offering alternative housing options when necessary. Finally, the initiatives put in place to directly promote trainee wellness are establishing an environment of psychological safety, providing mental health resources, maintaining the educational missions, solidifying a sense of community by showing appreciation, being attentive to childcare, and using social media to promote community morale. The initiatives to carry out the department's strategy presented in this article, which were well received by both faculty and trainee members of the authors' community, may be employed in other departments and even outside the context of COVID-19. The authors hope that colleagues at other institutions and departments, independent of specialty, will find the initiatives described here helpful during, and perhaps after, the pandemic as they develop their own institution-specific strategies to promote trainee wellness.

Leadership development of nursing students in a material and sterilization center / Desarrollo de liderazgo de estudiantes de enfermería en un centro de material y esterilización / Desenvolvimento de liderança de acadêmicos de enfermagem em um centro de material e esterilização

ABSTRACT Objective: To analyze the experiences of Nursing students during the mandatory hospital internship at a Material and Sterilization Center with a focus on leadership development. Method: This is an experience report of a mandatory hospital curricular internship anchored in the national curricular guidelines for Nursing, of a descriptive-reflective nature, and carried out in a general university hospital in southern Brazil, from March to June 2019. Results: Activities were developed in order to develop leadership aspects such as people, orthotics and prosthetics management, surgical planning, conflict management, and assertive communication. Final considerations: The mandatory hospital curricular internship at the Material and Sterilization Center favored the students in the leadership process, management, decision-making, and development of autonomy for leading nurses.

RESUMEN Objetivo: Analizar las experiencias de los estudiantes de enfermería durante el internado hospitalario obligatorio en un Centro de Material y Esterilización con enfoque en el desarrollo del liderazgo. Método: Se trata de un relato de experiencia de internado curricular hospitalario obligatorio anclado en los lineamientos curriculares nacionales de enfermería, de carácter descriptivo-reflexivo, realizado en un hospital universitario general del sur de Brasil, de marzo a junio de 2019. Resultados: Se desarrollaron actividades que brindaron el desarrollo de aspectos de liderazgo como el manejo de personas, manejo de ortesis y prótesis, planificación quirúrgica, manejo de conflictos y comunicación asertiva. Consideraciones finales: La internación curricular hospitalaria obligatoria en el Centro de Materiales y Esterilización favoreció a los estudiantes en el proceso de liderazgo, gestión, toma de decisiones y desarrollo de la autonomía por parte de enfermeras líderes.

RESUMO Objetivo: Analisar as vivências de acadêmicos de enfermagem durante o estágio curricular obrigatório hospitalar em um Centro de Material e Esterilização com foco no desenvolvimento de liderança. Método: Trata-se de um relato de experiência de estágio curricular obrigatório hospitalar ancorado nas diretrizes curriculares nacionais para a enfermagem, de cunho descritivo-reflexivo, realizado em um hospital geral universitário no sul do Brasil, no período de março à junho de 2019. Resultados: Foram desenvolvidas atividades que proporcionaram o desenvolvimento de aspectos de liderança como gestão de pessoas, gestão de órteses e próteses, do planejamento cirúrgico, da gestão de conflitos e comunicação assertiva. Considerações finais: O estágio curricular obrigatório hospitalar em Centro de Materiais e Esterilização favoreceu aos estudantes o processo de liderança, a gestão, a tomada de decisão e desenvolvimento da autonomia de enfermeiros líderes.

Clima educativo hospitalario y síndrome de burnout en internos de medicina / Hospital educational climate and burnout syndrome in foundation years

INTRODUCCIÓN: El clima educativo hospitalario facilita el aprendizaje significativo y depende de la percepción de los integrantes; el síndrome de burnout aparece en profesionales que trabajan de manera directa con otras personas: ambos pueden influir de manera importante en la formación y desempeño de los futuros médicos. OBJETIVO: Evaluar la correlación entre el clima educativo en los hospitales y el síndrome de burnout en los internos de medicina humana de la región Lambayeque en 2018. MATERIAL Y MÉTODOS: Estudio descriptivo, transversal y observacional. La muestra estuvo constituida por todos los internos de medicina de la región Lambayeque en 2018. Se utilizó la encuesta Postgraduate hospital educational environment measurement (PHEEM) para medir el clima educativo, la Maslach Burnout Inventory-Human Services Survey para el síndrome de burnout y una encuesta sociodemográfica-laboral. RESULTADOS: Se encontró que el 28% de los internos presentó síndrome de burnout. En 5 hospitales de la región Lambayeque se observó un clima educativo más positivo que negativo (PHEEM = 80-120) y solo en un hospital referencial del Ministerio de Salud hubo un clima educativo con muchos problemas (PHEEM = 40-80). Hay una correlación estadísticamente significativa (p = 0,019), inversa y baja (r = -0,19) entre el clima educativo hospitalario y el síndrome de burnout en internos de medicina de la región Lambayeque. Además, se encontró una correlación significativa de los factores sociodemográficos laborales con síndrome de burnout, inversa y baja con horas de sueño (r = -0,22 y p = 0,009) y directa y baja con horas de trabajo (r = 0,28 y p = 0,001). CONCLUSIONES: Existe una correlación baja e inversa entre clima educativo y síndrome de burnout

