Data-Based Process Variant Analysis

Processes in healthcare are complex and data-intensive. Process mining uses data recorded during process execution to obtain an understanding of the actual execution of a process. Due to the complexity of healthcare processes, it is useful to consider and analyse the process execution of certain cohorts, such as old and young patients, separately. While such analysis is facilitated by process variant analysis techniques, existing approaches for process variant analysis only consider a comparison based on the control flow and performance perspectives. Given the large amount of event data attributes available in healthcare settings, we propose the first data-based process variant analysis approach. Our approach allows comparing process variants based on differences in event data attributes by building on statistical tests. We applied our approach on the MIMIC-IV real-world data set on hospitalizations in the US, where we demonstrate that the approach is feasible and can actually provide relevant medical insights

National Healthcare Safety Network (NHSN) patient safety component manual

The NHSN is a secure, Internet-based surveillance system that expands and integrates patient and healthcare personnel safety surveillance systems managed by the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention. In addition, facilities that participate in certain reporting programs operated by the Centers for Medicare and Medicaid Services (CMS) can do so through use of NHSN. Furthermore, some U.S. states use NHSN as a means for healthcare facilities to submit data on healthcare-associated infections (HAIs) mandated through their specific state legislation.NHSN enables healthcare facilities to collect and use data about HAIs, adherence to clinical practices known to prevent HAIs, the incidence or prevalence of multidrug-resistant organisms within their organizations, trends and coverage of healthcare personnel safety and vaccination, and adverse events related to the transfusion of blood and blood products.The NHSN includes five components: Patient Safety, Healthcare Personnel Safety, Biovigilance, Dialysis, and Long-term Care Facility (Figure 1).pcsmanual_current.pdfChapter 1: National Healthcare Safety Network (NHSN) Overview -- Chapter 2: Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance -- Chapter 3: Patient Safety Monthly Reporting Plan and Annual Surveys -- Chapter 4: Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non-central line-associated Bloodstream Infection) -- Chapter 5: Central Line Insertion Practices (CLIP) Adherence Monitoring -- Chapter 6: Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event -- Chapter 7: Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and non-catheter-associated Urinary Tract Infection [UTI]) and Other Urinary System Infection (USI) Events -- Chapter 9: Surgical Site Infection (SSI) Event -- Chapter 10: Ventilator-Associated Event (VAE) -- Chapter 12: Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module -- Chapter 15: CDC Locations and Descriptions and Instructions for Mapping Patient Care Locations -- Chapter 16: General Key terms -- Chapter 17: CDC/NHSN Surveillance Definitions for Specific Types of Infections

National Healthcare Safety Network (NHSN) patient safety component manual

The NHSN is a secure, Internet-based surveillance system that expands and integrates patient and healthcare personnel safety surveillance systems managed by the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention. In addition, facilities that participate in certain reporting programs operated by the Centers for Medicare and Medicaid Services (CMS) can do so through use of NHSN. Furthermore, some U.S. states use NHSN as a means for healthcare facilities to submit data on healthcare-associated infections (HAIs) and transfusion-related adverse events mandated through their specific state legislation.NHSN enables healthcare facilities to collect and use data about HAIs, adherence to clinical practices known to prevent HAIs, the incidence or prevalence of multidrug-resistant organisms within their organizations, trends and coverage of healthcare personnel safety and vaccination, and adverse events related to the transfusion of blood and blood products.The NHSN includes six components: Patient Safety, Long-term Care Facility, Outpatient Dialysis, Healthcare Personnel Safety, Biovigilance, and Outpatient Procedure.pcsmanual_2021-508.pdfChapter 1: National Healthcare Safety Network (NHSN) Overview -- Chapter 2: Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance -- Chapter 3: Patient Safety Monthly Reporting Plan and Annual Surveys -- Chapter 4: Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non- central line-associated Bloodstream Infection) -- Chapter 5: Central Line Insertion Practices (CLIP) Adherence Monitoring -- Chapter 6: Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event -- Chapter 7: Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and non- catheter-associated Urinary Tract Infection [UTI]) and Other Urinary System Infection (USI) Events -- Chapter 9: Surgical Site Infection (SSI) Event -- Chapter 10: Ventilator-Associated Event (VAE) -- Chapter 11: Pediatric Ventilator-Associated Event (pedVAE) -- Chapter 12: Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module -- Chapter 14: Antimicrobial Use and Resistance (AUR) -- Chapter 15: CDC Locations and Descriptions and Instructions for Mapping Patient Care Locations -- Chapter 16: General Key terms -- Chapter 17: CDC/NHSN Surveillance Definitions for Specific Types of Infections.20211173

