State of the art in abdominal MRI structured reporting: a review

In the management of several abdominal disorders, magnetic resonance imaging (MRI) has the potential to significantly improve patient's outcome due to its diagnostic accuracy leading to more appropriate treatment choice. However, its clinical value heavily relies on the quality and quantity of diagnostic information that radiologists manage to convey through their reports. To solve issues such as ambiguity and lack of comprehensiveness that can occur with conventional narrative reports, the adoption of structured reporting has been proposed. Using a checklist and standardized lexicon, structured reports are designed to increase clarity while assuring that all key imaging findings related to a specific disorder are included. Unfortunately, structured reports have their limitations too, such as risk of undue report simplification and poor template plasticity. Their adoption is also far from widespread, and probably the ideal balance between radiologist autonomy and report consistency of has yet to be found. In this article, we aimed to provide an overview of structured reporting proposals for abdominal MRI and of works assessing its value in comparison to conventional free-text reporting. While for several abdominal disorders there are structured templates that have been endorsed by scientific societies and their adoption might be beneficial, stronger evidence confirming their imperativeness and added value in terms of clinical practice is needed, especially regarding the improvement of patient outcome

A study of the layout planning of plant facility based on the timed Petri net and systematic layout planning

The purpose of this research is to solve the problems of unreasonable layout of the production plant, disorder of the logistics process, and unbalanced production line in discrete manufacturing plants. By analyzing the production process and characteristics, the timed Petri net model is constructed according to the function and connection of each production unit, which is then used to generate a FlexSim simulation model of the production plant logistics system with a simulation software. Therewith the FlexSim simulation model is used to simulate the original layout of the plant, and to analyse the simulation data synthetically to put forward an improvement strategy. Combined with the use of the systematic layout planning method to analyze the overall layout of the plant and logistics relations, we infer the relevant drawings between the production units and determine the improved layout of the facilities. Finally, by comparing the before and after improvement simulation results, it is verified that the combination of timed Petri nets and systematic layout planning is effective to ameliorate the layout of the plant facilities and the logistics system. This method makes up for the factors that traditional methods have not considered, achieves the goal of reducing the cross circuitous route of the plant and the idle rate of equipment, and improving the efficiency of production

A Prospective Investigation to Develop Data-Driven Interventions and Improve Process Efficiency at a Level II Trauma Center

INTRODUCTION: The purpose of this investigation was to better understand process inefficiencies in a Level II trauma center through the identification and classification of flow disruptions. Data-driven interventions were systematically developed and introduced in an effort to reduce disruptions threatening the optimal delivery of trauma care. METHOD: Medical human factors researchers observed disruptions during resuscitation and imaging in 117 trauma cases. Data was classified using the human factors taxonomy Realizing Improved Patient Care through Human-centered Operating Room Design for Threat Window Analysis (RIPCHORD-TWA). Interdisciplinary subject matter experts (SMEs) utilized a human factors intervention matrix (HFIX) to generate targeted interventions designed to address the most detrimental disruptions. A multiple-baseline interrupted time-series (ITS) design was used to gauge the effectiveness of the interventions introduced. RESULTS: Significant differences were found in the frequency of disruptions between the pre-intervention (n=65 cases, 1137 disruptions) and post-intervention phases (n=52 cases, 939 disruptions). Results revealed significant improvements related to ineffective communication (x2 (1, n=2076) = 24.412, p=0.00, x2 (1, n=1031) = 9.504, p=0.002, x2 (1, n=1045) = 12.197, p=0.000); however, similar levels of improvement were not observed in the other targeted areas. CONCLUSION: This study provided a foundation for a data-driven approach to investigating precursor events and process inefficiencies in trauma care. Further, this approach allowed individuals on the front lines to generate specific interventions aimed at mitigating systemic weaknesses and inefficiencies frequently encountered in their work environment