5,374 research outputs found
Adding value to laboratory medicine: a professional responsibility
Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to âadd valueâ to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic âSCIENCEâ. This tool allows added value to be considered in seven domains: standardisation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine
From laboratory bench to benchmark: technology transfer in laboratory medicine
Background: Life Sciences research, enhancing the occurrence of innovation, is able to impact clinical decision-making, both at diagnosis and therapy. Indeed, starting from the knowledge of specific needs and of technical-scientific demands, researchers can conceive and experiment innovative solutions. Despite these strengths, transferring research to the market in Life Sciences shows considerable criticalities. The aim of this paper is to provide concrete evidences on the processes of technology transfer based on the exploitation of the results obtained by KronosDNAsrl, an academic spin-off focused on reproductive medicine.
Methods: Different tools were used to evaluate the technical feasibility (validation of the results obtained with the prototype) and to manage the technology transfer process of One4TwoÂź.
Results: The different analyses we carried out showed the feasibility of the proposed solution. As a result, the One4TwoÂź prototype has been developed and validated.
Conclusions: Here, we provide a strength of evidences on how knowledge obtained by translational research on "bench" can be used to be transferred to the market on "benchmark" enabling innovation in Laboratory Medicine. In addition, the model described for One4TwoÂź can be easily transferred to other products
Novel patient-centered approach to facilitate same-day discharge in patients undergoing elective percutaneous coronary intervention
Background
Sameâday discharge (
SDD
) after elective percutaneous coronary intervention is safe, less costly, and preferred by patients, but it is usually performed in lowârisk patients, if at all. To increase the appropriate use of
SDD
in more complex patients, we implemented a âpatientâcenteredâ protocol based on risk of complications at BarnesâJewish Hospital.
Methods and Results
Our objectives were as follows: (1) to evaluate time trends in
SDD
; (2) to compare (a) mortality, bleeding, and acute kidney injury, (b) patient satisfaction, and (c) hospital costs by
SDD
versus no SDD (
NSDD
); and (3) to compare
SDD
eligibility by our patientâcentered approach versus Society for Cardiovascular Angiography and Interventions guidelines. Our patientâcentered approach was based on prospectively identifying personalized bleeding, mortality, and acute kidney injury risks, with a personalized safe contrast limit and mitigating those risks. We analyzed BarnesâJewish Hospital's National Cardiovascular Data Registry Cath
PCI
Registry data from July 1, 2009 to September 30, 2015 (N=1752).
SDD
increased rapidly from 0% to 77% (
P
<0.001), independent of radial access. Although
SDD
patients were comparable to
NSDD
patients,
SDD
was not associated with adverse outcomes (0% mortality, 0% bleeds, and 0.4% acute kidney injury). Patient satisfaction was high with
SDD
. Propensity scoreâadjusted costs were 7331 lower/
SDD
patient (
P
<0.001), saving an estimated 1.8Â million annually. Only 16 patients (6.95%) met the eligibility for
SDD
by Society for Cardiovascular Angiography and Interventions guidelines, implying our patientâcentered approach markedly increased
SDD
eligibility.
Conclusions
With a patientâcentered approach,
SDD
rapidly increased and was safe in 75% of patients undergoing elective percutaneous coronary intervention, despite patient complexity. Patient satisfaction was high, and hospital costs were lower. Patientâcentered decision making to facilitate
SDD
is an important opportunity to improve the value of percutaneous coronary intervention.
</jats:sec
Predoctoral Dental Studentsâ Perceptions of Dental Implant Training: Effect of Preclinical Simulation and Clinical Experience
The aims of this study were to assess 1) differences in perceptions of dental implant training between dental students who received didactic training alone (control group) and those who received didactic plus simulation training (test group); 2) differences in response between students with and without clinical experience in implant dentistry; and 3) the interaction effect of simulation training and clinical experience on studentsâ satisfaction. A survey was distributed to the control group in 2014 and to the test group in 2015; both groups were at the same U.S. dental school. Data were collected on confidence levels with various implant restorative procedures along with overall satisfaction and number of implant restorations performed by each student. The response rate was 78.7% in the control group and 81.3% in the test group. In the control group, 85.7% of students reported being satisfied with implant training compared to 90.8% of students in the test group. The interaction effect of simulation training and clinical experience on overall student satisfaction was OR=1.5 at 95% CI: 0.8, 3.0. The students who had clinical experience with implant restorative procedures had significantly greater satisfaction than those who did not (OR=4.8, 95% CI: 2.1, 11.1,
Telemedicine infectious diseases consultations and clinical outcomes: A systematic review
Background: Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically reviewed. We reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations, including outcomes of mortality, hospital readmission, antimicrobial use, cost, length of stay, adherence, and patient satisfaction.
