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1.
Nature ; 585(7824): 193-202, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908264

RESUMO

Advances in machine learning and contactless sensors have given rise to ambient intelligence-physical spaces that are sensitive and responsive to the presence of humans. Here we review how this technology could improve our understanding of the metaphorically dark, unobserved spaces of healthcare. In hospital spaces, early applications could soon enable more efficient clinical workflows and improved patient safety in intensive care units and operating rooms. In daily living spaces, ambient intelligence could prolong the independence of older individuals and improve the management of individuals with a chronic disease by understanding everyday behaviour. Similar to other technologies, transformation into clinical applications at scale must overcome challenges such as rigorous clinical validation, appropriate data privacy and model transparency. Thoughtful use of this technology would enable us to understand the complex interplay between the physical environment and health-critical human behaviours.


Assuntos
Inteligência Ambiental , Assistência à Saúde/métodos , Monitoramento Ambiental/métodos , Algoritmos , Doença Crônica/terapia , Assistência à Saúde/normas , Unidades Hospitalares , Humanos , Saúde Mental , Segurança do Paciente , Privacidade
2.
Recenti Prog Med ; 111(9): 487-491, 2020 09.
Artigo em Italiano | MEDLINE | ID: mdl-32914776

RESUMO

CoViD-19 pandemic heavily impacted most on-going research activities, causing delays and need of re-programming. EASY-NET (NET-2016-02364191) is a network project, started in April 2019, co-funded by the Italian Ministry of Health and the participating regions. Within the general project, centred on the evaluation of Audit and Feedback (A&F) strategies in improving quality and equity in different health care contexts, the Piedmont region is responsible of the work package 3 (WP3) on specific oncology pathways and procedures. After a thorough evaluation of the impact of the CoViD-19 emergency on the WP3 activities, at the beginning of March 2020, the decision was to continue, with some adaptations, the audits already started, and to delay those in the early planning phase. The provisional availability of part of the time-persons involved in EASY-NET on one side, and the urgency of acquiring data on the management of the large number of CoViD-19 patients admitted to the study coordinator hospital on the other side, determined the personnel responsible of the WP3, in accordance with the hospital management, to invest these resources in monitoring the CoViD-19 hospitalized patients with both A&F activity and research objectives. Besides periodic reports, a web site, with restricted access to the involved health care personnel, was developed to allow a direct and timely consultation of graphics describing the flow of the patients, their management, and outcomes. This experience was made possible thanks to a favourable combination of different factors: the presence within the hospital of a group of experienced epidemiologists in A&F, the availability of extra resources, the strong support and collaboration by the hospital management and the readiness for authorisation by the Ethics Committee. We underline the need to provide a certain degree of flexibility in the long-term projects funded by the Ministry of Health, the extraordinary adaptability of the A&F approach also to emergency situations and the possibility of combining audit activities and research objectives in the same project.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Hospitalização/estatística & dados numéricos , Auditoria Médica/organização & administração , Pneumonia Viral/epidemiologia , Pesquisa Biomédica/organização & administração , Assistência à Saúde/normas , Humanos , Itália/epidemiologia , Pandemias , Qualidade da Assistência à Saúde
3.
PLoS One ; 15(9): e0239249, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960908

RESUMO

Since the end of February 2020 a severe diffusion of COVID-19 has affected Italy and in particular its northern regions, resulting in a high demand of hospitalizations in particular in the intensive care units (ICUs). Hospitals are suffering the high degree of patients to be treated for respiratory diseases and the majority of the health structures, especially in the north of Italy, are or are at risk of saturation. Therefore, the question whether and to what extent the reduction of hospital beds occurred in the past years has biased the management of the emergency has come to the front in the public debate. In our opinion, to start a robust analysis it is necessary to consider the Italian health system capacity prior to the emergency. Therefore, the aim of this study is to analyse the availability of hospital beds across the country as well as to determine their management in terms of complexity and performance of cases treated at regional level. The results of this study underlines that, despite the reduction of beds for the majority of the hospital wards, ICUs availabilities did not change between 2010 and 2017. Moreover, this study confirms that the majority of the Italian regions have a routinely efficient management of their facilities allowing hospitals to treat patients without the risk of having an overabundance of patients and a scarcity of beds. In fact, this analysis shows that, in normal situations, the management of hospital and ICU beds has no critical levels.


