scholarly journals Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers

2020 ◽  
Vol 15 (8) ◽  
pp. 483-488 ◽  
Author(s):  
Andrew Auerbach ◽  
Kevin J O'Leary ◽  
S Ryan Greysen ◽  
James D Harrison ◽  
Sunil Kripalani ◽  
...  
Keyword(s):  
Hospital Medicine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Use Of Technology ◽  
Academic Medical ◽  
Critical Approaches ◽  
Medical Wards ◽  
Or Team ◽  
Team Types

IMPORTANCE: Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units. OBJECTIVE: To characterize inpatient adaptations to care for non-ICU COVID-19 patients. DESIGN: Cross-sectional survey. SETTING: A network of 72 hospital medicine groups at US academic centers. MAIN OUTCOME MEASURES: COVID-19 testing, approaches to personal protective equipment (PPE), and features of respiratory isolation units (RIUs). RESULTS: Fifty-one of 72 sites responded (71%) between April 3 and April 5, 2020. At the time of our survey, only 15 (30%) reported COVID-19 test results being available in less than 6 hours. Half of sites with PPE data available reported PPE stockpiles of 2 weeks or less. Nearly all sites (90%) reported implementation of RIUs. RIUs primarily utilized attending physicians, with few incorporating residents and none incorporating students. Isolation and room-entry policies focused on grouping care activities and utilizing technology (such as video visits) to communicate with and evaluate patients. The vast majority of sites reported decreases in frequency of in-room encounters across provider or team types. Forty-six percent of respondents reported initially unrecognized non–COVID-19 diagnoses in patients admitted for COVID-19 evaluation; a similar number reported delayed identification of COVID-19 in patients admitted for other reasons. CONCLUSION: The COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of RIUs and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care. Journal of Hospital Medicine 2020;15:XXXXXX. © 2020 Society of Hospital Medicine

scholarly journals Hospitalists as Triagists: Description of the Triagist Role across Academic Medical Centers

2019 ◽  
pp. 87-90
Author(s):  
Sadie Trammel Velasquez ◽  
Emily S Wang ◽  
Andrew A White ◽  
Jagriti Chadha ◽  
Michael Mader ◽  
...  
Keyword(s):  
Electronic Communication ◽  
Academic Medical Centers ◽  
Inpatient Service ◽  
Advanced Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Academic Medical ◽  
Communication Practices ◽  
Similarities And Differences

From the hospitalist perspective, triaging involves the evaluation of a patient for potential admission to an inpatient service. Although traditionally done by residents, many academic hospitalist groups have assumed the responsibility for triaging. We conducted a cross-sectional survey of 235 adult hospitalists at 10 academic medical centers (AMCs) to describe the similarities and differences in the triagist role and assess the activities and skills associated with the role. Eight AMCs have a defined triagist role; at the others, hospitalists supervise residents/advanced practice providers. The triagist role is generally filled by a faculty physician and shared by all hospitalists. We found significant variability in verbal communication practices (P = .02) and electronic communication practices (P < .0001) between the triagist and the current provider (eg, emergency department, clinic provider), and in the percentage of patients evaluated in person (P < .0001). Communication skills, personal efficiency, and systems knowledge are dominant themes of attributes of an effective triagist.

scholarly journals The Use of the UTAUT Model in the Adoption of E-Learning Technologies

2020 ◽  
Vol 28 (4) ◽  
pp. 38-51
Author(s):  
David Abdou ◽  
Sajjad M. Jasimuddin
Keyword(s):  
Banking Sector ◽  
Learning Technologies ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Utaut Model ◽  
Use Of Technology ◽  
Process Learning ◽  
E Learning ◽  
Effective Development

E-learning is treated as a learning approach in higher education worldwide. E-learning systems are all about using digital technologies to acquire, store, and process learning resources. This article aims to examine the end-users' acceptance of e-learning in the banking sector using the unified theory of acceptance and use of technology (UTAUT) model. The paper reviews the extant literature from which a theoretical model is developed and tested empirically in the French context. The UTAUT is extended by incorporating one additional factor (top management support). A quantitative approach based on cross-sectional survey was used to collect data from 133 bank officials. Data was analyzed using, statistical software SPSS version 15. The article successfully confirms the applicability of e-learning in France-based banks. The model developed in this paper helps the practitioner to understand the factors that should be given emphasis to ensure the effective development and acceptance of the e-learning technologies in a commercial setting.

