scholarly journals Design and Evaluation of a Smartphone Medical Guidance App for Outpatients of Large-Scale Medical Institutions: A Retrospective Observational Study (Preprint)

2021 ◽  
Author(s):  
Kei Teramoto
Keyword(s):  
Waiting Time ◽  
Large Scale ◽  
University Hospital ◽  
Wait Times ◽  
Medical Facility ◽  
Medical Institutions ◽  
Medical Facilities ◽  
The Mean ◽  
Spread Of Infection ◽  
Electronic Medical Record Database

BACKGROUND The greatest stressor for outpatients is the waiting time before the start of the examination. If the patient is able to use their smartphone to check in with the reception, the patient can wait for their examination at any location, and the burden of waiting time can be reduced. OBJECTIVE This study aimed to report the design approach and post-introduction outcomes of the Tori RinRin (TR2) system that was developed to reduce outpatient burden imposed by wait times before examination. METHODS The TR2 system was introduced at Tottori University Hospital, a large medical facility that accepts an average of 1,500 outpatients daily. The system, which links the hospital’s electronic medical record database with patients’ mobile devices, has the following two functions: 1) GPS-based examination check-in processing and 2) sending appointment notification messages via a cloud notification service. RESULTS In an investigation of 363 subjects, the mean examination call message response time using the TR2 system was 31 seconds (median 14 seconds). After 12 months, the system had 5,994 registered users and was used by a daily average of 18% of outpatients (mean ± SD = 155.7 ± 30.3). Among 166 subjects who responded to a user survey, 86.7% (144 of 166 patients) said that the system was useful. CONCLUSIONS The ability of 18% of outpatients at a large medical facility to check in remotely and wait for examinations anywhere is effective for preventing the spread of infection, especially during pandemics such as the coronavirus disease. The app reported in this study is beneficial for large medical facilities striving to reduce outpatient burden imposed by wait times.

scholarly journals A Prediction Algorithm to Reduce Queuing Time using Parallel Patient Treatment Methodology

2018 ◽  
Vol 7 (3.12) ◽  
pp. 459
Author(s):  
John . ◽  
Vivia Mary ◽  
Gunda . ◽  
Rishik Reddy ◽  
Mullapudi . ◽  
...  
Keyword(s):  
Waiting Time ◽  
Real World ◽  
Large Scale ◽  
Treatment Time ◽  
Human Life ◽  
Treatment Plan ◽  
Prediction Algorithm ◽  
Patient Treatment ◽  
Efficient Treatment ◽  
Medical Institutions

Inefficient management of the patients’ queues is one of the major issues faced in medical institutions like clinics and hospitals which end up in creating large crowds at the hospital lobbies and an extended waiting time in the patients’ treatments. Waiting unnecessarily for a long period of time, ends only in loss or wastage of time, human life and hospital resources. It also increases the number or frustrated patients that are waiting to get treatment required. Every single patient has to undergo a diagnosis and then be forwarded to other departments or medical personnel for further procedures. Therefore, each patient’s waiting time is the time taken by the system to diagnose all the patients before him/her in the queue. In such a condition, the most practical decision would be to give out an efficient treatment plan to each patient. This can be implemented as a mobile application, wherein a predictable waiting time according to the diagnosis of the patient is uploaded, which then updates itself in real-time. Taking this into consideration, this paper proposes a Patient Treatment Time Prediction (PTTP) algorithm that can predict the time taken by a procedure for a particular patient. This algorithm can be applied to real-world scenarios and can be implemented in a large-scale environment. After predicting a treatment time necessary, the Hospital Queuing Recommendation (HQR) system can be developed. The job of calculating and predicting a convenient and an efficient treatment time for a particular patient can be done by the HQR system. The necessary input data for this is taken from a real world scenario like an actual doctor estimating time for a procedure at a particular hospital. This algorithm and system should work hand-in-hand generating responses of the utmost efficiency and very low latency. Once the model goes through extensive experimentation and simulation, an efficient model that demonstrates the effectiveness of this system can be recommended to other hospitals or medical institutions thus reducing waiting time per patient. 

