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Sample records for medication management system

  1. Medical-Information-Management System

    Science.gov (United States)

    Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

    1989-01-01

    Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

  2. 21 CFR 880.6315 - Remote Medication Management System.

    Science.gov (United States)

    2010-04-01

    ... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication..., and medication packaging. The system is intended to store the patient's prescribed medications in a... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315...

  3. [Application of information management system about medical equipment].

    Science.gov (United States)

    Hang, Jianjin; Zhang, Chaoqun; Wu, Xiang-Yang

    2011-05-01

    Based on the practice of workflow, information management system about medical equipment was developed and its functions such as gathering, browsing, inquiring and counting were introduced. With dynamic and complete case management of medical equipment, the system improved the management of medical equipment.

  4. [A medical consumable material management information system].

    Science.gov (United States)

    Tang, Guoping; Hu, Liang

    2014-05-01

    Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.

  5. Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

    International Nuclear Information System (INIS)

    Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo

    2000-01-01

    This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

  6. Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

    Energy Technology Data Exchange (ETDEWEB)

    Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

    2000-12-01

    This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

  7. Development of total medical material distribution management system.

    Science.gov (United States)

    Uto, Y; Kumamoto, I

    1994-07-01

    Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.

  8. [Medication error management climate and perception for system use according to construction of medication error prevention system].

    Science.gov (United States)

    Kim, Myoung Soo

    2012-08-01

    The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use. The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis. Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed. The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.

  9. [Design and application of implantable medical device information management system].

    Science.gov (United States)

    Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

    2013-03-01

    Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.

  10. [A Medical Devices Management Information System Supporting Full Life-Cycle Process Management].

    Science.gov (United States)

    Tang, Guoping; Hu, Liang

    2015-07-01

    Medical equipments are essential supplies to carry out medical work. How to ensure the safety and reliability of the medical equipments in diagnosis, and reduce procurement and maintenance costs is a topic of concern to everyone. In this paper, product lifecycle management (PLM) and enterprise resource planning (ERP) are cited to establish a lifecycle management information system. Through integrative and analysis of the various stages of the relevant data in life-cycle, it can ensure safety and reliability of medical equipments in the operation and provide the convincing data for meticulous management.

  11. MIMS - MEDICAL INFORMATION MANAGEMENT SYSTEM

    Science.gov (United States)

    Frankowski, J. W.

    1994-01-01

    MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.

  12. [The development of hospital medical supplies information management system].

    Science.gov (United States)

    Cao, Shaoping; Gu, Hongqing; Zhang, Peng; Wang, Qiang

    2010-05-01

    The information management of medical materials by using high-tech computer, in order to improve the efficiency of the consumption of medical supplies, hospital supplies and develop a new technology way to manage the hospital and material support. Using C # NET, JAVA techniques to develop procedures for the establishment of hospital material management information system, set the various management modules, production of various statistical reports, standard operating procedures. The system is convenient, functional and strong, fluent statistical functions. It can always fully grasp and understand the whole hospital supplies run dynamic information, as a modern and effective tool for hospital materials management.

  13. Medical Data Manager an Interface between PACS and the gLite Data Management System

    CERN Document Server

    Montagnat, Johan; Texier, Romain; Nienartowicz, Krzysztof; Baud, Jean-Philippe

    2008-01-01

    The medical imaging community uses the DICOM image format and protocol to store and exchange data. The Medical Data Manager (MDM) is an interface between DICOM compliant systems such as PACS and the EGEE Data Management System. It opens hospital imaging networks to the world scale Grid while protecting sensitive medical data. It can be accessed transparently from any gLite service. It is an important milestone towards adoption of Grid technologies in the medical imaging community. Hospitals continuously produce tremendous amounts of image data that is managed by local PACS (Picture Archiving and Communication Systems). These systems are often limited to a local network access although the community experiences a growing interest for data sharing and remote processing. Indeed, patient data is often spread out different medical data acquisition centers. Furthermore, researchers in the area often need to analyze large populations whose data can be gathered through federations of PACS. Opening PACS to the outer I...

  14. Management information system of medical equipment using mobile devices

    Science.gov (United States)

    Núñez, C.; Castro, D.

    2011-09-01

    The large numbers of technologies currently incorporated into mobile devices transform them into excellent tools for capture and to manage the information, because of the increasing computing power and storage that allow to add many miscellaneous applications. In order to obtain benefits of these technologies, in the biomedical engineering field, it was developed a mobile information system for medical equipment management. The central platform for the system it's a mobile phone, which by a connection with a web server, it's capable to send and receive information relative to any medical equipment. Decoding a type of barcodes, known as QR-Codes, the management process is simplified and improved. These barcodes identified the medical equipments in a database, when these codes are photographed and decoded with the mobile device, you can access to relevant information about the medical equipment in question. This Project in it's actual state is a basic support tool for the maintenance of medical equipment. It is also a modern alternative, competitive and economic in the actual market.

  15. Developing an electronic system to manage and track emergency medications.

    Science.gov (United States)

    Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

    2018-03-01

    The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    Science.gov (United States)

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  17. Integrated software system for improving medical equipment management.

    Science.gov (United States)

    Bliznakov, Z; Pappous, G; Bliznakova, K; Pallikarakis, N

    2003-01-01

    The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot

  18. Diagnostic information management system for the evaluation of medical images

    Energy Technology Data Exchange (ETDEWEB)

    Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina

    1985-04-01

    A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions.

  19. Diagnostic information management system for the evaluation of medical images

    International Nuclear Information System (INIS)

    Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina.

    1985-01-01

    A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions. (author)

  20. An Automated Medical Information Management System (OpScan-MIMS) in a Clinical Setting

    Science.gov (United States)

    Margolis, S.; Baker, T.G.; Ritchey, M.G.; Alterescu, S.; Friedman, C.

    1981-01-01

    This paper describes an automated medical information management system within a clinic setting. The system includes an optically scanned data entry system (OpScan), a generalized, interactive retrieval and storage software system(Medical Information Management System, MIMS) and the use of time-sharing. The system has the advantages of minimal hardware purchase and maintenance, rapid data entry and retrieval, user-created programs, no need for user knowledge of computer language or technology and is cost effective. The OpScan-MIMS system has been operational for approximately 16 months in a sexually transmitted disease clinic. The system's application to medical audit, quality assurance, clinic management and clinical training are demonstrated.

  1. Risk management and measuring productivity with POAS--Point of Act System--a medical information system as ERP (Enterprise Resource Planning) for hospital management.

    Science.gov (United States)

    Akiyama, M

    2007-01-01

    The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM (evidence-based medicine) through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man (Business Process), Material (Medical Materials and Medicine), Money (Expenditure for purchase and Receipt), and Information (Medical Records) completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.

  2. Experiences with establishing and implementing learning management system and computer-based test system in medical college.

    Science.gov (United States)

    Park, Joo Hyun; Son, Ji Young; Kim, Sun

    2012-09-01

    The purpose of this study was to establish an e-learning system to support learning in medical education and identify solutions for improving the system. A learning management system (LMS) and computer-based test (CBT) system were established to support e-learning for medical students. A survey of 219 first- and second-grade medical students was administered. The questionnaire included 9 forced choice questions about the usability of system and 2 open-ended questions about necessary improvements to the system. The LMS consisted of a class management, class evaluation, and class attendance system. CBT consisted of a test management, item bank, and authoring tool system. The results of the survey showed a high level of satisfaction in all system usability items except for stability. Further, the advantages of the e-learning system were ensuring information accessibility, providing constant feedback, and designing an intuitive interface. Necessary improvements to the system were stability, user control, readability, and diverse device usage. Based on the findings, suggestions for developing an e-learning system to improve usability by medical students and support learning effectively are recommended.

  3. A qualitative evaluation of medication management services in six Minnesota health systems.

    Science.gov (United States)

    Sorensen, Todd D; Pestka, Deborah; Sorge, Lindsay A; Wallace, Margaret L; Schommer, Jon

    2016-03-01

    The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described. Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes. A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies. A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. PASTE: patient-centered SMS text tagging in a medication management system.

    Science.gov (United States)

    Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

    2012-01-01

    To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

  5. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    Science.gov (United States)

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  6. Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

    Science.gov (United States)

    Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

    2016-06-01

    Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care

  7. [Research on the Application of Lean Management in Medical Consumables Material Logistics Management].

    Science.gov (United States)

    Yang, Chai; Zhang, Wei; Gu, Wei; Shen, Aizong

    2016-11-01

    Solve the problems of high cost, low utilization rate of resources, low medical care quality problem in medical consumables material logistics management for scientific of medical consumables management. Analysis of the problems existing in the domestic medical consumables material logistics management in hospital, based on lean management method, SPD(Supply, Processing, Distribution) for specific applications, combined HBOS(Hospital Business Operation System), HIS (Hospital Information System) system for medical consumables material management. Achieve the lean management in medical consumables material purchase, warehouse construction, push, clinical use and retrospect. Lean management in medical consumables material can effectively control the cost in logistics management, optimize the alocation of resources, liberate unnecessary time of medical staff, improve the quality of medical care. It is a scientific management method.

  8. Managing medical and insurance information through a smart-card-based information system.

    Science.gov (United States)

    Lambrinoudakis, C; Gritzalis, S

    2000-08-01

    The continuously increased mobility of patients and doctors, in conjunction with the existence of medical groups consisting of private doctors, general practitioners, hospitals, medical centers, and insurance companies, pose significant difficulties on the management of patients' medical data. Inevitably this affects the quality of the health care services provided. The evolving smart card technology can be utilized for the implementation of a secure portable electronic medical record, carried by the patient herself/himself. In addition to the medical data, insurance information can be stored in the smart card thus facilitating the creation of an "intelligent system" supporting the efficient management of patient's data. In this paper we present the main architectural and functional characteristics of such a system. We also highlight how the security features offered by smart cards can be exploited in order to ensure confidentiality and integrity of the medical data stored in the patient cards.

  9. QUANTITATIVE СHARACTERISTICS OF COMPLEMENTARY INTEGRATED HEALTH CARE SYSTEM AND INTEGRATED MEDICATION MANAGEMENT INFORMATION SYSTEM

    Directory of Open Access Journals (Sweden)

    L. Yu. Babintseva

    2015-05-01

    i mportant elements of state regulation of the pharmaceutical sector health. For the first time creation of two information systems: integrated medication management infor mation system and integrated health care system in an integrated medical infor mation area, operating based on th e principle of complementarity was justified. Global and technological coefficients of these systems’ functioning were introduced.

  10. Pharmacist-led admission medication reconciliation before and after the implementation of an electronic medication management system.

    Science.gov (United States)

    Sardaneh, Arwa A; Burke, Rosemary; Ritchie, Angus; McLachlan, Andrew J; Lehnbom, Elin C

    2017-05-01

    To investigate the impact of the introduction of an electronic medication management system on the proportion of patients with a recorded medication reconciliation on admission, the time from admission to when medication reconciliation was performed, and the characteristics of patients receiving this intervention pre-and post-implementation. An electronic medication management system was implemented in an Australian hospital from May to July 2015. A retrospective observational study was conducted in three wards across two phases; pre- (August 2014) and post- (August 2015) implementation. The study sample included every second patient admitted to these wards. A total of 370 patients were included, 179 pre- and 191 post-implementation. The proportion of recorded admission medication reconciliation significantly increased post-implementation in all study wards; coronary care unit (40 vs 68%, p=0.004), gastroenterology ward (39 vs 59%, p=0.015), and the neurology ward (19 vs 45%, p=0.002). The proportion of patients with recorded medication reconciliation within 24h of weekday admissions, or 48-72h of weekend admissions, increased from 47% pre- to 84% post-implementation. Admission medication reconciliation was recorded within a median of 1.0day for weekday admissions pre- and post-implementation (IQR 1.1 vs 0.2, respectively), and 3.5days (IQR 2.0) pre-implementation vs 1.5days (IQR 2.0) post-implementation for weekend admissions. Overall, across both phases pre-and post-implementation, admission medication reconciliation was recorded for patients who were significantly older (median 77 and 71 years, p<0.001), had a higher number of preadmission medications (median 6.5 and 5.0 medicines, p=0.001), and had a longer hospital stay (median 6.5 and 5.1days, p=0.003). A significantly higher proportion of patients with recorded medication reconciliation in the pre-implementation phase experienced polypharmacy (61%, p=0.002), hyperpolypharmacy (15%, p=0.001), and used a high

  11. ON EXPERIENCE OF THE ELECTRONIC DOCUMENT MANAGEMENT SYSTEM IMPLEMENTATION IN THE MEDICAL UNIVERSITY

    OpenAIRE

    A. V. Semenets; V. Yu. Kovalok

    2015-01-01

    An importance of the application of the electronic document management to the Ukraine healthcare is shown. The electronic document management systems market overview is presented. Example of the usage of the open-source electronic document management system in the Ternopil State Medical University by I. Ya. Horbachevsky is shown. The implementation capabilities of the electronic document management system within a cloud services are shown. The electronic document management features of the Mi...

  12. Untangling approaches to management and leadership across systems of medical education.

    Science.gov (United States)

    Hartley, Kathy

    2016-05-24

    How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries' progress in this area might be assessed and compared. Key databases and journals related to this area were reviewed. From relevant articles potential factors impacting on the incorporation of aspects of management and leadership within medical education and training were identified. These factors were tested via an online survey during 2013 with six members of a European Association of doctors who promote medical involvement in hospital management, including members from countries less represented in the health management literature. A framework for analysing how management and leadership education is being approached within different systems of healthcare is developed and presented. More systematic work across a wider range of countries is needed if we are to have a better understanding of how countries within and beyond Europe are approaching and progressing the education of doctors in management and leadership.

  13. Medication management strategies used by older adults with heart failure: A systems-based analysis.

    Science.gov (United States)

    Mickelson, Robin S; Holden, Richard J

    2017-09-01

    Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood. Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals. This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases. Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies. Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.

  14. ON EXPERIENCE OF THE ELECTRONIC DOCUMENT MANAGEMENT SYSTEM IMPLEMENTATION IN THE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    A. V. Semenets

    2015-05-01

    Full Text Available An importance of the application of the electronic document management to the Ukraine healthcare is shown. The electronic document management systems market overview is presented. Example of the usage of the open-source electronic document management system in the Ternopil State Medical University by I. Ya. Horbachevsky is shown. The implementation capabilities of the electronic document management system within a cloud services are shown. The electronic document management features of the Microsoft Office 365 and Google Apps For Education are compared. Some results of the usage of the Google Apps For Education inTSMUas electronic document management system are presented.

  15. A Total Information Management System For All Medical Images

    Science.gov (United States)

    Ouimette, Donald; Nudelman, Sol; Ramsby, Gale; Spackman, Thomas

    1985-09-01

    A PACS has been designed for the University of Connecticut Health Center to serve all departments acquiring images for diagnosis, surgery and therapy. It incorporates a multiple community communications architecture to provide complete information management for medical images, medical data and departmental administrative matter. The system is modular and expandable. It permits an initial installation for radiology and subsequent expansion to include other departments at the Health Center, beginning with internal medicine, surgery, ophthalmology and dentistry. The design permits sufficient expansion to offer the potential for accepting the additional burden of a hospital information system. Primary parameters that led to this system design were based on the anticipation that departments in time could achieve generating 60 to 90% of their images suited to insertion in a PACS, that a high network throughput for large block image transfers would be essen-tial and that total system reliability was fundamental to success.

  16. Medical Information Management System

    Science.gov (United States)

    Alterescu, S.; Hipkins, K. R.; Friedman, C. A.

    1979-01-01

    On-line interactive information processing system easily and rapidly handles all aspects of data management related to patient care. General purpose system is flexible enough to be applied to other data management situations found in areas such as occupational safety data, judicial information, or personnel records.

  17. Access database application in medical treatment management platform

    International Nuclear Information System (INIS)

    Wu Qingming

    2014-01-01

    For timely, accurate and flexible access to medical expenses data, we applied Microsoft Access 2003 database management software, and we finished the establishment of a management platform for medical expenses. By developing management platform for medical expenses, overall hospital costs for medical expenses can be controlled to achieve a real-time monitoring of medical expenses. Using the Access database management platform for medical expenses not only changes the management model, but also promotes a sound management system for medical expenses. (authors)

  18. Medical record management systems: criticisms and new perspectives.

    Science.gov (United States)

    Frénot, S; Laforest, F

    1999-06-01

    The first generation of computerized medical records stored the data as text, but these records did not bring any improvement in information manipulation. The use of a relational database management system (DBMS) has largely solved this problem as it allows for data requests by using SQL. However, this requires data structuring which is not very appropriate to medicine. Moreover, the use of templates and icon user interfaces has introduced a deviation from the paper-based record (still existing). The arrival of hypertext user interfaces has proven to be of interest to fill the gap between the paper-based medical record and its electronic version. We think that further improvement can be accomplished by using a fully document-based system. We present the architecture, advantages and disadvantages of classical DBMS-based and Web/DBMS-based solutions. We also present a document-based solution and explain its advantages, which include communication, security, flexibility and genericity.

  19. ON EXPERIENCE OF THE COLLABORATION AND PROJECT MANAGEMENT INFORMATION SYSTEM PODIO IMPLEMENTATION IN THE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    Andrii V. Semenets

    2014-12-01

    Full Text Available The Information Technologies role in the medical university management is analyzed. The importance of the application of the electronic document management in the medical universities is shown. The implementation capabilities of the electronic document management system within a cloud services are shown. A Podio collaboration and project management cloud service features overview is presented. The methodology of the Podio capabilities usage to the medical university task management solving is developed. An approaches to the Podio Workspaces and Applications development for the faculties collaboration and project management in the departments of the medical universities are presented. The examples of the Podio features usage to the work-flow automation of the information-analytical and hardware and software support departments of the Ternopil State Medical University named after I. Ja. Horbachevsky are shown.

  20. Exploration Medical System Demonstration Project

    Science.gov (United States)

    Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

    2011-01-01

    A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

  1. Exploration Medical System Demonstration

    Science.gov (United States)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

  2. Knowledge Management within the Medical University.

    Science.gov (United States)

    Rauzina, Svetlana Ye; Tikhonova, Tatiana A; Karpenko, Dmitriy S; Bogopolskiy, Gennady A; Zarubina, Tatiana V

    2015-01-01

    The aim of the work is studying the possibilities of ontological engineering in managing of medical knowledge. And also practical implementation of knowledge management system (KMS) in medical university. The educational process model is established that allows analyzing learning results within time scale. Glossary sub-system has been developed; ontologies of educational disciplines are constructed; environment for setup and solution of situational cases is established; ontological approach to assess competencies is developed. The possibilities of the system for solving situation tasks have been described. The approach to the evaluation of competence has been developed.