Assuntos
Infecções por Coronavirus/terapia , Número de Leitos em Hospital/estatística & dados numéricos , Unidades de Terapia Intensiva/provisão & distribução , Pneumonia Viral/terapia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/normas , Surtos de Doenças , Número de Leitos em Hospital/normas , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Itália/epidemiologia , Pandemias , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral/epidemiologia
6.
J Int AIDS Soc ; 23(8): e25587, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767707

RESUMO

INTRODUCTION: The COVID-19 pandemic reached the African continent in less than three months from when the first cases were reported from mainland China. As COVID-19 preparedness and response plans were rapidly instituted across sub-Saharan Africa, many governments and donor organizations braced themselves for the unknown impact the COVID-19 pandemic would have in under-resourced settings with high burdens of PLHIV. The potential negative impact of COVID-19 in these countries is uncertain, but is estimated to contribute both directly and indirectly to the morbidity and mortality of PLHIV, requiring countries to leverage existing HIV care systems to propel COVID-19 responses, while safeguarding PLHIV and HIV programme gains. In anticipation of COVID-19-related disruptions, PEPFAR promptly established guidance to rapidly adapt HIV programmes to maintain essential HIV services while protecting recipients of care and staff from COVID-19. This commentary reviews PEPFAR's COVID-19 technical guidance and provides country-specific examples of programme adaptions in sub-Saharan Africa. DISCUSSION: The COVID-19 pandemic may pose significant risks to the continuity of HIV services, especially in countries with high HIV prevalence and weak and over-burdened health systems. Although there is currently limited understanding of how COVID-19 affects PLHIV, it is imperative that public health systems and academic centres monitor the impact of COVID-19 on PLHIV. The general principles of the HIV programme adaptation guidance from PEPFAR prioritize protecting the gains in the HIV response while minimizing in-person home and facility visits and other direct contact when COVID-19 control measures are in effect. PEPFAR-supported clinical, laboratory, supply chain, community and data reporting systems can play an important role in mitigating the impact of COVID-19 in sub-Saharan Africa. CONCLUSIONS: As community transmission of COVID-19 continues and the number of country cases rise, fragile health systems may be strained. Utilizing the adaptive, data-driven programme approaches in facilities and communities established and supported by PEPFAR provides the opportunity to strengthen the COVID-19 response while protecting the immense gains spanning HIV prevention, testing and treatment reached thus far.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Assistência à Saúde , Infecções por HIV/complicações , Pneumonia Viral/complicações , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/mortalidade , África ao Sul do Saara/epidemiologia , China , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Efeitos Psicossociais da Doença , Assistência à Saúde/economia , Assistência à Saúde/normas , Assistência à Saúde/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/mortalidade , Humanos , Cooperação Internacional , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Prevalência
7.
Khirurgiia (Mosk) ; (7): 6-11, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32736457

