Statistical process control for improving healthcare processes. A case study in an Italian teaching hospital

This study aims to investigate the utility and potentialities of statistical process control for monitoring performances of healthcare organizations. We retrospectively applied the statistical process control for monitoring perioperative system performance, represented in this study by the operating room turnaround time. The results showed that the control charts are able to identify the steady-state behavior of the process and to detect improvements or deteriorations in process performance over tim

Klinische Performance eines neuen SARS-CoV-2-Antigen-Tests in der Notaufnahme eines Maximalversorgers

Ein Baustein zur Eindämmung der COVID-19-Pandemie ist die Verfügbarkeit von Tests mit hoher Sensitivität und Spezifität zur Detektion von SARS-CoV-2, insbesondere um Infizierte in vulnerablen Einrichtungen, z. B. Krankenhäusern und Pflegeeinrichtungen, zeitnah identifizieren und isolieren zu können. Dies betrifft alle Personengruppen dieser Einrichtungen, also Patient*innen/Bewohner*innen, Besucher*innen als auch Personal. Bisheriger Goldstandard für den Nachweis einer SARS-CoV-2-Infektion ist die RT-PCR. SARS-CoV-2-Antigen-Tests sind aufgrund ihres Point-of-Care-Ansatzes, der einfachen Handhabung und des günstigeren Preises eine wertvolle Ergänzung zur RT-PCR-Diagnostik. Sie erkennen mit ausreichender Sicherheit SARS-CoV-2-Infektionen bei symptomatischen Patient*innen und in Proben mit niedrigen Ct-Werten in der RT-PCR. Als Einzeltestung bei asymptomatischen Patient*innen ist ihre Wertigkeit dagegen deutlich eingeschränkt. Hier sollten repetitive Antigen-Testungen oder primär PCR-basierte Verfahren zur Anwendung kommen

Evaluating the organisational climate in Italian public healthcare institutions by means of a questionnaire

<p>Abstract</p> <p>Background</p> <p>By means of the ICONAS project, the Healthcare Agency of an Italian Region developed, and used a standardised questionnaire to quantify the organisational climate. The aims of the project were (a) to investigate whether the healthcare institutions were interested in measuring climate, (b) to estimate the range of applicability and reliability of the instrument, (c) to analyse the dimensions of climate among healthcare personnel, (d) to assess the differences among employees with different contractual positions.</p> <p>Methods</p> <p>The anonymous questionnaire containing 50 items, each with a scale from 1 to 10, was offered to the healthcare organisations, to be compiled during ad hoc meetings. The data were sent to the central project coordinator. The differences between highly specialised staff (mostly physicians) and other employees were assessed after descriptive statistical analysis of the single items. Both Principal Component Analysis and Factor Analysis were used.</p> <p>Results</p> <p>Ten healthcare organisations agreed to partecipate. The questionnaire was completed by 8691 employees out of 13202. The mean value of organisational climate was 4.79 (range 1–10). There were significant differences among single items and between the 2 groups of employees. Multivariate methods showed: (a) one principal component explained > 40% of the variance, (b) 7 factors summarised the data.</p> <p>Conclusion</p> <p>Italian healthcare institutions are interested in assessing organisational phenomena, especially after the reforms of the nineties. The instrument was found to be applicable and suitable for measuring organisational climate. Administration of the questionnaire leads to an acceptable response rate. Climate can be discribed by means of 7 underlying dimensions.</p

Exponentially Weighted Moving Average Control Schemes for Assessing Hospital Organizational Performance

Exponentially weighted moving average (EWMA) control charts have been successfully used in recent years in several areas of healthcare. Most of these applications have concentrated on the problem of detecting shifts in the mean level of a process. The EWMA chart for monitoring the variability has received, in general, less attention than its counterpart for the mean, although equally important and, to the best of our knowledge, it has never been used in the healthcare framework. In this work, EWMA control charts were applied retrospectively for monitoring the mean and variability of a hospital organizational performance indicator. The aim was to determine whether EWMA control charts can be used as a comprehensive approach for assessing the steady-state behaviour of the process and for early detection of changes indicating either improvement or deterioration in the performance of healthcare organizations. The results showed that the EWMA control schemes generate easy-to-read data displays that reflect process performance allowing a continuous monitoring and prompt detection of changes in process performance. Currently, hospital managers are designing an operating room dashboard which also includes the EWMA control charts

Patient and Health Care Professional Perspectives: A Case Study of the Lung Cancer Integrated Care Pathway

The purpose of this study was to evaluate the perception of the quality of care, considering both patient experience and health care professionals' perceptions as well as patient outcome measures of an integrated lung cancer pathway

Klinische Performance eines neuen SARS-CoV-2-Antigen-Tests in der Notaufnahme eines Maximalversorgers

Ein Baustein zur Eindämmung der COVID-19-Pandemie ist die Verfügbarkeit von Tests mit hoher Sensitivität und Spezifität zur Detektion von SARS-CoV-2, insbesondere um Infizierte in vulnerablen Einrichtungen, z. B. Krankenhäusern und Pflegeeinrichtungen, zeitnah identifizieren und isolieren zu können. Dies betrifft alle Personengruppen dieser Einrichtungen, also Patient*innen/Bewohner*innen, Besucher*innen als auch Personal. Bisheriger Goldstandard für den Nachweis einer SARS-CoV-2-Infektion ist die RT-PCR. SARS-CoV-2-Antigen-Tests sind aufgrund ihres Point-of-Care-Ansatzes, der einfachen Handhabung und des günstigeren Preises eine wertvolle Ergänzung zur RT-PCR-Diagnostik. Sie erkennen mit ausreichender Sicherheit SARS-CoV-2-Infektionen bei symptomatischen Patient*innen und in Proben mit niedrigen Ct-Werten in der RT-PCR. Als Einzeltestung bei asymptomatischen Patient*innen ist ihre Wertigkeit dagegen deutlich eingeschränkt. Hier sollten repetitive Antigen-Testungen oder primär PCR-basierte Verfahren zur Anwendung kommen

The Twenty Canons of the Council of Nicaea

Apart from the very important profession of faith, the Council of Nicaea also promulgated twenty canons, most of which do not receive the same attention in research as the Nicene Creed, although these were already highly esteemed in ancient times. First of all, this chapter provides a brief review of their textual transmission. Besides the original Greek text, which has been handed down in canonical collections and writings of ecclesiastical writers, there are some translations into other ancient languages (Latin, Syriac, Coptic). Then after dividing the twenty canons into various thematic groups (for example, laws pertaining to the clergy, sacraments, ecclesiastical jurisdiction), the second part explains each canon with the aid of previous research literature and interpretations in order to provide a short overview of their purpose and content. The third part deals with the reception of the canons in the early Church by councils, bishops, and ecclesiastical writers, and asks what importance was attributed to the Nicene canons in various canonical sources. Finally, some desiderata for future research are discussed