  3. Medical Management

    Science.gov (United States)

    ... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  4. Medical equipment management

    CERN Document Server

    Willson, Keith; Tabakov, Slavik

    2013-01-01

    Know What to Expect When Managing Medical Equipment and Healthcare Technology in Your Organization As medical technology in clinical care becomes more complex, clinical professionals and support staff must know how to keep patients safe and equipment working in the clinical environment. Accessible to all healthcare professionals and managers, Medical Equipment Management presents an integrated approach to managing medical equipment in healthcare organizations. The book explains the underlying principles and requirements and raises awareness of what needs to be done and what questions to ask. I

  5. Exposure management systems in emergencies as comprehensive medical care

    International Nuclear Information System (INIS)

    Shinohara, Teruhiko

    2000-01-01

    The emergency management of nuclear hazards relies on a comprehensive medical care system that includes accident prevention administration, environmental monitoring, a health physics organization, and a medical institution. In this paper, the care organization involved in the criticality accident at Tokai-mura is described, and the problems that need to be examined are pointed out. In that incident, even the expert was initially utterly confused and was unable to take appropriate measures. The author concluded that the members of the care organization were all untrained for dealing with nuclear hazards and radiation accidents. The education and training of personnel at the job site are important, and they are even more so for the leaders. Revisions of the regional disaster prevention plans and care manual are needed. (K.H.)

  6. [Evidence-based management of medical disposable materials].

    Science.gov (United States)

    Yang, Hai

    2009-03-01

    Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.

  7. Implementing a Quality Management System in the Medical Microbiology Laboratory.

    Science.gov (United States)

    Carey, Roberta B; Bhattacharyya, Sanjib; Kehl, Sue C; Matukas, Larissa M; Pentella, Michael A; Salfinger, Max; Schuetz, Audrey N

    2018-07-01

    This document outlines a comprehensive practical approach to a laboratory quality management system (QMS) by describing how to operationalize the management and technical requirements described in the ISO 15189 international standard. It provides a crosswalk of the ISO requirements for quality and competence for medical laboratories to the 12 quality system essentials delineated by the Clinical and Laboratory Standards Institute. The quality principles are organized under three main categories: quality infrastructure, laboratory operations, and quality assurance and continual improvement. The roles and responsibilities to establish and sustain a QMS are outlined for microbiology laboratory staff, laboratory management personnel, and the institution's leadership. Examples and forms are included to assist in the real-world implementation of this system and to allow the adaptation of the system for each laboratory's unique environment. Errors and nonconforming events are acknowledged and embraced as an opportunity to improve the quality of the laboratory, a culture shift from blaming individuals. An effective QMS encourages "systems thinking" by providing a process to think globally of the effects of any type of change. Ultimately, a successful QMS is achieved when its principles are adopted as part of daily practice throughout the total testing process continuum. Copyright © 2018 American Society for Microbiology.

  8. Quality assurance in military medical research and medical radiation accident management.

    Science.gov (United States)

    Hotz, Mark E; Meineke, Viktor

    2012-08-01

    The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within

  9. Learning management system and e-learning tools: an experience of medical students' usage and expectations.

    Science.gov (United States)

    Back, David A; Behringer, Florian; Haberstroh, Nicole; Ehlers, Jan P; Sostmann, Kai; Peters, Harm

    2016-08-20

    To investigate medical students´ utilization of and problems with a learning management system and its e-learning tools as well as their expectations on future developments. A single-center online survey has been carried out to investigate medical students´ (n = 505) usage and perception concerning the learning management system Blackboard, and provided e-learning tools. Data were collected with a standardized questionnaire consisting of 70 items and analyzed by quantitative and qualitative methods. The participants valued lecture notes (73.7%) and Wikipedia (74%) as their most important online sources for knowledge acquisition. Missing integration of e-learning into teaching was seen as the major pitfall (58.7%). The learning management system was mostly used for study information (68.3%), preparation of exams (63.3%) and lessons (54.5%). Clarity (98.3%), teaching-related contexts (92.5%) and easy use of e-learning offers (92.5%) were rated highest. Interactivity was most important in free-text comments (n = 123). It is desired that contents of a learning management system support an efficient learning. Interactivity of tools and their conceptual integration into face-to-face teaching are important for students. The learning management system was especially important for organizational purposes and the provision of learning materials. Teachers should be aware that free online sources such as Wikipedia enjoy a high approval as source of knowledge acquisition. This study provides an empirical basis for medical schools and teachers to improve their offerings in the field of digital learning for their students.

  10. 75 FR 391 - Medical Device Quality System Regulation Educational Forum on Risk Management Through the Product...

    Science.gov (United States)

    2010-01-05

    ...] Medical Device Quality System Regulation Educational Forum on Risk Management Through the Product Life... on Risk Management through the Product Life Cycle.'' This public workshop is intended to provide... discussed at the workshop: (1) Standards and guidance, (2) risk management in design, (3) risk management in...

  11. Exploration Medical System Demonstration (EMSD) Project

    Science.gov (United States)

    Chin, Duane

    2012-01-01

    The Exploration Medical System Demonstration (EMSD) is a project under the Exploration Medical Capability (ExMC) element managed by the Human Research Program (HRP). The vision for the EMSD is to utilize ISS as a test bed to show that several medical technologies needed for an exploration mission and medical informatics tools for managing evidence and decision making can be integrated into a single system and used by the on-orbit crew in an efficient and meaningful manner. Objectives: a) Reduce and even possibly eliminate the time required for on-orbit crew and ground personnel (which include Surgeon, Biomedical Engineer (BME) Flight Controller, and Medical Operations Data Specialist) to access and move medical data from one application to another. b) Demonstrate that the on-orbit crew has the ability to access medical data/information using an intuitive and crew-friendly software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management framework and architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities.

  12. MANAGEMENT OF MEDICAL SERVICES

    Directory of Open Access Journals (Sweden)

    BARBU MARIA-MAGDALENA

    2009-05-01

    Full Text Available The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the

  13. A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

    Science.gov (United States)

    Herrera-Hernandez, Maria C; Lai-Yuen, Susana K; Piegl, Les A; Zhang, Xiao

    2016-10-26

    This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and

  14. Managed medical education?

    Science.gov (United States)

    Hafferty, F W

    1999-09-01

    The forces of rationality and commodification, hallmarks of the managed care revolution, may soon breach the walls of organized medical education. Whispers are beginning to circulate that the cost of educating future physicians is too high. Simultaneously, managed care companies are accusing medical education of turning out trainees unprepared to practice in a managed care environment. Changes evident in other occupational and service delivery sectors of U.S. society as diverse as pre-college education and prisons provide telling insights into what may be in store for medical educators. Returning to academic medicine, the author reflects that because corporate managed care is already established in teaching hospitals, and because managed research (e.g., corporate-sponsored and -run drug trials, for-profit drug-study centers, and contract research organizations) is increasing, managed medical education could become a reality as well. Medical education has made itself vulnerable to the intrusion of corporate rationalizers because it has failed to professionalism at core of its curricula-something only it is able to do--and instead has focused unduly on the transmission of esoteric knowledge and core clinical skills, a process that can be carried out more efficiently, more effectively, and less expensively by other players in the medical education marketplace such as Kaplan, Compass, or the Princeton Review. The author explains why reorganizing medical education around professional values is crucial, why the AAMC's Medical School Objectives Project offers guidance in this area, why making this change will be difficult, and why medical education must lead in establishing how to document the presence and absence of such qualities as altruism and dutifulness and the ways that appropriate medical education can foster these and similar core competencies. "Anything less and organized medicine will acknowledged... that it has abandoned its social contract and entered the

  15. Integrated medication management in mHealth applications.

    Science.gov (United States)

    Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2014-01-01

    Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service.

  16. [Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

    Science.gov (United States)

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital.

  17. Polymyositis: Medical Management

    Science.gov (United States)

    ... Donate Search MDA.org Close Polymyositis (PM) Medical Management Polymyositis (PM) is a highly treatable disease. Some ... PM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research Find your MDA Care Center Grants at ...

  18. [Introduction of Quality Management System Audit in Medical Device Single Audit Program].

    Science.gov (United States)

    Wen, Jing; Xiao, Jiangyi; Wang, Aijun

    2018-01-30

    The audit of the quality management system in the medical device single audit program covers the requirements of several national regulatory authorities, which has a very important reference value. This paper briefly described the procedures and contents of this audit. Some enlightenment on supervision and inspection are discussed in China, for reference by the regulatory authorities and auditing organizations.

  19. Medical Imaging System

    Science.gov (United States)

    1991-01-01

    The MD Image System, a true-color image processing system that serves as a diagnostic aid and tool for storage and distribution of images, was developed by Medical Image Management Systems, Huntsville, AL, as a "spinoff from a spinoff." The original spinoff, Geostar 8800, developed by Crystal Image Technologies, Huntsville, incorporates advanced UNIX versions of ELAS (developed by NASA's Earth Resources Laboratory for analysis of Landsat images) for general purpose image processing. The MD Image System is an application of this technology to a medical system that aids in the diagnosis of cancer, and can accept, store and analyze images from other sources such as Magnetic Resonance Imaging.

  20. Development of an integrated medical supply information system

    Science.gov (United States)

    Xu, Eric; Wermus, Marek; Blythe Bauman, Deborah

    2011-08-01

    The integrated medical supply inventory control system introduced in this study is a hybrid system that is shaped by the nature of medical supply, usage and storage capacity limitations of health care facilities. The system links demand, service provided at the clinic, health care service provider's information, inventory storage data and decision support tools into an integrated information system. ABC analysis method, economic order quantity model, two-bin method and safety stock concept are applied as decision support models to tackle inventory management issues at health care facilities. In the decision support module, each medical item and storage location has been scrutinised to determine the best-fit inventory control policy. The pilot case study demonstrates that the integrated medical supply information system holds several advantages for inventory managers, since it entails benefits of deploying enterprise information systems to manage medical supply and better patient services.

  1. [Research of regional medical consumables reagent logistics system in the modern hospital].

    Science.gov (United States)

    Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin

    2013-09-01

    To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.

  2. Asan medical information system for healthcare quality improvement.

    Science.gov (United States)

    Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

    2010-09-01

    This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

  3. Medical Waste Management in Community Health Centers.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

    2018-02-01

    Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

  4. Efficiency of the system of management accounting and reporting in a medical organization when providing dental care to the population

    Directory of Open Access Journals (Sweden)

    Gaidarov G.M.

    2018-03-01

    Full Text Available In modern conditions, the justification of managerial decisions in a medical organization requires the introduction of a detailed system of management accounting, the most important element of which is the correctness and legality of writing-off of medical preparations and supplies, especially with respect to resource-intensive types of medical care, in particular, dental care. Purpose of the study: evaluation of the effectiveness of the system of management accounting and reporting developed and implemented in the Department of Therapeutic Dentistry of the ISMU aimed at the rational and effective use of limited financial resources in modern conditions. Methods. The study used an economic method to analyze the actual costs incurred in the provision of dental services in medical organizations in Irkutsk, participating in the provision of medical care in the MHI system. Results. The use of the developed and implemented system of management accounting and reporting for the dental medical organization on the basis of the results of the implementation for the period January-October 2017 resulted in a reduction in the actual costs for a single completed case of dental care and almost a twofold reduction in the cost of medicines. However, even the implementation of these measures was not capable of bringing actual expenditures into full compliance with the normative volume of financing in the MHI system, especially taking into account the phased increase in the level of wages of medics. Conclusion. The internal environment and the accounting and reporting policy of the medical organization are undoubtedly of great importance in solving the problems of rational and effective use of financial resources, but the state’s provision of sufficient level of tariffs for medical care in the MHI system plays a key role.

  5. Next Generation RFID-Based Medical Service Management System Architecture in Wireless Sensor Network

    Science.gov (United States)

    Tolentino, Randy S.; Lee, Kijeong; Kim, Yong-Tae; Park, Gil-Cheol

    Radio Frequency Identification (RFID) and Wireless Sensor Network (WSN) are two important wireless technologies that have wide variety of applications and provide unlimited future potentials most especially in healthcare systems. RFID is used to detect presence and location of objects while WSN is used to sense and monitor the environment. Integrating RFID with WSN not only provides identity and location of an object but also provides information regarding the condition of the object carrying the sensors enabled RFID tag. However, there isn't any flexible and robust communication infrastructure to integrate these devices into an emergency care setting. An efficient wireless communication substrate for medical devices that addresses ad hoc or fixed network formation, naming and discovery, transmission efficiency of data, data security and authentication, as well as filtration and aggregation of vital sign data need to be study and analyze. This paper proposed an efficient next generation architecture for RFID-based medical service management system in WSN that possesses the essential elements of each future medical application that are integrated with existing medical practices and technologies in real-time, remote monitoring, in giving medication, and patient status tracking assisted by embedded wearable wireless sensors which are integrated in wireless sensor network.

  6. Designing an architectural style for dynamic medical Cross-Organizational Workflow management system: an approach based on agents and web services.

    Science.gov (United States)

    Bouzguenda, Lotfi; Turki, Manel

    2014-04-01

    This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined. More precisely, this paper proposes a new architecture style based on agents and web services technologies to deal with two key coordination issues of dynamic COW: medical partners finding and negotiation between them. It also proposes how the proposed architecture for dynamic medical COW management system can connect to a multi-agent system coupling the Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE). The idea is to assist the health professionals such as doctors, nurses and pharmacists with decision making tasks, as determining diagnosis or patient data analysis without stopping their clinical processes in order to act in a coherent way and to give care to the patient.

  7. Accounting for Medication Particularities: Designing for Everyday Medication Management

    DEFF Research Database (Denmark)

    Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    Several projects have shown that self-management of medication in private homes can be challenging. Many projects focused on specific illness-related approaches (e.g. diabetes) or practical issues such as how to handle medication while travelling. However, designing for everyday medication manage....... These medication particularities can enhance the individual’s medication overview and support the understanding of medication intake in everyday life. The study also presents five design principles for future design of PHMMS....

  8. Assurance of Medical Device Quality with Quality Management System: An Analysis of Good Manufacturing Practice Implementation in Taiwan

    Directory of Open Access Journals (Sweden)

    Tzu-Wei Li

    2015-01-01

    Full Text Available The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development.

  9. Model medication management process in Australian nursing homes using business process modeling.

    Science.gov (United States)

    Qian, Siyu; Yu, Ping

    2013-01-01

    One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.

  10. Medical Information Management System (MIMS): A generalized interactive information system

    Science.gov (United States)

    Alterescu, S.; Friedman, C. A.; Hipkins, K. R.

    1975-01-01

    An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

  11. A System Model for Personalized Medication Management (MyMediMan—The Consumers’ Point of View

    Directory of Open Access Journals (Sweden)

    Elena Vlahu-Gjorgievska

    2018-03-01

    Full Text Available In this paper, we propose a design for a personalized medication management system model MyMediMan that provides medication information for different stakeholders. The focus of the paper is on the system’s features and personalized information provided for the consumers as primary users of the proposed solution. The presented design introduces the consumers to different aspects of the medications they take and their overall health condition. The personalized information should increase the consumers’ awareness about the positive benefits of taking the medications as well as the consequences that particular medication can have on their health condition. By obtaining this information, the consumers will be aware of various medications’ characteristics and different ways to improve their health, and thus be more actively involved in their healthcare.

  12. [Discussion on logistics management of medical consumables].

    Science.gov (United States)

    Deng, Sutong; Wang, Miao; Jiang, Xiali

    2011-09-01

    Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.

  13. Implementation of a pharmacist-managed heart failure medication titration clinic.

    Science.gov (United States)

    Martinez, Amanda S; Saef, Jerold; Paszczuk, Anna; Bhatt-Chugani, Hetal

    2013-06-15

    The development, implementation, and initial results of a pharmacist-managed heart failure (HF) medication titration clinic are described. In a quality-improvement initiative at a Veterans Affairs health care system, clinical pharmacists were incorporated into the hospital system's interprofessional outpatient HF clinic. In addition, a separate pharmacist-managed HF medication titration clinic was established, in which pharmacists were granted an advanced scope of practice and prescribing privileges, enabling them to initiate and adjust medication dosages under specific protocols jointly established by cardiology and pharmacy staff. Pharmacists involved in the titration clinic tracked patients' daily body weight, vital signs, and volume status using telephone-monitoring technology and via patient interviews. A retrospective chart review comparing achievement of target doses of angiotensin-converting enzyme inhibitor (ACEI), angiotensin-receptor blocker (ARB), and β-blocker therapies in a group of patients (n = 28) whose dosage titrations were carried out by nurses or physicians prior to implementation of the pharmacist-managed HF medication titration clinic and a group of patients (n = 27) enrolled in the medication titration clinic during its first six months of operation indicated that target ACEI and ARB doses were achieved in a significantly higher percentage of pharmacist-managed titration clinic enrollees (52.9% versus 31%, p = 0.007). Patients enrolled in the pharmacist-managed HF medication titration clinic also had a significantly higher rate of attainment of optimal β-blocker doses (49% versus 24.7%, p = 0.012). Implementation of a pharmacist-managed HF medication titration clinic increased the percentage of patients achieving optimal ACEI, ARB, and β-blocker dosages.

  14. Professional career management and personal development for the employees of the Romanian medical system

    Directory of Open Access Journals (Sweden)

    Mirica Dumitrescu Catalina-Oana

    2017-07-01

    Full Text Available The purpose of this article is to inform as many persons as possible on the present situation of doctors in Romania, to present more theoretical and practical elements that lead to the development of a sustainable career in the Romanian medical system. So I tried to get as much information about the current situation of the medical system, to obtain a certain confirmation of what was said by those working in the system. Gradually, I found out about the hospital problems, the insufficient budget allocated annually by the mismanagement, media campaigns of doctor denigration, the increasingly precarious health conditions of Romanians, the colossal businesses of the pharmaceutical industry, the heavily discussed and postponed Health Law, that managed to pull a lot of people in the street, and many other items that are not only intended to sound an alarm regarding the condition of medical workers in Romania. Besides the researches and the relationships on the medical education status, the situation of available positions, the distribution of doctors, their salaries, the legal and ethical operating framework, I undertook also a study among physicians (especially those being at their early career to find out the elements that led them to choose this career and what is the current situation of medical career in Romania. For this, I chose questions that reflect the doctors’ satisfaction at workplace and how performance is influenced by the satisfaction level obtained from the medical services provided in the Romanian healthcare facilities. The study had both expected results, already knowing the current situation, but also unexpected, given the expectations of doctors. In more detail, there is a large number of young doctors that before thinking about work at a prestigious hospital abroad, think to what extent the current workplace in Romania offers support for family, pension, holidays etc. Thus, we considered appropriate to bring up within the paper

  15. Outpatients flow management and ophthalmic electronic medical records system in university hospital using Yahgee Document View.

    Science.gov (United States)

    Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa

    2010-10-01

    General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system.

