Prediction of a time-sensitive condition among patients with dizziness assessed by the emergency medical services

BACKGROUND: Dizziness is a relatively common symptom among patients who call for the emergency medical services (EMS). AIM: To identify factors of importance for the early identification of a time-sensitive condition behind the symptom of dizziness among patients assessed by the EMS. METHODS: All patients assessed by the EMS and triaged using Rapid Emergency Triage and Treatment (RETTS) for adults code 11 (=dizziness) in the 660,000 inhabitants in the Municipality of Gothenburg, Sweden, in 2016, were considered for inclusion. The patients were divided into two groups according to the final diagnosis (a time-sensitive condition, yes or no). RESULTS: There were 1536 patients who fulfilled the inclusion criteria, of which 96 (6.2%) had a time-sensitive condition. The majority of these had a stroke/transitory ischaemic attack (TIA). Eight predictors of a time-sensitive condition were identified. Three were associated with a reduced risk: 1) the dizziness was of a rotatory type, 2) the dizziness had a sudden onset and 3) increasing body temperature. Five were associated with an increased risk: 1) sudden onset of headache, 2) a history of head trauma, 3) symptoms of nausea or vomiting, 4) on treatment with anticoagulants and 5) increasing systolic blood pressure. CONCLUSION: Among 1536 patients who were triaged by the EMS for dizziness, 6.2% had a time-sensitive condition. On the arrival of the EMS, eight factors were associated with the risk of having a time-sensitive condition. All these factors were linked to the type of symptoms or to clinical findings on the arrival of the EMS or to the recent clinical history

Value Creation from Public Healthcare IS

Part 1: Creating ValueInternational audienceThe obtainment of value from IT is a recurring theme that has diffused into healthcare information systems (HIS). Having completed the implementation of an integrated HIS, the Faroese Health Service (FHS) has started discussions regarding the obtainment of value from its IT investment which is the subject of this paper. Based on an action research project focusing on the improvement of the stroke process, this paper reveals that it is not possible to distinguish between working processes and HIS and that the realization of value in this context has a much broader significance than mere financial value. During the project, specific key performance indicators (KPIs) were identified and a baseline was established for the stroke process. The outcome is a framework for measuring IS public value as: professional, organizational, patient-perceived and employee-perceived quality as well as learning. Selected non-financial measures for each dimension and their development are presented, e.g., a decrease in mortality

What's New in New Forms of Organizing? On the Construction of Gender in Project-Based Work

In several industries, projects are now the normal form of work for individuals. The consequences of project work have not so far been subject to critical inquiry, however. This implies inquiry not only on how people handle project work at work, it also means inquiring into how they live their lives when working by projects. In this paper, we study this from a constructionist gender perspective, in which project work is seen as an ongoing construction of patterns of femininity and masculinity in society. The aim of the paper is to contribute to an understanding of how project work is related to the ongoing construction of femininity and masculinity in the work and lives of human beings. Copyright Blackwell Publishing Ltd 2006.

Project organizing as negotiation of (dis)ordering

This paper proposes to study the constitution of organization at the interstice of order and disorder. By putting forward the processual, heterogeneous, and fragmented nature of organization, it explores the mediating role of communication in organizational becoming (Tsoukas and Chia, 2002). More specifically, the paper focuses on how organizations overcome the inherently precarious, contingent, and disorderly character of their existence in and through language use. Taking a communicative centered approach, the paper argues for considering language-in-use as intrinsically embedding both order and disorder. To do so it relies on the empirical material of three extensive qualitative case studies in three distinct project-based organizations: a science and technology diffusion program, a software development company, and a management consulting firm. The transversal analysis of these studies shows that efforts of ordering are continuously haunted by disordering, that is, the plurality of many potential orders, which are at work in communication. Furthermore, the analysis highlights the key and yet paradoxical role of ordering devices (in the three cases studied inscribed in texts), which are designed to create and maintain order, and because of their language-based nature, generate contingency and undecidability. Language is indeed a source of ambivalence (Weick, 1990). As such, the call for order can (usually does) trigger disorder and the other way around