scholarly journals Mean Waiting Time in Large-Scale and Critically Loaded Power of d Load Balancing Systems

2021 ◽  
Vol 5 (2) ◽  
pp. 1-34
Author(s):  
Tim Hellemans ◽  
Benny Van Houdt
Keyword(s):  
Load Balancing ◽  
Waiting Time ◽  
Large Scale ◽  
Mean Field ◽  
Arrival Rate ◽  
Mean Field Limit ◽  
Mean Waiting Time ◽  
Constant Rate ◽  
Finite Set ◽  
The Mean

Mean field models are a popular tool used to analyse load balancing policies. In some exceptional cases the waiting time distribution of the mean field limit has an explicit form. In other cases it can be computed as the solution of a set of differential equations. In this paper we study the limit of the mean waiting time E[Wλ] as the arrival rate λ approaches 1 for a number of load balancing policies in a large-scale system of homogeneous servers which finish work at a constant rate equal to one and exponential job sizes with mean 1 (i.e. when the system gets close to instability). As E[Wλ] diverges to infinity, we scale with -log(1-λ) and present a method to compute the limit limλ-> 1- -E[Wλ]/l(1-λ). We show that this limit has a surprisingly simple form for the load balancing algorithms considered. More specifically, we present a general result that holds for any policy for which the associated differential equation satisfies a list of assumptions. For the well-known LL(d) policy which assigns an incoming job to a server with the least work left among d randomly selected servers these assumptions are trivially verified. For this policy we prove the limit is given by 1/d-1. We further show that the LL(d,K) policy, which assigns batches of K jobs to the K least loaded servers among d randomly selected servers, satisfies the assumptions and the limit is equal to K/d-K. For a policy which applies LL(di) with probability pi, we show that the limit is given by 1/ ∑i pi di - 1. We further indicate that our main result can also be used for load balancers with redundancy or memory. In addition, we propose an alternate scaling -l(pλ) instead of -l(1-λ), where pλ is adapted to the policy at hand, such that limλ-> 1- -E[Wλ]/l(1-λ)=limλ-> 1- -E[Wλ]/l(pλ), where the limit limλ-> 0+ -E[Wλ]/l(pλ) is well defined and non-zero (contrary to limλ-> 0+ -E[Wλ]/l(1-λ)). This allows to obtain relatively flat curves for -E[Wλ]/l(pλ) for λ ∈ [0,1] which indicates that the low and high load limits can be used as an approximation when λ is close to one or zero. Our results rely on the earlier proven ansatz which asserts that for certain load balancing policies the workload distribution of any finite set of queues becomes independent of one another as the number of servers tends to infinity.

scholarly journals Use of a Smartphone Application to Speed Up Interhospital Transfer of Acute Ischemic Stroke Patients for Thrombectomy

2021 ◽  
Vol 12 ◽  
Author(s):  
Sheng-Ta Tsai ◽  
Wei-Chun Wang ◽  
Yu-Ting Lin ◽  
Wei-Shih Huang ◽  
Hung-Yu Huang ◽  
...  
Keyword(s):  
Large Scale ◽  
Stroke Care ◽  
Time Lapse ◽  
Smartphone Application ◽  
Communication Barriers ◽  
University Hospital ◽  
Time Saving ◽  
Interhospital Transfer ◽  
The Mean ◽  
Point To Point