Developing a Community for Patients With Cancer Through Longer-Term Art Therapy

2020 ◽  
pp. OP.20.00419
Author(s):  
Sam Brondfield ◽  
Naike Bochatay ◽  
Cynthia Perlis
Keyword(s):  
Content Analysis ◽  
Art Therapy ◽  
Median Frequency ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Medical Centers ◽  
Directed Content Analysis

PURPOSE: Art therapy (AT) improves quality of life and symptoms in patients with cancer. However, previous studies that have demonstrated these effects focused on time-limited interventions. The benefits of longer-term AT interventions for patients with cancer remain unexplored. We aimed to delineate the benefits of one such intervention for patients with cancer. METHODS: The Art for Recovery open art studio (OAS) is a weekly experience that provides patients the opportunity to express themselves through art and discussion. In April 2019, we sent a cross-sectional survey with closed- and open-ended components to all patients attending the OAS. We analyzed the closed-ended results using descriptive statistics and the open-ended results using directed content analysis through the theoretical framework of community-based development (CBD). RESULTS: The response rate was 82% (18 of 22 patients). The median duration of OAS attendance was 2 years, and the median frequency of attendance was three times per month. All respondents found the OAS very helpful, and 17 (94%) of 18 believed that the friendships they had made were very valuable. Directed content analysis revealed three themes: togetherness, active engagement, and familiar surroundings. These themes and our closed-ended results aligned well with the CBD framework. CONCLUSION: Longer-term AT experiences may provide benefits, such as community development, that briefer interventions lack. Medical centers should consider providing longer-term AT experiences for patients with cancer to give them access to these benefits.

scholarly journals Differences in the Epidemiological Characteristics and Clinical Outcomes of Pandemic (H1N1) 2009 Influenza, Compared with Seasonal Influenza

2010 ◽  
Vol 31 (7) ◽  
pp. 676-682 ◽  
Author(s):  
Kevin T. Shiley ◽  
Gregory Nadolski ◽  
Timothy Mickus ◽  
Neil O. Fishman ◽  
Ebbing Lautenbach
Keyword(s):  
Pandemic Influenza ◽  
Seasonal Influenza ◽  
Cross Sectional Study ◽  
Pandemic H1n1 ◽  
Cross Sectional ◽  
Medical Centers ◽  
Academic Medical ◽  
Clinical Presentations ◽  
Pandemic H1n1 2009 ◽  
Epidemiological Characteristics

Background.There are limited data comparing the clinical presentations, comorbidities, and outcomes of patients with infections due to seasonal influenza with patients with infections due to pandemic (H1N1) 2009 influenza.Objective.To compare the epidemiological characteristics and outcomes of pandemic (H1N1) 2009 influenza with those of seasonal influenza.Methods.A cross-sectional study was conducted among patients who received diagnoses during emergency department and inpatient encounters at 2 affiliated academic medical centers in Philadelphia, Pennsylvania. Cases of seasonal influenza during the period November 1, 2005, through June 1, 2008, and cases of pandemic influenza during the period from May 1, 2009, through August 7, 2009, were identified retrospectively.Results.Forty-nine cases of pandemic influenza and 503 cases of seasonal influenza were identified. Patients with pandemic H1N1 were younger (median age, 29 years) than patients with seasonal influenza (median age, 59 years) (P<.001). More patients with pandemic H1N1 (35 [71%] of 49) were African American, compared with patients with seasonal influenza (267 [53%] of 503;P= .02). Several symptoms were more common among patients with pandemic influenza infections than among patients with seasonal influenza infections: cough (98% vs 83%;P= .007), myalgias (71% vs 46%;P= .001), and pleuritic chest pain (45% vs 15%;P< .001). Pregnancy was the only comorbidity that occurred significantly more often in the pandemic influenza group than in the seasonal influenza group (16% vs 1%;P< .001). There were no significant differences in frequencies of deaths of hospitalized patients, intensive care unit admission, or length of hospitalization between groups.Conclusion.Other than pregnancy, there were few clinically important differences between infections due to seasonal influenza and those due to pandemic influenza. The greater rate of lower respiratory tract symptoms in pandemic cases might serve to differentiate pandemic influenza from seasonal influenza.

