Human Factors and Organizational Issues in 2015: The Increasing Complexity of the Healthcare Domain Calls for More Comprehensive Approaches

Pelayo, Sylvia; Santos, Raquel

doi:10.15265/iy-2016-043

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…The majority of patients were over 65 years old and showed a high level of comorbidities. This is in line with previous papers that described the recent changes in health-care use [4,[36][37]. The majority of our patients used a lot of resources (high RT), showed clinical complexity (high CCI), nearly 1/3 of them were potentially evolving at the NEWS and 1/3 to half of the patients in the different divisions were over the SOFA cut-off.…”

Section: Discussionsupporting

confidence: 91%

“…In an overcrowded hospital, appropriate management of inpatients disposition and resources would not only need frequent census of bed occupancy rates, but also a prognostic stratification based on severity, clinical risk and co-morbidity [2][3]. Different models have been proposed for clinical risk assessment: diagnosis, severity-of-illness, deterioration of physiological parameters and co-morbid conditions are used as risk adjusters to evaluate clinical complexity [4][5]. The severity-of-illness scores (Sequential Organ Failure Assessment SOFA etc. )…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Reverse Triage with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index to classify medical inpatients of an Italian II level hospital according to their resource’s need

et al. 2019

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Background:Resource allocation in our overcrowded hospitals would require classification of inpatients according to the severity of illness, the evolving risk and the clinical complexity. Reverse triage (RT) is a method used in disasters to identify inpatients according to their use of hospital resources.The aim of this observational prospective study is to evaluate the use of RT in medical inpatients of an Italian Hospital and to compare the RT score with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index. Material and Methods: Cluster sampling was performed on High Dependency Unit (HDU), Geriatrics (Ger) and Internal Medicine (IM) wards. We calculate RT, NEWS, SOFA and CCI from inpatient charts. Length of stay (LOS), transfer to a higher level of care, death and discharge date were collected after 30 days. Results: We obtained demographics, comorbidities, severity and clinical complexity of 260 inpatients. We highlighted differences in NEWS, SOFA and CCI in the three divisions. On the contrary RT score was uniformly high (median 7), with 85% of patients with RT=8. NEWS, SOFA and CCI were higher in patients with higher RT score. We used the sum of the interventions listed by RT (RT sum) as a proxy of the level of care needed. RT-sum showed moderate correlation with NEWS (r=0,52 Spearman, p<0,001). RT-sum was the highest in HDU, related to the evolving severity of HDU patients. Ger patients, that showed the highest CCI score (with all patients in the CCI ≥3 category) had the second highest RT-sum. Conclusions: RT score showed similar values in the majority of the inpatients regardless of differences in NEWS, SOFA and CCI in different ward subgroups. RT-sum is related both to evolving severity (NEWS) and to clinical complexity (CCI). RT and NEWS could predict inpatient level of care and resource need associated with CCI.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Comparison of Reverse Triage with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index to classify medical inpatients of an Italian II level hospital according to their resource’s need

et al. 2019

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“…Enhancing collaboration remains a vital objective, yet communication among providers has become multi-faceted and complex from a technological perspective [14]. We posit that diverse teams of clinical and non-clinical administrative students who participate in interprofessional education simulations will improve their level of communication and collaboration.…”

Section: Introductionmentioning

confidence: 99%

Integrating Diverse Disciplines to Enhance Interprofessional Competency in Healthcare Delivery

Champagne‐Langabeer

Revere

Tankimovich³

et al. 2019

Healthcare

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Interprofessional education (IPE) typically involves clinical simulation exercises with students from medical and nursing schools. Yet, healthcare requires patient-centered teams that include diverse disciplines. Students from public health and informatics are rarely incorporated into IPE, signaling a gap in current educational practices. In this study, we integrated students from administrative and non-clinical disciplines into traditional clinical simulations and measured the effect on communication and teamwork. From July 2017–July 2018, 408 students from five schools (medicine, nursing, dentistry, public health, and informatics) participated in one of eight three-hour IPE clinical simulations with Standardized Patients and electronic health record technologies. Data were gathered using a pre-test–post-test interventional Interprofessional Collaborative Competency Attainment Survey (ICCAS) and through qualitative evaluations from Standardized Patients. Of the total 408 students, 386 (94.6%) had matched pre- and post-test results from the surveys. There was a 15.9% improvement in collaboration overall between the pre- and post-tests. ICCAS competencies showed improvements in teamwork, communication, collaboration, and conflict management, with an average change from 5.26 to 6.10 (t = 35.16; p < 0.001). We found by creating new clinical simulations with additional roles for non-clinical professionals, student learners were able to observe and learn interprofessional teamwork from each other and from faculty role models.

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Trends and Progress in Human Factors and Organizational Issues in 2016: Learning from Experience

Pelayo¹,

Santos²

2017

Yearb Med Inform

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SummaryObjective: To summarize significant research contributions on human factors and organizational issues in medical informatics published in 2016. Methods: An extensive search using PubMed/Medline and Web of Science® was conducted to identify the scientific contributions published in 2016 that address human factors and organizational issues in medical informatics. The selection process comprised three steps: (i) 15 candidate best papers were first selected by the two section editors, (ii) external reviewers from internationally renowned research teams reviewed each candidate best paper, and (iii) the final selection of five best papers was conducted by the editorial board of the Yearbook. Results: The five selected best papers present studies with rigorous methods, properly designed and described and are, therefore, efficiently reusable for other researches. Conclusion: Human factors and ergonomics-based interventions must be tailored to the context, but meaningful ways must be simultaneously found to generate a stronger evidence base for research and to provide efficient, easy to implement, and useful methods.

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Human Factors and Organizational Issues in 2015: The Increasing Complexity of the Healthcare Domain Calls for More Comprehensive Approaches

Cited by 3 publications

References 18 publications

Comparison of Reverse Triage with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index to classify medical inpatients of an Italian II level hospital according to their resource’s need

Comparison of Reverse Triage with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index to classify medical inpatients of an Italian II level hospital according to their resource’s need

Integrating Diverse Disciplines to Enhance Interprofessional Competency in Healthcare Delivery

Trends and Progress in Human Factors and Organizational Issues in 2016: Learning from Experience

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