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48 h in the ED and the hospitalization rate within 8 h from ED by triage levels of 1, 2, and 3 in different levels of hospitals from 2013 to 2019. Poisson regression analysis was used to quantify time trends of the query rate of the MediCloud system, the rate of staying more than 48 h in ED, admission rate within 8 h in ED, and the effect of healthcare quality in ED after MediCloud system implementation; Results The health information exchange decreased the rate of staying over 48 h in the ED of medical centers. It also improved the early hospitalization of urgent ED patients in regional hospitals; Conclusions Through medical information exchange to understand patients' current conditions, we can reduce crowding in the ED of medical centers and facilitate rapid hospitalization of urgent patients in regional hospitals. According to these findings, the government should establish medical information exchange to improve the healthcare quality of ED.In the wake of growing attempts to assess the validity of public reporting, much research has examined the effectiveness of public reporting regarding cost or quality of care. However, relatively little is known about whether transparency through public reporting significantly influences hospital efficiency despite its emerging expectations for providing value-based care. This study aims to identify the dynamics that transparency brought to the healthcare market regarding hospital technical efficiency, taking the role of competition into account. We compare the two public reporting schemes, All-Payer Claims Database (APCD) and Hospital Compare. Employing Data Envelopment Analysis (DEA) and a cross-sectional time-series Tobit regression analysis, we found that APCD is negatively associated with hospital technical efficiency, while hospitals facing less competition responded significantly to increasingly transparent information by enhancing their efficiency relative to hospitals in more competitive markets. We recommend that policymakers take market mechanisms into consideration jointly with the introduction of public reporting schemes in order to produce the best outcomes in healthcare.The spread of COVID-19 has led students to take classes online (rather than face-to-face) worldwide, including in China. For this study, we conducted qualitative focus group discussions to identify the experience of and difficulties faced by online physical education students in higher education taking online classes, including the impact on their physical activity performance, as well as some health problems they face while taking online classes during the quarantine period, such as weight gain, depression, and anxiety. Finally, utilizing Mayer's learning model as a conceptual framework, we propose a method that addresses how to effectively manage an optimal future learning system for physical education students, both during and after the COVID-19 outbreak situation. During the isolation period of COVID-19, the required equipment for the participants was rarely available at home while attending the online classes, which inevitably reduced the number of physical education units that could be conveyed. This resulted in a transfer of attention from competition to underperformance, weight gain, and adverse psychological conditions. We conclude that it is important to review and systematize the methods of online physical education learning, particularly highlighting the cultural and educational characteristics of different countries, and to investigate the effectiveness of online physical education as a whole.This paper presents the findings of the National Fluoride Varnish Workshop in 2018 along with subsequent actions to scale-up the use of fluoride varnish nationally in Australia. The use of fluoride varnish programs to prevent dental caries in high-risk child populations is an evidence-based population health approach used internationally. Such programs have not been implemented at scale nationally in Australia. A National Fluoride Varnish Consensus Workshop was held in Sydney in November 2018 with an aim of sharing the current work in this area being undertaken by various Australian jurisdictions and seeking consensus on key actions to improve the scale-up nationally. Forty-four people attended the Workshop with oral health representatives from all Australian state and territory health departments, as well as the Australian Dental Association (ADA) at both NSW branch and Federal levels. There was strong support for further scale-up of fluoride varnish programs nationally and to see the wider use of having non-dental professionals apply the varnish. This case study identifies key actions required to ensure scale-up of systematic fluoride varnish programs as part of a strategic population oral health approach to preventing dental caries among high-risk children who may not routinely access dental care.The operating room is a challenging learning environment for many students. Preparedness for practice is important as perceived stress and the fear of making mistakes are known to hamper learning. The aim was to evaluate students' perspectives of an e-learning resource for achieving preparedness. A mixed methods design was used. Students (n = 52) from three educational nursing and medical programs were included. A questionnaire was used to explore demographics, student use of the e-learning resource, and how the learning activities had helped them prepare for their clinical placement. Five focus group interviews were conducted as a complement. Most students (79%) stated that the resource prepared them for their clinical placement and helped them to feel more relaxed when attending to the operating room. In total, 93% of the students recommended other students to use the e-learning resource prior to a clinical placement in the operating room. Activities containing films focusing on practical procedures were rated as the most useful. We conclude that an e-learning resource seems to increase students' perceived preparedness for their clinical practice in the operating room. The development of e-learning resources has its challenges, and we recommend student involvement to evaluate the content.We thank van den Broek et al. [...].
