MEDTHINKER: Novel computer‐based simulation to assess technical and nontechnical skills using medical content in healthcare providers

2021 ◽  
Vol 51 (12) ◽  
pp. 1163-1169
Author(s):  
Satish Krishnamurthy ◽  
Piers MacNaughton ◽  
Lawrence Chin ◽  
Mantosh Dewan
Keyword(s):  
Healthcare Providers ◽  
Nontechnical Skills ◽  
Computer Based

scholarly journals Understanding cause of stillbirth: a prospective observational multi-country study from sub-Saharan Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mamuda Aminu ◽  
Sarah Bar-Zeev ◽  
Sarah White ◽  
Matthews Mathai ◽  
Nynke van den Broek
Keyword(s):  
Sierra Leone ◽  
Cause Of Death ◽  
Expert Panel ◽  
Healthcare Providers ◽  
Sub Saharan Africa ◽  
Primary Data ◽  
Middle Income ◽  
Computer Based ◽  
Sub Saharan ◽  
Low And Middle Income

Abstract Background Every year, an estimated 2.6 million stillbirths occur worldwide, with up to 98% occurring in low- and middle-income countries (LMIC). There is a paucity of primary data on cause of stillbirth from LMIC, and particularly from sub-Saharan Africa to inform effective interventions. This study aimed to identify the cause of stillbirths in low- and middle-income settings and compare methods of assessment. Methods This was a prospective, observational study in 12 hospitals in Kenya, Malawi, Sierra Leone and Zimbabwe. Stillbirths (28 weeks or more) were reviewed to assign the cause of death by healthcare providers, an expert panel and by using computer-based algorithms. Agreement between the three methods was compared using Kappa (κ) analysis. Cause of stillbirth and level of agreement between the methods used to assign cause of death. Results One thousand five hundred sixty-three stillbirths were studied. The stillbirth rate (per 1000 births) was 20.3 in Malawi, 34.7 in Zimbabwe, 38.8 in Kenya and 118.1 in Sierra Leone. Half (50.7%) of all stillbirths occurred during the intrapartum period. Cause of death (range) overall varied by method of assessment and included: asphyxia (18.5–37.4%), placental disorders (8.4–15.1%), maternal hypertensive disorders (5.1–13.6%), infections (4.3–9.0%), cord problems (3.3–6.5%), and ruptured uterus due to obstructed labour (2.6–6.1%). Cause of stillbirth was unknown in 17.9–26.0% of cases. Moderate agreement was observed for cause of stillbirth as assigned by the expert panel and by hospital-based healthcare providers who conducted perinatal death review (κ = 0.69; p < 0.0005). There was only minimal agreement between expert panel review or healthcare provider review and computer-based algorithms (κ = 0.34; 0.31 respectively p < 0.0005). Conclusions For the majority of stillbirths, an underlying likely cause of death could be determined despite limited diagnostic capacity. In these settings, more diagnostic information is, however, needed to establish a more specific cause of death for the majority of stillbirths. Existing computer-based algorithms used to assign cause of death require revision.

scholarly journals Design and Implementation of a Guideline-Based Workflow Software System for Improving the Chemotherapy Process

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Reza Afrash ◽  
Azamossadat Hosseini ◽  
Reza Rabiei ◽  
Sina Salari ◽  
Mohammad Mehdi Sepehri ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Clinical Decision ◽  
Nursing Administration ◽  
Safety Improvement ◽  
Specific Standard ◽  
Computer Based ◽  
Communication And Coordination ◽  
Minimum Dataset ◽  
Python Programming ◽  
Based Medicine