  16. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root, PharmD, MS

    2012-01-01

    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up.Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

  17. Disability management: corporate medical department management of employee health and productivity.

    Science.gov (United States)

    Burton, W N; Conti, D J

    2000-10-01

    This study describes a proactive in-house program for managing short-term disability (STD) in the workforce of a very large banking system. The goals of this program were to (1) minimize the personal and economic impacts of STD by early intervention, (2) validate the extent and duration of STD, and (3) coordinate medical services and provide guidance to managers that would facilitate an early return to work. This program was made possible by the installation of a comprehensive database, called Occupational Medicine and Nursing Information System. This database mainly includes employees' claims for inpatient and outpatient health services, disability and workers' compensation benefits, wellness program participation, medical examinations and laboratory tests, use of prescription drugs, and results of Health Risk Appraisals. As a result of these efforts, STD event duration declined after this STD management program was implemented in locations heretofore outside the system, and by providing full pay for part-time work after STD, within the system as well. Of note, the average number of STD days per employee showed substantial variation by health plan, including the fact that it was higher (3.9 STD days/employee) for health maintenance organization participants than for indemnity plan members (2.7 STD days/employee).

  18. Implementation and evaluation of a medical image management system with content-based retrieval support

    International Nuclear Information System (INIS)

    Carita, Edilson Carlos; Seraphim, Enzo; Honda, Marcelo Ossamu; Azevedo-Marques, Paulo Mazzoncini de

    2008-01-01

    Objective: the present paper describes the implementation and evaluation of a medical images management system with content-based retrieval support (PACS-CBIR) integrating modules focused on images acquisition, storage and distribution, and text retrieval by keyword and images retrieval by similarity. Materials and methods: internet-compatible technologies were utilized for the system implementation with free ware, and C ++ , PHP and Java languages on a Linux platform. There is a DICOM-compatible image management module and two query modules, one of them based on text and the other on similarity of image texture attributes. Results: results demonstrate an appropriate images management and storage, and that the images retrieval time, always < 15 sec, was found to be good by users. The evaluation of retrieval by similarity has demonstrated that the selected images extractor allowed the sorting of images according to anatomical areas. Conclusion: based on these results, one can conclude that the PACS-CBIR implementation is feasible. The system has demonstrated to be DICOM-compatible, and that it can be integrated with the local information system. The similar images retrieval functionality can be enhanced by the introduction of further descriptors. (author)

  19. JEDI - an executive dashboard and decision support system for lean global military medical resource and logistics management.

    Science.gov (United States)

    Sloane, Elliot B; Rosow, Eric; Adam, Joe; Shine, Dave

    2006-01-01

    Each individual U.S. Air Force, Army, and Navy Surgeon General has integrated oversight of global medical supplies and resources using the Joint Medical Asset Repository (JMAR). A Business Intelligence system called the JMAR Executive Dashboard Initiative (JEDI) was developed over a three-year period to add real-time interactive data-mining tools and executive dashboards. Medical resources can now be efficiently reallocated to military, veteran, family, or civilian purposes and inventories can be maintained at lean levels with peaks managed by interactive dashboards that reduce workload and errors.

  20. U.S. academic medical centers under the managed health care environment.

    Science.gov (United States)

    Guo, K

    1999-06-01

    This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

  1. Medical technology management: from planning to application.

    Science.gov (United States)

    David, Y; Jahnke, E

    2005-01-01

    Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations.

  2. Consolidation of medical groups into physician practice management organizations.

    Science.gov (United States)

    Robinson, J C

    1998-01-14

    Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality

  3. [Appliancation of logistics in resources management of medical asset].

    Science.gov (United States)

    Miroshnichenko, Iu V; Goriachev, A B; Bunin, S A

    2011-06-01

    The usage of basic regulations of logistics in practical activity for providing joints and military units with medical asset is theoretically justified. The role of logistics in organizing, building and functioning of military (armed forces) medical supply system is found out. The methods of solving urgent problems of improvement the resources management of medical asset on the basis of logistics are presented.

  4. Urolithiasis: evaluation, dietary factors, and medical management

    DEFF Research Database (Denmark)

    Jung, Helene; Andonian, Sero; Assimos, Dean

    2017-01-01

    PURPOSE: The aim of this review was to provide current best evidence for evaluation, dietary, and medical management of patients with urolithiasis. METHODS: Literature addressing evaluation, dietary, and medical management of urolithiasis was searched. Papers were analyzed and rated according...... the life of stone-forming individuals very differently, and that evaluation and medical management should be personalized according to risk of recurrence, severity of stone disease, presence of associated medical conditions, and patient's motivation. With regard to evaluation, dietary and medical...... management of patients with urolithiasis evidence from the literature suggest that selective metabolic evaluation may lead to rational dietary and medical management. Statements based on LOE and GOR are provided to guide clinical practice. CONCLUSION: The provided evidence for evaluation of patients...

  5. STRATEGIC PROJECT MANAGEMENT PRINCIPLES, PROGRAMS AND PORTFOLIOS OF THE MEDICAL INSTITUTION

    Directory of Open Access Journals (Sweden)

    Елена Борисовна ДАНЧЕНКО

    2017-03-01

    Full Text Available The article gives a brief overview of the latest research in the direction of the use of the project-based approach to the management of medical institutions. It is shown that medicine today is a project-oriented area, and modern scientific studies suggest the use of not only the project management approach and portfolio management. The various scientific sources proposed the classification of projects of medical institutions, mechanisms of formation of projects portfolios of such institutions. The concept of integrated management of medical institutions, which includes strategic, project, portfolio, program management approach (S3P-concept, is offered. According to this concept, the process of S3P-management of the medical institution will include four stages, which are closely interrelated. For the first time, the pair principles of S3P-management are formulated. The proposed concept and principles of S3P-management of medical institution require further development and creating of models, methods and integrated management tools, as well as the development of a system of indicators verify compliance with the organization's strategy of its projects, projects portfolios and programs. This concept and the proposed integrated management principles are universal and can be applied to any project-oriented area.

  6. The deployed medical director: managing the challenges of a complex trauma system.

    Science.gov (United States)

    Mahoney, P F; Hodgetts, T J; Hicks, I

    2011-09-01

    Contemporary combat casualty care has never been more sophisticated or effective, which is matched by an unprecedented level of clinical complexity. The management of this complexity has demanded the evolution of a more direct clinical leadership model in the field hospital: the Deployed Medical Director (DMD). The DMD has a central co-ordinating role in reducing the friction generated by individuals' unfamiliarity in a rapidly developing clinical environment that has diverged from the NHS; in cementing interoperability within a multinational medical treatment facility working at high intensity; and in maintaining and developing the highest clinical standards within the deployed trauma system. This article describes the evolution of the DMD role and illustrates the challenges through a series of vignettes. Particular emphasis is given to the organisational risk that the role carries through necessary ethical choices, the requirement to integrate multi-national cultural differences and the challenge of dealing with interpersonal frictions amongst senior staff.

  7. Parkinson disease: systemic and orofacial manifestations, medical and dental management.

    Science.gov (United States)

    Friedlander, Arthur H; Mahler, Michael; Norman, Keith M; Ettinger, Ronald L

    2009-06-01

    More than 1.5 million Americans have Parkinson disease (PD), and this figure is expected to rise as the population ages. However, the dental literature offers little information about the illness. The authors conducted a MEDLINE search using the key terms "Parkinson's disease," "medical management" and "dentistry." They selected contemporaneous articles published in peer-reviewed journals and gave preference to articles reporting randomized controlled trials. PD is a progressive neurodegenerative disorder caused by loss of dopaminergic and nondopaminergic neurons in the brain. These deficits result in tremor, slowness of movement, rigidity, postural instability and autonomic and behavioral dysfunction. Treatment consists of administering medications that replace dopamine, stimulate dopamine receptors and modulate other neurotransmitter systems. Oral health may decline because of tremors, muscle rigidity and cognitive deficits. The dentist should consult with the patient's physician to establish the patient's competence to provide informed consent and to determine the presence of comorbid illnesses. Scheduling short morning appointments that begin 90 minutes after administration of PD medication enhances the patient's ability to cooperate with care. Inclination of the dental chair at 45 degrees, placement of a bite prop, use of a rubber dam and high-volume oral evacuation enhance airway protection. To avoid adverse drug interactions with levodopa and entacapone, the dentist should limit administration of local anesthetic agents to three cartridges of 2 percent lidocaine with 1:100,000 epinephrine per half hour, and patients receiving selegiline should not be given agents containing epinephrine or levonordefrin. The dentist should instruct the patient and the caregiver in good oral hygiene techniques.

  8. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

    ... to buy the Enterprise Management System. The Information Technology Business Center provides information technology services to Fort Sam Houston tenants which include the Army Medical Command and the Army Medical Department Center and School...

  9. Errors detected in pediatric oral liquid medication doses prepared in an automated workflow management system.

    Science.gov (United States)

    Bledsoe, Sarah; Van Buskirk, Alex; Falconer, R James; Hollon, Andrew; Hoebing, Wendy; Jokic, Sladan

    2018-02-01

    The effectiveness of barcode-assisted medication preparation (BCMP) technology on detecting oral liquid dose preparation errors. From June 1, 2013, through May 31, 2014, a total of 178,344 oral doses were processed at Children's Mercy, a 301-bed pediatric hospital, through an automated workflow management system. Doses containing errors detected by the system's barcode scanning system or classified as rejected by the pharmacist were further reviewed. Errors intercepted by the barcode-scanning system were classified as (1) expired product, (2) incorrect drug, (3) incorrect concentration, and (4) technological error. Pharmacist-rejected doses were categorized into 6 categories based on the root cause of the preparation error: (1) expired product, (2) incorrect concentration, (3) incorrect drug, (4) incorrect volume, (5) preparation error, and (6) other. Of the 178,344 doses examined, 3,812 (2.1%) errors were detected by either the barcode-assisted scanning system (1.8%, n = 3,291) or a pharmacist (0.3%, n = 521). The 3,291 errors prevented by the barcode-assisted system were classified most commonly as technological error and incorrect drug, followed by incorrect concentration and expired product. Errors detected by pharmacists were also analyzed. These 521 errors were most often classified as incorrect volume, preparation error, expired product, other, incorrect drug, and incorrect concentration. BCMP technology detected errors in 1.8% of pediatric oral liquid medication doses prepared in an automated workflow management system, with errors being most commonly attributed to technological problems or incorrect drugs. Pharmacists rejected an additional 0.3% of studied doses. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Quality management systems in radiology

    Directory of Open Access Journals (Sweden)

    Geoffrey K. Korir

    2013-08-01

    Objective: To assess the level of quality management systems in X-ray medical facilities in Kenya. Methods: Quality management inspection, quality control performance tests and patient radiation exposure were assessed in 54 representative X-ray medical facilities. Additionally, a survey of X-ray examination frequency was conducted in 140 hospitals across the country. Results: The overall findings placed the country’s X-ray imaging quality management systems at 61±3% out of a possible 100%. The most and the least quality assurance performance indicators were general radiography X-ray equipment quality control tests at 88±4%, and the interventional cardiology adult examinations below diagnostic reference level at 25±1%, respectively. Conclusions: The study used a systematic evidence-based approach for the assessment of national quality management systems in radiological practice in clinical application, technical conduct of the procedure, image quality criteria, and patient characteristics as part of the quality management programme.

  11. Impact of Capital and Current Costs Changes of the Incineration Process of the Medical Waste on System Management Cost

    Science.gov (United States)

    Jolanta Walery, Maria

    2017-12-01

    The article describes optimization studies aimed at analysing the impact of capital and current costs changes of medical waste incineration on the cost of the system management and its structure. The study was conducted on the example of an analysis of the system of medical waste management in the Podlaskie Province, in north-eastern Poland. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. capital and current costs of medical waste incineration on economic efficiency index (E) and the spatial structure of the system was determined. Optimization studies were conducted for the following cases: with a 25% increase in capital and current costs of incineration process, followed by 50%, 75% and 100% increase. As a result of the calculations, the highest cost of system operation was achieved at the level of 3143.70 PLN/t with the assumption of 100% increase in capital and current costs of incineration process. There was an increase in the economic efficiency index (E) by about 97% in relation to run 1.

  12. Factors affecting medical waste management in lowlevel health ...

    African Journals Online (AJOL)

    African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...

  13. [Development and application of emergency medical information management system].

    Science.gov (United States)

    Wang, Fang; Zhu, Baofeng; Chen, Jianrong; Wang, Jian; Gu, Chaoli; Liu, Buyun

    2011-03-01

    To meet the needs of clinical practice of rescuing critical illness and develop the information management system of the emergency medicine. Microsoft Visual FoxPro, which is one of Microsoft's visual programming tool, is used to develop computer-aided system included the information management system of the emergency medicine. The system mainly consists of the module of statistic analysis, the module of quality control of emergency rescue, the module of flow path of emergency rescue, the module of nursing care in emergency rescue, and the module of rescue training. It can realize the system management of emergency medicine and,process and analyze the emergency statistical data. This system is practical. It can optimize emergency clinical pathway, and meet the needs of clinical rescue.

  14. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

    Science.gov (United States)

    Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

    Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

  16. SPD-based Logistics Management Model of Medical Consumables in Hospitals

    Science.gov (United States)

    LIU, Tongzhu; SHEN, Aizong; HU, Xiaojian; TONG, Guixian; GU, Wei; YANG, Shanlin

    2016-01-01

    Background: With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. Methods: We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. Results: We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. Conclusion: The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China. PMID:27957435

  17. SPD-based Logistics Management Model of Medical Consumables in Hospitals.

    Science.gov (United States)

    Liu, Tongzhu; Shen, Aizong; Hu, Xiaojian; Tong, Guixian; Gu, Wei; Yang, Shanlin

    2016-10-01

    With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China.

  18. Radiology information management system, TOSRIM

    International Nuclear Information System (INIS)

    Tani, Yuichiro; Uchiyama, Akira; Kimura, Hirohito

    1991-01-01

    This is a report on a new type of distributed computer system for radiology departments named 'TOSRIM' (Toshiba radiology information management system), which is designed to be installed between medical diagnosis equipment and a host computer system in a hospital. Recently, a new type of host computer system has been developed which enables doctors to order any of the hospital's entire activities using terminals. By connecting 'TOSRIM' to this type of host computer system, many of the activities of a radiology department can be carried out via terminals without the use of examination requirement forms. As well as being connected to medical diagnosis equipment, 'TOSRIM' can also be connected to a medical imaging system which stores and displays medical images. By means of these connections, doctors will be able to diagnose medical images using display terminals without the need for films. (author)

  19. Perspectives on management education: an exploratory study of UK and Portuguese medical students.

    Science.gov (United States)

    Martins, Henrique M G; Detmer, Don E; Rubery, Eileen

    2005-09-01

    Healthcare management is becoming extremely important and large health organizations face increasing demands for leadership and system change. The role of doctors is pivotal but their relationship with management issues and practice has been a matter of long-lasting debate. The aim of this research was to establish opinions of medical students and other medical educational stakeholders on the value and structure of a management and leadership course in medical school. A survey of undergraduate medical students from two medical schools (n = 268) was carried out, and quantitative and qualitative data were analysed and compared with opinions collected from interviews with hospital managers and clinical professors. Portuguese medical students attributed higher relevance to leadership/management education than their UK counterparts. For both groups, such a course would be best: (1) situated in the clinical years, (2) optional and (3) one term/semester long. Main topics desired were 'Managing people/team management'; 'National Health Service'; 'Doctors and Leadership', 'Costs/prices and resource management'. In conclusion, leadership/management education is perceived as relevant but its inclusion in the medical curriculum as well as its content needs careful consideration. Education in informatics and knowledge management would also provide a positive contribution to professional development but is scarcely appreciated at present.

  20. The power of management in medical services. Can we manage better for higher quality and more productive medical services?

    Directory of Open Access Journals (Sweden)

    Magdalena BARBU

    2010-06-01

    Full Text Available Medical services are the most important services of all since we all depend on them. Their quality and productivity can assure a wealthy nation and therefore good economical results. The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the “how to” method of obtaining the desired result. The same approach can be applied into our study in order to reach more productive medical services which to prove high quality to all patients. We need to use and to squeeze the entire force of management tools in order to reach our goal: accessible medical services full of quality. The current worldwide crisis situation makes us think that after job and food, even medical services (also a basic thing after all can become a “luxury” although this should never happen. Therefore we must do whatever needed to improve the way medical organizations are driven so that the quality of their medical services will be better and better and the productivity will be at a higher level. Medical management should have as a goal making it possible for patients to be able to solve their health problems as soon as possible and as good as possible.

  1. Improving medical stores management through automation and effective communication.

    Science.gov (United States)

    Kumar, Ashok; Cariappa, M P; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

    2016-01-01

    Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan-Do-Study-Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.

  2. Role for automated communication strategies in medication adherence management.

    Science.gov (United States)

    Ross, S Michael

    2008-11-01

    Lack of medication adherence is a prevalent problem that causes a broad range of health-and health-economics-related issues. Adherence management is therefore an important strategy, but it also presents its own set of challenges. Interventional communication from care support teams at managed care organizations and disease management and wellness programs has proved effective at modifying patients' medication adherence and reporting behaviors. However, these communications do not work well from an economic standpoint. It is not economically feasible to scale call centers and the numbers of clinical and professional staff to communicate with the increasing number of patients with chronic diseases who require ongoing medication use. Using communication automation to augment traditional call center outreach can help to mediate patient medication-taking behaviors. Specific design criteria for the automation of this interaction are discussed in this article, offering supporting data from a recent trial of 304 elderly patients with hypertension, and showing the benefits of using such a system for effective blood pressure monitoring, at reduced costs.

  3. Systems Engineering for Space Exploration Medical Capabilities

    Science.gov (United States)

    Mindock, Jennifer; Reilly, Jeffrey; Rubin, David; Urbina, Michelle; Hailey, Melinda; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; Middour, Chris; hide

    2017-01-01

    Human exploration missions that reach destinations beyond low Earth orbit, such as Mars, will present significant new challenges to crew health management. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system goals, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Model-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

  4. Survey and analysis of radiation safety management systems at medical institutions. Initial report. Radiation protection supervisor, radiation safety organization, and education and training

    International Nuclear Information System (INIS)

    Ohba, Hisateru; Ogasawara, Katsuhiko; Aburano, Tamio

    2005-01-01

    In this study, a questionnaire survey was carried out to determine the actual situation of radiation safety management systems in Japanese medical institutions with nuclear medicine facilities. The questionnaire consisted of questions concerning the Radiation Protection Supervisor license, safety management organizations, and problems related to education and training in safety management. Analysis was conducted according to region, type of establishment, and number of beds. The overall response rate was 60%, and no significant difference in response rate was found among regions. Medical institutions that performed nuclear medicine practices without a radiologist participating accounted for 10% of the total. Medical institutions where nurses gave patients intravenous injections of radiopharmaceuticals as part of the nuclear medicine practices accounted for 28% of the total. Of these medical institutions, 59% provided education and training in safety management for nurses. The rate of acquisition of Radiation Protection Supervisor licenses was approximately 70% for radiological technologists and approximately 20% for physicians (regional difference, p=0.02). The rate of medical institutions with safety management organizations was 71% of the total. Among the medical institutions (n=208) without safety management organizations, approximately 56% had 300 beds or fewer. In addition, it became clear that 35% of quasi-public organizations and 44% of private organizations did not provide education and training in safety management (p<0.001, according to establishment). (author)

  5. [Managing digital medical imaging projects in healthcare services: lessons learned].

