Adult Hospital Inpatient Experience in Qatar And Associated Factors: A Cross-Sectional Study

Background: Evaluation of hospital inpatient experience (HIE) is an important measure used by healthcare organizations to evaluate the effectiveness of their current processes and understand how responsive and respectful the healthcare providers are in addressing patient needs and preferences. Aim: The aim of this thesis was to estimate the overall HIE in the State of Qatar and identify related factors using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey from April 2017 to 2019, inclusive. Methods: This was a cross-sectional study using secondary HCAHPS data from the Ministry of Public Health from 12 public and private hospitals in Qatar. Multivariable multilevel linear regression methods were used to analyse the data. Results: This study included 14,367 survey participants. The national average for overall hospital rating was 88.9%. The trend for the average overall hospital rating increased from 2017 to 2019 (87.7% to 88.6%; F=7.3, p=0.007). The national average for willingness to recommend the hospital to family and friends was 89.0%. Also, recommendation of hospital showed a higher score in 2019 compared to 2017 (87.6% to 88.7%; F=8.5, p=0.004). Communication with doctors and nurses rating domains had the largest association with overall hospital rating and recommendation of the hospital. Responsiveness of hospital staff was the only HCAHPS domain, which was not statistically associated with overall hospital rating. Patient-level and hospital-level iv predictors showed different association patterns across HCAHPS domains and individual items. Patient’s overall health rating was a statistically significant predictor for all HCAHPS domains and individual items excluding communication with nurses and communication with doctors’ domains. Communication with nurses average score decreased from 92.7% to 89.4% in all hospitals over the study period (F=103.3, p=<0.001). Similarly, communication with doctors scores decreases in all hospitals from 93.2% to 90.1% (F=94.3, p=<0.001) Conclusions: Improving patient experience and engagement with the healthcare system is an important outcome, which should be evaluated and monitored regularly to assess the progress in achieving the NHS 2018-2022 priorities for Qatar. The findings provide a baseline measure for the HIE on a national level and highlight important factors associated with HIE. This information is helpful for planning and prioritizing national and hospital-level quality improvement projects in Qatar

Addressing the challenges of ECMO simulation

This document is the Accepted Manuscript. The final, definitive version of this paper has been published in Perfusion, May 2018, published by SAGE Publishing, All rights reserved.Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants’ suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Methods: Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. Results: A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. Conclusion: The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.Peer reviewe

Systematic review of the safety of medication use in inpatient, outpatient and primary care settings in the Gulf Cooperation Council countries

Background Errors in medication use are a patient safety concern globally, with different regions reporting differing error rates, causes of errors and proposed solutions. The objectives of this review were to identify, summarise, review and evaluate published studies on medication errors, drug related problems and adverse drug events in the Gulf Cooperation Council (GCC) countries. Methods A systematic review was carried out using six databases, searching for literature published between January 1990 and August 2016. Research articles focussing on medication errors, drug related problems or adverse drug events within different healthcare settings in the GCC were included. Results Of 2094 records screened, 54 studies met our inclusion criteria. Kuwait was the only GCC country with no studies included. Prescribing errors were reported to be as high as 91% of a sample of primary care prescriptions analysed in one study. Of drug-related admissions evaluated in the emergency department the most common reason was patient non-compliance. In the inpatient care setting, a study of review of patient charts and medication orders identified prescribing errors in 7% of medication orders, another reported prescribing errors present in 56% of medication orders. The majority of drug related problems identified in inpatient paediatric wards were judged to be preventable. Adverse drug events were reported to occur in 8.5–16.9 per 100 admissions with up to 30% judged preventable, with occurrence being highest in the intensive care unit. Dosing errors were common in inpatient, outpatient and primary care settings. Omission of the administered dose as well as omission of prescribed medication at medication reconciliation were common. Studies of pharmacists’ interventions in clinical practice reported a varying level of acceptance, ranging from 53% to 98% of pharmacists’ recommendations. Conclusions Studies of medication errors, drug related problems and adverse drug events are increasing in the GCC. However, variation in methods, definitions and denominators preclude calculation of an overall error rate. Research with more robust methodologies and longer follow up periods is now required.Peer reviewe

Art and Medicine: A Collaborative Project Between Virginia Commonwealth University in Qatar and Weill Cornell Medicine in Qatar

Four faculty researchers, two from Virginia Commonwealth University in Qatar, and two from Weill Cornell Medicine in Qatar developed a one semester workshop-based course in Qatar exploring the connections between art and medicine in a contemporary context. Students (6 art / 6 medicine) were enrolled in the course. The course included presentations by clinicians, medical engineers, artists, computing engineers, an art historian, a graphic designer, a painter, and other experts from the fields of art, design, and medicine. To measure the student experience of interdisciplinarity, the faculty researchers employed a mixed methods approach involving psychometric tests and observational ethnography. Data instruments included pre- and post-course semi-structured audio interviews, pre-test / post-test psychometric instruments (Budner Scale and Torrance Tests of Creativity), observational field notes, self-reflective blogging, and videography. This book describes the course and the experience of the students. It also contains images of the interdisciplinary work they created for a culminating class exhibition. Finally, the book provides insight on how different fields in a Middle Eastern context can share critical /analytical thinking tools to refine their own professional practices

Hazardous materials and CBRN incidents: Fundamentals of pre-hospital readiness in the State of Qatar

