Lean-ing Method in an Emergency Department of the Italian Epicenter of the COVID-19 Outbreak: When the Algorithm Makes Difference

Desai, Antonio; Goretti, Giulia; Giordano, Mauro; Voza, Antonio

doi:10.3390/asi4030055

Cited by 4 publications

(3 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding the length of hospital stay, literature evidence reports that this would be related to multiple factors, especially during the COVID-19 pandemic [ 44 , 45 , 46 ]. Several factors could contribute to the lack of a significant association observed between antithrombotic therapy and the length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Antithrombotic Therapy Outcomes in Mild Traumatic Brain-Injury Patients: A Focus on Bleeding Risk and Hospital-Stay Duration

Desai,

Shiffer,

Giordano

et al. 2024

Life

Self Cite

View full text Add to dashboard Cite

Background: Traumatic brain injury (TBI) in the elderly is a noteworthy pathology due to the exponential increase in population age, and the effects of antiplatelet and anticoagulation on patients’ outcomes are still a matter of dispute. The aim of the present study was to evaluate the impact of various antithrombotic agents on patients with mild TBI, focusing on the risk of intracranial bleeding (ICH) and length of hospitalization (LOS). Methods: A retrospective analysis was conducted, including patients with a diagnosis of TBI admitted to the Emergency Department between 2021 and 2022. Patients were classified according to the concurrent antithrombotic therapy as aspirin (ASA), antiplatelets, direct oral anticoagulants (DOACs), and low-molecular-weight heparin (LMWH). The primary outcome was the ICH occurrence, while the secondary outcome was the LOS. The statistical analysis was performed via logistic regression models in R and STATA 13.1 software. Fisher’s exact test was used for the statistical significance. Results: 267 patients with mild TBI were included; 148 were not on antithrombotic agents, 43 were on aspirin, 33 on DOACs, 5 on LMWH, 22 on antiplatelets, and 16 on VKA. Out of the total, 9 patients experienced ICH, none of which were on DOACs, LMWH, or VKA, but 4—out of 65—were on antiplatelets, and 5—out of 148—were not on antithrombotic therapies. Patients not on antithrombotic therapy had the shortest LOS at 0.46 days, while those on VKA had the longest LOS at 1.19 days; similar trends were observed for patients on DOAC and LMWH. Conclusions: The results reveal that TBI patients on anticoagulants/antiplatelets had longer hospital stays compared with those on aspirin alone. Notably, VKA was the strongest predictor for an extended LOS. Regarding ICH, patients taking only aspirin were twice as likely to experience bleeding compared with those on anticoagulants/antiplatelets. However, to achieve statistically significant evidence, further research with a larger cohort of patients is needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Antithrombotic Therapy Outcomes in Mild Traumatic Brain-Injury Patients: A Focus on Bleeding Risk and Hospital-Stay Duration

Desai,

Shiffer,

Giordano

et al. 2024

Life

Self Cite

View full text Add to dashboard Cite

show abstract

“…Last but not least, this special issue also published a practice-based research [9]. This paper proposed a Leaning approach as an operative model for dealing with the COVID-19 pandemic, so the authors aggregated data from the Lean model's implementation in an Emergency Department, the pandemic's epicenter, to critically assess its efficacy and feasibility.…”

Section: Editorialmentioning

confidence: 99%

Systems and Industries in Response to COVID-19 Crisis: Closing Remarks

Sorooshian

2022

ASI

View full text Add to dashboard Cite

Many industries and systems have faced consequences as a result of the COVID-19 outbreak. In this time, we are happy to had the publication of a Special Issue of Applied System Innovation titled “Systems and Industries in Response to the COVID-19 Crisis”. This editorial article contains the special issue’s closing remarks. However, while the scope of this given special issue grabbed the interest of practitioners and scholars, there is still much to be learned from COVID-19’s experience. Thus, suggestions for future special issues are included with this letter.

show abstract

“…To improve the management of radiological services in the COVID-19 pandemic, the health management model called lean healthcare is an ideal candidate for optimizing the work processes. Its tools have been applied in this pandemic scenario, helping the performance, facing challenges, such as staff shortages and rising costs, and providing high-quality services, while also considering the current financial restrictions [ 20 ]. As evidenced by the literature, implementing lean healthcare offers remarkable opportunities to improve overcrowding, costs, patient flow, difficulty in screening, and elimination of inefficient processes (i.e., waiting, movement, and overprocessing) [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Best Practices on Radiology Department Workflow: Tips from the Impact of the COVID-19 Lockdown on an Italian University Hospital

et al. 2022

View full text Add to dashboard Cite

Purpose: The workload of the radiology department (RD) of a university hospital in northern Italy dramatically changed during the COVID-19 outbreak. The restrictive measures of the COVID-19 pandemic lockdown influenced the use of radiological services and particularly in the emergency department (ED). Methods: Data on diagnostic services from March 2020 to May 2020 were retrospectively collected and analysed in aggregate form and compared with those of the same timeframe in the previous year. Data were sorted by patient type in the following categories: inpatients, outpatients, and ED patients; the latter divided in “traumatic” and “not traumatic” cases. Results: Compared to 2019, 6449 fewer patients (−32.6%) were assisted in the RD. This decrease was more pronounced for the emergency radiology unit (ERU) (−41%) compared to the general radiology unit (−25.7%). The proportion of investigations performed for trauma appeared to decrease significantly from 14.8% to 12.5% during the COVID-19 emergency (p < 0.001). Similarly, the proportion of assisted traumatic patients decreased from 16.6% to 12.5% (p < 0.001). The number of emergency patients assisted by the RD was significantly reduced from 45% during routine activity to 39.4% in the COVID-19 outbreak (p < 0.001). Conclusion: The COVID-19 outbreak had a tremendous impact on all radiology activities. We documented a drastic reduction in total imaging volume compared to 2019 because of both the pandemic and the lockdown. In this context, investigations performed for trauma showed a substantial decrease.

show abstract

Lean-ing Method in an Emergency Department of the Italian Epicenter of the COVID-19 Outbreak: When the Algorithm Makes Difference

Cited by 4 publications

References 56 publications

Comparative Analysis of Antithrombotic Therapy Outcomes in Mild Traumatic Brain-Injury Patients: A Focus on Bleeding Risk and Hospital-Stay Duration

Comparative Analysis of Antithrombotic Therapy Outcomes in Mild Traumatic Brain-Injury Patients: A Focus on Bleeding Risk and Hospital-Stay Duration

Systems and Industries in Response to COVID-19 Crisis: Closing Remarks

Best Practices on Radiology Department Workflow: Tips from the Impact of the COVID-19 Lockdown on an Italian University Hospital

Contact Info

Product

Resources

About