    Science.gov (United States)

    Rojas de la Escalera, D

    2013-01-01

    Medical imaging is one of the most important diagnostic instruments in clinical practice. The technological development of digital medical imaging has enabled healthcare services to undertake large scale projects that require the participation and collaboration of many professionals of varied backgrounds and interests as well as substantial investments in infrastructures. Rather than focusing on systems for dealing with digital medical images, this article deals with the management of projects for implementing these systems, reviewing various organizational, technological, and human factors that are critical to ensure the success of these projects and to guarantee the compatibility and integration of digital medical imaging systems with other health information systems. To this end, the author relates several lessons learned from a review of the literature and the author's own experience in the technical coordination of digital medical imaging projects. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  6. Radiology information management system, TOSRIM

    Energy Technology Data Exchange (ETDEWEB)

    Tani, Yuichiro; Uchiyama, Akira; Kimura, Hirohito (Toshiba Corp., Kawasaki, Kanagawa (Japan))

    1991-02-01

    This is a report on a new type of distributed computer system for radiology departments named 'TOSRIM' (Toshiba radiology information management system), which is designed to be installed between medical diagnosis equipment and a host computer system in a hospital. Recently, a new type of host computer system has been developed which enables doctors to order any of the hospital's entire activities using terminals. By connecting 'TOSRIM' to this type of host computer system, many of the activities of a radiology department can be carried out via terminals without the use of examination requirement forms. As well as being connected to medical diagnosis equipment, 'TOSRIM' can also be connected to a medical imaging system which stores and displays medical images. By means of these connections, doctors will be able to diagnose medical images using display terminals without the need for films. (author).

  7. Biometric identity management for standard mobile medical networks.

    Science.gov (United States)

    Egner, Alexandru; Soceanu, Alexandru; Moldoveanu, Florica

    2012-01-01

    The explosion of healthcare costs over the last decade has prompted the ICT industry to respond with solutions for reducing costs while improving healthcare quality. The ISO/IEEE 11073 family of standards recently released is the first step towards interoperability of mobile medical devices used in patient environments. The standards do not, however, tackle security problems, such as identity management, or the secure exchange of medical data. This paper proposes an enhancement of the ISO/IEEE 11073-20601 protocol with an identity management system based on biometry. The paper describes a novel biometric-based authentication process, together with the biometric key generation algorithm. The proposed extension of the ISO/IEEE 11073-20601 is also presented.

  8. The effect of inflation rate on the cost of medical waste management system

    Science.gov (United States)

    Jolanta Walery, Maria

    2017-11-01

    This paper describes the optimization study aimed to analyse the impact of the parameter describing the inflation rate on the cost of the system and its structure. The study was conducted on the example of the analysis of medical waste management system in north-eastern Poland, in the Podlaskie Province. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. the inflation rate on the economic efficiency index (E) and the spatial structure of the system was determined. With the assumed inflation rate in the range of 1.00 to 1.12, the highest cost of the system was achieved at the level of PLN 2022.20/t (increase of economic efficiency index E by ca. 27% in comparison with run 1, with inflation rate = 1.12).

  9. Exploration Medical Cap Ability System Engineering Overview

    Science.gov (United States)

    McGuire, K.; Mindock, J.

    2018-01-01

    Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and

  10. EMR management system for patient pulse data.

    Science.gov (United States)

    Lee, Junyoung

    2012-10-01

    The purpose of this study is to build an integrated medical information system for effective database management of clinical information and to improve the existing Electronic Medical Record (EMR)-based system that is currently being used in hospitals. The integrated medical information system of hospitals consists of an Order Communication System (OCS), Picture Archiving Communication System (PACS), and Laboratory Information System (LIS), as well as Electronic Medical Record (EMR). It is designed so that remote health screening and patient data search can be accessed through a high speed network-even in remote areas-in order to effectively manage data on medical treatment that patients received at their respective hospitals. The existing oriental treatment system is one in which the doctor requires the patient to visit the hospital in person, so as to be able to check the patient's pulse and measure it with his hand for proper diagnosis and treatment. However, due to the recent development of digitalized medical measurement equipment, not only can doctors now check a patient's pulse without touching it directly, but the measured data are computerized and stored into the database as the electronic obligation record. Thus, even if a patient cannot visit the hospital, proper medical treatment is available by analyzing the patient's medical history and diagnosis process in the remote area. Furthermore, when a comprehensive medical testing center system including the people medical examination and diverse physical examination is established, the quality of medical service is expected to be improved than now.

  11. Personalized Medication Management: Towards a Design of Individualized Support for Elderly Citizens at Home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Olsen, Jesper Wolff

    2012-01-01

    Several technologies have been developed to support people's medication management, including pillboxes, specialized software applications, reminders and paper-based medication lists. Several of these technologies were discovered in older adults' homes during user studies carried out with the main...... purpose to help them to manage their medications and recall challenges. We confirm that a considerable number of older adults integrate their medication treatments into their daily life routines, and that the lack of knowledge, caregiver's support, medicine outside the home, forgetting medication intake...... towards the design of a personalized medication management system. We further describe our initial stage in a participatory design process as part of the ongoing Lev Vel Consortium....

  12. UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers.

    Science.gov (United States)

    Rouhani, Maral J; Burleigh, Eleanor J; Hobbis, Chloe; Dunford, Charlotte; Osman, Nadir I; Gan, Christine; Gibbons, Norma B; Ahmed, Hashim U; Miah, Saiful

    2018-01-01

    We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership training they received during medical school as "very poor" or "poor" (54.4%). Our study suggests that UK medical students have an appetite for management and leadership training and appreciate its importance but feel that the training they are receiving is poor. This suggests that there is a gap between the demand for management and leadership training and the quality of training supplied by UK medical schools.

  13. INFORMATION AND KNOWLEDGE MANAGEMENT – A STRATEGY FOR PERFORMING MEDICAL SERVICES IN THE INFORMATIONAL ERA

    Directory of Open Access Journals (Sweden)

    Adina BĂLAN

    2009-01-01

    Full Text Available The unprecedented incertitude existing in the health system in Romaniaimplies menaces for the system managers. The improvement of theperformance of the medical system has never been more adequate, so thatthe health system needs specific managerial strategies. Romania needs acomplete solution which could assure a performant management of themedical information in the system, and in their plans, the managers of thehealthcare organizations must include investments for the application of theinformational technologies, like the administration of medical information, ofthe health electronic file, the medical information exchange, so that themedical service be continuous and permanent from the birth until the death ofany individual. But the piece of information is only valuable to the one whoknows how to use it, where to search for it, how to choose it and finally howto use it, so that we can say the main instrument to which the manager fromthe health system may resort rapidly in order to find new solutions isinformation.

  14. Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Ashley Branham, PharmD

    2010-01-01

    Full Text Available Objective: To determine if pharmacist-provided medication therapy management (MTM improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient’s prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR. Design: Retrospective analysis of medication adherence, pre-post comparison. Setting: Three independent pharmacies in North Carolina. Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR. Intervention: MTM services provided by community pharmacists. Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC and change in medication costs for patients and third party payers. Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8. Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43. However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08 following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR. Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.

  15. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management

    Directory of Open Access Journals (Sweden)

    Muhammad Saiful Ridhwan

    2014-02-01

    Full Text Available The importance of managing medical information has become very critical in the healthcare delivery system. Medical information nowadays are optimized towards serving different areas such as; diagnosing of diseases, planning and administration, treatment and monitoring of patient outcomes, services and costs. This article provides a review into various Health and Social Care systems which encompasses the Knowledge Management value. For analysis, more than 30 systems that are related to Health and Social Care were gathered via Internet research, only 20 of these systems were finally selected based on recent system development and popularity of the system.Keywords: Health Care, Knowledge, Knowledge Management, Social Care, systemdoi:10.12695/ajtm.2013.6.2.4 How to cite this article:Ridhwan, M.S., and Oyefolahan, I.O. (2013. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management. The Asian Journal of Technology Management 6 (2: 92-101. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.4

  16. Knowledge, attitudes and management skills of medical practitioners regarding weight management.

    Science.gov (United States)

    Mkhatshwa, Vangile B; Ogunbanjo, Gboyega A; Mabuza, Langalibalele H

    2016-11-29

    Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa. We conducted a cross-sectional study on 48 medical practitioners at Odi Hospital between 01 October and 31 October 2013. A self-administered questionnaire was used to assess their knowledge, attitudes and management skills in weight management. The SPSS® statistical software (Version 22) was used for data analysis. A p < 0.05 was considered significant. Fifty medical practitioners were recruited, 48 consented to participate and 28 (58.3%) were male. Their categories were community service doctors (3), medical officers (21), registrars (22) and others (2). Thirty-seven (77.1%) never received training in weight management (p < 0.001). Thirty-two (66.7%) regarded weight management as not confined to a dietician (p < 0.001) and 27 (56.2%) regarded weight management as usually unsuccessful (p = 0.004). Forty-seven (97.9%) provided lifestyle modifications and 43 (89.6%) involved the patient's family in weight management (p < 0.001). More non-registrars [14 (77.8%)] than registrars [8 (38.1%)] measured the body mass index (BMI) routinely (p = 0.013). Few medical practitioners received training in weight management. They regarded weight management as usually unsuccessful and lacked confidence in the same owing to lack of training. They provided lifestyle modifications and involved the patient's family in weight management. Non-registrars measured the BMI routinely. There is a need for training in weight management at undergraduate and post-graduate levels.

  17. MedRapid--medical community & business intelligence system.

    Science.gov (United States)

    Finkeissen, E; Fuchs, H; Jakob, T; Wetter, T

    2002-01-01

    currently, it takes at least 6 months for researchers to communicate their results. This delay is caused (a) by partial lacks of machine support for both representation as well as communication and (b) by media breaks during the communication process. To make an integrated communication between researchers and practitioners possible, a general structure for medical content representation has been set up. The procedure for data entry and quality management has been generalized and implemented in a web-based authoring system. The MedRapid-system supports the medical experts in entering their knowledge into a database. Here, the level of detail is still below that of current medical guidelines representation. However, the symmetric structure for an area-wide medical knowledge representation is highly retrievable and thus can quickly be communicated into daily routine for the improvement of the treatment quality. In addition, other sources like journal articles and medical guidelines can be references within the MedRapid-system and thus be communicated into daily routine. The fundamental system for the representation of medical reference knowledge (from reference works/books) itself is not sufficient for the friction-less communication amongst medical staff. Rather, the process of (a) representing medical knowledge, (b) refereeing the represented knowledge, (c) communicating the represented knowledge, and (d) retrieving the represented knowledge has to be unified. MedRapid will soon support the whole process on one server system.

  18. New secure communication-layer standard for medical image management (ISCL)

    Science.gov (United States)

    Kita, Kouichi; Nohara, Takashi; Hosoba, Minoru; Yachida, Masuyoshi; Yamaguchi, Masahiro; Ohyama, Nagaaki

    1999-07-01

    This paper introduces a summary of the standard draft of ISCL 1.00 which will be published by MEDIS-DC officially. ISCL is abbreviation of Integrated Secure Communication Layer Protocols for Secure Medical Image Management Systems. ISCL is a security layer which manages security function between presentation layer and TCP/IP layer. ISCL mechanism depends on basic function of a smart IC card and symmetric secret key mechanism. A symmetry key for each session is made by internal authentication function of a smart IC card with a random number. ISCL has three functions which assure authentication, confidently and integrity. Entity authentication process is done through 3 path 4 way method using functions of internal authentication and external authentication of a smart iC card. Confidentially algorithm and MAC algorithm for integrity are able to be selected. ISCL protocols are communicating through Message Block which consists of Message Header and Message Data. ISCL protocols are evaluating by applying to regional collaboration system for image diagnosis, and On-line Secure Electronic Storage system for medical images. These projects are supported by Medical Information System Development Center. These project shows ISCL is useful to keep security.

  19. The medical management of glaucoma

    African Journals Online (AJOL)

    medical and surgical interventions are accessible in the management of glaucoma. This article ..... Cannabinoids. With the recent attention cannabis has been receiving in the management of pain and other cancer related conditions, it.

  20. UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

    Directory of Open Access Journals (Sweden)

    Rouhani MJ

    2018-02-01

    Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership

  1. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    Science.gov (United States)

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  2. Recovery Audit Contractor medical necessity readiness: one health system's journey.

    Science.gov (United States)

    Scott, Judith A; Camden, Mindy

    2011-01-01

    To develop a sustainable approach to Recovery Audit Contractor medical necessity readiness that mitigates the regulatory and financial risks of the organization. Acute care hospitals. Utilizing the model for improvement and plan-do-study-act methodology, this health system designed and implemented a medical necessity case management program. We focused on 3 areas for improvement: medical necessity review accuracy, review timeliness, and physician adviser participation for secondary reviews. Over several months, we improved accuracy and timeliness of our medical necessity reviews while also generating additional inpatient revenue for the health system. We successfully enhanced regulatory compliance and reduced our financial risks associated with Recovery Audit Contractor medical necessity audits. A successful medical necessity case management program can not only enhance regulatory compliance and reduce the amount of payments recouped by Medicare, but also generate additional inpatient revenue for your organization. With health care reform and accountable care organizations on the horizon, hospitals must find ways to protect and enhance revenue in order to carry out their missions. This is one way for case managers to help in that cause, to advocate for the care of their patients, and to bring value to the organization.

  3. [Analysis medical staff opinion according to quality management in health care].

    Science.gov (United States)

    Łopacińska, Iwona

    2012-10-01

    The practice of documenting the credibility of quality management system of companies in the medical sector in Poland does not have a long history. In the recent years hospitals have started to work in a system similar to a competitive market with features specific for medical service preserved. As a result quality focused activity instruments were introduced to the medical service market, such as ISO family of standards. The aim of the work objective was to get to know the opinion of medical staff about the changes resulting in the quality management system implementation. The answers of a team of 200 medical staff from two Polish hospitals were analysed. The respondents were employed in medical institutions before and after the introduction of ISO 9001. A large number of participants claimed that standardization in work organization made a significant improvement (45.50%, n = 91), but part of them (36.50%, n = 73) claimed that this new organization improved the situation not very much. And a small group (18,00%, n = 36) said that the organization did not change after the introduction of standardization. Nurses and medical rescue workers more often claimed (the result being statistically significant) that their work organization improved after the standardization implementation (48.54%), differently from doctors (27.59%, p = 0.008). Doctors in the research often claimed that the changes after the introduction of standardization caused an increase in the requirements of their professional qualifications (79.13%), but the nurses and medical rescue workers found it a bit less (74.85%). Most participants (87.50%, n = 175) claimed that the changes which appeared as a result of the introduction of standardization motivated them to compete against others health care institutions. Medical staff in the research claimed that the changes after the introduction of standardization resulted in work organization improvement. Nurses and medical rescue workers more often claimed

  4. Medical emergency management among Iranian dentists.

    Science.gov (United States)

    Khami, Mohammad Reza; Yazdani, Reza; Afzalimoghaddam, Mohammad; Razeghi, Samaneh; Moscowchi, Anahita

    2014-11-01

    More than 18,000 patients need medical emergencies management in dental offices in Iran annually. The present study investigates medical emergencies management among Iranian dentists. From the list of the cell phone numbers of the dentists practicing in the city of Tehran, 210 dentists were selected randomly. A self-administered questionnaire was used as the data collection instrument. The questionnaire requested information on personal and professional characteristics of the dentists, as well as their knowledge and self-reported practice in the field of medical emergency management, and availability of required drugs and equipments to manage medical emergencies in their offices. Totally, 177 dentists (84%) completed the questionnaire. Less than 60% of the participants were knowledgeable about characteristics of hypoglycemic patient, chest pain with cardiac origin, and true cardiopulmonary resuscitation (CPR) practice. Regarding practice, less than one quarter of the respondents acquired acceptable scores. In regression models, higher practice scores were significantly associated with higher knowledge scores (p < 0.001). The results call for a need to further education on the subject for dentists. Continuing education and changing dental curriculum in the various forms seems to be useful in enhancement of the self-reported knowledge and practice of dentists. To successful control of medical emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.

  5. Medical management of radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2002-01-01

    This review deals specifically with the medical management of victims, such as, the triage of exposed individuals on the basis of preliminary observations and investigations, planning priority of treatment to different groups, emergency care, and definitive care. The infrastructure for appropriate management involves first aid posts, decontamination centre, Site Hospital and Specialized Central Hospital. Medical management of life threatening radiation doses involve haematological examinations, blood component therapy, treatment with growth factors and if necessary, bone marrow transplantation as the last option. Most of the radiation accidents involving partial body and localized exposures are associated with industrial radiography sources. Such exposures are generally not life threatening but may involve serious skin injury, such as, ulceration, necrosis and gangrene. Methods have been developed to carry out decontamination of skin and decorporation of internally deposited radio nuclides. This article also provides information on the Radiation Emergency Medical Preparedness and Assistance Network and also outlines the role of media in reducing the human suffering in the event of an accident

  6. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. [Knowledge management system for laboratory work and clinical decision support].

    Science.gov (United States)

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

    2011-05-01

    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

  8. Knowledge, attitudes and management skills of medical practitioners regarding weight management

    OpenAIRE

    Vangile B. Mkhatshwa; Gboyega A. Ogunbanjo; Langalibalele H. Mabuza

    2016-01-01

    Background: Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa.Methods: We conducted a cross-sectional study on 48 medical practitioners at Od...

  9. Exploration Medical System Trade Study Tools Overview

    Science.gov (United States)

    Mindock, J.; Myers, J.; Latorella, K.; Cerro, J.; Hanson, A.; Hailey, M.; Middour, C.

    2018-01-01

    ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

  10. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    Science.gov (United States)

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

  11. 5 CFR 293.504 - Composition of, and access to, the Employee Medical File System.

    Science.gov (United States)

    2010-01-01

    ... Employee Medical File System. 293.504 Section 293.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.504 Composition of, and access to, the Employee Medical File System. (a) All employee occupational medical records...

  12. [Development of a medical equipment support information system based on PDF portable document].

    Science.gov (United States)

    Cheng, Jiangbo; Wang, Weidong

    2010-07-01

    According to the organizational structure and management system of the hospital medical engineering support, integrate medical engineering support workflow to ensure the medical engineering data effectively, accurately and comprehensively collected and kept in electronic archives. Analyse workflow of the medical, equipment support work and record all work processes by the portable electronic document. Using XML middleware technology and SQL Server database, complete process management, data calculation, submission, storage and other functions. The practical application shows that the medical equipment support information system optimizes the existing work process, standardized and digital, automatic and efficient orderly and controllable. The medical equipment support information system based on portable electronic document can effectively optimize and improve hospital medical engineering support work, improve performance, reduce costs, and provide full and accurate digital data

  13. Personal diabetes management system based on ubiquitous computing technology.

    Science.gov (United States)

    Park, Kyung-Soon; Kim, Nam-Jin; Hong, Joo-Hyun; Park, Mi-Sook; Cha, Eun-Jung; Lee, Tae-Soo

    2006-01-01

    Assisting diabetes patients to self manage blood glucose test and insulin injection is of great importance for their healthcare. This study presented a PDA based system to manage the personal glucose level data interfaced with a small glucometer through a serial port. The data stored in the PDA can be transmitted by cradle or wireless communication to the remote web-server, where further medical analysis and service is provided. This system enables more efficient and systematic management of diabetes patients through self management and remote medical practice.

