The Influence of Telepathology on Coordination Practices

Background: Coordination between physicians and allied professionals is essential to the effective delivery of care services and is associated with positive patient outcomes. As information technology can radically transform how professionals collaborate, both researchers and health care accreditation bodies are devoting a growing interest to the means of achieving better coordination. Introduction: The primary aim of this study is to explain the extent to which and how coordination practices between pathologists, technologists, and surgeons are transformed when telepathology is being implemented. Materials and Methods: An interpretive case study was conducted. A total of 60 semi-structured interviews with key participants were conducted, in addition to several days of direct observation of telepathology-based intraoperative consultations (IOC). Results: Three major kinds of transformation of coordination practices were observed. First, the telepathology system itself constrains and disrupts coordination routines, such as the presentation of slides. Second, anticipating IOC, proactively performed by the laboratory personnel in traditional settings, requires more formal requests in a telepathology context. Third, local technologists become more autonomous in performing complex macroscopy manipulations and managing the laboratory, tasks traditionally performed by pathologists. Conclusions: Successful coordination of work in a telepathology-based IOC context requires that significant transformations be anticipated and accounted for. Project managers need to formalize new work processes, support the transformations in professional roles and mitigate the major hindrances that small material changes may have on work routines.

The Influence of Telepathology on Coordination Practices

Background: Coordination between physicians and allied professionals is essential to the effective delivery of care services and is associated with positive patient outcomes. As information technology can radically transform how professionals collaborate, both researchers and health care accreditation bodies are devoting a growing interest to the means of achieving better coordination. Introduction: The primary aim of this study is to explain the extent to which and how coordination practices between pathologists, technologists, and surgeons are transformed when telepathology is being implemented. Materials and Methods: An interpretive case study was conducted. A total of 60 semi-structured interviews with key participants were conducted, in addition to several days of direct observation of telepathology-based intraoperative consultations (IOC). Results: Three major kinds of transformation of coordination practices were observed. First, the telepathology system itself constrains and disrupts coordination routines, such as the presentation of slides. Second, anticipating IOC, proactively performed by the laboratory personnel in traditional settings, requires more formal requests in a telepathology context. Third, local technologists become more autonomous in performing complex macroscopy manipulations and managing the laboratory, tasks traditionally performed by pathologists. Conclusions: Successful coordination of work in a telepathology-based IOC context requires that significant transformations be anticipated and accounted for. Project managers need to formalize new work processes, support the transformations in professional roles and mitigate the major hindrances that small material changes may have on work routines.

COMPARATIVE ASPECTS OF PARETO EFFICIENCY IN COMPUTED TOMOGRAPHY SERVICES

When the economic allocation of resources in any system is not Pareto efficient, there exists possibility for the Pareto improvement. In this paper the means of attaining the Pareto efficiency in providing services of computed tomography is discussed and compared. The study aims at analysing the use of computed tomography for the purpose of providing healthcare services in the European Union and other countries by making comparisons of data collected by the State Health Care Accreditation Agency under the Ministry of Health of the Republic of Lithuania. Using the methods of benchmarking and synthesis, authors seek to determine the potential efficient uses of computed tomography and propose the possible solutions for achieving the Pareto efficiency.

Understanding Clinical Alarm Safety

Patient safety organizations and health care accreditation agencies recognize the significance of clinical alarm hazards. The Association for the Advancement of Medical Instrumentation, a nonprofit organization focused on development and use of safe and effective medical equipment, identifies alarm management as a major issue for health care organizations. ECRI Institute, a nonprofit organization that researches approaches for improving patient safety and quality of care, identifies alarm hazards as the most significant of the “Top Ten Health Technology Hazards” for 2014. A new Joint Commission National Patient Safety Goal focusing on clinical alarm safety contains new requirements for accredited hospitals to be fully implemented by 2016. Through a fictional unfolding case study, this article reviews selected contributing factors to clinical alarm hazards present in inpatient, high-acuity settings. Understanding these factors improves contributions by nurses to clinical alarm safety practice.