National Healthcare Safety Network (NHSN) patient safety component manual

The NHSN is a secure, Internet-based surveillance system that expands and integrates patient and healthcare personnel safety surveillance systems managed by the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention. Facilities that participate in certain reporting programs operated by the Centers for Medicare and Medicaid Services (CMS) can do so through use of NHSN. Furthermore, some U.S. states use NHSN as a means for healthcare facilities to submit data on healthcare-associated infections (HAIs) and other healthcare measures mandated through their specific state legislation.NHSN enables healthcare facilities to collect and use data about HAIs, adherence to clinical practices known to prevent HAIs, the incidence or prevalence of multidrug-resistant organisms within their organizations, trends and coverage of healthcare personnel safety and vaccination, and adverse events related to the transfusion of blood and blood products. The NHSN includes seven components: Patient Safety, Long-term Care Facility, Outpatient Dialysis, Healthcare Personnel Safety, Biovigilance, Outpatient Procedure, and Neonatal.Please Note: The NHSN Patient Safety Component Manual is updated annually based on subject matter expert review and user feedback. Over time, certain chapters have been retired or moved to other components. To avoid confusion, the chapters in the PSC manual do not shift to account for these changes; therefore, chapters 8 and 13 are not listed in the Table of Contents or included in this document.Chapter 1: National Healthcare Safety Network (NHSN) Overview -- Chapter 2: Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance -- Chapter 3: Patient Safety Monthly Reporting Plan and Annual Surveys -- Chapter 4: Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non- central line-associated Bloodstream Infection) -- Chapter 5: Central Line Insertion Practices (CLIP) Adherence Monitoring -- Chapter 6: Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event -- Chapter 7: Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and non- catheter-associated Urinary Tract Infection [UTI]) and Other Urinary System Infection (USI) Events -- Chapter 9: Surgical Site Infection (SSI) Event -- Chapter 10: Ventilator-Associated Event (VAE) -- Chapter 11: Pediatric Ventilator-Associated Event (pedVAE) -- Chapter 12: Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module -- Chapter 14: Antimicrobial Use and Resistance (AUR) -- Chapter 15: CDC Locations and Descriptions and Instructions for Mapping Patient Care Locations -- Chapter 16: General Key Terms -- Chapter 17: CDC/NHSN Surveillance Definitions for Specific Types of Infections

National Healthcare Safety Network (NHSN) patient safety component manual

The NHSN is a secure, Internet-based surveillance system that expands and integrates patient and healthcare personnel safety surveillance systems managed by the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention. Facilities that participate in certain reporting programs operated by the Centers for Medicare and Medicaid Services (CMS) can do so through use of NHSN. Furthermore, some U.S. states use NHSN as a means for healthcare facilities to submit data on healthcare-associated infections (HAIs) and transfusion-related adverse events mandated through their specific state legislation.NHSN enables healthcare facilities to collect and use data about HAIs, adherence to clinical practices known to prevent HAIs, the incidence or prevalence of multidrug-resistant organisms within their organizations, trends and coverage of healthcare personnel safety and vaccination, and adverse events related to the transfusion of blood and blood products.The NHSN includes seven components: Patient Safety, Long-term Care Facility, Outpatient Dialysis, Healthcare Personnel Safety, Biovigilance, Outpatient Procedure, and Neonatal.pcsmanual_current.pdfChapter 1: National Healthcare Safety Network (NHSN) Overview -- Chapter 2: Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance -- Chapter 3: Patient Safety Monthly Reporting Plan and Annual Surveys -- Chapter 4: Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non- central line-associated Bloodstream Infection) -- Chapter 5: Central Line Insertion Practices (CLIP) Adherence Monitoring -- Chapter 6: Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event -- Chapter 7: Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and non- catheter-associated Urinary Tract Infection [UTI]) and Other Urinary System Infection (USI) Events -- Chapter 9: Surgical Site Infection (SSI) Event -- Chapter 10: Ventilator-Associated Event (VAE) -- Chapter 11: Pediatric Ventilator-Associated Event (pedVAE) -- Chapter 12: Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module -- Chapter 14: Antimicrobial Use and Resistance (AUR) -- Chapter 15: CDC Locations and Descriptions and Instructions for Mapping Patient Care Locations -- Chapter 16: General Key terms -- Chapter 17: CDC/NHSN Surveillance Definitions for Specific Types of Infections.20221173