Background: While chemotherapy is an effective modality for the treatment of patients with cancer, it is a complex, multidisciplinary, and error-prone process. Paper-based protocols are commonly applied in chemotherapy; however, they fail to eliminate the complexity of this process. Therefore, a new guideline-based workflow software (GWS) system is needed to improve the workflow and quality of chemotherapy process. Methods: Planning was initiated 11 months before the system implementation and it involved a multidisciplinary group to analyze the current chemotherapy workflow and protocols for identifying the workflow components, analyzing paper-based protocols, developing computer-based protocols, and designing of systems based on an object-oriented analysis. To implement the GWS, we applied a system based on Python programming language and SQL language. Results: The conceptual model was developed based on need assessments and chemotherapy steps. A minimum dataset was developed for the electronic health records. We established examination forms for the patient management system (PMS), as well as specific standard forms for chemotherapy ordering, prescription verification and administration templates. Finally, developed GWS system consisted of a PMS, computerized provider order entry (CPOE), prescription verification system (PVS), and nursing administration system (NAS). Conclusions: A PMS, a PVS, a NAS, and a protocol-based clinical decision support system were integrated into the CPOE system to improve the chemotherapy process. Elimination of iterations and unnecessary steps in old chemotherapy workflow, increase of patient safety, improvement of communication and coordination between healthcare providers, and use of updated evidence-based medicine in direct chemotherapy orders justify the integration of GWS in the cancer care settings.

Internet Resources for Dentistry: Utilization of the Internet to Support Professional Growth, Decision Making, and Patient Care

1999 ◽  
Vol 1 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Gary F. Guest
Keyword(s):  
Professional Development ◽  
Decision Making ◽  
Professional Growth ◽  
Healthcare Providers ◽  
The Internet ◽  
Know How ◽  
The Past ◽  
Internet Resources ◽  
Computer Based ◽  
Use Of The Internet

Abstract The use of computers as an information resource in dentistry has grown dramatically over the past ten years. Fueled by the availability of more powerful computers, societal acceptance of computer-based resources, and the development of the Internet, millions of documents now provide a tremendously important repository of information for healthcare providers. Those involved in delivery of dental care need to know how to access and use this information for their professional development and to support clinically related activities. This paper presents issues related to the use of the Internet. It also provides information on the use of search engines to find resources (websites) on the Internet and descriptions of some available resources of interest to those involved in oral healthcare.

scholarly journals A Qualitative Analysis Evaluating The Purposes And Practices Of Clinical Documentation

2014 ◽  
Vol 05 (01) ◽  
pp. 153-168 ◽  
Author(s):  
Y.-X. Ho ◽  
C. S. Gadd ◽  
K.L. Kohorst ◽  
S.T. Rosenbloom
Keyword(s):  
Qualitative Analysis ◽  
Healthcare Providers ◽  
Clinical Documentation ◽  
Research Education ◽  
Clinical Notes ◽  
Important Challenge ◽  
Timely Fashion ◽  
Computer Based ◽  
Combination Of Methods ◽  
Documentation Tool

SummaryObjectives: An important challenge for biomedical informatics researchers is determining the best approach for healthcare providers to use when generating clinical notes in settings where electronic health record (EHR) systems are used. The goal of this qualitative study was to explore healthcare providers’ and administrators’ perceptions about the purpose of clinical documentation and their own documentation practices.Methods: We conducted seven focus groups with a total of 46 subjects composed of healthcare providers and administrators to collect knowledge, perceptions and beliefs about documentation from those who generate and review notes, respectively. Data were analyzed using inductive analysis to probe and classify impressions collected from focus group subjects.Results: We observed that both healthcare providers and administrators believe that documentation serves five primary domains: clinical, administrative, legal, research, education. These purposes are tied closely to the nature of the clinical note as a document shared by multiple stake-holders, which can be a source of tension for all parties who must use the note. Most providers reported using a combination of methods to complete their notes in a timely fashion without compromising patient care. While all administrators reported relying on computer-based documentation tools to review notes, they expressed a desire for a more efficient method of extracting relevant data.Conclusions: Although clinical documentation has utility, and is valued highly by its users, the development and successful adoption of a clinical documentation tool largely depends on its ability to be smoothly integrated into the provider’s busy workflow, while allowing the provider to generate a note that communicates effectively and efficiently with multiple stakeholders.Citation: Ho Y-X, Gadd CS, Kohorst KL, Rosenbloom ST. A qualitative analysis evaluating the purposes and practices of clinical documentation. Appl Clin Inf 2014; 5: 153–168 http://dx.doi.org/10.4338/ACI-2013-10-RA-0081

scholarly journals Generating Clinical Notes for Electronic Health Record Systems