It can be presumed that introducing accreditation standards and obtaining national accreditation by a hospital should translate into increased patient satisfaction. The aim was to analyze the impact of introducing accreditation standards on patient satisfaction in cardiology departments.
1080 patients, who were hospitalized in four cardiological wards (W1-W4) between 2009-2015, were asked to complete a 22-item questionnaire that assessed the level of their satisfaction with their medical care. 58 questionnaires were excluded because of incomplete data. The hospital was accredited in 2013.
In 3 of the 4 wards, a statistically higher total score (the patient was more satisfied) in the period after the accreditation (2013-2015) compared to the period before the accreditation (2009-2012) was as follows W1 (80.37 ± 6.54 vs. 83.85 ± 5.9;
= 0.0004), W2 (79.95 ± 7.62 vs. 81.46 ± 8.2
= 0.0376), W4 (78.84 ± 7.94 vs. 84.91 ± 5.57;
= 0.0376); in one ward, there was no statistical difference W3 (80.11 ± 8.42 vs. 81.07 ± 8.15;
= 0.3284). A significant difference was found in the number of points for the total assessment that were collected for all of the analyzed departments throughout the entire period (2009-2015)-W1
= 0.0032; W2
= 0.0176; W3
= 0.0313 and W4
< 0.0001). The medium-term rate of the change of the total score decreased after the accreditation.
Preparing a hospital for a national accreditation program brought significant benefits for patients in a long-term observation.
Preparing a hospital for a national accreditation program brought significant benefits for patients in a long-term observation.Parenteral products must be compounded using an aseptic technique to ensure sterility of the medicine. We compared the effect of three clinical environments as compounding areas as well as different aseptic techniques on the sterility of the compounded parenteral product. Clinical pharmacists and pediatric nurses compounded 220 samples in total in three clinical environments a patient room, a medicine room and biological safety cabinet. The study combined four methods observation, environmental monitoring (settle plates), monitoring of personnel (finger dab plates) and sterility testing (membrane filtration). Of the compounded samples, 99% were sterile and no significant differences emerged between the clinical environments. Based on the settle plates, the biological safety cabinet was the only area that fulfilled the requirements for eliminating microbial contamination. Most of the steps on the observation form for aseptic techniques were followed. All participants disinfected their hands, wore gloves and disinfected the septum of the vial. selleck kinase inhibitor Non-contaminated finger dab plates were mostly detected after compounding in the biological safety cabinet. Aseptic techniques were followed relatively well in all environments. However, these results emphasize the importance of good aseptic techniques and support the recommendation of compounding parenteral products in biological safety cabinets in clinical environments.We read with great interest the recent article by Laratta et al. [...].A new decision rule based on net benefit per capita is proposed and exemplified with the aim of assisting policymakers in deciding whether to lockdown or reopen an economy-fully or partially-amidst a pandemic. Bayesian econometric models using Markov chain Monte Carlo algorithms are used to quantify this rule, which is illustrated via several sensitivity analyses. While we use COVID-19 data from the United States to demonstrate the ideas, our approach is invariant to the choice of pandemic and/or country. The actions suggested by our decision rule are consistent with the closing and reopening of the economies made by policymakers in Florida, Texas, and New York; these states were selected to exemplify the methodology since they capture the broad spectrum of COVID-19 outcomes in the U.S.This study aimed to (1) describe the characteristics of community residents who used coronavirus disease 2019 (COVID-19)-related telephone consultation systems by public health nurses (PHNs) and (2) analyze the concerns they had during the first wave of COVID-19 in Japan. Among 1126 telephone consultations, PHNs recorded telephone consultations between 25 March, and 30 April, 2020, in City A, Japan. We analyzed 1017 consultations involving 799 (79%) community residents (resident group) and 218 (21%) organizational representatives (organization group) located in City A. Half of the consultations were made during midmorning, and most of the consultations were regarding COVID-19 symptoms. Among the resident group, visiting a primary care doctor was the most common recommendation by the PHNs; there was no difference in provision of consultation by sex. Health- and welfare-related organizations mainly consulted PHNs about "having COVID-19-related symptoms" and "undergoing PCR testing," and PHNs' recommended them to visit a primary care doctor and coordinate PCR testing. The results suggest that public health centers should provide more helpful information on COVID-19 that accurately reflects the concerns of the population.
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