Theoretical and technological building blocks for an innovation accelerator

The scientific system that we use today was devised centuries ago and is inadequate for our current ICT-based society: the peer review system encourages conservatism, journal publications are monolithic and slow, data is often not available to other scientists, and the independent validation of results is limited. Building on the Innovation Accelerator paper by Helbing and Balietti (2011) this paper takes the initial global vision and reviews the theoretical and technological building blocks that can be used for implementing an innovation (in first place: science) accelerator platform driven by re-imagining the science system. The envisioned platform would rest on four pillars: (i) Redesign the incentive scheme to reduce behavior such as conservatism, herding and hyping; (ii) Advance scientific publications by breaking up the monolithic paper unit and introducing other building blocks such as data, tools, experiment workflows, resources; (iii) Use machine readable semantics for publications, debate structures, provenance etc. in order to include the computer as a partner in the scientific process, and (iv) Build an online platform for collaboration, including a network of trust and reputation among the different types of stakeholders in the scientific system: scientists, educators, funding agencies, policy makers, students and industrial innovators among others. Any such improvements to the scientific system must support the entire scientific process (unlike current tools that chop up the scientific process into disconnected pieces), must facilitate and encourage collaboration and interdisciplinarity (again unlike current tools), must facilitate the inclusion of intelligent computing in the scientific process, must facilitate not only the core scientific process, but also accommodate other stakeholders such science policy makers, industrial innovators, and the general public

Office Emergencies

This text provides essential, practical guidance for handling the most common emergencies presenting in person or by telephone in primary care offices and urgent care centers. The authors--primary care and emergency medicine physicians--focus on the essential information needed to triage and treat both adults and children. Concise chapters, organized by presenting problem rather than diagnosis, allow for rapid reference. Integrates state-of-the-art emergency care with the realities of practice in an outpatient office. Prioritizes treatment of emergencies with specific steps for staff and clinicians. Offers information on transfer of patients for specific types of emergencies. Features tips for recognition of emergencies for both triage staff members and clinicians. Includes information on chemical terrorism and bioterrorism · environmental emergencies · and obstetrical and gynecological emergencies. Gives pediatric considerations for each type of emergency. Lists equipment needed in the office, making it easier for clinicians to ensure they are adequately supplied. Recommendations are evidence-based wherever possible, supplemented with clinical experience from practicing physicians

Office Emergencies

This text provides essential, practical guidance for handling the most common emergencies presenting in person or by telephone in primary care offices and urgent care centers. The authors--primary care and emergency medicine physicians--focus on the essential information needed to triage and treat both adults and children. Concise chapters, organized by presenting problem rather than diagnosis, allow for rapid reference. Integrates state-of-the-art emergency care with the realities of practice in an outpatient office. Prioritizes treatment of emergencies with specific steps for staff and clinicians. Offers information on transfer of patients for specific types of emergencies. Features tips for recognition of emergencies for both triage staff members and clinicians. Includes information on chemical terrorism and bioterrorism · environmental emergencies · and obstetrical and gynecological emergencies. Gives pediatric considerations for each type of emergency. Lists equipment needed in the office, making it easier for clinicians to ensure they are adequately supplied. Recommendations are evidence-based wherever possible, supplemented with clinical experience from practicing physicians.https://corescholar.libraries.wright.edu/books/1177/thumbnail.jp

Trends in boarding of admitted patients in US Emergency Departments 2003-2005

OBJECTIVES: The objective was to study the association between factors related to emergency department (ED) crowding and patient satisfaction. METHODS: The authors performed a retrospective cohort study of all patients admitted through the ED who completed Press-Ganey patient satisfaction surveys over a 2-year period at a single academic center. Ordinal and binary logistic regression was used to study the association between validated ED crowding factors (such as hallway placement, waiting times, and boarding times) and patient satisfaction with both ED care and assessment of satisfaction with the overall hospitalization. RESULTS: A total of 1,501 hospitalizations for 1,469 patients were studied. ED hallway use was broadly predictive of a lower likelihood of recommending the ED to others, lower overall ED satisfaction, and lower overall satisfaction with the hospitalization (p \u3c 0.05). Prolonged ED boarding times and prolonged treatment times were also predictive of lower ED satisfaction and lower satisfaction with the overall hospitalization (p \u3c 0.05). Measures of ED crowding and ED waiting times predicted ED satisfaction (p \u3c 0.05), but were not predictive of satisfaction with the overall hospitalization. CONCLUSIONS: A poor ED service experience as measured by ED hallway use and prolonged boarding time after admission are adversely associated with ED satisfaction and predict lower satisfaction with the entire hospitalization. Efforts to decrease ED boarding and crowding might improve patient satisfaction

The impact of emergency department crowding measures on time to antibiotics for patients with community-acquired pneumonia

STUDY OBJECTIVE: We seek to determine the impact of emergency department (ED) crowding on delays in antibiotic administration for patients with community-acquired pneumonia. METHODS: We performed a retrospective cohort study of adult patients admitted with community-acquired pneumonia from January 1, 2003, to April 31, 2005, at a single, urban academic ED. The main outcome was a delay (\u3e4 hours from arrival) or nonreceipt of antibiotics in the ED. Eight ED crowding measures were assigned at triage. Multivariable regression and bootstrapping were used to test the adjusted impact of ED crowding measures of delayed (or no) antibiotics. Predicted probabilities were then calculated to assess the magnitude of the impact of ED crowding on the probability of delayed (or no) antibiotics. RESULTS: In 694 patients, 44% (95% confidence interval [CI] 40% to 48%) received antibiotics within 4 hours and 92% (95% CI 90% to 94%) received antibiotics in the ED. Increasing levels of ED crowding were associated with delayed (or no) antibiotics, including waiting room number (odds ratio [OR] 1.05 for each additional waiting room patient [95% CI 1.01 to 1.10]) and recent ED length of stay for admitted patients (OR 1.14 for each additional hour [95% CI 1.04 to 1.25]). When the waiting room and recent length of stay were both at the lowest quartiles (ie, not crowded), the predicted probability of delayed (or no) antibiotics within 4 hours was 31% (95% CI 21% to 42%); when both were at the highest quartiles, the predicted probability was 72% (95% CI 61% to 81%). CONCLUSION: ED crowding is associated with delayed and nonreceipt of antibiotics in the ED for patients admitted with community-acquired pneumonia