2010 ◽  
Vol 01 (03) ◽  
pp. 232-243 ◽  
Author(s):  
W.W. Stead ◽  
J.C. Denny ◽  
D. Giuse ◽  
N.M. Lorenzi ◽  
S.H. Brown ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
System Development ◽  
Healthcare Providers ◽  
Content Standards ◽  
Health Record ◽  
Clinical Documentation ◽  
Clinical Workflow ◽  
Clinical Notes ◽  
Computer Based ◽  
Electronic Health

SummaryClinical notes summarize interactions that occur between patients and healthcare providers. With adoption of electronic health record (EHR) and computer-based documentation (CBD) systems, there is a growing emphasis on structuring clinical notes to support reusing data for subsequent tasks. However, clinical documentation remains one of the most challenging areas for EHR system development and adoption. The current manuscript describes the Vanderbilt experience with implementing clinical documentation with an EHR system. Based on their experience rolling out an EHR system that supports multiple methods for clinical documentation, the authors recommend that documentation method selection be made on the basis of clinical workflow, note content standards and usability considerations, rather than on a theoretical need for structured data.

scholarly journals 983. Hand Hygiene not only the Motion but the Moments

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S519-S520
Author(s):  
Shahrzad E Darvish ◽  
Jean-Sebastien Rachoin ◽  
Dennis Meredith ◽  
Denise Polat ◽  
Jessica McKnight ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Control Charts ◽  
Infection Prevention ◽  
Pearson Correlation ◽  
Healthcare Providers ◽  
Post Intervention ◽  
Before And After ◽  
Computer Based ◽  
Education Process

Abstract Background Hand hygiene (HH) is a paradigm of infection prevention.Often emphasis has been placed on appropriate motion of hand hygiene.The implementation of the 5 moments of HH in clinical practice hindered by the perceived enormous lift of educating healthcare providers. Hand Hygiene Moments Opportunities Methods Retrospective evaluation of education on WHO 5 moments of HH implementation. Other data collected CLABSI, CAUTI, MDR Acinetobacter, MRSA, Clostridium difficile LabID. Education occurred between October and December 2018. Data was collected from January 2018 to December 2019. Baseline 5 Moments of HH was obtained for 3 weeks prior to education as this was newly introduced. Statistical analyses using control charts with testing for special cause variations included all data point before and after education of 5 moments of HH. We used Pearson correlation to assess relation between HAI and HH. 5 moments of HH education was done through direct observation with feedback, traditional lecturing, and computer-based education mandatory to all employees and posters placed in strategic locations through the institution. Determination of patient and hospital zone allowed to streamline the education process. Education on different moments was individualized for each discipline in accordance to its involvement with patients. Zones by Lay Out Patient Zone and Hospital Zone Results Education increased HH compliance over the 12 months period post intervention. The number of observations per moment per month ranged between 96 and 351 observations most observation opportunities during moment 1 (M1) and 5 (M5). M1 correlated positively significantly with moment 2 (M2) (P=0.001) moment 3 (M3) (p &lt; 0.001) moment 4 (M4) (p =0,001) but not moment 5 (M5) M2 correlated positively with M3 (p &lt; 0.001), M4 (p&lt; 0.001) Not M5. M3 correlated positively with M4(p&lt; 0.001) Not M5 No Correlations between CLABSI, CAUTI, CDI, MRSA and M1-M5 or Hand Hygiene. There is a correlation between the decrease in MDR Acinetobacter incidence and point prevalence and compliance with M1 (p 0.04), M2 (p &lt; 0.001), M3 (p 0.002) and M4 (p 0.028). Conclusion Education of 5 moments of HH in a combined effort between infection prevention and front-line staff to identify patient and hospital zone showed an increased adherence to Hand hygiene overtime. Compliance with M 1 was associated with increased compliance with M2, M3 and M4. Disclosures Raquel Nahra, MD, Medline sponsored the study (Other Financial or Material Support, Supported financially and provided material)

scholarly journals Simulation for competency assessment in vascular and cardiac ultrasound

2018 ◽  
Vol 23 (2) ◽  
pp. 172-180 ◽  
Author(s):  
Florence H Sheehan ◽  
R Eugene Zierler
Keyword(s):  
Healthcare Providers ◽  
Peak Systolic Velocity ◽  
Duplex Ultrasound ◽  
Competency Assessment ◽  
Cardiac Ultrasound ◽  
Peripheral Vascular ◽  
Dynamics Modeling ◽  
Color Flow ◽  
Vascular Ultrasound ◽  
Computer Based

