Evaluation of an Automated Reminder System for Reducing Missed MRI Appointments

Background The high frequency of missed appointments continues to be a burden to healthcare providers, leading to decreased productivity, quality of service, and quality of outcome. The purpose of this study is to evaluate the effectiveness of Televox’s automated appointment reminder service in reducing the missed appointment rate. Televox appointment reminders were implemented at three of five locations in October 2018, and the total and no-show numbers were summed across those locations for each month to calculate monthly missed appointment rates. T-tests were used to compare the missed appointment rate before and after October for four groups, locations with or without Televox implementation, in 2018 or 2019. Results An insignificant decline in missed appointment rates was found in locations using with Televox (p = 0.495) overall, although a significant decrease in missed appointments was found among Medicaid patients (p = 0.0381). Conclusion Implementation of Televox appointment reminder systems did not significantly affect appointment attendance overall, but could be more useful specifically for encouraging Medicaid patients to attend MRI appointments.

A comparison of methods for determining performance based employee deployment in production systems

Employee deployment is a crucial process in production systems. Based on qualification and individual performance of employees, deployment decisions can lead to ambiguous outcomes. This paper first reviews the state of the art and further compares two methods based on combinatorial analysis for employee deployment. Therefore, this paper emphasizes the costs and benefits of a Brute Force and an alternative Greedy method. When considering the qualification and individual performance of each employee, both algorithms provide working solutions. In direct comparison, the outcome of the alternative Greedy algorithm is more efficient in terms of calculation time whereas the Brute Force method provides the combination with the global optimum. This means calculation time as well as quality of outcome differ. The exponential growth of employee allocation possibilities depends on the amount of employees and leads to high calculation times, when using a Brute Force method. The comparison of both methods reveal that the proposed alternative Greedy algorithm reaches nearly as high outcomes as the Brute Force does, with significantly less calculation time. Furthermore, this paper offers an insight into the impact of deployment decisions within production systems.

American Orthopedic Foot-and-Ankle Society Score, Where Are We Now? – A Narrative Review of Quality of Life Measures in Foot-and-Ankle Surgery

BACKGROUND: The American Orthopedic Foot and Ankle Society (AOFAS) score is the mostly widely used quality of life index for foot-and-ankle pathologies. However, there are many shortcomings of the QOL index with respect to validity, reliability, and responsiveness. AIM: The narrative review will examine the AOFAS scoring system and review the outcome measure using the GRADE tool for quality of outcome measure. CONCLUSIONS: Clinicians and researchers should cease using the AOFAS score as it is not a reliable tool. However, the recommendations suggested in this article can be used to upgrade the quality of the scoring system.

Judicial Experiments in Caseflow Management 1920-1970

This article explores the evolution of a subordinate judicial office of the Official Referee which was the revolutionary creation of the Judicature Commission of 1872. What is described here is the innovation and evolution of a rudimentary form of case management more than 70 years before its formal introduction in the English courts under the Civil Procedure Rules. This article considers evidence of that evolution as well as the innovations and experiments of judges ahead of their time: Sir Francis Newbolt and his successor Official Referees. It argues that the consensual and business-like approach adopted by Newbolt and others facilitated earlier settlement by means of judicial encouragement during discussions in chambers at an early interlocutory stage. It considers the extent to which Newbolt’s Scheme focused on what Marc Galanter has described as ‘quality of outcome’ and attempts to place this study in the context of the approach taken by Galanter. Such study would not be complete without reference to the work of the late Simon Roberts, which saw civil courts as being transformed into instruments of structured negotiation.

Influence of Revision Surgeries and Revision Rate on Quality Indicators in Certified Centres for Joint Replacement (EndoProthetikZentren)

Background The annual report of EndoCert publishes the results of the quality indicators (QI) and key figures of all certified centres for joint replacement (EndoProthetikZentren – EPZ). For some results it seems that centres with fewer revisions might have higher complication rates. However, to avoid misinterpretation the results have to be evaluated in more detail. The influence of the quantity of the revisions or the revision quotient on the quality of outcome was investigated. Material and Methods This study included all certified EPZ and centres of excellence for joint replacement (EPXmax) (n = 492) and evaluated the data from 2016. Centres beyond the action limit were identified with the help of funnel plots and a confidence limit of 99.7% as action limit. Additionally data of the quality indicators were analysed with ANCOVA. The level of significance was p < 0.05. Results The comparison by ANCOVA with number of revisions as co-variate showed no differences in the complication rates when related to the quantity of revisions. When considering a so called revision quotient (ratio of revision to all joint replacements) significant differences in the rate of fractures and fissures as well as in mortality for hip replacements and also in mortality for knee replacements were observed. Conclusion EPZ with fewer revisions do not have higher complication rates than centers with high numbers of revisions. Thus, the quantity of revisions has no influence on the quality of the outcome, considering that on the basis of the data of the EndoCert system no risk adjustment of patient-specific data was performed. Therefore the revisioin quotient of an EPZ shows that quantity is not equal with quality.