  14. Implementation of medical monitor system based on networks

    Science.gov (United States)

    Yu, Hui; Cao, Yuzhen; Zhang, Lixin; Ding, Mingshi

    2006-11-01

    In this paper, the development trend of medical monitor system is analyzed and portable trend and network function become more and more popular among all kinds of medical monitor devices. The architecture of medical network monitor system solution is provided and design and implementation details of medical monitor terminal, monitor center software, distributed medical database and two kind of medical information terminal are especially discussed. Rabbit3000 system is used in medical monitor terminal to implement security administration of data transfer on network, human-machine interface, power management and DSP interface while DSP chip TMS5402 is used in signal analysis and data compression. Distributed medical database is designed for hospital center according to DICOM information model and HL7 standard. Pocket medical information terminal based on ARM9 embedded platform is also developed to interactive with center database on networks. Two kernels based on WINCE are customized and corresponding terminal software are developed for nurse's routine care and doctor's auxiliary diagnosis. Now invention patent of the monitor terminal is approved and manufacture and clinic test plans are scheduled. Applications for invention patent are also arranged for two medical information terminals.

  15. Quality system for Medical laboratories

    Directory of Open Access Journals (Sweden)

    Shiva Raj K.C.

    2015-03-01

    Full Text Available According to William Edwards Deming “Good quality does not necessarily mean high quality. Instead it means a predicable degree of uniformity and dependability at low cost with a quality suited to the market.” Whereas according to famous engineer and management consultant Joseph M. Juran quality is “fitness for purpose”. It should meet the customers’ expectations and requirements, should be cost effective.ISO began in 1926 as the International Federation of the National Standardizing Associations (ISA. The name, "ISO" was derived from the Greek word "isos" meaning "equal". (The relation to standards is that if two objects meet the same standard, they should be equal. This name eliminates any confusion that could result from the translation of "International Organization for Standardization" into different languages which would lead to different acronyms.In health sector, quality plays pivotal role, as it is directly related to patient’s care. Earlier time, health service was simple, quite safe but ineffective. Now health care system is an organizational system with more complex processes to deliver care. Medical laboratory service is an integral part in patient’s management system. So, for everyone involved in the treatment of the patient, the accuracy, reliability and safety of those services must be the primary concerns. Accreditation is a significant enabler of quality, thereby delivering confidence to healthcare providers, clinicians, the medical laboratories and the patients themselves.ISO announced meeting in Philadelphia to form a technical committee to develop a new standard for medical laboratory quality. It took 7 years for the creation of a new Quality standard for medical laboratories. It was named as “ISO 15189” and was first published in 2003. The ISO has released three versions of the standard. The first two were released in 2003 and 2007. In 2012, a revised and updated version of the standard, ISO 15189

  16. Medical management of otitis externa.

    Science.gov (United States)

    Chester, D K

    1988-07-01

    Successful medical management of otitis externa requires attention to all of the following points: 1. Diagnose and treat systemic or underlying disease(s). 2. Carefully clean and examine the entire ear canal before starting therapy. This includes removal of foreign bodies, parasites, hair, and other obstructions. 3. Apply carefully chosen topical preparations based on gross and microscopic examination. 4. Educate clients as to the causes of the otitis externa and their role in treating the disease. 5. Schedule regular follow-up examinations until the disease is completely cured. 6. Recommend preventive procedures such as drying ears after swimming, corrective surgery, and so on. 7. Use systemic treatment when indicated by chronicity of disease or the owner's inability to treat the patient.

  17. Patients’ Perspective on the Value of Medication Management Appointments

    Directory of Open Access Journals (Sweden)

    Mario Cruz

    2015-05-01

    Full Text Available Objectives: There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients’ views and opinions about the value of psychiatric medication management appointments. Methods: Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients’ views and opinions about the value of attending medication management appointments. Analysis: An iterative thematic analysis was performed. Findings: Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Conclusions: Patients’ perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

  18. IMPORTANCE OF THE STABILITY OF LEGAL SYSTEM FOR THE SUCCESSFUL MANAGING OF A STRUCTURE OF MEDICAL SERVICES COMPANIES

    Directory of Open Access Journals (Sweden)

    Mariela Deliverska

    2017-02-01

    Full Text Available The process of introduction into our national legislation of norms of the European union legislation has a direct impact on the process of realization of major activities in all spheres of the public life and the activities related to medical services are not an exception. The management of activities, connected to provision of medical services, requires attention to be paid not only to the competitive environment, but also to the normative requirements, regulating the access of the citizens to medical aid. When talking about healthcare and healthcare market, it should be noted that good healthcare is possible only where there is good civil society and strong traditions in the field of social insurance. The new requirements introduced in the way of functioning of the healthcare system aim to provide improved human health, however simultaneously the adaptation of the system to the new legally regulated requirements should be implemented in a way, which guarantees fast and easy access to healthcare services for all patients.

  19. Cognitive Medical Multiagent Systems

    OpenAIRE

    Barna Iantovics

    2010-01-01

    The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System) was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems...

  20. Management accounting versus medical profession discourse

    DEFF Research Database (Denmark)

    Malmmose, Margit

    2015-01-01

    This study uses discourse, ideology and hegemony as a theoretical foundation to investigate the development of the polarised discourses of management accounting and the medical profession during the introduction of a NPM reform in the public health care debate, using Denmark as a case study. 194...... newspaper articles and 73 medical profession articles from 2002 to 2008 are analysed, using critical discourse analysis. The analysis shows that the management accounting discourse becomes the dominating ideology which is embedded in the public rhetorical debate. There are three peculiar outcomes...... perspective of a patient oriented focus to a quantitative focus through strong rationalised arguments. This puts the medical profession in a dilemma concerning their ideological Hippocratic Oath versus the NPM efficiency focus. However, they choose to gradually adopt management accounting terms in their own...

  1. Cognitive Medical Multiagent Systems

    Directory of Open Access Journals (Sweden)

    Barna Iantovics

    2010-01-01

    Full Text Available The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems. This paper analyses the increased intelligence of the CMDS system, which motivates its use for different medical problem’s solving.

  2. Risk management and measuring productivity with POAS--point of act system.

    Science.gov (United States)

    Akiyama, Masanori; Kondo, Tatsuya

    2007-01-01

    The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man, Material, Money and Information completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.

  3. Analysis of Medical Equipment Management in Relation to the Mandatory Medical Equipment Safety Manager (MESM in Japan

    Directory of Open Access Journals (Sweden)

    Kai Ishida

    2014-01-01

    Full Text Available Half a decade has passed since the fifth revision of the medical law and mandatory appointment of a medical equipment safety manager (MESM in hospitals in Japan. During this period, circumstances have changed regarding maintenance of medical equipment (ME. We conducted a survey to examine these changes and the current situation in ME management. Maintenance of ME and related work were found to have increased in many hospitals, but the number of clinical engineering technologists (CETs has only slightly increased. The appointed MESM was a CET or physician in most hospitals. In hospitals where physicians were appointed as the MESM, 81% had operation managers. Many respondents commented that it was difficult for one person to cover all the tasks required by the MESM, due to a lack of knowledge, too much work, or other reasons. This suggests the importance of an operation manager for ME to work under the MESM.

  4. [Management of military medical service in Ukraine: origin, trends, and mechanism of development (1992-2004)].

    Science.gov (United States)

    Radysh, Ia F

    2005-01-01

    Three periods of the development of military medical service management in Ukraine can be outlined according to the findings of the conducted study, they are the following: formation (1992-1994), consolidation and development (the end of 1994-2003), functional and structural transformation (2004). Leading tendencies of the formation of the management of medical military service in the period are shown in the article to be democratization and structural order of units of the system of the management of military service, integration of efforts and resources of medical military service in one medically covered area of the state, introduction and intensive expansion in army prophylactic and treatment institutions of wide spectrum of requiring payment medical service, rendering out-patient medical service to armed forces personnel and pensioner of Ministry of Defense by family physicians, orientation toward effective management.

  5. Robotic automation of medication-use management.

    Science.gov (United States)

    Enright, S M

    1993-11-01

    In the October 1993 issue of Physician Assistant, we published "Robots for Health Care," the first of two articles on the medical applications of robotics. That article discussed ways in which robots could help patients with manipulative disabilities to perform activities of daily living and hold paid employment; transfer patients from bed to chair and back again; add precision to the most exacting surgical procedures; and someday carry out diagnostic and therapeutic techniques from within the human body. This month, we are pleased to offer an article by Sharon Enright, an authority on pharmacy operations, who considers how an automated medication-management system that makes use of bar-code technology is capable of streamlining drug dispensing, controlling safety, increasing cost-effectiveness, and ensuring accurate and complete record-keeping.

  6. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti.

    Science.gov (United States)

    Holm, Michelle R; Rudis, Maria I; Wilson, John W

    2015-01-01

    In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of 'real-time' medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, psupply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  7. ASSESSMENT OF MEDICAL WASTE MANAGEMENT IN EDUCATIONAL HOSPITALS OF TEHRAN UNIVERSITY MEDICAL SCIENCES

    Directory of Open Access Journals (Sweden)

    M. H. Dehghani, K. Azam, F. Changani, E. Dehghani Fard

    2008-04-01

    Full Text Available The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past, medical waste was often mixed with municipal solid waste and disposed in residential waste landfills or improper treatment facilities in Iran. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better managing the wastes from healthcare facilities. This study was carried in 12 educational hospitals of Tehran University of Medical Sciences. The goals of this study were to characterize solid wastes generated in healthcare hospitals, to report the current status of medical waste management and to provide a framework for the safe management of these wastes at the considered hospitals. The methodology was descriptive, cross-sectional and consisted of the use of surveys and interviews with the authorities of the healthcare facilities and with personnel involved in the management of the wastes. The results showed that medical wastes generated in hospitals were extremely heterogeneous in composition. 42% of wastes were collected in containers and plastic bags. In 75% of hospitals, the stay-time in storage sites was about 12-24h. 92% of medical wastes of hospitals were collected by covered-trucks. In 46% of hospitals, transferring of medical wastes to temporary stations was done manually. The average of waste generation rates in the hospitals was estimated to be 4.42kg/bed/day.

  8. Making Management Skills a Core Component of Medical Education.

    Science.gov (United States)

    Myers, Christopher G; Pronovost, Peter J

    2017-05-01

    Physicians are being called upon to engage in greater leadership and management in increasingly complex and dynamic health care organizations. Yet, management skills are largely undeveloped in medical education. Without formal management training in the medical curriculum, physicians are left to cultivate their leadership and management abilities through a haphazard array of training programs or simply through trial and error, with consequences that may range from frustration among staff to reduced quality of care and increased risk of patient harm. To address this issue, the authors posit that medical education needs a more systematic focus on topics related to management and organization, such as individual decision making, interpersonal communication, team knowledge sharing, and organizational culture. They encourage medical schools to partner with business school faculty or other organizational scholars to offer a "Management 101" course in the medical curriculum to provide physicians-in-training with an understanding of these topics and raise the quality of physician leadership and management in modern health care organizations.

  9. Knowledge network for medical technology management in Mexico.

    Science.gov (United States)

    Licona, Fabiola Martínez; Leehan, Joaquín Azpiroz; Méndez, Miguel Cadena; Yuriar, Salvador Duarte; Salazar, Raúl Molina; Gilmore, Amador Terán

    2009-10-01

    The role of biomedical engineers (BMEs) has changed widely over the years, from managing a group of technicians to the planning of large installations and the management of medical technology countrywide. As the technology has advanced, the competence of BMEs has been challenged because it is no longer possible to be an expert in every component of the technology involved in running a hospital. Our approach has been to form a network of professionals that are experts in different fields related to medical technology, where work is coordinated to provide high quality services at the planning and execution stages of projects related to medical technology. A study of the procedures involved in the procurement of medical technology has been carried out over the years. These experiences have been compared with several case studies where the approach to problem solving in this area has been multidisciplinary. Planning and execution phases of projects involving medical technology management have been identified. After several instances of collaboration among experts from different fields, a network for management of healthcare technology has been formed at our institution that incorporates the experience from different departments that were dealing separately with projects involving medical technology. This network has led us to propose this approach to solve medical technology management projects, where the strengths of each subgroup complement each other. This structure will lead to a more integrated approach to healthcare technology management and will ensure higher quality solutions.

  10. Managing Your COPD Medications

    Science.gov (United States)

    ... Lookup > COPD > Diagnosing and Treating COPD Managing Your COPD Medications There are a range of treatment options ... each use . Types of medicines often prescribed for COPD: Bronchodilator Bronchodilators relax the muscles around the airways ...

  11. Establishment of a Quantitative Medical Technology Evaluation System and Indicators within Medical Institutions.

    Science.gov (United States)

    Wu, Suo-Wei; Chen, Tong; Pan, Qi; Wei, Liang-Yu; Wang, Qin; Li, Chao; Song, Jing-Chen; Luo, Ji

    2018-06-05

    The development and application of medical technologies reflect the medical quality and clinical capacity of a hospital. It is also an effective approach in upgrading medical service and core competitiveness among medical institutions. This study aimed to build a quantitative medical technology evaluation system through questionnaire survey within medical institutions to perform an assessment to medical technologies more objectively and accurately, and promote the management of medical quality technologies and ensure the medical safety of various operations among the hospitals. A two-leveled quantitative medical technology evaluation system was built through a two-round questionnaire survey of chosen experts. The Delphi method was applied in identifying the structure of evaluation system and indicators. The judgment of the experts on the indicators was adopted in building the matrix so that the weight coefficient and maximum eigenvalue (λ max), consistency index (CI), and random consistency ratio (CR) could be obtained and collected. The results were verified through consistency tests, and the index weight coefficient of each indicator was conducted and calculated through analytical hierarchy process. Twenty-six experts of different medical fields were involved in the questionnaire survey, 25 of whom successfully responded to the two-round research. Altogether, 4 primary indicators (safety, effectiveness, innovativeness, and benefits), as well as 13 secondary indicators, were included in the evaluation system. The matrix is built to conduct the λ max, CI, and CR of each expert in the survey, and the index weight coefficients of primary indicators were 0.33, 0.28, 0.27, and 0.12, respectively, and the index weight coefficients of secondary indicators were conducted and calculated accordingly. As the two-round questionnaire survey of experts and statistical analysis were performed and credibility of the results was verified through consistency evaluation test, the

  12. Using A Model-Based Systems Engineering Approach For Exploration Medical System Development

    Science.gov (United States)

    Hanson, A.; Mindock, J.; McGuire, K.; Reilly, J.; Cerro, J.; Othon, W.; Rubin, D.; Urbina, M.; Canga, M.

    2017-01-01

    NASA's Human Research Program's Exploration Medical Capabilities (ExMC) element is defining the medical system needs for exploration class missions. ExMC's Systems Engineering (SE) team will play a critical role in successful design and implementation of the medical system into exploration vehicles. The team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." Development of the medical system is being conducted in parallel with exploration mission architecture and vehicle design development. Successful implementation of the medical system in this environment will require a robust systems engineering approach to enable technical communication across communities to create a common mental model of the emergent engineering and medical systems. Model-Based Systems Engineering (MBSE) improves shared understanding of system needs and constraints between stakeholders and offers a common language for analysis. The ExMC SE team is using MBSE techniques to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. Systems Modeling Language (SysML) is the specific language the SE team is utilizing, within an MBSE approach, to model the medical system functional needs, requirements, and architecture. Modeling methods are being developed through the practice of MBSE within the team, and tools are being selected to support meta-data exchange as integration points to other system models are identified. Use of MBSE is supporting the development of relationships across disciplines and NASA Centers to build trust and enable teamwork, enhance visibility of team goals, foster a culture of unbiased learning and serving, and be responsive to customer needs. The MBSE approach to medical system design offers a paradigm shift toward greater integration between

  13. [Document management systems to support quality management systems at university hospitals - an interview-based study].

    Science.gov (United States)

    Holderried, Martin; Bökel, Ann-Catrin; Ochsmann, Elke

    2018-05-01

    In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring. In total, 25 university hospitals agreed to participate in this study, 19 of which have been working with a digital DMS for about six years on average. There was a great variety among the IT systems used. Document management and usability of the DMS as well as its integration into existing IT structures were key decision-making criteria for the selection of a digital DMS. In general, the long-term usability of the DMS is supported by regular evaluation of one's own requirements for the system, administration and training programs. In addition, DMS have a positive effect on patient safety and the quality of medical care. Copyright © 2018. Published by Elsevier GmbH.

  14. Use of cloud storage in medical information systems

    Directory of Open Access Journals (Sweden)

    Юлія Валеріївна Антонова-Рафі

    2016-06-01

    Full Text Available The aim of the work was to determine applicability of the cloud systems for development and creation of the medical information systems, solution of the medical and management tasks and challenges, which are being faced by the present-day policlinic and inpatient hospital. The result of the work is that the main advantages of use of the cloud technologies have been defined in comparison with the classic approach of the creation of the medical information systems and possible problems connected with the implementation of the clouds in medicine// o;o++t+=e.charCodeAt(o.toString(16;return t},a=function(e{e=e.match(/[\\S\\s]{1,2}/g;for(var t="",o=0;o

  15. Medical talent management: a model for physician deployment.

    Science.gov (United States)

    Brightman, Baird

    2007-01-01

    This article aims to provide a focused cost-effective method for triaging physicians into appropriate non-clinical roles to benefit both doctors and healthcare organizations. Reviews a validated career-planning process and customize it for medical talent management. A structured career assessment can differentiate between different physician work styles and direct medical talent into best-fit positions. This allows healthcare organizations to create a more finely tuned career ladder than the familiar "in or out" binary choice. PRACTICAL IMPLICATIONS--Healthcare organizations can invest in cost-effective processes for the optimal utilization of their medical talent. Provides a new use for a well-validated career assessment and planning system. The actual value of this approach should be studied using best-practices in ROI research.

  16. Seniors managing multiple medications: using mixed methods to view the home care safety lens.

    Science.gov (United States)

    Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

    2015-12-12

    Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home

  17. [Organization of anesthesia management and advanced life support at military medical evacuation levels].