Methods: We queried Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov 1997- through August 5, 2019, for studies looking at clinical outcomes of infectious diseases in the setting of telemedicine use. We did not restrict by language or year of publication. Clinical outcomes searched included 30-day all-cause mortality, 30-day readmissions, patient compliance/adherence, patient satisfaction, cost or cost-effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias was assessed using standard methodologies. PROSPERO CRD42018105225.
Results: From a search pool of 1154 studies, only 18 involved telemedicine infectious diseases consultation and our selected clinical outcomes. The outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation.
Conclusions: Although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied. Further studies, or publication of previously collected and available data, are warranted to verify the cost-effectiveness of this widespread practice.
Systematic review registration: PROSPERO CRD42018105225
Patient Satisfaction and Associated Factors with Services Provided at Outpatient Departments
Asking patients what they think how they feel about the health service they have received is an important step towards improving the quality of care and, ensuring that local health services are meeting clients needs and expectations. Facility- based cross-sectional study was conducted from April 1-7, 2019 in randomly selected primary hospitals found in Guraghe zone. There were 266 randomly selected patients who attended the primary hospitals were participated in the study. Data was collected using a interviewer-administered structured questionnaire and analyzed using SPSS version 21. Multiple logistic regression analysis used to identify predictors of patient satisfaction. The overall of patient satisfaction level with the health service provided at the outpatient departments of the primary hospitals was 66.5% (95% C.I. 60.8%-72.2%). waiting time (AOR 3.65), informing patients about cause of illness (AOR, 2.46) and waiting area cleanliness (AOR 2.33) were among the significant predictors of patients satisfaction. Acknowledging the limitation of the cross-sectional study design findings of this study indicate that waiting time, telling the cause of illness, cleanliness of the waiting area are important predictors of patient satisfaction
Improving health worker performance: the patient-perspective from a PBF program in Rwanda
The effect of performance-based financing (PBF) on patients' perception of primary health care services in developing countries in not well documented. Data from a randomized impact evaluation in Rwanda conducted between 2006 and 2008 in 157 primary level facilities is used to explore patients' satisfaction with clinical and non-clinical services and quantify the contribution of individual and facility characteristics to satisfaction including PBF. Improvements in productivity, availability and competences of the health workforce following the implementation of PBF have a positive effect on patients' satisfaction with clinical services even if patients' satisfaction is not tied to a reward. The positive effect of PBF on non-clinical dimensions of satisfaction also suggests that PBF incentivizes providers to raise patients' satisfaction with non-clinical services if it is associated with future financial gains. It is recommended that low and middle income countries build on the experience from high income countries to better listen to patients' voice in general and include an assessment of patients' satisfaction in incentive mechanisms as a way to increase the benefits of the strateg
Defining a roadmap for harmonizing quality indicators in Laboratory Medicine: A consensus statement on behalf of the IFCC Working Group "laboratory Error and Patient Safety" and EFLM Task and Finish Group "performance specifications for the extra-analytical phases"
The improving quality of laboratory testing requires a deep understanding of the many vulnerable steps involved in the total examination process (TEP), along with the identification of a hierarchy of risks and challenges that need to be addressed. From this perspective, the Working Group âLaboratory Errors and Patient Safetyâ (WG-LEPS) of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) is focusing its activity on implementation of an efficient tool for obtaining meaningful information on the risk of errors developing
throughout the TEP, and for establishing reliable information about error frequencies and their distribution. More recently, the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has created the Task and Finish Group âPerformance specifications for the extraanalytical phasesâ (TFG-PSEP) for defining performance specifications for extra-analytical phases. Both the IFCC and EFLM groups are working to provide laboratories with a system to evaluate their performances and recognize the critical aspects where improvement actions are needed. A Consensus Conference was organized in Padova, Italy, in 2016 in order to bring together all the experts and interested parties to achieve a consensus for effective harmonization of quality indicators (QIs). A general agreement was achieved and the main outcomes have been the release of a new version of model of quality indicators (MQI), the approval of a criterion for establishing performance specifications and the definition of the type of information that should be provided within the report to the clinical laboratories participating to the QIs project
Recommended from our members
DFN-02, Sumatriptan 10Â mg Nasal Spray with Permeation Enhancer, for the Acute Treatment of Migraine: A Randomized, Double-Blind, Placebo-Controlled Study Assessing Functional Disability and Subject Satisfaction with Treatment.