Multimodal Clinical Imaging Assessment of the Outcome in Mild-to-Moderate Acne: A Prospective Study

Background: The quality of outcome assessment in acne studies has been either subjective/insufficient or time consuming through the ordinary lesion counting. Objective: To evaluate the application of multimodal clinical imaging (MCI), a combination of imaging technology and computation, in the assessment of acne lesions in a clinical study setting. Methods: A prospective, monocentric, single-group open study designed to evaluate the efficacy and tolerance of a cosmetic product (IP/SG) in subjects with mild-to-moderate facial acne by classical clinical counting (CCC) – change in the total/inflammatory/noninflammatory acne lesion number compared with baseline (D0) – Investigator Global Assessment (IGA) and self-reported outcomes. Concomitantly, MCI was administered. The study was performed for 12 weeks (D84) with a 4-week follow-up (D112). Results: Mean age of patients (n = 49) was 18.2 ± 3.7 years (range 13–25). The mean acne duration was 3.8 ± 2.8 years. The total number of lesions did not differ significantly between D0/D84 by both CCC and MCI. However, the Cardiff Acne Disability Index (CADI) and uncomfortable feeling improved at D28/D0, the perception of oily skin improved at D14/D0, and the perception of sticky skin improved from D28/D0 to D56/D0. Deterioration was detected between D84/D0 and D112/D0, namely after product discontinuation. Interestingly, a change in trend was recorded for acne lesions at D14/D0 by MCI but not by CCC. Conclusion: MCI, applied for the first time in a small clinical study setting, is at least as reliable as CCC and may allow for a sensitive longitudinal evaluation of single acne lesions and their response to products, especially in conditions where clinical evaluation reaches its limits.

Hospital service quality as antecedent of patient satisfaction – a conceptual framework

Purpose The purpose of this paper is to explore dimensions of perceived service quality in hospitals and to develop a conceptual framework showing relationship between hospital service quality, patient satisfaction and their behavioural intention. Design/methodology/approach This paper is based on extensive review of existing literature on hospital service quality, patient satisfaction and behavioural intention. Critical analysis of these literature studies has resulted in determining and defining the dimensions of perceived service quality and establishing relationship between hospital service quality, patient satisfaction and behavioural intention. Findings This study has identified six major areas through which patients perceive quality of service in hospitals. These six areas are technical quality, procedural quality, infrastructural quality, interactional quality, personnel quality, social support quality. Further 20 dimensions of hospital service quality are identified under these 6 major areas. These are clinical procedure, quality of outcome, admission, discharge, waiting time, patient safety, billing and price, follow-up, ambience, availability of resources, accessibility, food, staff attitude, personalised attention, information availability, staff competency, trustworthiness, staff diversity, hospital image and social responsibility. The conceptual framework proposes direct relationship between service quality, patient satisfaction and behavioural intention. Originality/value Though many studies have been conducted on hospital service quality, none of them has been able to project all the possible dimensions to measure the same. The “6-Q framework” developed by this study explores all the possible dimensions of perceived service quality in hospitals.

Use of IMMPACT domains in clinical trials of acupuncture for chronic pain: a protocol for a methodological survey

IntroductionPain is one of the most common and most debilitating complaints among patients. It affects the individual, their relationship with friends and family, their ability to function at work, and their sociability. Acupuncture is one of the therapeutic resources for managing chronic pain. Given the variability of outcome measures in controlled randomised clinical trials on non-oncologicchronic pain (CRCT-NOCP), the Initiative in Methods, Measurements and Pain Assessment in Clinical Trials (IMMPACT) recommends six domains to be covered in evaluating the effectiveness of treatments for chronic pain.ObjectiveTo check whether the methodological quality of outcome reporting in published trials has used IMMPACT recommendations in measuring CRCT-NOCP outcomes when acupuncture was used as a treatment.MethodThis is a methodological study. We will systematically search for eligible studies in specific databases with a defined strategy. We will use the MeSHterms of ‘acupuncture’, ‘chronic pain’ and similar terms, without restrictions on idiom. Eligible studies will include those which are randomised and chose NOCP patients to be treated with acupuncture or control (sham acupuncture or no acupuncture), recruited after September 2004, with ≥100 patients. The measured outcomes are to be the presence of outcome domains recommended by IMMPACT, domains reported by the patient or clinician, tools used to measure such domains, as well as other features of the studies. We shall conduct a regression analysis to explore factors which can be associated with the presence of outcome domains according to IMMPACT recommendations.Ethics and disseminationThis survey will be submitted for presentation at congresses and for publication in a scientific journal. The findings obtained in this study will allow us to measure the quality of the evidence and provide greater transparency in decisions regarding the use of acupuncture as a viable alternative to managing chronic pain.

