scholarly journals Living and Working in a Multisensory World: From Basic Neuroscience to the Hospital

2019 ◽  
Vol 3 (1) ◽  
pp. 2 ◽  
Author(s):  
Kendall Burdick ◽  
Madison Courtney ◽  
Mark Wallace ◽  
Sarah Baum Miller ◽  
Joseph Schlesinger
Keyword(s):  
Patient Outcomes ◽  
Music Theory ◽  
Healthcare Providers ◽  
Vital Signs ◽  
Clinical Information ◽  
False Alarms ◽  
Alarm System ◽  
Potential Solution ◽  
Alarm Fatigue ◽  
Improve Patient

The intensive care unit (ICU) of a hospital is an environment subjected to ceaseless noise. Patient alarms contribute to the saturated auditory environment and often overwhelm healthcare providers with constant and false alarms. This may lead to alarm fatigue and prevent optimum patient care. In response, a multisensory alarm system developed with consideration for human neuroscience and basic music theory is proposed as a potential solution. The integration of auditory, visual, and other sensory output within an alarm system can be used to convey more meaningful clinical information about patient vital signs in the ICU and operating room to ultimately improve patient outcomes.

Dynamic Alarm Systems for Hospitals (D.A.S.H.)

2018 ◽  
Vol 26 (4) ◽  
pp. 14-19 ◽  
Author(s):  
Jasmine M. Greer ◽  
Kendall J. Burdick ◽  
Arman R. Chowdhury ◽  
Joseph J. Schlesinger
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Improve Patient Safety ◽  
Environmental Noise ◽  
Care Quality ◽  
False Alarms ◽  
Alarm Fatigue ◽  
Alarm Systems ◽  
Physiological Information ◽  
Improve Patient

Hospital alarms today indicate urgent clinical need, but they are seldom “true.” False alarms are contributing to the ever-increasing issue of alarm fatigue, or desensitization, among doctors and nurses. Alarm fatigue is a high-priority health care concern because of its potential to compromise health care quality and inflict harm on patients. To address this concern, we have engineered Dynamic Alarm Systems for Hospitals (D.A.S.H.), a dynamic alarm system that self-regulates alarm loudness based on the environmental noise level and incorporates differentiable and learnable alarms. D.A.S.H., with its ability to adapt to environmental noise and encode nuanced physiological information, may improve patient safety and attenuate clinician alarm fatigue.

scholarly journals Can an emergency department clinical “triggers” program based on abnormal vital signs improve patient outcomes? – CORRIGENDUM

CJEM ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 80-80
Author(s):  
Jason Imperato ◽  
Tyler Mehegan ◽  
Daniel J. Henning ◽  
John Patrick ◽  
Chase Bushey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Outcomes ◽  
Vital Signs ◽  
Improve Patient

Reasoning about Who to Notify to avoid Alarm Fatigue: Algorithm Development and Validation (Preprint)

2020 ◽  
Author(s):  
Chrystinne Fernandes ◽  
Simon Miles ◽  
Carlos José Pereira De Lucena
Keyword(s):  
Constraint Satisfaction Problem ◽  
Vital Signs ◽  
High Volume ◽  
False Alarms ◽  
Healthcare Team ◽  
Alarm Fatigue ◽  
Automatic Reasoning ◽  
Reasoning System ◽  
Future Work ◽  
Reasoning Algorithm

BACKGROUND Alarm Fatigue is a scenario experienced by an overwhelmed and fatigued healthcare team that is desensitized and slow to respond to alarms. The most common alarm-related issues that may lead to Alarm Fatigue include the excessive number of alarms, a number of alarms generated by many different types of alarm devices, and the high percentage of false alarms (80%-99%). All of these alerts have to be processed by the healthcare teams who are consistently under pressure: they should analyze the high volume of inputs they are receiving in order to answer to them quickly and correctly, by making decisions in real-time about the response to the next alarm. Under alarm fatigue conditions, the staff may ignore and/or silence alarms, putting patients in risky situations. OBJECTIVE This paper’s main goal is to propose a feasible solution for mitigating alarm fatigue by using an automatic reasoning mechanism to choose the best caregiver to be assigned to a given notification within the set of available caregivers in an Intensive Care Unit. METHODS Our main contribution in this work consists of an algorithm that decides who is the best caregiver to notify in an ICU. We formalized this problem as a Constraint-Satisfaction Problem and we present one example of how it can be solved. We designed a case study where patients’ vital signs were collected through a vital signs’ generator that also triggers alarms. We conducted five experiments to test our algorithm considering different situations for an ICU. The evaluation of our algorithm was made through the comparison between the results of the choices made by our reasoning algorithm and another strategy that we call “blind” strategy, which randomly assigns caregivers to notifications. RESULTS Experiments are used to demonstrate that providing a reasoning system we could decide who is the best caregiver to receive a notification. By comparing the choices made by our reasoning algorithm and the “blind” strategy, our reasoning algorithm achieved a better result in terms of prioritizing the assignments we wanted to make based on our defined criteria: patient’s severity, the distance between caregivers and patients, caregivers’ experience, the probability of a notification to be false, and the number of notifications caregivers have received. CONCLUSIONS The experimental results strongly suggest that this reasoning algorithm is a useful strategy for mitigating alarm fatigue. We showed, in our experiments, that caregivers with higher levels of experience received more notifications than the ones with lower levels. Our future work is to deal with resource negotiation and to evaluate the distribution of the notifications to the caregivers’ teams made by the algorithms.