Background: In most countries, large cerebral artery occlusion is identified as the leading cause of disability. In 2015, five large-scale clinical trials confirmed the benefit of intra-arterial thrombectomy. However, thrombectomy is a highly technical and facility-dependent procedure. Primary stroke centers need to transfer patients to comprehensive stroke centers to perform thrombectomy. The time-lapse during interhospital transfer would decrease the chance of the patient's proper recovery. Communication barriers also contribute to this delay.Aims: We used a smartphone application to overcome communication barriers between hospitals. We aimed to shorten the door-to-puncture time of interhospital transfer patients.Methods: We began using a smartphone application, “LINE,” to facilitate interhospital communication on May 01, 2018. We carried out retrospective data analyses for all the transfer patients (n = 351), with the primary outcome being the door-to-puncture time in our comprehensive stroke center (China Medical University Hospital). We compared the three periods: May 01 to Dec 31, 2017 (before the use of the smartphone application); May 01 to Dec 31, 2018 (the 1st year of using the smartphone application); and May 01 to Dec 31, 2019 (the 2nd year of using the smartphone application). We also compared the transfer data with non-transfer thrombectomies in the same period.Results: We compared 2017, 2018, and 2019 data. The total number of transfer patients increased over the years: 63, 113, 175, respectively. The mean door-to-puncture time decreased significantly, going from 109, through 102, to 92 min. Meanwhile, the mean door-to-puncture time in non-transfer patients were 140.3, 122.1, and 129.3 min. The main reason of time saving was the change of the way of communication, from point-to-point interhospital communication to hub-to-spoke interhospital communication.Conclusions: We used this smartphone application to enhance interhospital communication, changed from the point-to-point to hub-to-spoke method. It made us overcome the communication barrier and build up interhospital connection, thus shortening the door-to-puncture time. Our experience demonstrated the importance of close communication and teamwork in hyperacute stroke care, especially in interhospital transfer for thrombectomy.

scholarly journals An Improved Queuing Model for Reducing Average Waiting Time of Emergency Surgical Patients Using Preemptive Priority Scheduling

2021 ◽  
Vol 9 (6) ◽  
pp. 827-840
Keyword(s):  
Waiting Time ◽  
Time Management ◽  
Arrival Rate ◽  
Preemptive Priority ◽  
Queuing Model ◽  
Priority Scheduling ◽  
Average Waiting Time ◽  
Public Sector Hospital ◽  
Medical Facilities ◽  
The Mean

Our research objective is to reduce the Average Waiting Time for patients in an Emergency Department of public sector hospital. We have based our model on M/M/s Queuing System, our study revealssignificant findings on arrival rate of patients. During this simulation, we have used a preemptive priority scheduling model. In our practice, the arrival rate followed a Poisson distribution, averaging 30 patients per hour, with the Mean Service time of1.5 hours and Average Waiting Time recorded around 12.13 minutes. This research offersvaluable help to achieve better time management in emergency departments of high-density medical facilities.

scholarly journals Pancytopenia of Unknown Cause in Adult Patients Admitted to a Tertiary Hospital in Ethiopia: Case series

1970 ◽  
Vol 28 (4) ◽  
Author(s):  
Esayas Kebede Gudina ◽  
Hiwot Amare ◽  
Kasahun Benti ◽  
Shoba Ibrahim ◽  
Gashahun Mekonnen
Keyword(s):  
Large Scale ◽  
Complete Blood Count ◽  
White Cell Count ◽  
Case Series ◽  
Adult Patients ◽  
University Hospital ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
The Mean ◽  
Jimma University

BACKGROUND: Over the past few years, we have witnessed a dramatic increase in the number of patients presenting with severe pancytopenia to Jimma University Hospital. We now present sociodemographic and clinical characteristics of adult patients admitted with pancytopenia of unknown cause to Jimma University Hospital during the period of March 2015 to June 2016. Complete blood count and other diagnostic tests were done for all patients to uncover underlying causes.RESULT: Out of 65 cases admitted with pancytopenia during the specified period, 40 were excluded for various reasons. The rest 25 patients were included in this review. The mean age was 32.1 years (SD=14.9); 14 were younger than 30 years of age. The mean hemoglobin level, white cell count and platelet count were 48.6 g/L (SD=1.9), 1,918 /μL (SD=879.8) and 36,200 /μL (SD=26,131) respectively. The major presenting symptoms were generalized malaise and fever. No geographic or seasonal clustering of the caseswas seen.CONCLUSION: The number of cases with pancytopenia of unidentified cause seen at the hospital over the specified period is alarmingly high and deserves great attention. The hematologic alteration in most of the patients was found to be severe with poor clinical outcome. This calls for large scale community based investigation to uncover the root cause of the problem.KEYWORDS: Aplastic anemia, Pancytopenia, Ethiopia, Jimma