Healthcare providers who use peripheral vascular and cardiac ultrasound require specialized training to develop the technical and interpretive skills necessary to perform accurate diagnostic tests. Assessment of competence is a critical component of training that documents a learner’s progress and is a requirement for competency-based medical education (CBME) as well as specialty certification or credentialing. The use of simulation for CBME in diagnostic ultrasound is particularly appealing since it incorporates both the psychomotor and cognitive domains while eliminating dependency on the availability of live patients with a range of pathology. However, successful application of simulation in this setting requires realistic, full-featured simulators and appropriate standardized metrics for competency testing. The principal diagnostic parameter in peripheral vascular ultrasound is measurement of peak systolic velocity (PSV) on Doppler spectral waveforms, and simulation of Doppler flow detection presents unique challenges. The computer-based duplex ultrasound simulator developed at the University of Washington uses computational fluid dynamics modeling and presents real-time color-flow Doppler images and Doppler spectral waveforms along with the corresponding B-mode images. This simulator provides a realistic scanning experience that includes measuring PSV in various arterial segments and applying actual diagnostic criteria. Simulators for echocardiography have been available since the 1990s and are currently more advanced than those for peripheral vascular ultrasound. Echocardiography simulators are now offered for both transesophageal echo and transthoracic echo. These computer-based simulators have 3D graphic displays that provide feedback to the learner and metrics for assessment of technical skill that are based on transducer tracking data. Such metrics provide a motion-based or kinematic analysis of skill in performing cardiac ultrasound. The use of simulation in peripheral vascular and cardiac ultrasound can provide a standardized and readily available method for training and competency assessment.

Cyberbullying and adolescent mental health

2012 ◽  
Vol 24 (1) ◽  
Author(s):  
Keita Suzuki ◽  
Reiko Asaga ◽  
Andre Sourander ◽  
Christina W. Hoven ◽  
Donald Mandell
Keyword(s):  
Risk Factors ◽  
Social Interactions ◽  
Healthcare Providers ◽  
Cross Sectional ◽  
Policy Makers ◽  
School Officials ◽  
Age And Gender Differences ◽  
Computer Based ◽  
And Gender ◽  
Psychological Risk

Abstract The rapid growth of electronic and computer-based communication and information sharing during the past decade has dramatically changed social interactions, especially among teenagers. Cyberbullying has emerged as a new form of bullying and harassment, and it has been shown to possess different ramifications from traditional schoolyard bullying. This problem has emerged in nations worldwide. Cybervictims have reported various emotional and behavioral symptoms, along with school-related problems. This paper reviews international cross-sectional studies relating to the definition, prevalence, age, and gender differences inherent in cyberbullying. Psychosocial and risk factors associated with cyberbullying are also addressed. Prevention and intervention strategies for school officials and parents are suggested. Healthcare providers, policy makers, and families must be ever-mindful of the grave dangers cyberbullying poses to youths. Longitudinal studies are warranted to assess the psychological risk factors of cyberbullying.

Cell morphology, volume, and surface area determinations from multilevel contouring within HVEM micrographs of serial sections and whole-cell mounts

1987 ◽  
Vol 45 ◽  
pp. 588-589
Author(s):  
M. Marko ◽  
A. Leith ◽  
D. Parsons
Keyword(s):  
Surface Area ◽  
Electron Micrographs ◽  
Cell Morphology ◽  
Individual Variation ◽  
Serial Section ◽  
Stereo Pair ◽  
Complex Structures ◽  
Serial Sections ◽  
Surface Areas ◽  
Computer Based

The use of serial sections and computer-based 3-D reconstruction techniques affords an opportunity not only to visualize the shape and distribution of the structures being studied, but also to determine their volumes and surface areas. Up until now, this has been done using serial ultrathin sections.The serial-section approach differs from the stereo logical methods of Weibel in that it is based on the Information from a set of single, complete cells (or organelles) rather than on a random 2-dimensional sampling of a population of cells. Because of this, it can more easily provide absolute values of volume and surface area, especially for highly-complex structures. It also allows study of individual variation among the cells, and study of structures which occur only infrequently.We have developed a system for 3-D reconstruction of objects from stereo-pair electron micrographs of thick specimens.

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