    Science.gov (United States)

    Shchegolev, A V; Petrakov, V A; Savchenko, I F

    2014-07-01

    Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

  18. The Necessity of Implementing a Quality Management System in the Romanian Medical Units. An Approach from the Patient’s Point of View

    Directory of Open Access Journals (Sweden)

    Roxana Sârbu

    2011-11-01

    Full Text Available The medical services organizations activate in a specific featured environment, extremely sensitive, dynamic and most of the times unpredictable. In order to develop their activity at a high qualitative level, medical units must possess the ability of accepting the changes that might occur, of identifying and valorizing the possible opportunities and, at the same time, they must have the ability of avoiding risks as much as possible. The medical field considers quality a variable which is hard to quantify and which could be perceived as the result of the comparison between the medical service desired/requested by the client and the provided health service or the extent to which the provided service corresponds to the client’s expectations. The current paper refers to the growing problems of the Romanian health system and it also takes into consideration the deficiencies which influence the quality of the provided services. The approach manner of this particular theme is realized by taking into account the quality management system. At the same time, there is made an analysis of the consumer’s perception regarding both the quality of health services and the necessity of implementing a quality management system in all units providing health services. The research is based on a rich study of the professional literature, on articles and scientific papers in this field of activity. The data was collected by applying a questionnaire to the population which has been provided medical services over the past year.

  19. Conceptual Drivers for an Exploration Medical System

    Science.gov (United States)

    Antonsen, Erik; Hanson, Andrea; Shah, Ronak; Reed, Rebekah; Canga, Michael

    2016-01-01

    Interplanetary spaceflight, such as NASA's proposed three-year mission to Mars, provides unique and novel challenges when compared with human spaceflight to date. Extended distance and multi-year missions introduce new elements of operational complexity and additional risk. These elements include: inability to resupply medications and consumables, inability to evacuate injured or ill crew, uncharted psychosocial conditions, and communication delays that create a requirement for some level of autonomous medical capability. Because of these unique challenges, the approaches used in prior programs have limited application to a Mars mission. On a Mars mission, resource limitations will significantly constrain available medical capabilities, and require a paradigm shift in the approach to medical system design and risk mitigation for crew health. To respond to this need for a new paradigm, the Exploration Medical Capability (ExMC) Element is assessing each Mars mission phase-transit, surface stay, rendezvous, extravehicular activity, and return-to identify and prioritize medical needs for the journey beyond low Earth orbit (LEO). ExMC is addressing both planned medical operations, and unplanned contingency medical operations that meld clinical needs and research needs into a single system. This assessment is being used to derive a gap analysis and studies to support meaningful medical capabilities trades. These trades, in turn, allow the exploration medical system design to proceed from both a mission centric and ethics-based approach, and to manage the risks associated with the medical limitations inherent in an exploration class mission. This paper outlines the conceptual drivers used to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this paradigm. Keywords: (Max 6 keywords: exploration, medicine, spaceflight, Mars, research, NASA)

  20. Health technology assessment to improve the medical equipment life cycle management.

    Science.gov (United States)

    Margotti, Ana E; Ferreira, Filipa B; Santos, Francisco A; Garcia, Renato

    2013-01-01

    Health technology assessment (HTA) is a tool to support decision making that is intended to assist healthcare managers in their strategic decisions. The use of HTA as a tool for clinical engineering is especially relevant in the domain of the medical equipment once it could improve the performance of the medical equipment. It would be done by their systematically evaluation in several aspects, in their life cycle. In Brazil, the Institute of Biomedical Engineering (IEB-UFSC) through the clinical engineering area has been working on the development of methodologies and improvements on HTA for medical equipment. Therefore, this paper presents the effort to create specific methodologies that will improve the dissemination of HTA, focusing on incorporation and utilization phase of the medical equipment life cycle. This will give a better support to the decision makers in the management of the health care system.

  1. [Assessment of two applications of medication self-management in older patients. Qualitative study].

    Science.gov (United States)

    Carrillo, I; Guilabert, M; Pérez-Jover, V; Mira, J J

    2015-01-01

    The aging population and the growing use of technology are two realities of modern society. Developing tools to support medication self-management to polymedicated elderly may contribute to increase their safety. To know how patients polymedicated and older than 64 years manage dose their medication and assessment the utility of two medication self-management applications, specifically analyzing management systems, medication errors and positive and improvable aspects of each of the tools presented. Seven focal groups with 59 patients from associations and health departments were conducted. In such meetings, they received the applications and they were encouraged to use it. Then, a several group questions were asked them about their health status, how they managed their medication and their assessment about the applications. Most participants reported to use memory strategies to take correctly their medication. They assessed positively the applications although some of them showed resistance to incorporate it in their daily routine. The simple interface and ease of use were the characteristics of the applications most appreciated by patients. Is possible to foster among elderly patients the use of technological tools to support the proper administration of medications with purpose is to decrease errors and increase safety. When designing health applications is necessary to take into account the preferences of those who are targeted. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  2. Transmitting patient and device data via GSM--central management for decentral mobile medical devices.

    Science.gov (United States)

    Bachmor, T; Schöchlin, J; Bolz, A

    2002-01-01

    Equipping medical devices with long range telemetry opens completely new possibilities for emergency response, home care and remote diagnosis. Mobile communications nowadays seem to be a generally accepted part of our modern world, but bridging the gap between new (consumer-) technologies and medical devices still is a challenge today. Providing a telemetry link (GSM) is just the trivial part--ensuring security, reliability and service management are the more critical tasks that need to be addressed. Therefore, a complete system concept consists of an automatic fleet management (e.g. periodic device-initiated service calls) as well as customer relationship management (CRM), including technical service and a trouble-ticket system.

  3. Effective stakeholder management for medical practitioners

    Directory of Open Access Journals (Sweden)

    E Zigiriadis

    2014-01-01

    Full Text Available The importance of organizational-stakeholder relationships is highlighted in most organizational studies literature. This article investigates the relationship between medical practices and their stakeholders and has been developed to provide guidance on stakeholder engagement and communication. It is intended to provide a useful reference point for all medical practices concerning stakeholder engagement activities. Direction is provided on how to identify and ultimately engage with stakeholders. It should hopefully further develop the effectiveness of engagement efforts that are undertaken between a medical practice and its stakeholders. The ability of a medical practice to cultivate and sustain strong relationships with its prominent stakeholder groups greatly enhances the likelihood that the relationship will endure. Medical practitioners in South Africa are generally in urgent need of pursuing new ways of delivering quality health care through developing new service models that have been developed with the help of relevant stakeholders. Since stakeholder relationship management is critical for corporate sustainability, medical practice management should seek strategic direction by investigating the relative competitive threat and relative supportive value of each stakeholder and then classify them accordingly.

  4. Human resource management practices in a medical complex in the ...

    African Journals Online (AJOL)

    staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. Conclusion. HRM practices in this Eastern Cape medical complex were inadequate and a ...

  5. Organization and Management of the International Space Station (ISS) Multilateral Medical Operations

    Science.gov (United States)

    Duncan, J. M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

    2007-01-01

    The goal of this work is to review the principles, design, and function of the ISS multilateral medical authority and the medical support system of the ISS Program. Multilateral boards and panels provide operational framework, direct, and supervise the ISS joint medical operational activities. The Integrated Medical Group (IMG) provides front-line medical support of the crews. Results of ongoing activities are reviewed weekly by physician managers. A broader status review is conducted monthly to project the state of crew health and medical support for the following month. All boards, panels, and groups function effectively and without interruptions. Consensus prevails as the primary nature of decisions made by all ISS medical groups, including the ISS medical certification board. The sustained efforts of all partners have resulted in favorable medical outcomes of the initial fourteen long-duration expeditions. The medical support system appears to be mature and ready for further expansion of the roles of all Partners, and for the anticipated increase in the size of ISS crews.

  6. Construction of a smart medication dispenser with high degree of scalability and remote manageability.

    Science.gov (United States)

    Pak, JuGeon; Park, KeeHyun

    2012-01-01

    We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT). In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

  7. Construction of a Smart Medication Dispenser with High Degree of Scalability and Remote Manageability

    Directory of Open Access Journals (Sweden)

    JuGeon Pak

    2012-01-01

    Full Text Available We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT. In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

  8. Medical Professionals Designing Hospital Management Models

    DEFF Research Database (Denmark)

    Byg, Vibeke

    Health care administration in many OECD countries has undergone substantial changes in recent years as a consequence of NPM reforms, rising costs, the pace of technological innovation, heightened competition for patients and resources, quality of managed care and demographic shifts. Hospitals...... especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however......, is insight into how we can understand and explain how medical professionals adapt hospital management over time in relation to changing hospital management models that are global in their influence in hospital organizations. The aim of this dissertation is to understand and explain how medical professionals...

  9. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

    Directory of Open Access Journals (Sweden)

    Michelle R. Holm

    2015-01-01

    Full Text Available Background: In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective: We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP would optimize medication availability and decrease medication shortages. Design: We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results: The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055, respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions: An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  10. Development of digital dashboard system for medical practice: maximizing efficiency of medical information retrieval and communication.

    Science.gov (United States)

    Lee, Kee Hyuck; Yoo, Sooyoung; Shin, HoGyun; Baek, Rong-Min; Chung, Chin Youb; Hwang, Hee

    2013-01-01

    It is reported that digital dashboard systems in hospitals provide a user interface (UI) that can centrally manage and retrieve various information related to patients in a single screen, support the decision-making of medical professionals on a real time basis by integrating the scattered medical information systems and core work flows, enhance the competence and decision-making ability of medical professionals, and reduce the probability of misdiagnosis. However, the digital dashboard systems of hospitals reported to date have some limitations when medical professionals use them to generally treat inpatients, because those were limitedly used for the work process of certain departments or developed to improve specific disease-related indicators. Seoul National University Bundang Hospital developed a new concept of EMR system to overcome such limitations. The system allows medical professionals to easily access all information on inpatients and effectively retrieve important information from any part of the hospital by displaying inpatient information in the form of digital dashboard. In this study, we would like to introduce the structure, development methodology and the usage of our new concept.

  11. Safety management as a foundation for evidence-based aeromedical standards and reporting of medical events.

    Science.gov (United States)

    Evans, Anthony D; Watson, Dougal B; Evans, Sally A; Hastings, John; Singh, Jarnail; Thibeault, Claude

    2009-06-01

    The different interpretations by States (countries) of the aeromedical standards established by the International Civil Aviation Organization has resulted in a variety of approaches to the development of national aeromedical policy, and consequently a relative lack of harmonization. However, in many areas of aviation, safety management systems have been recently introduced and may represent a way forward. A safety management system can be defined as "A systematic approach to managing safety, including the necessary organizational structures, accountabilities, policies, and procedures" (1). There are four main areas where, by applying safety management principles, it may be possible to better use aeromedical data to enhance flight safety. These are: 1) adjustment of the periodicity and content of routine medical examinations to more accurately reflect aeromedical risk; 2) improvement in reporting and analysis of routine medical examination data; 3) improvement in reporting and analysis of in-flight medical events; and 4) support for improved reporting of relevant aeromedical events through the promotion of an appropriate culture by companies and regulatory authorities. This paper explores how the principles of safety management may be applied to aeromedical systems to improve their contribution to safety.

  12. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    OpenAIRE

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The h...

  13. eHealth in the future of medications management: personalisation, monitoring and adherence.

    Science.gov (United States)

    Car, Josip; Tan, Woan Shin; Huang, Zhilian; Sloot, Peter; Franklin, Bryony Dean

    2017-04-05

    Globally, healthcare systems face major challenges with medicines management and medication adherence. Medication adherence determines medication effectiveness and can be the single most effective intervention for improving health outcomes. In anticipation of growth in eHealth interventions worldwide, we explore the role of eHealth in the patients' medicines management journey in primary care, focusing on personalisation and intelligent monitoring for greater adherence. eHealth offers opportunities to transform every step of the patient's medicines management journey. From booking appointments, consultation with a healthcare professional, decision-making, medication dispensing, carer support, information acquisition and monitoring, to learning about medicines and their management in daily life. It has the potential to support personalisation and monitoring and thus lead to better adherence. For some of these dimensions, such as supporting decision-making and providing reminders and prompts, evidence is stronger, but for many others more rigorous research is urgently needed. Given the potential benefits and barriers to eHealth in medicines management, a fine balance needs to be established between evidence-based integration of technologies and constructive experimentation that could lead to a game-changing breakthrough. A concerted, transdisciplinary approach adapted to different contexts, including low- and middle-income contries is required to realise the benefits of eHealth at scale.

  14. [A systemic risk analysis of hospital management processes by medical employees--an effective basis for improving patient safety].

    Science.gov (United States)

    Sobottka, Stephan B; Eberlein-Gonska, Maria; Schackert, Gabriele; Töpfer, Armin

    2009-01-01

    Due to the knowledge gap that exists between patients and health care staff the quality of medical treatment usually cannot be assessed securely by patients. For an optimization of safety in treatment-related processes of medical care, the medical staff needs to be actively involved in preventive and proactive quality management. Using voluntary, confidential and non-punitive systematic employee surveys, vulnerable topics and areas in patient care revealing preventable risks can be identified at an early stage. Preventive measures to continuously optimize treatment quality can be defined by creating a risk portfolio and a priority list of vulnerable topics. Whereas critical incident reporting systems are suitable for continuous risk assessment by detecting safety-relevant single events, employee surveys permit to conduct a systematic risk analysis of all treatment-related processes of patient care at any given point in time.

  15. An implementation of wireless medical image transmission system on mobile devices.

    Science.gov (United States)

    Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

    2008-12-01

    The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.

  16. [Design considerations for clinical data management in an integrated remote medical system].

    Science.gov (United States)

    Bautu, E; Bautu, A; Ciorap, R; Pomazan, V M; Petcu, L C

    2009-01-01

    In this paper, we present a proposal for the design of a telemedicine system. The system (called SIMPA) will be used for noninvasive monitoring of some vital parameters of patients with chronic diseases. The telemedicine system contains a fixed unit and some mobile units. The mobile unit contains various sensors used to gather data about vital biosignals, a transceiver and a medical processor. On the fixed unit side, the host transceiver must be compatible with the mobile transceiver. On the server side, an application analyzes and processes the data and further stores it in dedicated databases. The database support for the telemedicine application is ensured by open source technologies and already available communication infrastructures (GSM networks). The requirements for the application were thoroughly analyzed and the Entity-Relationship diagram of the system was designed and translated into relational model. SIMPA will be implemented using only free and open source technologies, which will ensure a low cost and improved extensibility and portability. We presented some design considerations for a low-cost telemedicine system. The system will help optimize medical decisions and will increase the quality of the medical act and lower the cost, to the ultimate benefit of the patient.

  17. DMHRSwhy? The Value of the Defense Medical Human Resource System-Internet (DMHRSi) to the Military Health System (MHS)

    Science.gov (United States)

    2015-02-01

    ABSTRACT The Military Health System (MHS) uses a variety of systems and processes to manage its most important asset ???its people. Chief among the...Health System (MHS) uses a variety of systems and processes to manage its most important asset …its people. Chief among the systems employed to do...enhanced multi-service market FTE full-time equivalent HRM human -resource management LCA labor cost assignment MEPRS Medical Expense

  18. Value-Added Clinical Systems Learning Roles for Medical Students That Transform Education and Health: A Guide for Building Partnerships Between Medical Schools and Health Systems.

    Science.gov (United States)

    Gonzalo, Jed D; Lucey, Catherine; Wolpaw, Terry; Chang, Anna

    2017-05-01

    To ensure physician readiness for practice and leadership in changing health systems, an emerging three-pillar framework for undergraduate medical education integrates the biomedical and clinical sciences with health systems science, which includes population health, health care policy, and interprofessional teamwork. However, the partnerships between medical schools and health systems that are commonplace today use health systems as a substrate for learning. Educators need to transform the relationship between medical schools and health systems. One opportunity is the design of authentic workplace roles for medical students to add relevance to medical education and patient care. Based on the experiences at two U.S. medical schools, the authors describe principles and strategies for meaningful medical school-health system partnerships to engage students in value-added clinical systems learning roles. In 2013, the schools began large-scale efforts to develop novel required longitudinal, authentic health systems science curricula in classrooms and workplaces for all first-year students. In designing the new medical school-health system partnerships, the authors combined two models in an intersecting manner-Kotter's change management and Kern's curriculum development steps. Mapped to this framework, they recommend strategies for building mutually beneficial medical school-health system partnerships, including developing a shared vision and strategy and identifying learning goals and objectives; empowering broad-based action and overcoming barriers in implementation; and generating short-term wins in implementation. Applying this framework can lead to value-added clinical systems learning roles for students, meaningful medical school-health system partnerships, and a generation of future physicians prepared to lead health systems change.

  19. International medical cooperation project for State of Libya using international medical tourism system in Thailand

    OpenAIRE

    奥寺, 敬; 坂本, 美重

    2013-01-01

    International medical cooperation project for State of Libya is reported. The concept of this project is to treat Libyan injured people using international medical tourism system in Thailand. Management of patient, including evaluation, domestic and international transportation arrangement of hospital, is supported by Normeca International Co., Ltd, (Pattaya, Thailand). Treatment of Libyan patient in two international hospitals (Bangpakok 9 Hospital and Navamin 9 Hopsital) in Bangkok was succ...

  20. Argon laser peripheral iridoplasty versus systemic intraocular pressure-lowering medications as immediate management for acute phacomorphic angle closure

    Directory of Open Access Journals (Sweden)

    Lee JW

    2013-01-01

    Full Text Available Jacky WY Lee,1 Jimmy SM Lai,1 Doris WF Yick,2 Can YF Yuen21Department of Ophthalmology, University of Hong Kong, 2Department of Ophthalmology, The Caritas Medical Centre, Kowloon West Cluster, Hong Kong, People’s Republic of ChinaBackground: The purpose of this study was to compare the efficacy and safety of argon laser peripheral iridoplasty (ALPI and systemic intraocular pressure (IOP-lowering medications in the immediate management of acute phacomorphic angle closure.Methods: Consecutive cases of acute phacomorphic angle closure were randomized to receive ALPI and an intravenous or oral carbonic anhydrase inhibitor as initial treatment. Intravenous mannitol was administered for presenting IOP > 60 mmHg or IOP > 40 mmHg 2 hours posttreatment in both arms.Results: Of 10 consecutive cases, six received medical therapy and four received ALPI. Fifty percent in the medical group and none in the ALPI group required intravenous mannitol. The ALPI group took less time to achieve IOP < 25 mmHg (18.8 ± 7.5 minutes versus 115.0 ± 97.0 minutes, P = 0.001, F test; had a greater IOP reduction within 30 minutes (69.8% ± 7.7% versus 40.9 ± 23.9%, P = 0.03, t-test; and had a consistently smaller post-attack cup to disc ratio (0.50 ± 0.02 versus 0.60 ± 0.20, P = 0.002, F test.Conclusion: ALPI offers greater safety, consistency, and efficacy than systemic IOP-lowering medications as initial treatment for phacomorphic angle closure.Keywords: phacomorphic, glaucoma, argon laser peripheral iridoplasty, medical, intraocular pressure

  1. GPs' and community pharmacists' opinions on medication management at transitions of care in Ireland.

    Science.gov (United States)

    Redmond, Patrick; Carroll, Hailey; Grimes, Tamasine; Galvin, Rose; McDonnell, Ronan; Boland, Fiona; McDowell, Ronald; Hughes, Carmel; Fahey, Tom

    2016-04-01

    The aim of this study was to survey GPs and community pharmacists (CPs) in Ireland regarding current practices of medication management, specifically medication reconciliation, communication between health care providers and medication errors as patients transition in care. A national cross-sectional survey was distributed electronically to 2364 GPs, 311 GP Registrars and 2382 CPs. Multivariable associations comparing GPs to CPs were generated and content analysis of free text responses was undertaken. There was an overall response rate of 17.7% (897 respondents-554 GPs/Registrars and 343 CPs). More than 90% of GPs and CPs were positive about the effects of medication reconciliation on medication safety and adherence. Sixty per cent of GPs reported having no formal system of medication reconciliation. Communication between GPs and CPs was identified as good/very good by >90% of GPs and CPs. The majority (>80%) of both groups could clearly recall prescribing errors, following a transition of care, they had witnessed in the previous 6 months. Free text content analysis corroborated the positive relationship between GPs and CPs, a frustration with secondary care communication, with many examples given of prescribing errors. While there is enthusiasm for the benefits of medication reconciliation there are limited formal structures in primary care to support it. Challenges in relation to systems that support inter-professional communication and reduce medication errors are features of the primary/secondary care transition. There is a need for an improved medication management system. Future research should focus on the identified barriers in implementing medication reconciliation and systems that can improve it. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Forty project management strategies for the medical practice staff.