Combined Approaches to the Skull Base for Intracranial Extension of Tumors via Perineural Spread can Improve Patient Outcomes

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Sheri Palejwala ◽  
Jonnae Barry ◽  
Crystal Rodriguez ◽  
Chandni Parikh ◽  
Stephen Goldstein ◽  
...  
Keyword(s):  
Skull Base ◽  
Patient Outcomes ◽  
Intracranial Extension ◽  
Perineural Spread ◽  
Improve Patient

Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe
Keyword(s):  
Patient Outcomes ◽  
Surgical Procedures ◽  
Systematic Approach ◽  
Surgical Intervention ◽  
Transfusion Requirement ◽  
Cardiac Surgical Procedures ◽  
Platelet Inhibitors ◽  
Hemostatic Agents ◽  
Surgical Field ◽  
Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

Expectations about pain and analgesic treatment depend on medical providers’ facial appearances

2020 ◽  
Author(s):  
Elizabeth A. Necka ◽  
Carolyn Amir ◽  
Troy C. Dildine ◽  
Lauren Yvette Atlas
Keyword(s):  
Patient Outcomes ◽  
Visual Information ◽  
Healthcare Providers ◽  
Medical Procedures ◽  
Medical Providers ◽  
Analgesic Treatment ◽  
Digital Services ◽  
Receive Treatment ◽  
Facial Images ◽  
Trait Impressions

There is a robust link between patients’ expectations and clinical outcomes, as evidenced by the placebo effect. These expectations are shaped by the context surrounding treatment, including the patient-provider interaction. Prior work indicates that the provider’s behavior and characteristics, including warmth and competence, can shape patient outcomes. Yet humans rapidly form trait impressions of others prior to any in-person interaction. Here, we tested whether trait-impressions of hypothetical medical providers, based purely on facial images, influence participants’ choice of medical providers and expectations about their health following hypothetical medical procedures performed by those providers in a series of vignettes. Across five studies, participants selected providers who appeared more competent, based on facial visual information alone. Further, providers’ apparent competence predicted participants’ expectations about post-procedural pain and medication use. Participants’ perception of their similarity to providers also shaped expectations about pain and treatment outcomes. Our results suggest that humans develop expectations about their health outcomes prior to even setting foot in the clinic, based exclusively on first impressions. These findings have strong implications for health care, as individuals increasingly rely on digital services to choose healthcare providers, schedule appointments, and even receive treatment and care, a trend which is exacerbated as the world embraces telemedicine.

scholarly journals How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041743
Author(s):  
Christina Østervang ◽  
Annmarie Touborg Lassen ◽  
Charlotte Myhre Jensen ◽  
Elisabeth Coyne ◽  
Karin Brochstedt Dieperink
Keyword(s):  
Patient Outcomes ◽  
Participatory Design ◽  
Hospital Admissions ◽  
Phase 1 ◽  
Family Needs ◽  
Focus Group Interviews ◽  
Phase 3 ◽  
Ace Study ◽  
Group Interviews ◽  
Improve Patient

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.

67 The Evolution of A Frailty Service

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Abbott ◽  
K Bishop ◽  
F Hill ◽  
C Finlow ◽  
R Maraj
Keyword(s):  
Cost Effectiveness ◽  
Patient Outcomes ◽  
Local Population ◽  
Management Team ◽  
Pdsa Cycle ◽  
North Wales ◽  
Number Of Patients ◽  
Constant State ◽  
Clinical Resource ◽  
Improve Patient

Abstract Introduction In September 2017 our frailty service was started within our medium sized DGH in North Wales. Working with our management team we secured a significant clinical resource including: We describe how resources, setting and staffing develop over a 2 year period in order to create a service which meets the needs of the local population. Method The service has been in a constant state of development since it has been in operation, utilising a PDSA model with regular meetings of clinical and managerial staff to analyse performance. Results With each new PDSA cycle the amount of patients reviewed has increased. With the move to AMU we increased the monthly number of patients reviewed from 29 to 172 patients reviewed, 97 of which were discharged directly from the unit. Conclusion Using QI methodology our Frailty Service has improved dramatically since its inception. We will continue to analyse how we work to improve patient outcomes and cost effectiveness.

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