scholarly journals Accuracy of perceived glaucoma risk by patients in a clinical setting

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257453
Author(s):  
Chiun-Ho Hou ◽  
Jiahn-Shing Lee ◽  
Ken-Kuo Lin ◽  
Laura Liu ◽  
Yung-Sung Lee ◽  
...  
Keyword(s):  
Medical Attention ◽  
Considerable Proportion ◽  
Marginal Effect ◽  
College Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Final Study ◽  
High Concern ◽  
Study Population

Objective To determine whether patients attending the ophthalmology department underestimate their glaucoma risks. Method We conducted a cross-sectional survey with a final study population of 1203 individuals from two medical centers in Taiwan during January 1–June 30, 2019. The “High concern” group was defined as the set of patients who rated themselves as having low risk but who had been rated by physicians as having medium or high risk of developing glaucoma over the next year. Results Approximately 12% of the respondents belonged to the “High concern” group. For those with education at the college level or higher, the interaction term was estimated to be 0.294 (95% CI = 0.136–0.634). Marginal effect calculations revealed significant sex-based differences in the effect of knowledge at specific age intervals. Conclusions A considerable proportion of patients attending the ophthalmology department underestimate their glaucoma risks. Misjudgment of glaucoma risks can lead to delays in seeking of medical attention. Glaucoma education should be designed according to each patient’s education level and sex, as its effect is not consistent across different education and sex clusters.

scholarly journals Using the Unified Theory of Acceptance and Use of Technology (UTAUT) to Investigate the Intention to Use Physical Activity Apps: Cross-Sectional Survey

10.2196/13127 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e13127 ◽  
Author(s):  
Di Liu ◽  
Remina Maimaitijiang ◽  
Jing Gu ◽  
Shuyi Zhong ◽  
Mengping Zhou ◽  
...  
Keyword(s):  
Physical Activity ◽  
University Students ◽  
Cross Sectional Study ◽  
Intention To Use ◽  
Unified Theory ◽  
Normal Range ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Performance Expectancy ◽  
Use Of Technology

Background Many university students are lacking adequate physical exercise and are failing to develop physical activity (PA) behaviors in China. PA app use could improve this situation. Objective The aim of this study was to use the unified theory of acceptance and use of technology (UTAUT) to investigate the intention to use PA apps among university students in Guangzhou, China, and how body mass index (BMI) moderates the effects of UTAUT in explaining PA app use intention. Methods A cross-sectional study was conducted among 1704 university students from different universities in Guangzhou, China. The UTAUT model was used to measure the determinants of intention to use PA apps. Results Of the participants, 41.8% (611/1461) intended to use PA apps. All three UTAUT-related scales (performance expectancy, effort expectancy, and social influence) were positively associated with the intention to use PA apps after adjusting for background variables (adjusted odds ratio 1.10-1.31, P<.001). The performance expectancy scale had stronger associations with the intention to use PA apps among those whose BMI were beyond normal range compared with those whose BMI were within normal range (P<.001). Conclusions UTAUT is useful for understanding university students’ intention to use PA apps. Potential moderating effects should be kept in mind when designing UTAUT-based interventions to improve PA via app use.

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