scholarly journals Coupling early warning services, crowdsourcing, and modelling for improved decision support and wildfire emergency management

Author(s):  
C. Bielski ◽  
V. O'Brien ◽  
C. Whitmore ◽  
K. Ylinen ◽  
I. Juga ◽  
...  
JAMIA Open ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 261-268
Author(s):  
Devin J Horton ◽  
Kencee K Graves ◽  
Polina V Kukhareva ◽  
Stacy A Johnson ◽  
Maribel Cedillo ◽  
...  

Abstract Objective The objective of this study was to assess the clinical and financial impact of a quality improvement project that utilized a modified Early Warning Score (mEWS)-based clinical decision support intervention targeting early recognition of sepsis decompensation. Materials and Methods We conducted a retrospective, interrupted time series study on all adult patients who received a diagnosis of sepsis and were exposed to an acute care floor with the intervention. Primary outcomes (total direct cost, length of stay [LOS], and mortality) were aggregated for each study month for the post-intervention period (March 1, 2016–February 28, 2017, n = 2118 visits) and compared to the pre-intervention period (November 1, 2014–October 31, 2015, n = 1546 visits). Results The intervention was associated with a decrease in median total direct cost and hospital LOS by 23% (P = .047) and .63 days (P = .059), respectively. There was no significant change in mortality. Discussion The implementation of an mEWS-based clinical decision support system in eight acute care floors at an academic medical center was associated with reduced total direct cost and LOS for patients hospitalized with sepsis. This was seen without an associated increase in intensive care unit utilization or broad-spectrum antibiotic use. Conclusion An automated sepsis decompensation detection system has the potential to improve clinical and financial outcomes such as LOS and total direct cost. Further evaluation is needed to validate generalizability and to understand the relative importance of individual elements of the intervention.


2021 ◽  
Vol 331 ◽  
pp. 04003
Author(s):  
Dewi Prima Meiliasari ◽  
Berton Suar Panjaitan ◽  
Toto Heryanto ◽  
Wilopo

The application of nuclear power plants in the world is increasing and has the potential for accidents, including nuclear weapons tests from outside the Nuclear Non-Proliferation Treaty, thus allowing radioactive releases to fall into Indonesian territory, which is a potential threat. Indonesia also utilizes nuclear power in many fields, thus also potentially becoming a national threat. To prevent the threat of radiation potential requires a nuclear disaster Early Warning System (EWS) that can be accessed by the community. This research analysed the EWS that Indonesia needed, using qualitative methods by describing the results of research obtained from interviews and secondary data. Results and research discussions starting from observation and monitoring of radiation exposure, warning services, information dissemination, and supported by countermeasures for the effectiveness of the EWS. The results showed that the development of an integrated nuclear disaster EWS that is easily accessible to the community quickly and continuously under the development of an emergency is a strategy as a decision to reduce the risk of nuclear disaster. The development of the strategy requires a legal basis that regulates coordination between ministries/institutions, from planning to information dissemination to ensure the safety of the public and Indonesian people's security.


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