RESUMO

OBJECTIVE: To analyze morbidity and factors affecting mortality in emergency abdominal surgery in the Russian Federation. MATERIAL AND METHODS: The study included patients with acute abdominal diseases aged 18 years and older. All patients were hospitalized in emergency surgical care departments of 3.194 state healthcare institutions in 84 regions of the Russian Federation in 2018. Morbidity, surgical activity and mortality were analyzed. RESULTS: There were 680.337 cases of hospitalization in emergency surgical department, morbidity rate was 582 cases per 100 000. The most common emergency surgical diseases were acute appendicitis (142.3 cases per 100 000), acute cholecystitis (139.0 cases per 100 000) and acute pancreatitis (131.2 cases per 100 000). Surgery was performed in 399.051 (58.7%) patients. In-hospital mortality rate was 2.4% (16 051 cases). CONCLUSION: There are certain factors affecting mortality rate in acute abdominal diseases. The leading problems in organizing emergency surgical care in Russia are insufficient equipment of rural and small municipal surgical hospitals, different staffing with surgeons in rural areas and large cities and late hospitalization of patients.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Doenças do Sistema Digestório/epidemiologia , Doenças do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Abdome/cirurgia , Doença Aguda/epidemiologia , Doença Aguda/mortalidade , Doença Aguda/terapia , Adolescente , Adulto , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Doenças do Sistema Digestório/mortalidade , Procedimentos Cirúrgicos do Sistema Digestório/mortalidade , Emergências/epidemiologia , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Morbidade , População Rural/estatística & dados numéricos , Federação Russa/epidemiologia , Adulto Jovem
8.
Diabetes Metab Syndr ; 14(5): 1283-1289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32755822

RESUMO

BACKGROUND AND AIMS: An epidemic outbreak of COVID-19 has increased the demand for medical equipment, medical accessories along with daily essentials for the safety of healthcare workers. This study aims to identify the operational challenges faced by retailers in providing efficient services. The study also aimed to propose the roadmap of Industry 4.0 to reduce the impact of COVID-19. METHODS: A detailed literature review is done on an epidemic outbreak and supply chain using appropriate keywords on SCOPUS, Science Direct, Google Scholar. Some relevant industry reports and blogs are also taken to get insights. RESULTS: We have identified twelve significant challenges for the retail sectors that are acting as operational barriers and provided the application of Industry 4.0 technologies to deal with it. CONCLUSION: Industry 4.0 can act as a significant driver for reducing the impact of identified challenges on retailers to fight against the pandemic. There is a need to build trust and transparency for the effective management of healthcare essentials. The supply chain partners and government bodies should act wisely for improving the services during COVID-19 and of similar situations. The proposed roadmap provide future research directions for researchers working in the area of epidemic control, supply chain, and disaster management.


Assuntos
Betacoronavirus/isolamento & purificação , Biotecnologia/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Assistência à Saúde/normas , Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções/organização & administração , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Índia/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Prognóstico
11.
PLoS One ; 15(8): e0236706, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760146

RESUMO

INTRODUCTION: Due to provider shortages, it is probable that non-Latinx health care providers (HCPs) will treat Latinx patients. Because of this discrepancy, both providers and patients are likely to experience barriers and cultural differences during medical encounters. This article discusses select cultural factors and behaviors such as language, communication styles, and health care practices of Latinx families through the lens of their non-Latinx HCPs. The purpose of this study was to examine how non-Latinx HCPs perceive and describe certain behaviors they observe during healthcare visits with Latinx patients and families, and to illustrate how those behaviors can alternatively be interpreted as representing Latinx cultural norms. METHODS: This qualitative study used a template coding approach to examine narrative interviews conducted with 18 non-Latinx HCPs to report how they described interactions with and the behaviors of their Latinx patients. Template codes were based on well-established Latinx cultural norms (e.g., familismo, respeto, personalismo, simpatía, confianza). RESULTS: Many HCP descriptions of Latinx patient behaviors were coded into the Latinx cultural values categories (familismo, personalismo, simpatía, respeto, and confianza) by the research team. Results suggest that HCPs were not aware of how several of their patients' behaviors may be culturally grounded, and that cultural differences between HCPs and their Latinx patients may exist. DISCUSSION: Understanding how Latinx-specific cultural norms may be exhibited by Latinx patients and their families during healthcare encounters has potential to improve providers' understanding of patient behavior, helping to promote culturally congruent care for Latinxs.


