How can patient journey in surgical wards of a referral hospital be improved?

Background: We studied the patient journey in surgical wards in order to find an effective and efficient way of scheduling in surgical wards.Methods: We applied Root cause analysis (RCA) model within three months in a referral hospital. After understanding root causes of the events occurred through a focus discussion group, required interventions were proposed according to literatures, experiences, and preference of the stakeholders. Possible interventions were also analyzed based on its ability to reduce contributing factors in the events and the belief of process-owner that if interventions can be implemented.Results: The results were provided for five main steps: 1) the most important root cause was “not prioritizing patients and pre-scheduling the number of surgical procedures in the days before”. 2) Constraints indicated that workforce weren't allocated proportionally to the number of surgical operations in varying shift lengths, increased numbers of on-calls physicians increased related costs, the admission of patients in VIP wards have been getting a high priority, and surgeon compensation based on fee for service method was challenging. 3) The current situation of allocating three rooms on average for each physician can be changed depending on numbers of surgeries. 4) Proposed interventions are establishing a computer registration system, reforming payment methods, setting up an electronic waiting list, development of scheduling guidelines, and Applying MIP model.Conclusions: Implementing of scheduling reforms requires a comprehensive action plan system and predefined functional indicators. These should be achieved with considering comments of all clinical and technical groups to ensure the feasibility of an operating room schedule.Keywords: patient journey, surgery, scheduling, Root cause analysis (RCA), patient transfe

Feasibility studies of time-like proton electromagnetic form factors at PANDA at FAIR

Simulation results for future measurements of electromagnetic proton form factors at \PANDA (FAIR) within the PandaRoot software framework are reported. The statistical precision with which the proton form factors can be determined is estimated. The signal channel $\bar p p \to e^+ e^-$ is studied on the basis of two different but consistent procedures. The suppression of the main background channel, $\textit{i.e.}$ $\bar p p \to \pi^+ \pi^-$, is studied. Furthermore, the background versus signal efficiency, statistical and systematical uncertainties on the extracted proton form factors are evaluated using two different procedures. The results are consistent with those of a previous simulation study using an older, simplified framework. However, a slightly better precision is achieved in the PandaRoot study in a large range of momentum transfer, assuming the nominal beam conditions and detector performance

Prevalence of psychiatric disorders in patients with chest pain complaints referred to the heart emergency department of Taleghani hospital in Tehran, Iran

Background: Chest pain is one of the most common reasons for people to go to cardiac emergency clinics. This study was conducted with the aim to evaluate the prevalence of psychiatric disorders in patients with chest pain referred to the heart emergency clinic of Taleghani Hospital, Tehran, Iran. Methods: This descriptive-analytic study was performed on 103 patients with chest pain who were referred to the emergency department. Furthermore, a follow-up was carried out. Data were collected using a demographic information form and mental health survey (28-item General Health Questionnaire; Goldberg & Hillier, 1979) in the two groups of cardiac and non-cardiac chest pain. Results: Among all the referred patients, 74 patients (71.8) did not have a definitive diagnosis of cardiovascular disorders (CVDs). The results revealed that among the patients with non-cardiac chest pain, 56 (75.7), 55 (74.3), 54 (73), and 22 (29.7) individuals had phyisical disorder, anxiety, social dysfunction, and depressive disorder. Among the patients, who were definitively diagnosed with CVDs, 14 (48.3), 10 (34.5), 7 (24.1), and 6 (20.7) individuals had anxiety, physical disoreder, social dysfunction, and depressive disorder. Among all patients, physical disorder had a significant relationship with gender (P = 0.047), and physical and anxiety disorders had a significant relationship‎ with history of recurrent chest pain in the last 6 months (P < 0.05). Conclusion: Due to the high number of non-cardiac patients who refer to the emergency department with chest pain complaints, it is recommended that all patients with chest pain complaints be screened for psychiatric diseases. © 2020 saeid alami

Study of doubly strange systems using stored antiprotons

Bound nuclear systems with two units of strangeness are still poorly known despite their importance for many strong interaction phenomena. Stored antiprotons beams in the GeV range represent an unparalleled factory for various hyperon-antihyperon pairs. Their outstanding large production probability in antiproton collisions will open the floodgates for a series of new studies of systems which contain two or even more units of strangeness at the P‾ANDA experiment at FAIR. For the first time, high resolution γ-spectroscopy of doubly strange ΛΛ-hypernuclei will be performed, thus complementing measurements of ground state decays of ΛΛ-hypernuclei at J-PARC or possible decays of particle unstable hypernuclei in heavy ion reactions. High resolution spectroscopy of multistrange Ξ−-atoms will be feasible and even the production of Ω−-atoms will be within reach. The latter might open the door to the |S|=3 world in strangeness nuclear physics, by the study of the hadronic Ω−-nucleus interaction. For the first time it will be possible to study the behavior of Ξ‾+ in nuclear systems under well controlled conditions

Feasibility studies for the measurement of time-like proton electromagnetic form factors from p¯ p→ μ+μ- at P ¯ ANDA at FAIR

This paper reports on Monte Carlo simulation results for future measurements of the moduli of time-like proton electromagnetic form factors, | GE| and | GM| , using the p¯ p→ μ+μ- reaction at P ¯ ANDA (FAIR). The electromagnetic form factors are fundamental quantities parameterizing the electric and magnetic structure of hadrons. This work estimates the statistical and total accuracy with which the form factors can be measured at P ¯ ANDA , using an analysis of simulated data within the PandaRoot software framework. The most crucial background channel is p¯ p→ π+π-, due to the very similar behavior of muons and pions in the detector. The suppression factors are evaluated for this and all other relevant background channels at different values of antiproton beam momentum. The signal/background separation is based on a multivariate analysis, using the Boosted Decision Trees method. An expected background subtraction is included in this study, based on realistic angular distributions of the background contribution. Systematic uncertainties are considered and the relative total uncertainties of the form factor measurements are presented

Precision resonance energy scans with the PANDA experiment at FAIR: Sensitivity study for width and line shape measurements of the X(3872)

This paper summarises a comprehensive Monte Carlo simulation study for precision resonance energy scan measurements. Apart from the proof of principle for natural width and line shape measurements of very narrow resonances with PANDA, the achievable sensitivities are quantified for the concrete example of the charmonium-like X(3872) state discussed to be exotic, and for a larger parameter space of various assumed signal cross-sections, input widths and luminosity combinations. PANDA is the only experiment that will be able to perform precision resonance energy scans of such narrow states with quantum numbers of spin and parities that differ from J P C = 1 - -