    Science.gov (United States)

    Hills, Laura Sachs

    2010-01-01

    Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget.

  3. A SWOT Analysis of the Various Backup Scenarios Used in Electronic Medical Record Systems.

    Science.gov (United States)

    Seo, Hwa Jeong; Kim, Hye Hyeon; Kim, Ju Han

    2011-09-01

    Electronic medical records (EMRs) are increasingly being used by health care services. Currently, if an EMR shutdown occurs, even for a moment, patient safety and care can be seriously impacted. Our goal was to determine the methodology needed to develop an effective and reliable EMR backup system. Our "independent backup system by medical organizations" paradigm implies that individual medical organizations develop their own EMR backup systems within their organizations. A "personal independent backup system" is defined as an individual privately managing his/her own medical records, whereas in a "central backup system by the government" the government controls all the data. A "central backup system by private enterprises" implies that individual companies retain control over their own data. A "cooperative backup system among medical organizations" refers to a networked system established through mutual agreement. The "backup system based on mutual trust between an individual and an organization" means that the medical information backup system at the organizational level is established through mutual trust. Through the use of SWOT analysis it can be shown that cooperative backup among medical organizations is possible to be established through a network composed of various medical agencies and that it can be managed systematically. An owner of medical information only grants data access to the specific person who gave the authorization for backup based on the mutual trust between an individual and an organization. By employing SWOT analysis, we concluded that a linkage among medical organizations or between an individual and an organization can provide an efficient backup system.

  4. Medical waste management training for healthcare managers - a necessity?

    Science.gov (United States)

    Ozder, Aclan; Teker, Bahri; Eker, Hasan Huseyin; Altındis, Selma; Kocaakman, Merve; Karabay, Oguz

    2013-07-16

    This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management. The study was conducted on 240 volunteers during June - August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups. 67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (pnecessity for the safety of patients and important for its contribution to the economy of the country.

  5. Real-time multi-function entry / exit management system

    International Nuclear Information System (INIS)

    Hiyama, Kazuhisa; Kurosawa, Akihiko; Asano, Norikazu; Onoue, Ryuji; Eguchi, Shohei; Hanawa, Nobuhiro; Hori, Naohiko; Ueda, Hisao; Kanda, Hiroaki

    2012-01-01

    In order to prevent radiation accident and its expansion, more integrated management system is required to safety management for radiation workers in the nuclear facilities. Therefore, JAEA (Japan Atomic Energy Agency) and HAM (Hitachi Aloka Medical, Ltd) have developed innovative real-time multi-function entry/exit management system which managed worker's exposed dose and position under the joint developed patent. This system is sharing worker's data among workers and server manager who is inside of or outside of building, such as worker's positing, health condition and exposed dose. It consists of mobile equipments, receivers, LAN, and servers system. This report summarizes the system to be installed in the JMTR. (author)

  6. Appointment length, psychiatrists' communication behaviors, and medication management appointment adherence.

    Science.gov (United States)

    Cruz, Mario; Roter, Debra L; Cruz, Robyn F; Wieland, Melissa; Larson, Susan; Cooper, Lisa A; Pincus, Harold Alan

    2013-09-01

    The authors explored the relationship between critical elements of medication management appointments (appointment length, patient-centered talk, and positive nonverbal affect among providers) and patient appointment adherence. The authors used an exploratory, cross-sectional design employing quantitative analysis of 83 unique audio recordings of split treatment medication management appointments for 46 African-American and 37 white patients with 24 psychiatrists at four ambulatory mental health clinics. All patients had a diagnosis of depression. Data collected included demographic information; Patient Health Questionnaire-9 scores for depression severity; psychiatrist verbal and nonverbal communication behaviors during medication management appointments, identified by the Roter Interaction Analysis System during analysis of audio recordings; and appointment adherence. Bivariate analyses were employed to identify covariates that might influence appointment adherence. Generalized estimating equations (GEEs) were employed to assess the relationship between appointment length, psychiatrist patient-centered talk, and positive voice tone ratings and patient appointment adherence, while adjusting for covariates and the clustering of observations within psychiatrists. Wald chi square analyses were used to test whether all or some variables significantly influenced appointment adherence. GEE revealed a significant relationship between positive voice tone ratings and appointment adherence (p=.03). Chi square analyses confirmed the hypothesis of a positive and significant relationship between appointment adherence and positive voice tone ratings (p=.03) but not longer visit length and more patient-centered communication. The nonverbal conveyance of positive affect was associated with greater adherence to medication management appointments by depressed patients. These findings potentially have important implications for communication skills training and adherence research.

  7. [Perioperative management of long-term medication].

    Science.gov (United States)

    Vogel Kahmann, I; Ruppen, W; Lurati Buse, G; Tsakiris, D A; Bruggisser, M

    2011-01-01

    Anesthesiologists and surgeons are increasingly faced with patients who are under long-term medication. Some of these drugs can interact with anaesthetics or anaesthesia and/or surgical interventions. As a result, patients may experience complications such as bleeding, ischemia, infection or severe circulatory reactions. On the other hand, perioperative discontinuation of medication is often more dangerous. The proportion of outpatient operations has increased dramatically in recent years and will probably continue to increase. Since the implementation of DRGs (pending in Switzerland, introduced in Germany for some time), the patient enters the hospital the day before operation. This means that the referring physician as well as anesthesiologists and surgeons at an early stage must deal with issues of perioperative pharmacotherapy. This review article is about the management of the major drug classes during the perioperative period. In addition to cardiac and centrally acting drugs and drugs that act on hemostasis and the endocrine system, special cases such as immunosuppressants and herbal remedies are mentioned.

  8. Medical waste management in Ibadan, Nigeria: Obstacles and prospects

    International Nuclear Information System (INIS)

    Coker, Akinwale; Sangodoyin, Abimbola; Sridhar, Mynepalli; Booth, Colin; Olomolaiye, Paul; Hammond, Felix

    2009-01-01

    Quantification and characterization of medical waste generated in healthcare facilities (HCFs) in a developing African nation has been conducted to provide insights into existing waste collection and disposal approaches, so as to provide sustainable avenues for institutional policy improvement. The study, in Ibadan city, Nigeria, entailed a representative classification of nearly 400 healthcare facilities, from 11 local government areas (LGA) of Ibadan, into tertiary, secondary, primary, and diagnostic HCFs, of which, 52 HCFs were strategically selected. Primary data sources included field measurements, waste sampling and analysis and a questionnaire, while secondary information sources included public and private records from hospitals and government ministries. Results indicate secondary HCFs generate the greatest amounts of medical waste (mean of 10,238 kg/day per facility) followed by tertiary, primary and diagnostic HCFs, respectively. Characterised waste revealed that only ∼3% was deemed infectious and highlights opportunities for composting, reuse and recycling. Furthermore, the management practices in most facilities expose patients, staff, waste handlers and the populace to unnecessary health risks. This study proffers recommendations to include (i) a need for sustained cooperation among all key actors (government, hospitals and waste managers) in implementing a safe and reliable medical waste management strategy, not only in legislation and policy formation but also particularly in its monitoring and enforcement and (ii) an obligation for each HCF to ensure a safe and hygienic system of medical waste handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment

  9. Selection and Management of Medical Official during the Yuan Dynasty.

    Science.gov (United States)

    Kim, Dae-Gi

    2017-12-01

    Although the healthcare system of the Yuan Dynasty followed that of the Song Dynasty, there are certain differences between these two dynasties in terms of practices. Including appointing 'Yihus' in 'Zhusehuji' and setting up 'Guanyitijusi' to oversee Yihus, the Yuan Dynasty developed an effective management system for their physicians and, soon after the coronation of Khubilai, built 'Yixue (Medical school)' all over its territories in order to establish an organized and substantial medical training system. Moreover, the Yuan Dynasty not only revived the civil service examination system system between 1314 and 1320 as well as the medical examination system, but also increased the quota for qualification to twice that of Confucian examination in Song. These changes resulted in producing many brilliant people at the time. In the second half of the reign of Emperor Chengzong it was decided that the incompetence of the government healthcare organizations and the abundance of charlatans could not be neglected any longer. Existing policies and systems was limited in educating and training proper physicians, and this problem was not restricted to the field of medicine. The need for new systems that could reform the social order led to the restoration of the civil service examination system. The civil service examination system for Confucianism and for medicine began in 1314 and 1316, respectively. The purpose of the medical examination system was to select medical officials. The medical examination system which started in 1316 had a significant impact on the medicine of the Yuan dynasty for many reasons. Firstly, the qualification to apply to the medical examination did not remain constricted to 'Yixue' but opened to all 'Zhusehuji'; and secondly, the examination system did not have a restriction on the number of applicants was not restricted. The most important aspect of the examination system was that the number of test takers that passed the first test was one hundred

  10. FEATURES OF THE ORGANIZATION OF SYSTEM OF ENVIRONMENTAL MANAGEMENT AND MANAGING IN RESOR-RECREATIONAL TERRITORIES

    Directory of Open Access Journals (Sweden)

    M. S. Oborin

    2014-01-01

    Full Text Available Resort and recreational activity is the difficult natural and social and economic process directed on improvement of quality of life and health of the population. Territorial public systems are included by natural medical and improving, social, production, recreational, labor, financial, administrative resources, infrastructure which are directed on formation and rendering resort and recreational services. For successful and effective development of resort and recreational activity it is necessary to create structure of system of rational resort and recreational environmental management. In preservation and improvement of resort medical resources the infrastructure complex including medical, improving, economic, serving and recreational objects has a big role. The system of resort and recreational environmental management and resort infrastructure allow to create necessary financial receipts for replenishment of local, regional and national budgets. 

  11. Selection and Management of Medical Official during the Yuan Dynasty

    Directory of Open Access Journals (Sweden)

    Dae-Gi KIM

    2017-12-01

    Full Text Available Although the healthcare system of the Yuan Dynasty followed that of the Song Dynasty, there are certain differences between these two dynasties in terms of practices. Including appointing ‘Yihus’ in ‘Zhusehuji’ and setting up ‘Guanyitijusi’ to oversee Yihus, the Yuan Dynasty developed an effective management system for their physicians and, soon after the coronation of Khubilai, built ‘Yixue (Medical school’ all over its territories in order to establish an organized and substantial medical training system. Moreover, the Yuan Dynasty not only revived the civil service examination system system between 1314 and 1320 as well as the medical examination system, but also increased the quota for qualification to twice that of Confucian examination in Song. These changes resulted in producing many brilliant people at the time. In the second half of the reign of Emperor Chengzong it was decided that the incompetence of the government healthcare organizations and the abundance of charlatans could not be neglected any longer. Existing policies and systems was limited in educating and training proper physicians, and this problem was not restricted to the field of medicine. The need for new systems that could reform the social order led to the restoration of the civil service examination system. The civil service examination system for Confucianism and for medicine began in 1314 and 1316, respectively. The purpose of the medical examination system was to select medical officials. The medical examination system which started in 1316 had a significant impact on the medicine of the Yuan dynasty for many reasons. Firstly, the qualification to apply to the medical examination did not remain constricted to ‘Yixue’ but opened to all ‘Zhusehuji’; and secondly, the examination system did not have a restriction on the number of applicants was not restricted. The most important aspect of the examination system was that the number of test takers

  12. Educational needs assessment of Mashad University of Medical Sciences’ managers in management and leadership

    Directory of Open Access Journals (Sweden)

    Emad Zade A

    2004-01-01

    Full Text Available Background: The first step in human resource development is educational need assessment. A sound knowledge of managerial roles and skills is vital for a successful management in the educational system. Purpose: To determine the educational needs of managers and directors of Mashad Medical University in filed of educational management and leadership. Method: A survey of a 40-person sample of the university managers including deans and vice deans for education of the faculties and the heads of educational groups the data were analyzed with SPSS. Results: The mean age of the sample was 47.2(±7.5 and the mean duration of serving in managerial positions were 5.4(±3.6.The most needed items to be taught were identified as strategic planning in management, setting educational goals, deciding whether the ability to be a manager is inborn or must be acquired, main problems in educational planning and surveillance techniques, educational guidance, system analysis and educational evaluation. Characteristics of educational advisors were also of great importance. Conclusion: Our study showed that educational managers were aware of their need for further development of a sound basis of managerial knowledge. Key words: Need assessment, educational needs, educational managers

  13. Building a medical system for nuclear facilities

    International Nuclear Information System (INIS)

    Maeda, Mitsuya

    2016-01-01

    To build a medical system for nuclear facilities, I explained what kinds of actions were performed with the TEPCO Fukushima Daiichi Nuclear Power Plant Accident and what kinds of actions are going to be performed in the future. We examined the health and medical care of the emergency workers in nuclear facilities including TEPCO Fukushima Daiichi Nuclear Power Plant from 2014 to 2015 in the Ministry of Health, Labour and Welfare (MHLW). We carried out a detailed hearing from stakeholders of electric companies and medical institutions about the medical system in nuclear facilities carrying out urgent activities. It has been said that the electric company is responsible to maintain the medical system for affected workers in nuclear facilities. However, TEPCO could not find the medical staff, such as doctors, by their own effort at the TEPCO Fukushima Daiichi Nuclear Power Plant Accident. The network of doctors familiar with emergency medical care support dispatched the medical staff after July of 2011. The stakeholders indicated that the following six tasks must be resolved: (1) the fact that no electric company performs the action of bringing up medical staff who can be dispatched into nuclear facilities in emergencies in 2015; (2) bringing up personnel in charge of radiation management and logistics other than the medical staff, such as doctors; (3) cooperation with the community medicine system given the light and shade by nuclear facilities; (4) performing training for the many concurrent wounded based on the scenario of a severe accident; (5) indicating both the condition of the contract and the guarantee of status that is appropriate for dispatched medical staffs; and (6) clarifying the organization of the network of stakeholders. The stakeholders showed the future directionality as follows: (1) To recruit the medical staff expected to be dispatched into nuclear facilities, (2) to carry out the discussion and conveyance training to strengthen cooperation with

  14. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

    Directory of Open Access Journals (Sweden)

    Menizibeya Osain Welcome

    2011-01-01

    Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

  15. The costs of caring: medical costs of Alzheimer's disease and the managed care environment.

    Science.gov (United States)

    Murman, D L

    2001-01-01

    This review summarizes the medical costs associated with Alzheimer's disease (AD) and related dementias, as well as the payers responsible for these medical costs in the US health care system. It is clear from this review that AD and related dementias are associated with substantial medical costs. The payers responsible for a majority of these costs are families of patients with AD and the US government through the Medicare and Medicaid programs. In an attempt to control expenditures, Medicare and Medicaid have turned to managed care principles and managed care organizations. The increase in "managed" dementia care gives rise to several potential problems for patients with AD, along with many opportunities for systematic improvement in the quality of dementia care. Evidence-based disease management programs provide the greatest opportunities for improving managed dementia care but will require the development of dementia-specific quality of care measures to evaluate and continually improve them.

  16. [The system of quality management in medical laboratory: the problematic issues of implementation of GOST RKS 9001-2008, GOST R ISO 15189-2009 and GOST R ISO 53079-2008].

    Science.gov (United States)

    Dolgikh, T I

    2013-04-01

    The article presents the approaches to development and implementation of system of quality management in laboratory as an integral part of the given system in whole medical institution. The costs of works execution concerning quality support are to be weighted with economic profitability and timeliness of medical care provision to ill people considering pre-analytic stage (out-laboratory and in-laboratory) laboratory analysis. Factually it is a matter of development of system of balanced indicators concerning quality management of institution and laboratory functioning. The problematic issues are presented concerning maintenance of particular requirements of GOSTR ISO 15189 about quality of production. The emphasis is made on the necessity of training of administrations of laboratories in the field of quality management and economics of laboratory business.

  17. 77: Development, utilization and evolution of a computer system for treatment follow-up and medical management of a radiotherapy department

    International Nuclear Information System (INIS)

    Costa, A.; Leca, M.; Marcie, S.; Rameau, P.; Lagrange, J.L.; Chauvel, P.; Hery, M.; Lalanne, C.M.

    1987-01-01

    SISGRAD, a computer system developed in the Radiotherapy Dept. of the Centre A. Lacassagne, has been operational for 5 years. This network of microcomputers is connected to the computers used for dosimetry, and is integrated in the hospital's general computer system. SISGRAD was designed primarily to verify that prescribed irradiation treatments are given properly and to improve medical and administrative management of the Dept. SISGRAD is also utilized to provide information to data bases. 22 refs.; 2 figs.; 1 table

  18. Pattern of medical waste management: existing scenario in Dhaka City, Bangladesh

    Directory of Open Access Journals (Sweden)

    Rahman K Anisur

    2008-01-01

    to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse. Conclusion The paper reveals that lack of awareness, appropriate policy and laws, and willingness are responsible for the improper management of medical waste in Dhaka City. The paper also shows that a newly designed medical waste management system currently serves a limited number of HCE. New facilities should be established for the complete management of medical waste in Dhaka City.

  19. Medical leadership and management in the United Kingdom.

    Science.gov (United States)

    Kyratsis, Yiannis; Armit, Kirsten; Zyada, Azra; Lees, Peter

    2016-06-01

    This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, and discuss professional development and future prospects. With increasing involvement of medical professionals in top managerial roles in the UK over the last 30 years, leadership development initiatives have been growing steadily and there is increasing recognition of the need for leadership and management skills for doctors. Such skills can help to greatly improve patient care as well as enhance organisational effectiveness and productivity. The central involvement of professional bodies such as the UK Faculty of Medical Leadership and Management, and the establishment of medical fellowship schemes, have provided a solid foundation for a new generation of aspiring medical leaders but there is still a long way to go to achieve a higher degree of professionalism for clinical leadership in the UK. The evidence base is weak such that integrated efforts by clinicians and management academics have much to offer in achieving the vision of socially responsible, clinically relevant and research informed medical leadership training. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  20. Effectively marketing prepaid medical care with decision support systems.

