The Problem of Improving the Strategic Planning of Development and Implementation of Cloud Software Products

Aim. The presented study aims to substantiate the content of the problem of improving the strategic planning of production and implementation of cloud software products (CSPs).Tasks. The author analyzes the demand for cloud software products from the strategic perspective; analyzes the theoretical foundations of strategic planning; substantiates major enterprise goals in the development of SCPs in accordance with the goals and objectives of the national projects of the Russian Federation and the needs of user enterprises; classifies informatization enterprises engaged in the development of SCPs, making it possible to conduct a comparative audit of enterprises engaged in SCP development; develops the concept of strategic planning for informatization enterprises engaged in the development and implementation of SCPs.Methods. This study uses strategic planning tools, statistical analysis of the development of digitalization enterprises based on cloud software products, the systems approach, theory of the efficiency of strategic planning of SCP development and implementation, theory of emergence in the assessment of the activities of an interconnected chain of cloud digitalization enterprises, mechanisms for coordinating economic interests based on the theory of collective decision-making.Results. The pace of cloud digitalization of the Russian economy is insufficient and requires scientific, methodological, and government support. Well-known theoretical and methodological studies of strategic planning do not make allowance for the specific aspects of the activities of enterprises engaged in the production and implementation of SCPs and need to be further developed in this direction. The existing classification of SCPs does not fully meet the objectives of the national projects of the Russian Federation and the requirements of user enterprises. Enterprises engaged in the development and implementation of SCPs are classified to enable audit of the quality of their activities. The author proposes an original concept of improving the strategic planning of enterprises engaged in the development and implementation of SCPs.Conclusions. Resolving the issues identified by the author is an important national economic objective for improving the strategic planning of the activities of informatization enterprises engaged in the development and implementation of SCPs. Solving this problem is key to increasing the economic efficiency of both informatization enterprises and SCP user enterprises in the context of cloud information systems, improving the efficiency of digitalization of the country’s economy as a whole.

923 How Did the Initial Wave Of COVID-19 Affect CEPOD Waiting Times for Vascular Surgery? A Comparative Audit

Aim Many vascular patients present acutely, relying on emergency theatre availability when surgical intervention is required. The prioritisation of the CEPOD operating list is a challenge, and the additional pressures of the COVID-19 pandemic have necessitated changes to established practice. The purpose of this audit was to review the effects of the pandemic on the CEPOD waiting times for vascular patients at the main centre for the South West Wales Vascular Network. Method The CEPOD waiting times for vascular patients during the initial wave of the COVID-19 pandemic were compared with the same period the previous year. Data was analysed according to booking category and procedure type. Results 98 emergency vascular procedures were performed during the initial wave of the COVID pandemic, compared to 133 in 2019. In 2019, amputations (major and minor) accounted for 47% of cases, which rose to 53% during the pandemic. Median waiting times for category 1 and 2a operations were significantly shorter in 2020, whilst category 3 waiting times rose. There was no significant difference overall in the proportion of patients operated on within the target timescale, regardless of CEPOD booking category. Conclusions Managing the impact of COVID-19 required change to established practice. Although fewer procedures were performed, significant logistical challenges were faced. By adjusting the organisation of CEPOD, the most urgent vascular cases were performed quicker during this time. It is important to identify and promote the positive organisational changes that have arisen as a result of COVID-19, and to continue to review procedures as the pandemic progresses.

Quality of written informed consent forms for electroconvulsive therapy in Australia: a comparative analysis

Objectives: We compared the quality of the written informed consent forms for electroconvulsive therapy (ECT) in Australian jurisdictions. Method: For this comparative audit-type study, a checklist was developed to compare informed consent forms from different jurisdictions. The main information sources for consent forms were government health department websites and Google. The directors of clinical services were contacted if a consent form was not available through a web source. Results: Majority of the informed consent forms covered information about ECT, general anaesthesia and alternative treatments, supports available for decision making, and a reference to the right to withdraw consent. Missing information affected information areas such as likely outcome if no ECT, lack of guaranteed response and cultural and linguistic supports. Conclusions: A standardised consent form that can be used across all jurisdictions can help improve the ECT practice.