Background: Hazardous Materials and Chemical/Biological/Radiological/Nuclear (HazMat-CBRN) incidents represent a serious threat to the population and the environment. They require a pre-hospital medical response system well equipped and supported with logistics and clinicians with appropriate knowledge and skills to prevent exposure and mitigate risks. Our aim is to determine if the Hamad Medical Corporation Ambulance Service (HMCAS) fulfils the pre-hospital readiness requirements for such incidents. Methods: This cross-sectional study was performed in HMCAS. An online survey assessed staff behaviour and knowledge in relation to HazMat-CBRN incidents. Responses were obtained on health risks and pre-hospital medical management of related threats in Qatar. Based on the results, a training module “HazMat Incident Management” was prepared with pre-/post-activity assessments. The results were explored using a multivariate linear regression and non-parametric Wilcoxon test for paired samples. Specialized Emergency Management (SEM) staff opinion about this training was assessed through an online survey. Both surveys’ validity and reliability tests were conducted. Ishikawa cause and effects diagram was built for the identification of the factors leading to a pre-hospital successful response to HazMat-CBRN incidents. Results: HMCAS has the proper logistics and plans to manage potential HazMat-CBRN incidents. The knowledge survey demonstrated that the pre-hospital medical staff information about this topic needs reinforcement. The multivariate linear regression and non-parametric Wilcoxon test demonstrated that this was obtained thanks to the implemented training module. The course satisfaction survey showed not only a big interest in this activity but also staff recommended more related topics. Earlier-RSDAT (Recognition, Safety, Decontamination, Antidot, Transport) is a tool proposed as a response acronym to build a successful risk-based response for HazMat CBRN incidents in pre-hospital setting. Conclusion: HMCAS fulfills the readiness requirements for safe and effective response to potential HazMat-CBRN incidents in Qatar. The RSDAT response matrix might help in mitigating pre-hospital response risks

Clinical Information System: Measuring End-User Satisfaction in a Governmental Hospital in Qatar

Clinical services in hospitals are too diversified and include different kinds of care patient needs. To be efficient, clinical services need to be supported by a promising clinical information system. As we did not find enough literature talking about the clinical information system (CIS) in terms of end-users’ satisfaction in the context of Qatar, we took the initiative and conducted this research to study this vital feature of CIS. In this paper, the satisfaction of three categories of clinicians was tested. These job categories included: physicians, nurses, and pharmacists who work in Al Wakra Hospital, a member of Hamad Medical Corporation (HMC) which is the dominant healthcare provider in Qatar. The study tested the following research questions: RQ 1: What are the key variables affecting the satisfaction of CIS end-users in Al Wakra Hospital? RQ 2: What are the levels of CIS end-user satisfaction in Al Wakra Hospital? The research model incorporated five independent variables measuring their impact on end-user satisfaction. These variables included: information quality, system quality, service quality, professional maturity, and personal innovativeness. The survey questionnaire was divided into two sections: the first one collected demographic data while the second one included measured related to different variables included in the study. Necessary approval was collected from Qatar University IRB Committee. The questionnaire was distributed to targeted end-users. A total of 308 responses was collected, out of which there were eight incomplete responses. After removing three outliers, the necessary analysis was conducted for the remaining 297 useful responses. The following analyses were conducted including frequencies, descriptive analytics, reliability, validity, Pearson’s correlation, and regression. Results revealed reliable measures and variables as Cronbach’s alpha exceed minimally accepted scoring. Collinearity was eliminated via conducting necessary Pearson’s Correlation and VIF test. One variable, system quality, was found to be insignificant and was eliminated from the model. Four hypotheses were supported, while one hypothesis was not supported eventually. Research findings can be used by related decision-makers to improve understanding of reasons impacting end-users’ satisfaction. Listening to the end-users and considering their feedback can help optimize CIS and reach the best possible utilization of it. Nonetheless, there are certain limitations to the study that need to be kept in mind

Sound Perception:Encapsulating Intangible Voice Memories in a Physical Memento

We live in a very busy world with a variety of sensory stimulation including the olfactory, visual, tactile, and auditory. The five senses are triggered by our surroundings and help us to form meaning about the world.ⅰ Based on where someone grows up, she or he is introduced to various sites and sounds, affecting how they interpret the world. Sounds relate meaning through the association between hearing, memory and an event. Hearing is one of the learning processes, in which individuals give, receive, and store information. We typically rely on our five senses, which contribute to the process of understanding, communicating, and comprehending information. Moving beyond visual perception requires systematic attention to individual learning modalities.ⅱ Sound is one of the developing areas in the field of perception that moves beyond vision to help people understand nature, objects, narratives and varieties of perception. In order to comprehend how people hear, it is important to understand the role of perception. Sound functions as a signal, but also varies according to the capacity to hear. An individual’s physical ability to hear, and their unique experiences with sound, differ from one person to the next, and can result in a range of emotions and reactions. Certain sounds, like the voice of a loved one, also have the power to trigger emotion and convey meaning due to the association between hearing, memory and specific events from one›s past In short, the three aspects of sound perception–signal, hearing, and emotional reaction–play an integral role in auditory perception and the subjectivity of sound. However, the value of sound is often taken for granted or viewed as secondary to visual perception. This thesis will explore the value of sound perception by investigating two of its primary aspects–hearing and emotional response–in application to memory. Through a series of experiential objects, that trigger the senses. The aim is to utilize design to memorialize precious sounds in order to raise awareness about the emotional value of sound to the human experience

Supporting information for National, regional, and worldwide estimates of low birthweight rates in 2015, with trends from 2000: a systematic analysis

Data produced by the World Health Organization, UNICEF, LSHTM and Johns Hopkins University to estimate national low birthweight (LBW) and numbers for 195 countries. LBW data was collated through a systematic review of national routine/registration systems, nationally representative surveys, and other data sources, and subsequently modelled using restricted maximum likelihood estimation with country-level random effects. Data includes a list of 1447 rate data points used as an input to the modelled estimates, yearly national-level covariates for each of the 195 countries studied from 2000 to 2015, and information on estimated low birthweight rates from 2000 to 2015 for 148 countries with data. Stata code used to generate these estimates is provided