INTRODUCTION:The educational hospital climate provides meaningful learning, and is dependent on the perception of its staff. Burnout syndrome appears in professionals who work directly with other people, and both can have a significant influence on the training and performance of future physicians. OBJECTIVE: To evaluate the correlation between the educational environment of hospitals and the Burnout syndrome in the Foundation of doctors in the Lambayeque region of Peru during 2018. MATERIAL AND METHODS: A descriptive, cross-sectional and observational study was conducted on a sample that consisted of all foundation year doctors from the Lambayeque region during 2018. The Postgraduate Hospital Educational Environment Measurement (PHEEM) questionnaire was used to measure the educational climate, the Maslach Burnout Inventory-Human Services Survey to measure burnout syndrome, as well as a socio-demographic-occupational questionnaire. RESULTS: It was found that 28% of the foundation year doctors had burnout syndrome. A more positive than negative educational climate was observed in 5 hospitals in the Lambayeque region (PHEEM = 80-120), and only in a reference hospital of the Ministry of Health there was an educational climate with many problems (PHEEM = 40-80). There was a statistically significant correlation (p = 0.019), and an inverse and low correlation (r = -0.19) between hospital educational climate and burnout syndrome in foundation year doctors in the Lambayeque region. In addition, a significant correlation was found between the sociodemographic occupational factors and burnout syndrome, inverse and low with hours of sleep (r = -0.22 and p = 0.009), and direct and low with hours of work (r = 0.28 and p = .001). CONCLUSIONS: There is a low and inverse correlation between educational climate and burnout syndrome

Del conocimiento a la práctica: integración de equipos de trabajo por supervisora de Enfermería / From knowledge to practice: integration of work teams by nursing supervisor / Do conhecimento á pratica: integração de equipes de trabalho por supervisora de enfermagem

Resumen Esta investigación tuvo por objetivo determinar las estrategias de la enfermera supervisora en la integración de equipos de trabajo de enfermería en una institución hospitalaria. Se trata de una investigación cualitativa realizada en un hospital de segundo nivel de atención, entre agosto de 2017 y julio de 2018. Se aplicó una entrevista individual a 10 enfermeras supervisoras de dicha institución. El análisis se efectuó mediante la técnica cromática y el análisis de contenido; la discusión se elaboró con base en el contraste de los datos obtenidos con la teoría de los Roles de Equipo de Belbin. Se presentan en categorías y subcategorías relacionadas con las características del talento humano de enfermería: nivel de conocimientos, habilidades técnicas, personalidad, habilidades interpersonales y equipos de alto desempeño. Se identificaron las estrategias que las supervisoras de enfermería utilizan al integrar equipos de trabajo.

Abstract This research aimed to determine the strategies of the supervising nurse in the integration of nursing work teams in a hospital institution. This is a qualitative investigation carried out in a second level hospital, between August 2017 and July 2018. An individual interview was applied to 10 supervising nurses of that institution. The análisis was carried out using the chromatic technique and the content analysis; the discussion was developed based on the contrast of the data obtained with the Belbin Team Roles theory. They are presented in categories and subcategories related to the characteristics of human nursing talent: level of knowledge, technical skills, personality, interpersonal skills and high performance teams. Strategies that nursing supervisors use when integrating work teams were identified.

Resumo Esta pesquisa teve como objetivo determinar as estratégias do enfermeiro supervisor na integração de equipes de trabalho de enfermagem em uma instituição hospitalar. Trata-se de uma investigação qualitativa realizada em um hospital de segundo nível, entre agosto de 2017 e julho de 2018. Foi aplicada uma entrevista individual a 10 enfermeiros supervisores dessa instituição. A análise foi realizada utilizando a técnica cromática e a análise de conteúdo; a discussão foi desenvolvida com base no contraste dos dados obtidos com a teoria dos papéis da equipe de Belbin. São apresentados em categorias e subcategorias relacionadas às características do talento humano em enfermagem: nível de conhecimento, habilidades técnicas, personalidade, habilidades interpessoais e equipes de alto desempenho. Estratégias que os supervisores de enfermagem usam ao integrar equipes de trabalho foram identificadas.