Efficacy and safety data for the Ab interno XEN45 gel stent implant at 3 Years: A retrospective analysis

Purpose: To report efficacy and safety measures of the XEN45 gel stent at 36 months in the UK National Health Service setting. Methods: Retrospective non-comparative audit of the records of patients who underwent XEN45 implantation between June 2015 and May 2017 was performed. Main outcome measures were intraocular pressure and number of antihypertensive medications used. Failure was defined as need for further surgery or stent removal. Success was defined as a 20% decrease in intraocular pressure without the need for additional glaucoma medications or a reduction in antihypertensive medications without an increase in baseline intraocular pressure. Needling rates and preoperative factors effect were assessed. Results: The cohort included 205 patients (205 eyes) with primary open angle glaucoma (84.4%), angle closure glaucoma (7.8%), or refractory glaucoma (7.8%), 62.9% had a stand-alone procedure and 37.1%, a combined phaco-XEN45 procedure. Mean intraocular pressure was 22.6 ± 7.0 mmHg at baseline compared to 14.7 ± 3.8 mmHg at 24 months and 14.0 ± 2.9 mmHg at 36 months ( p < 0.001 for both). Mean number of medications used was 2.6 ± 1.1 at baseline compared to 0.5 ± 0.9 and 0.6 ± 1.0, at 24- and 36-months, respectively ( p < 0.001 for both). The failure rate at 36 months was 25%. Needling was required in 36.6%. Evaluation of background factors yielded an increased failure rate in non-Caucasians compared to Caucasians (74% vs 21%, p < 0.001). Conclusion: XEN45 implantation is effective and safe at 36 months’ follow-up. Patients should be advised regarding the risk of failure and possible need for bleb revisions. Careful patient selection may be required.

Efficacy and safety data for the XEN45 implant at 2 years: a retrospective analysis

AimTo report efficacy and safety measures for XEN45 in a National Health Service setting after 24-month follow-up.MethodsThis is a retrospective, non-comparative audit of records of patients who underwent XEN45 procedure between June 2015 and May 2017. The main outcome measures were intraocular pressure (IOP) reduction and number of antihypertensive medications at each timepoint. Failure was defined as requiring further surgery or removal of XEN. Success was defined as 20% reduction of IOP without additional glaucoma medications or reduction in antihypertensive medications without increase in baseline IOP. Needling rates were assessed and subgroup analysis was performed.ResultsA total of 151 eyes were included in the study. The main diagnoses were primary open angle glaucoma (84.1%), angle closure glaucoma (8.6%) and refractory glaucoma (7.3%). Stand-alone procedure was performed in 62.3% and combined phaco-XEN was done in 37.7%. The mean IOP at baseline was 22.1±6.5 mm Hg, and the mean IOP at 12 and 24 months was 15.4±5.9 mm Hg and 14.5±3.3 mm Hg, respectively (p<0.001). The mean number of medications was 2.77±1.1 at baseline, and 0.3±0.7 and 0.5±1.0 medications at 12 and 24 months, respectively (p<0.001). 25% of patients failed at the 24-month timepoint. Needling was required in 37.7% of patients at 24 months. Non-Caucasian ethnicity was found to be related to higher failure rate. No significant adverse events were noted.ConclusionXEN45 is a viable, effective and safe procedure after 2 years of follow-up. Patients should be advised regarding failure rate as well as possible need for bleb revisions and medication use.

Surgical outcomes for rhinosinusitis

This chapter discusses Hopkins, Browne, Slack, Brown, Lund, Copley, and Van der Meulen’s paper on The National Comparative Audit of Surgery for Nasal Polyposis and Rhinosinusitis including the design of the study (outcome measures, results, conclusions, and a critique).