Assuntos
Assistência à Saúde/normas , Comportamentos Relacionados com a Saúde/etnologia , Pessoal de Saúde/psicologia , Hispano-Americanos/psicologia , Pesquisa Qualitativa , Adulto , Família , Feminino , Equidade em Saúde , Humanos , Renda , Masculino , Relações Profissional-Paciente
12.
J Med Internet Res ; 22(9): e20143, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32795997

RESUMO

BACKGROUND: The COVID-19 pandemic has necessitated a rapid increase of space in highly infectious disease intensive care units (ICUs). At Houston Methodist Hospital (HMH), a virtual intensive care unit (vICU) was used amid the COVID-19 outbreak. OBJECTIVE: The aim of this paper was to detail the novel adaptations and rapid expansion of the vICU that were applied to achieve patient-centric solutions while protecting staff and patients' families during the pandemic. METHODS: The planned vICU implementation was redirected to meet the emerging needs of conversion of COVID-19 ICUs, including alterations to staged rollout timing, virtual and in-person staffing, and scope of application. With the majority of the hospital critical care physician workforce redirected to rapidly expanded COVID-19 ICUs, the non-COVID-19 ICUs were managed by cardiovascular surgeons, cardiologists, neurosurgeons, and acute care surgeons. HMH expanded the vICU program to fill the newly depleted critical care expertise in the non-COVID-19 units to provide urgent, emergent, and code blue support to all ICUs. RESULTS: Virtual family visitation via the Consultant Bridge application, palliative care delivery, and specialist consultation for patients with COVID-19 exemplify the successful adaptation of the vICU implementation. Patients with COVID-19, who were isolated and separated from their families to prevent the spread of infection, were able to virtually see and hear their loved ones, which bolstered the mental and emotional status of those patients. Many families expressed gratitude for the ability to see and speak with their loved ones. The vICU also protected medical staff and specialists assigned to COVID-19 units, reducing exposure and conserving personal protective equipment. CONCLUSIONS: Telecritical care has been established as an advantageous mechanism for the delivery of critical care expertise during the expedited rollout of the vICU at Houston Methodist Hospital. Overall responses from patients, families, and physicians are in favor of continued vICU care; however, further research is required to examine the impact of innovative applications of telecritical care in the treatment of critically ill patients.


Assuntos
Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Unidades de Terapia Intensiva/organização & administração , Pneumonia Viral/terapia , Telemedicina/organização & administração , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Assistência à Saúde/métodos , Assistência à Saúde/normas , Feminino , Humanos , Unidades de Terapia Intensiva/normas , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Telemedicina/métodos , Telemedicina/normas
15.
J Community Psychol ; 48(7): 2131-2137, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32789911

RESUMO

In addition to the twinned crises of ecology and political economy, we face today a crisis of care. The crisis of care, I contend, is fundamentally a political and an ethical crisis. In this short commentary, I outline the structural (i.e., systemic) and reproductive (i.e., labour) character of this crisis, using the COVID-19 pandemic as an example. From here, I argue for the imperative to centre an expansive conception of care in critical community psychology work. Specifically, I posit that by working with and alongside activist care workers, community psychologists can assist in building socially just modalities of care. After reflecting on my work with collective caring initiatives, I offer five (tentative) guiding principles for a community psychology that is committed to addressing the crisis of care, namely: (1) commitment to building political coalitions; (2) commitment to refuting capitalist conceptions of care; (3) commitment to expanding conceptions of care; (4) commitment to embracing the psychological consequences of care work; and (5) a politicoethical commitment.


Assuntos
Infecções por Coronavirus , Assistência à Saúde/normas , Pessoal de Saúde/normas , Pandemias , Pneumonia Viral , Política , Psicologia Aplicada/normas , Características de Residência , Humanos
16.
PLoS One ; 15(8): e0237635, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32823269