Pembelajaran Aplikatif Pondok Pesantren dan Dampaknya Terhadap kualitas Outcome Siswa (Studi Kasus di Pondok Pesantren Darunnajah, Jakarta)

Education is the process of humanizing human beings, in other words, education is a humanization process, thus the learning process must be adapted to the human condition. However, there are differences in interpret humanizing human beings, so, resulting the differences in opinion between humanist education according to Islam with humanist education according to western theory. Islam seeshumanizinghumanbeingsbygivingfreedomtohumans as long as it is not contrary to Islam, thus human freedom is not unlimited freedom. This is contrast to the western-based view of humanist education which states that humanist education is education by giving freedom to the students during the learning process. The implication of humanist learning according to Islam which came to be known as humanistic Islamic Education. It is the applicative learning of Islamic Boarding School. Learning with this model, student practice directly about the material that they have learnt. Thus, education is a habit. This means that to improve the quality of outcome needs to be given the education through habituation. The higher level of habituation performed, the higher quality of outcome. The outcomes quality in Islamic Boarding School Darunnajah is quite good. It can be seen that the alumni of Islamic Boarding School Darunnajah are accepted in Gajah Mada University (UGM), Institut Teknologi Bandung (ITB), Institut Pertanian Bogor (IPB) and Institut Agama Islam Negeri (IAIN) Sunan Ampel. Even many of them are continuing their education abroad, such as : Malaysia, Cairo (Egypt), Madinah and England, while with Pakistan, the cooperation is just opened in 2017. Keywords: Islamic boarding school, Islamic humanistic education, Applicative learning, Outcome. Pendidikan merupakan proses memanusiakan manusia, dengan kata lain pendidikan merupakan proses humanisasi, dengan demikian proses pembelajaran harus disesuaikan dengan keadaan manusia. Namun terdapat perbedaan dalam memaknai memanusiakan manusia, sehingga timbul perbedaan pendapat antara pendidikan humanis menurut agama Islam dengan pendidikan humanis menurut teori Barat. Islam memandang memanusiakan manusia adalah dengan memberikan kebebasan kepada manusia selama tidak bertentangan dengan agama Islam, dengan demikian kebebasan manusiabukanlahkebebasantanpabatas. Hal ini berbedadengan pandangan pendidikan humanis versi barat yang menyatakan bahwa pendidikan humanis adalah pendidikan dengan memberikan kebebasan pada siswa selama proses pembelajaran. Implikasi dari pembelajaran humanis menurut Islam yang kemudian dikenal dengan nama Pendidikan Humanistik Islami adalah pembelajaan aplikatif pondok pesantren. Pembelajaran dengan model ini, santri/siswa mempraktekkan langsung tentang materi yang sudah dipelajarinya. Dengan demikian, pendidikan merupakan pembiasaan. Hal ini berarti untuk meningkatkan kualitas outcome maka perlu diberikan pendidikan melalui pembiasaan. Semakin tinggi tingkat pembiasaan yang dilakukan maka semakin tinggi pula kualitas outcome. Kualitas outcome pondok pesantren Darunnajah cukup baik, hal ini bisa dilihat bahwa alumni pondok pesantren Darunnajah diterima di Universitas Gajah Mada (UGM), Institut Teknologi Bandung (ITB), Institut Pertanian Bogor (IPB) dan Institut Agama Islam Negeri (IAIN) Sunan Ampel atas beasiswa dari Departemen Agama. Bahkan banyak diantara mereka yang melanjutkan pendidikan ke luar negeri, yaitu : Malaysia, Kairo (Mesir), Madinah dan Inggris, sedangkan dengan Pakistan baru pada tahun 2017 ini dibuka kerjasama. Kata Kunci: Pondok Pesantren, Pendidikan Humanistik Islam, Pembelajaran Aplikatif, Outcome.