NHSN patient safety component manual

The NHSN is a secure, Internet-based surveillance system that expands and integrates patient and healthcare personnel safety surveillance systems managed by the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention. In addition, facilities that participate in certain reporting programs operated by the Centers for Medicare and Medicaid Services (CMS) can do so through use of NHSN. Furthermore, some U.S. states use NHSN as a means for healthcare facilities to submit data on healthcare-associated infections (HAIs) and transfusion-related adverse events mandated through their specific state legislation.NHSN enables healthcare facilities to collect and use data about HAIs, adherence to clinical practices known to prevent HAIs, the incidence or prevalence of multidrug-resistant organisms within their organizations, trends and coverage of healthcare personnel safety and vaccination, and adverse events related to the transfusion of blood and blood products.The NHSN includes six components: Patient Safety, Long-term Care Facility, Outpatient Dialysis, Healthcare Personnel Safety, Biovigilance, and Outpatient Procedure.Please Note: The NHSN Patient Safety Component Manual is updated annually based on subject matter expert review and user feedback. Over time, certain chapters have been retired or moved to other components. To avoid confusion, the chapters in the PSC manual do not shift to account for these changes; therefore, chapters 8 and 13 are not listed in the Table of Contents or included in this document.Chapter 1: National Healthcare Safety Network (NHSN) Overview -- Chapter 2: Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance -- Chapter 3: Patient Safety Monthly Reporting Plan and Annual Surveys -- Chapter 4: Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non-central line-associated Bloodstream Infection) -- Chapter 5: Central Line Insertion Practices (CLIP) Adherence Monitoring -- Chapter 6: Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event -- Chapter 7: Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and non-catheter-associated Urinary Tract Infection [UTI]) and Other Urinary System Infection (USI) Events -- Chapter 9: Surgical Site Infection (SSI) Event -- Chapter 10: Ventilator-Associated Event (VAE) -- Chapter 11: Pediatric Ventilator-Associated Event (pedVAE) -- Chapter 12: Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module -- Chapter 15: CDC Locations and Descriptions and Instructions for Mapping Patient Care Locations -- Chapter 16: General Key terms -- Chapter 17: CDC/NHSN Surveillance Definitions for Specific Types of Infections.201

A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial

BACKGROUND: Blood Pressure related disease affected 118 million people in India in the year 2000; this figure will double by 2025. Around one in four adults in rural India have hypertension, and of those, only a minority are accessing appropriate care. Health systems in India face substantial challenges to meet these gaps in care, and innovative solutions are needed. METHODS: We hypothesise that a multifaceted intervention involving capacity strengthening of primary healthcare doctors and non-physician healthcare workers through use of a mobile device-based clinical decision support system will result in improved blood pressure control for individuals at high risk of a cardiovascular disease event when compared with usual healthcare. This intervention will be implemented as a stepped wedge, cluster randomised controlled trial in 18 primary health centres and 54 villages in rural Andhra Pradesh involving adults aged ≥40 years at high cardiovascular disease event risk (approximately 15,000 people). Cardiovascular disease event risk will be calculated based on World Health Organisation/International Society of Hypertension's region-specific risk charts. Cluster randomisation will occur at the level of the primary health centres. Outcome analyses will be conducted blinded to intervention allocation. EXPECTED OUTCOMES: The primary study outcome is the difference in the proportion of people meeting guideline-recommended blood pressure targets in the intervention period vs. the control period. Secondary outcomes include mean reduction in blood pressure levels; change in other cardiovascular disease risk factors, including body mass index, current smoking, reported healthy eating habits, and reported physical activity levels; self-reported use of blood pressure and other cardiovascular medicines; quality of life (using the EQ-5D); and cardiovascular disease events (using hospitalisation data). Trial outcomes will be accompanied by detailed process and economic evaluations. SIGNIFICANCE: The findings are likely to inform policy on a scalable strategy to overcome entrenched inequities in access to effective healthcare for under-served populations in low and middle income country settings. TRIAL REGISTRATION: Clinical Trial Registry India CTRI/2013/06/003753

Supporting Governance in Healthcare Through Process Mining: A Case Study

Healthcare organizations are under increasing pressure to improve productivity, gain competitive advantage and reduce costs. In many cases, despite management already gained some kind of qualitative intuition about inefciencies and possible bottlenecks related to the enactment of patients' careows, it does not have the right tools to extract knowledge from available data and make decisions based on a quantitative analysis. To tackle this issue, starting from a real case study conducted in San Carlo di Nancy hospital in Rome (Italy), this article presents the results of a process mining project in the healthcare domain. Process mining techniques are here used to infer meaningful knowledge about the patient careflows from raw event logs consisting of clinical data stored by the hospital information systems. These event logs are analyzed using the ProM framework from three different perspectives: the control flow perspective, the organizational perspective and the performance perspective. The results on the proposed case study show that process mining provided useful insights for the governance of the hospital. In particular, we were able to provide answers to the management of the hospital concerning the value of last investments, and the temporal distribution of abandonments from emergency room and exams without reservation

