The Relationship between Doctor Communication and Patient Satisfaction in ICUs and PCUs

The relationship between doctor communication and patient satisfaction is understudied, and there is little information concerning Intensive Care Units (ICUs) and Progressive Care Units (PCUs), where doctors interact with more complex patients. Effective doctor-patient communication improves patient satisfaction and hospital ratings from the Centers for Medicare and Medicaid Services (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Medicare\u27s Hospital Value-Based Purchasing (VBP) Program evaluates and reimburses hospitals based on HCAHPS patient satisfaction surveys. The purpose of this retrospective quasi-experimental quantitative study was to examine the relationship between doctor communication and patient satisfaction of ICUs and PCUs in five central and eastern hospitals of a large healthcare system located in the Southeastern United States. The Donabedian structure-process-outcome theoretical framework was used in this study where structural factors (ICUs and PCUs) affect care processes (doctor communication), which affect health status outcomes (patient satisfaction). An ordinal logistic regression analysis of two research questions revealed a statistically significant relationship between doctor communication performance and patient satisfaction as measured by HCAHPS for ICUs and PCUs. Recommendations for future research include expanding into all hospital-based units and other hospital-based physician groups. This study may influence hospital best practices and enhance doctor communication tools to improve patient satisfaction. This study can potentially affect positive social change by enhancing the knowledge about doctor communication and its relationship to patient satisfaction

The Guidebook, the Friend, and the Room: Visitor Experience in a Historic House

In this paper, we describe an electronic guidebook prototype and report on a study of its use in a historic house. Supported by mechanisms in the guidebook, visitors constructed experiences that had a high degree of interaction with three entities: the guidebook, their companions, and the house and its contents. For example, we found that most visitors played audio descriptions played through speakers (rather than using headphones or reading textual descriptions) to facilitate communication with their companions

Use of an index to reflect the aggregate burden of long-term exposure to criteria air pollutants in the United States.

Air pollution control in the United States for five common pollutants--particulate matter, ground-level ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide--is based partly on the attainment of ambient air quality standards that represent a level of air pollution regarded as safe. Regulatory and health agencies often focus on whether standards for short periods are attained; the number of days that standards are exceeded is used to track progress. Efforts to explain air pollution to the public often incorporate an air quality index that represents daily concentrations of pollutants. While effects of short-term exposures have been emphasized, research shows that long-term exposures to lower concentrations of air pollutants can also result in adverse health effects. We developed an aggregate index that represents long-term exposure to these pollutants, using 1995 monitoring data for metropolitan areas obtained from the U.S. Environmental Protection Agency's Aerometric Information Retrieval System. We compared the ranking of metropolitan areas under the proposed aggregate index with the ranking of areas by the number of days that short-term standards were exceeded. The geographic areas with the highest burden of long-term exposures are not, in all cases, the same as those with the most days that exceeded a short-term standard. We believe that an aggregate index of long-term air pollution offers an informative addition to the principal approaches currently used to describe air pollution exposures; further work on an aggregate index representing long-term exposure to air pollutants is warranted

Sotto Voce: Exploring the Interplay of Conversation and Mobile Audio Spaces

In addition to providing information to individual visitors, electronic guidebooks have the potential to facilitate social interaction between visitors and their companions. However, many systems impede visitor interaction. By contrast, our electronic guidebook, Sotto Voce, has social interaction as a primary design goal. The system enables visitors to share audio information - specifically, they can hear each other's guidebook activity using a technologically mediated audio eavesdropping mechanism. We conducted a study of visitors using Sotto Voce while touring a historic house. The results indicate that visitors are able to use the system effectively, both as a conversational resource and as an information appliance. More surprisingly, our results suggest that the technologically mediated audio often cohered the visitors' conversation and activity to a far greater degree than audio delivered through the open air.Comment: 8 page

Launch Vehicle Control Center Architectures

Launch vehicles within the international community vary greatly in their configuration and processing. Each launch site has a unique processing flow based on the specific launch vehicle configuration. Launch and flight operations are managed through a set of control centers associated with each launch site. Each launch site has a control center for launch operations; however flight operations support varies from being co-located with the launch site to being shared with the space vehicle control center. There is also a nuance of some having an engineering support center which may be co-located with either the launch or flight control center, or in a separate geographical location altogether. A survey of control center architectures is presented for various launch vehicles including the NASA Space Launch System (SLS), United Launch Alliance (ULA) Atlas V and Delta IV, and the European Space Agency (ESA) Ariane 5. Each of these control center architectures shares some similarities in basic structure while differences in functional distribution also exist. The driving functions which lead to these factors are considered and a model of control center architectures is proposed which supports these commonalities and variations