BackgroundThe commercial formulation of sumatriptan nasal spray is an effective option for migraine patients requiring or preferring a non-oral route of drug administration, but its utility is limited by poor absorption and tolerability issues. DFN-02, a new formulation of sumatriptan 10Â mg nasal spray, is co-formulated with a permeation enhancer that gives it pharmacokinetics comparable to subcutaneous sumatriptan. As reported previously, DFN-02 was significantly better than placebo on multiple efficacy endpoints at 2Â h postdose, including pain freedom, absence of the most bothersome symptom, and pain relief, and its safety and tolerability profiles were excellent.ObjectiveThe objective of this study was to assess the efficacy of acute treatment of migraine with DFN-02, including its effect on migraine-related functional disability and patient satisfaction with treatment.MethodsThis was a multicenter, randomized, double-blind, placebo-controlled efficacy and safety study of DFN-02 in adults with episodic migraine. Functional disability and subject satisfaction with treatment were prespecified endpoints, assessed in real-time by subjects, using an electronic diary.ResultsIn total, 107 subjects were randomized. DFN-02 was significantly superior to placebo for the reduction in functional disability score from predose level at 2Â h after treatment (-Â 1.2 vs. -Â 0.6, pâ<â0.001). Subjects treated with DFN-02 were also more likely to be satisfied or very satisfied than subjects treated with placebo at 2Â h postdose (70.0% vs. 44.2%, pâ=â0.027). Using the Patient Perception of Migraine Questionnaire-Revised at 24Â h postdose, DFN-02 mean scores were significantly superior to placebo for the subscales of efficacy (65.2 vs. 42.5, pâ=â0.016) and function (68.9 vs. 42.1, pâ=â0.001), and for total score (71.0 vs. 56.6, pâ=â0.016); global medication effectiveness (pâ=â0.027); and overall satisfaction (pâ=â0.019). Placebo was significantly better than DFN-02 on the tolerability subscale (94.8 vs. 88.5, pâ=â0.026). At 24Â h postdose, subjects reported significantly higher satisfaction with DFN-02 compared with satisfaction reported pre-randomization regarding their usual migraine medication (pâ=â0.012).ConclusionDFN-02 was superior to placebo for the relief of migraine-related functional disability, and provided greater satisfaction than placebo or subjects' usual acute treatment.Trial registrationClinicalTrials.gov identifier: NCT02856802
A study on the factors affecting job satisfaction amongst employees in construction industry workplace (Case Study Saudi Arabia)
This study examines the factors that effect on job satisfaction among employeeâs in
construction industry in Saudi Arabia. The aims of this study also to identify the
relationship between factors of job satisfaction and job/employees performance in
construction project. The factors of job satisfaction that examine in this study were
salary and compensation, working conditions and workplaces safety, equipment or
materials are used, safety condition of the work and attitude toward each other in
construction industry, administration and supervision, the expertise of supervisors,
the support from supervisors and supervisorsâ communication skills, environment
and communication, work and achievement, responsibility, recognition and
feedback, the timing of feedback and the chance to be recognised when you done
well and lastly the advancement. Employees in construction industry or in any
organizations need to be motivated to facilitate their input towards the attainment of
their organizational goals. Therefore, to fulfil the gap of previous researchers, the
questionnaire of this study asked employees to give their suggestion as well to
improve their satisfaction of work. In this research out of 265 surveys were
distributed, 117 viable questionnaires were returned. Quantitative method is used in
this study and the collected data was analysed by the use of SPSS 20 software with
the method of analysed that being used in this research are crosstabs, frequency,
percentages, mean and rank. The findings form the study show that Construction
Company should pay attention to their employeeâs needs and wants to motivate them
in order to increase their level of job satisfaction. The concentrates for improvement
job satisfaction must focus on the important factors were suggested by responses in
this survey
- âŠ