NHSN biovigilance component protocol

The NHSN is a secure, internet-based surveillance system that integrates former CDC surveillance systems, including the National Nosocomial Infections Surveillance System (NNIS), National Surveillance System for Healthcare Workers (NaSH), and the Dialysis Surveillance Network (DSN). NHSN enables healthcare facilities to collect and use data about healthcare-associated infections, adherence to clinical practices known to prevent healthcare-associated infections, the incidence or prevalence of multidrug-resistant organisms within their organizations, trends and coverage of healthcare personnel safety and vaccination, and adverse events related to the transfusion of blood and blood products. Some U.S. states utilize NHSN as a means for healthcare facilities to submit data on healthcare-associated infections (HAIs) mandated through their specific state legislation. The NHSN includes four components, each concerned with various aspects of control and prevention of HAIs. Those four components are Patient Safety, Healthcare Personnel Safety, Biovigilance, and Research and Development. NHSN users do not use the Research and Development Component of the system. NHSN users do however, access and participate in the Patient Safety, Healthcare Personnel Safety, and Biovigilance Components of NHSN. A facility (acute care hospital, ambulatory surgery center, outpatient dialysis center) may use one, two, or all three NHSN components concurrently. The Biovigilance Component of NHSN was developed in collaboration with the transfusion and transplant communities. Biovigilance includes the collection of adverse event data to improve outcomes in the use of blood products, organs, tissues, and cellular therapies. The Hemovigilance Module is the first module of the Biovigilance Component to be developed in NHSN. This module is designed for staff in healthcare facility transfusion services to track adverse events, including recipient adverse reactions and quality control incidents, related to blood transfusion.National Healthcare Safety Network (NHSN) -- Biovigilance component -- Using the NHSN Hemovigilance module -- Appendix A. Adverse reaction case definition criteria -- Appendix B. Adverse reaction clinical and laboratory definitions -- Appendix C. Adverse reaction severity and imputability definitions -- Appendix D. Antibodies associated with hemolytic transfusion reactions -- Appendix E. NHSN occupation codes -- Appendix F. NHSN incident codes -- Appendix G. Incident definitionsJuly 2010

Healthcare associated infection surveillance: Examining influences on reliable and valid data collection and analysis

Healthcare settings are dangerous places. Individuals who receive healthcare may be subject to unintended harm as a consequence. One potential adverse event is a ‘healthcare associated infection’. This contemporary term refers to any infection which is acquired in healthcare facilities or any infection that occurs as a result of healthcare interventions. This thesis is concerned with the topic of healthcare associated infections. The effects of healthcare associated infections are felt not only by individual patients through increased morbidity and mortality but also by health services faced with higher costs associated with infections. The prevention of infection requires a multifaceted approach which is underpinned by healthcare-associated infection surveillance. Surveillance is used to influence practice and policy as well as to evaluate the effectiveness of strategies to reduce healthcare associated infections. Surveillance of healthcare associated infections is a critical element of any infection control program and it is crucial that healthcare-associated infection surveillance data are reliable and valid. In this thesis, three individual studies are presented. The three studies focus on two specific healthcare-associated infections: Staphylococcus aureus bacteraemia and Clostridium difficile infection. The aim of this thesis is to explore the epidemiology of these two infections and, in doing so, to examine methodological influences on reliable and valid healthcare associated infection data collection and analysis. The first study – an examination of the epidemiology of Staphylococcus aureus bacteraemia in Tasmania, Australia – used a descriptive, observational, population-based study design. This is the first known Australian study to capture and analyse data from all cases of SAB at a population-based level and represent this as an incidence. Four key findings can be identified from this study. First, the incidence of Staphylococcus aureus bacteraemia at a population level was accurately determined for the first time in Australia and was found to be 21.26 per 100,000 population, with 42% of Staphylococcus aureus bacteraemia being healthcare associated. Second, 55% of healthcare associated Staphylococcus aureus bacteraemia was associated with intravascular device management. Third, case definitions for healthcare associated Staphylococcus aureus bacteraemia have an influence on detection. Sixty-eight per cent of healthcare associated Staphylococcus aureus bacteraemia occurred in persons hospitalised less than 48 hours but had other criteria which resulted in them being defined as healthcare associated. Therefore, in cases where no criteria other than timeframe are used to define cases of SAB, approximately 30% of cases of SAB would be incorrectly identified as community associated. Fourth, 11% of Staphylococcus aureus bacteraemia were identified in private hospitals which fall outside the scope of almost all Staphylococcus aureus bacteraemia surveillance programs in Australia...