RESUMO

BACKGROUND: The Health Resources and Services Administration's (HRSA), HIV/AIDS Bureau (HAB) is responsible for leading the nation's efforts to provide health care, medications, and support services to low-income people living with HIV through the Ryan White HIV/AIDS Program (RWHAP). The RWHAP funds and coordinates with cities, states, and local community-based organizations to deliver efficient and effective HIV care, treatment, and support services for over half a million vulnerable people living with HIV (PLWH) and their families in the United States. The annual RWHAP Services Report (RSR) is an important source of information for monitoring RWHAP's progress towards National HIV/AIDS Strategy goals. Since 2010, HRSA HAB has used the annual client-level RSR data to monitor program-related outcomes, conduct program evaluations, understand service provision, and conduct extensive analysis on disparities in viral suppression and retention in HIV care. HRSA HAB receives annual RSR submissions from RWHAP recipients and sub-recipients. However, the de-identified nature of the data limits HRSA HAB's ability to expand beyond year-to-year analyses and conduct additional analyses to evaluate outcomes for clients who are seen in multiple years. The current paper describes the development and validation of a method to link RSR client-level records across multiple data years. METHODS AND FINDINGS: Using seven RSR reporting years of data (2010 to 2016), we applied a Fellegi-Sunter (F-S) linkage model that used client demographic characteristics and their providers' geographic locations to calculate matching weights for each record pair based on estimated agreement and disagreement conditional probabilities across RSR years. To validate our methodology, we conducted an internal sample review and external validation to assess the level of accuracy of the linkage, and the extent to which the linked data set corresponds accurately to clinical records of individual clients. The linkage result yielded 70 to 80 percent year-to-year client carry-over rate over seven years of the RSR data; 96 percent linkage ratio from the internal sample review and 79.9 to 94.2 percent of provider network client carry- over rate per year from the external validation. CONCLUSIONS: This methodology addresses a gap in data analysis capabilities by allowing HRSA HAB to link RWHAP clients across reporting years. Despite weak identifying information and lack of continuity of service reporting, the longitudinal linkage improves HRSA HAB's ability to evaluate the patterns of viral suppression and monitor service utilization over time for individuals who receive services in multiple years. These analyses will support future analytic activities in understanding the impact and outcomes of the RWHAP, and will assist HRSA HAB in monitoring progress toward meeting National HIV/AIDS Strategy goals. For those looking for ways to assess health services data, the F-S unsupervised method combining weak identifying attributes and geographic proximity offers practical solutions to the problem of linking de-identified information about individuals across multiple years and improving longitudinal research.


Assuntos
Algoritmos , Assistência à Saúde/normas , Infecções por HIV/terapia , HIV/isolamento & purificação , Acesso aos Serviços de Saúde/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/normas , United States Health Resources and Services Administration/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Estudos Longitudinais , Patient Protection and Affordable Care Act , Avaliação de Programas e Projetos de Saúde , Estados Unidos
18.
Cochrane Database Syst Rev ; 8: CD012012, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32803893