User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis

1993 ◽  
Vol 32 (05) ◽  
pp. 365-372 ◽  
Author(s):  
T. Timmeis ◽  
J. H. van Bemmel ◽  
E. M. van Mulligen
Keyword(s):  
Data Analysis ◽  
Clinical Research ◽  
Clinical Data ◽  
University Hospital ◽  
User Evaluation ◽  
Scientific Staff ◽  
Medical Institutions ◽  
Clinical Data Analysis ◽  
Research Problems ◽  
The University

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.

The Russian Red Cross Society and staff replenishment of sisters of mercy on the eve of the First World War (1908–1914)

2020 ◽  
pp. 136-153
Author(s):  
Elizaveta E. Polianskaia ◽  
Keyword(s):  
Red Cross ◽  
World War ◽  
Medical Institutions ◽  
The First World War ◽  
Medical Facilities ◽  
Wide Scale ◽  
Sisters Of Mercy ◽  
The Military ◽  
The Great War ◽  
First World

This article deals with the problem of recruiting sisters of mercy by the Russian Red Cross Society (also RRCS, Red Cross) in 1908-1914s. In case of war, Red Cross had to send sisters of mercy to its own institutions and to medical institutions of the military Department. The war ministry was developing a mobilization plan, which included a plan for the deployment of medical facilities. The ministry sent this plan to the administration of the Red Cross. In accordance with the request of the ministry, the RRCS strengthened its efforts to attract new staff of sisters of mercy. This activity led to certain results. On the eve of the war, there was a number of sisters of mercy that were required to replenish the medical institutions of the Red Cross and the military Department. That means that according to the pre-war plan, in the matter of creating a cadre of sisters of mercy, the RRCS was ready for the war. However, the Great War took on a wide scale, a situation which the army, the industry, and the medical service were not prepared for. The Russian Red Cross Society was forced to quickly open new medical institutions and to urgently train new personnel. Sometimes the duties of nurses were performed by those who did not have the necessary education.

Peculiarities of the phytosanitary state of pome fruits in industrial horticulture

2020 ◽  
Vol 60 (1) ◽  
pp. 159-168
Author(s):  
V. V. Antonenko ◽  
A. V. Zubkov ◽  
S. N. Kruchina
Keyword(s):  
Mechanism Of Action ◽  
Large Scale ◽  
High Efficiency ◽  
Fruit Trees ◽  
Fruit Crops ◽  
Planting Material ◽  
Relative Safety ◽  
Pome Fruits ◽  
Weed Plants ◽  
Spread Of Infection

Data were obtained on the basis of the results of research carried out on the territory of the educational and experimental farm of the Timiryazev State Agrarian University, in Moscow during 2018-2019. As a result of the surveys, the most dangerous diseases and pests of pome crops on the territory of this farm were established. The most resistant apple and pear varieties to major diseases have been identified. Peculiarities of development of alternariosis on pear are described, the harmfulness of the disease on pear and apple seedlings is noted. A possible role in the transfer of alternariosis infection from garden-protective plantations and weed vegetation to fruit trees was noted. A possible role has been established in the transport of septoriosis, powdery dew infection from dicotyledonous weeds plants. The peculiarities of the spread of infection under the influence of wind direction are noted. The results and peculiarities of the application of various methods of scaring birds in the orchard are presented. As a result of route surveys the most harmful weed plants have been identified. The possibility of using herbicides of different mechanism of action in fruit gardens for weed control has been studied. High efficiency and relative safety of application of herbicides of contact action in nursery fields, operational orchards and for control of piglets on fruit trees are shown. Recommendations are given for the use of soil and systemic herbicides of soil in seedlings beds, the first and second fields of the nursery, as well as in the process of production of large-scale planting material and operational orchards of fruit crops. The safety of the herbicides in question is established when used in accordance with the recommended methods of use.

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

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