RESUMO

BACKGROUND: A well-functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. OBJECTIVES: To assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid and Embase Ovid in May 2019. We searched Global Health, Ovid and PsycInfo in April 2016. In January 2020 we searched for grey literature in the Grey Literature Report and in OpenGrey, and for ongoing trials using the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov. In October 2019 we also did a cited reference search using Web of Science, and a 'similar articles' search in PubMed. SELECTION CRITERIA: Randomised and non-randomised trials, controlled before-after studies and time-series studies comparing routine health information system interventions, with controls, in primary, hospital or community health care settings. Participants included clinical staff and management, district management and community health workers using routine information systems. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed records to identify studies for inclusion, extracted data from the included studies and assessed the risk of bias. Interventions and outcomes were too varied across studies to allow for pooled risk analysis. We present a 'Summary of findings' table for each intervention comparisons broadly categorised into Technical and Organisational (or a combination), and report outcomes on data quality and service quality. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS: We included six studies: four cluster randomised trials and two controlled before-after studies, from Africa and South America. Three studies evaluated technical interventions, one study evaluated an organisational intervention, and two studies evaluated a combination of technical and organisational interventions. Four studies reported on data quality and six studies reported on service quality. In terms of data quality, a web-based electronic TB laboratory information system probably reduces the length of time to reporting of TB test results, and probably reduces the overall rate of recording errors of TB test results, compared to a paper-based system (moderate certainty evidence). We are uncertain about the effect of the electronic laboratory information system on the recording rate of serious (misidentification) errors for TB test results compared to a paper-based system (very low certainty evidence). Misidentification errors are inaccuracies in transferring test results between an electronic register and patients' clinical charts. We are also uncertain about the effect of the intervention on service quality (timeliness of starting or changing a patient's TB treatment) (very low certainty evidence). A hand-held electronic device probably improves the length of time to report TB test results, and probably reduces the total frequency of recording errors in TB test results between the laboratory notebook and the electronic information record system, compared to a paper-based system (moderate-certainty evidence). We are, however, uncertain about the effect of the intervention on the frequency of serious (misidentification) errors in recording between the laboratory notebook and the electronic information record, compared to a paper-based system (very low certainty evidence). We are uncertain about the effect of a hospital electronic health information system on service quality (length of time outpatients spend at hospital, length of hospital stay, and hospital revenue collection), compared to a paper-based system (very low certainty evidence). High-intensity brief text messaging (SMS) may make little or no difference to data quality (in terms of completeness of documentation of pregnancy outcomes), compared to low-intensity brief text messaging (low-certainty evidence). We are uncertain about the effect of electronic drug stock notification (with either data management support or product transfer support) on service quality (in terms of transporting stock and stock levels), compared to paper-based stock notification (very low certainty evidence). We are uncertain about the effect of health information strengthening (where it is part of comprehensive service quality improvement intervention) on service quality (health worker motivation, receipt of training by health workers, health information index scores, quality of clinical observation of children and adults) (very low certainty evidence). AUTHORS' CONCLUSIONS: The review indicates mixed effects of mainly technical interventions to improve data quality, with gaps in evidence on interventions aimed at enhancing data-informed health system management. There is a gap in interventions studying information support beyond clinical management, such as for human resources, finances, drug supply and governance. We need to have a better understanding of the causal mechanisms by which information support may affect change in management decision-making, to inform robust intervention design and evaluation methods.


Assuntos
Assistência à Saúde/organização & administração , Sistemas de Informação em Saúde/normas , Política Organizacional , Melhoria de Qualidade , Viés , Sistemas de Informação em Laboratório Clínico/organização & administração , Sistemas de Informação em Laboratório Clínico/normas , Computadores de Mão , Coleta de Dados/normas , Tomada de Decisões , Assistência à Saúde/normas , Serviços de Informação sobre Medicamentos/normas , Sistemas de Informação Hospitalar/normas , Testes de Sensibilidade Microbiana , Inovação Organizacional , Preparações Farmacêuticas/provisão & distribução , Ensaios Clínicos Controlados Aleatórios como Assunto , Envio de Mensagens de Texto/normas , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico
19.
JACC Cardiovasc Interv ; 13(16): 1951-1957, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32819485

RESUMO

As the world slowly starts to recover from the coronavirus disease-2019 pandemic, health care systems are now thinking about resuming elective cardiovascular procedures, including procedures in cardiac catheterization laboratories. Rebooting catheterization laboratories will be an arduous process, in part because of limited health care resources, new processes, and fears stemming from the coronavirus disease-2019 pandemic. The authors propose a detailed phased-in approach that considers clinical, patient-centered, and operational strategies to safely and effectively reboot catheterization laboratory programs during these unprecedented times. This model balances the delivery of essential cardiovascular care with reduced exposure and preservation of resources. The guiding principles detailed in this review can be used by catheterization laboratory programs when restarting elective interventional procedures.


Assuntos
Betacoronavirus , Cateterismo Cardíaco/normas , Procedimentos Cirúrgicos Cardíacos/normas , Infecções por Coronavirus/complicações , Assistência à Saúde/normas , Laboratórios Hospitalares/normas , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/normas , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia
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