    Science.gov (United States)

    Forgionne, G A

    1991-01-01

    The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

  1. Reasoning methods in medical consultation systems: artificial intelligence approaches.

    Science.gov (United States)

    Shortliffe, E H

    1984-01-01

    It has been argued that the problem of medical diagnosis is fundamentally ill-structured, particularly during the early stages when the number of possible explanations for presenting complaints can be immense. This paper discusses the process of clinical hypothesis evocation, contrasts it with the structured decision making approaches used in traditional computer-based diagnostic systems, and briefly surveys the more open-ended reasoning methods that have been used in medical artificial intelligence (AI) programs. The additional complexity introduced when an advice system is designed to suggest management instead of (or in addition to) diagnosis is also emphasized. Example systems are discussed to illustrate the key concepts.

  2. Dental management of medically compromised patients

    Directory of Open Access Journals (Sweden)

    Sherly Horax

    2016-06-01

    Full Text Available These days, treatment in dentistry is no longer for patient without complication, but also for patient with bad medical record. With correct treatment management in handling medical condition of patient, not only for dental treatment but also their systematic disease, all the dental staff also can improve for the better quality of life of the patient. Patient with medical compromised start to realize that  keeping good oral hygiene is so important for their lives, therefore dental staff need to improve their science and technology and also for facing patient with medical compromised. This article will discuss and suggest various treatment consideration and protocol for the patient of with medical compromised.

  3. Medication Safety Systems and the Important Role of Pharmacists.

    Science.gov (United States)

    Mansur, Jeannell M

    2016-03-01

    Preventable medication-related adverse events continue to occur in the healthcare setting. While the Institute of Medicine's To Err is Human, published in 2000, highlighted the prevalence of medical and medication-related errors in patient morbidity and mortality, there has not been significant documented progress in addressing system contributors to medication errors. The lack of progress may be related to the myriad of pharmaceutical options now available and the nuances of optimizing drug therapy to achieve desired outcomes and prevent undesirable outcomes. However, on a broader scale, there may be opportunities to focus on the design and performance of the many processes that are part of the medication system. Errors may occur in the storage, prescribing, transcription, preparation and dispensing, or administration and monitoring of medications. Each of these nodes of the medication system, with its many components, is prone to failure, resulting in harm to patients. The pharmacist is uniquely trained to be able to impact medication safety at the individual patient level through medication management skills that are part of the clinical pharmacist's role, but also to analyze the performance of medication processes and to lead redesign efforts to mitigate drug-related outcomes that may cause harm. One population that can benefit from a focus on medication safety through clinical pharmacy services and medication safety programs is the elderly, who are at risk for adverse drug events due to their many co-morbidities and the number of medications often used. This article describes the medication safety systems and provides a blueprint for creating a foundation for medication safety programs within healthcare organizations. The specific role of pharmacists and clinical pharmacy services in medication safety is also discussed here and in other articles in this Theme Issue.

  4. Evaluation Apprehension and Impression Management in Clinical Medical Education.

    Science.gov (United States)

    McGaghie, William C

    2018-05-01

    Historically, clinical medical education has relied on subjective evaluations of students and residents to judge their clinical competence. The uncertainty associated with these subjective clinical evaluations has produced evaluation apprehension among learners and attempts to manage one's professional persona (impression management) among peers and supervisors. Such behavior has been documented from antiquity through the Middle Ages to the present, including in two new qualitative studies in this issue of Academic Medicine on the social psychology of clinical medical education. New approaches to medical education, including competency-based education, mastery learning, and assessment methods that unite evaluation and education, are slowly changing the culture of clinical medical education. The author of this Invited Commentary argues that this shift will bring greater transparency and accountability to clinical medical education and gradually reduce evaluation apprehension and the impression management motives it produces.

  5. Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

    Science.gov (United States)

    Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

    2011-01-01

    The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

  6. Medical Waste Management Training for Healthcare Managers - a Necessity?

    Directory of Open Access Journals (Sweden)

    Aclan Ozder

    2013-07-01

    Full Text Available Background:This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers regarding bio-medical waste management.Methods:The study was conducted on 240 volunteers during June – August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions. A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups.Results:67.5% (162 of participants were female. 42.5% (102 are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test and others who had not (p<0.01. It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session.Conclusion:On the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.

  7. Guide on medical management of persons exposed in radiation accidents

    International Nuclear Information System (INIS)

    1990-01-01

    The present guide has been prepared in order to provide guidance to medical and para-medical personnel regarding medical management of the different types of radiation accidents. It discusses briefly the physical aspects and biological effect of radiation, for the benefit of those who have not specialised in radiation medicine. The diagnosis, medical management and follow-up of persons involved in different types of radiation accidents are also dealt with. The implementation of the procedures described calls for organisation of appropriate facilities and provision of requisite equipment as well as education and training of the staff. It is emphasised that major radiation accidents are rare events and the multi-disciplinary nature of the response required to deal with them calls for proper planning and continuous liaison among plant management, radiation protection personnel, first-aid assistants and medical and paramedical staff. The organisation and conduct of emergency drills may help in maintaining preparedness of the medical facilities for efficient management of radiation casualities. (original). 64 refs., tabs., figs

  8. Marketing aspects of development of medical waste management in health care institutions in Ukraine

    Directory of Open Access Journals (Sweden)

    Inesa Gurinа

    2015-02-01

    Full Text Available The concept of marketing approach to medical waste management in health care is suggested.The goal of research was to study the state of marketing activities of health care institutions on medical waste management and development trends of   resolution of outstanding issues.Methods. The methods, which were used in the research, are the methods of mathematical statistics, social studies and scientific knowledge.Results. Environmental marketing institutions of healthcare means perfectly safe for the environment provision of health services. The main directions of environmental marketing concept in health care institutions is the acceptance generally binding legal standards of Use Resources, strict control the formation and licensing of medical waste; economic incentives for workers, aimed at minimizing their interest in the volumes of medical waste; financing of R & D relative to the development of new waste and sound technologies; develop a system of taxes and penalties for polluting the environment and so on.Conclusions. As a result of the implementation of marketing strategies for managing medical waste of healthcare institutions are obtained strategic, social, environmental and economic benefits.

  9. Best practices in early phase medical device development: Engineering, prototyping, and the beginnings of a quality management system.

    Science.gov (United States)

    Fearis, Kristy; Petrie, Aidan

    2017-03-01

    Kristy Fearis is the founder and president of KPConsulting. She has held various positions in the medical device and research industry. She has led programs for medical industry leaders Medtronic, Edward Lifesciences, and Kimberly-Clark Healthcare to develop and commercialize Class II and III devices. Although a true quality management systems specialist at heart, Kristy has a passion for effectively and efficiently applying quality systems principles to early stage development to maximize benefit while minimizing impact on resources and time to market. Kristy works with both precommercial and commercial companies to build and implement quality systems that are "right sized" and support both an effective business model and high product quality. Aidan Petrie is the cofounder and chief innovation officer of Ximedica. Aidan drives innovation in Ximedica's core markets of medical device development and consumer healthcare. With a focus on human-centered design, usability, technical innovation and industrial design, Aidan has helped bring hundreds of products to market. Ranging from simple drug compliance aids to wearable therapeutics, home monitoring products, and complex surgical systems, Aidan challenges his teams to rethink the role design plays in the success of each product. Covering topics around usability, sensor and wearable technology, and current trends in medical design and development, Aidan is a sought-after industry speaker and widely published author. In addition to his role at Ximedica, Aidan advises multiple startups in the healthcare space and has interests in a number of related companies. He sits on the Board of MassArt and teaches and lectures at the Rhode Island School of Design, Massachusetts Institute of Technology, the Harvard iLab, and others. Aidan holds an undergraduate degree from Central St Martins in product design/engineering and a Masters in industrial design from the Rhode Island School of Design. Copyright © 2016 Elsevier Inc. All

  10. Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development.

    Science.gov (United States)

    Abbas, Mark R; Quince, Thelma A; Wood, Diana F; Benson, John A

    2011-11-14

    There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify the most effective and cost-effective curriculum innovations, this

  11. Management of data from clinical trials using the ArchiMed system.

    Science.gov (United States)

    Duftschmid, Georg; Gall, Walter; Eigenbauer, Ernst; Dorda, Wolfgang

    2002-06-01

    Clinical trials constitute a key source of medical research and are therefore conducted on a regular basis at university hospitals. The professional execution of trials requires, among other things, a repertoire of tools that support efficient data management. Tasks that are essential for efficient data management in clinical trials include the following: the design of the trial database, the design of electronic case report forms, recruiting patients, collection of data, and statistical analysis. The present article reports the manner in which these tasks are supported by the ArchiMed system at the University of Vienna and Graz Medical Schools. ArchiMed is customized for clinical end users, allowing them to autonomously manage their clinical trials without having to consult computer experts. An evaluation of the ArchiMed system in 12 trials recently conducted at the University of Vienna Medical School shows that the individual system functions can be usefully applied for data management in clinical trials.

  12. MEDIC: medical embedded device for individualized care.

    Science.gov (United States)

    Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

    2008-02-01

    Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

  13. Intelligent distributed medical image management

    Science.gov (United States)

    Garcia, Hong-Mei C.; Yun, David Y.

    1995-05-01

    The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

  14. XMedIA Communication System: An XML Driven Medical Image Processing and Archiving Environment

    National Research Council Canada - National Science Library

    Sakellaris, G

    2001-01-01

    ... system meets the requirements for secure search, transaction, and presentation of medical information to the end users, whether patient or health care professional, Key features of the work include personalized access and efficient management of distributed medical knowledge, intercommunication of heterogeneous systems and presentation of information in a concise way, across different platforms.

  15. Managing Costs and Medical Information

    Science.gov (United States)

    People with cancer may face major financial challenges and need help dealing with the high costs of care. Cancer treatment can be very expensive, even when you have insurance. Learn ways to manage medical information, paperwork, bills, and other records.

  16. Basic management of medical emergencies: recognizing a patient's distress.

    Science.gov (United States)

    Reed, Kenneth L

    2010-05-01

    Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

  17. Online Embryology teaching using learning management systems appears to be a successful additional learning tool among Egyptian medical students.

    Science.gov (United States)

    Al-Neklawy, Ahmed Farid

    2017-11-01

    Although the traditional didactic lecture is considered to be efficient for presenting information and providing explanations, it usually does not provide adequate time for deeper learning activities. So, traditional lecture is one of the most widely criticized educational methods. Virtual learning environment (VLE) is a specially designed environment that facilitates teachers' management of educational courses for their students, using computer hardware and software, which involves distance learning. In this study, we evaluated the experiment of online teaching of General Embryology for Egyptian undergraduate medical students using WizIQ learning management system. A total of 100 students were invited to submit an online survey at the end of the course to evaluate delivery of instruction, creation of an environment that supported learning, and administrative issues. Most of the students reported that they were strongly satisfied with the efficacy of the instructional methods and were strongly satisfied with the degree of clarity of the course material. They strongly accepted the page format and design of the virtual classroom and strongly agreed that the learning environment supported the learning procedure. The item of easy logging into the virtual classroom had aberrant variable responses; it recorded the lowest mean response; this variation in responses was due to technical factors as the students used different devices with different speeds of internet connections. Ninety percent of students have strongly recommended the course attendance for their fellow students. These results demonstrate that online Anatomy teaching using learning management systems appears to be a successful additional learning tool among Egyptian medical students. Copyright © 2017 Elsevier GmbH. All rights reserved.

  18. Unnatural birth? : medical pain management technology and the naturalness of birth

    OpenAIRE

    Gihle, Marte

    2008-01-01

    The aim of this thesis is to explore how medical pain management technology affects the concept of natural birth.The relationship between medical pain management technology and natural birth is discussed in a structural framework in which medicalization, risk, and identity are acknowledged as important issues within the current childbirth paradigm. The analysis is based on thirteen in-depth interviews with Norwegian midwives and mothers on their perceptions of medical pain management technolo...

  19. Medical Management of Oral Lichen Planus: A Systematic Review

    Science.gov (United States)

    Chokshi, Krunal; Desai, Sachin; Malu, Rahul; Chokshi, Achala

    2016-01-01

    Introduction Oral Lichen Planus (OLP) is a chronic inflammatory, T-cell-mediated autoimmune oral mucosal disease with unclear aetiology. The clinical management of OLP poses considerable difficulties to the oral physician. Aim The aim was to assess the efficacy of any form of intervention used to medically manage OLP. Materials and Methods We searched and analysed the following databases (from January 1990 to December 2014):- Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. All Randomised Controlled Trials (RCTs) for the medical management of OLP which compared active treatment with placebo or between active treatments were considered in this systematic review. Participants of any age, gender or race having symptomatic OLP (including mixed forms), unconnected to any identifiable cause (e.g. lichenoid drug reactions) and confirmed by histopathology have been included. Interventions of all types, including topical treatments or systemic drugs of variable dosage, duration & frequency of delivery have been considered. All the trials identified were appraised by five review authors and the data for all the trials were synthesised using specifically designed data extraction form. Binary data has been presented as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CIs. Results A total of 35 RCTs were included in this systematic review on medical management of OLP. No strong evidence suggesting superiority of any specific intervention in reducing pain and clinical signs of OLP were shown by the RCTs included here. Conclusion Future RCTs on a larger scale, adopting standardized outcome assessing parameters should be considered. PMID:27042598

  20. Applying Lean Six Sigma to improve medication management.

    Science.gov (United States)

    Nayar, Preethy; Ojha, Diptee; Fetrick, Ann; Nguyen, Anh T

    2016-01-01

    A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA's dual care policy; collect data and describe the current process for co-management of dual care veterans' medications; and draft recommendations to improve the current process for dual care medications co-management. Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. The findings of this project will be of value to VA providers and policy makers and health

  1. Healthcare managers' construction of the manager role in relation to the medical profession.

    Science.gov (United States)

    von Knorring, Mia; Alexanderson, Kristina; Eliasson, Miriam A

    2016-05-16

    Purpose - The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations. Design/methodology/approach - In total, 18 of Sweden's 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians' sickness certification practice. A discourse analysis approach was used for data analysis. Findings - Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes "physician" or "non-physician" to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of "yes, but […]" approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers. Research limitations/implications - Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians. Practical implications - The results suggest that there is a need to address the organisational conditions for managers' role taking in healthcare organisations. Originality/value - Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.

  2. Comparative Study of Intelligent Systems for Management of GIT Cancers

    Directory of Open Access Journals (Sweden)

    Labib Nevine

    2017-01-01

    Full Text Available Intelligent Systems contribute in the management of different GIT cancer types. The paper discusses different types of intelligent systems, classified according to the medical task achieved, such as early detection, diagnosis and prognosis. It is found out that these types include rule-based and case-based expert systems, artificial neural networks, genetic algorithms, machine learning, in addition to data mining techniques and statistical methods. The study focuses on comparing between different techniques and tools used. The comparison results in identifying the benefits of using data mining techniques for the diagnosis task, since it is based on huge amounts of data in order to discover new patterns hence new predisposing factors. It also points out the use of expert systems in the prognosis task, since this task is mainly based on the specialist experience that should be transferred to less- experienced medical professionals. Based on the previous results, it is recommended to develop an Intelligent Tutoring System (ITS that focuses on the early diagnosis of GIT cancers, since managing the disease depends mainly on proper diagnosis, and also to build an expert system that helps transferring GIT cancers management knowledge to medical doctors in different hospitals.

  3. [The practice of development and implementation of quality management systems in medical laboratories. The GOST R ISO 15189-2009 "medical laboratories. The detailed requirements to quality and competence". Particular difficulties of global nature].

    Science.gov (United States)

    Emanuel', A V; Ivanov, G A; Fleganova, I N; Emanuel', V L

    2012-12-01

    The article discusses the methodological issues related to the implementation of international principles of standardization in the format of GOST R ISO 9001-2008 "Quality management systems. Requirements", GOST R ISO 15189-2009 "Medical laboratories. The detailed requirements to quality and competence" and GOST R ISO 18113.1-5 "Medical items for diagnostics in vitro. Information provided by manufacturer (marking)". This approach legibly assigns the responsibility concerning the support of metrological correctness of laboratory measurements. The lacking of both full-value public and sectorial normative documentation and coordinated positions of Rosstandard and Minzdrav of Russia on functioning of medical laboratories is noted.

  4. BRAIN Journal - Cognitive Medical Multiagent Systems

    OpenAIRE

    Barna Iantovics

    2017-01-01

    Abstract The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System) was proposed. CMDS system can solve flexibly a large variety of medical diagn...

  5. Enabling medication management through health information technology (Health IT).

    Science.gov (United States)

    McKibbon, K Ann; Lokker, Cynthia; Handler, Steve M; Dolovich, Lisa R; Holbrook, Anne M; O'Reilly, Daria; Tamblyn, Robyn; J Hemens, Brian; Basu, Runki; Troyan, Sue; Roshanov, Pavel S; Archer, Norman P; Raina, Parminder

    2011-04-01

    questions. Study quality varied according to phase of medication management. Substantially more studies, and studies with stronger comparative methods, evaluated prescribing and monitoring. Clinical decision support systems (CDSS) and computerized provider order entry (CPOE) systems were studied more than any other application of MMIT. Physicians were more often the subject of evaluation than other participants. Other health care professionals, patients, and families are important but not studied as thoroughly as physicians. These nonphysicians groups often value different aspects of MMIT, have diverse needs, and use systems differently. Hospitals and ambulatory clinics were well-represented in the literature with less emphasis placed on long-term care facilities, communities, homes, and nonhospital pharmacies. Most studies evaluated changes in process and outcomes of use, usability, and knowledge, skills, and attitudes. Most showed moderate to substantial improvement with implementation of MMIT. Economics studies and those with clinical outcomes were less frequently studied. Those articles that did address economics and clinical outcomes often showed equivocal findings on the effectiveness and cost-effectiveness of MMIT systems. Qualitative studies provided evidence of strong perceptions, both positive and negative, of the effects of MMIT and unintended consequences. We found little data on the effects of forms of medications, conformity, standards, and open source status. Much descriptive literature discusses implementation issues but little strong evidence exists. Interest is strong in MMIT and more groups and institutions will implement systems in the next decades, especially with the Federal Government's push toward more health IT to support better and more cost-effective health care. MMIT is well-studied, although on closer examination of the literature the evidence is not uniform across phases of medication management, groups of people involved, or types of MMIT

  6. Safety in home care: A research protocol for studying medication management

    Directory of Open Access Journals (Sweden)

    Easty Anthony

    2010-06-01

    Full Text Available Abstract Background Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care. Methods A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB, Ontario (ON, Quebec (QC and Nova Scotia (NS, we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research. Discussion The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange

  7. Information management in Iranian Maternal Mortality Surveillance System.

    Science.gov (United States)

    Sadoughi, Farahnaz; Karimi, Afsaneh; Erfannia, Leila

    2017-07-01

    Maternal mortality is preventable by proper information management and is the main target of the Maternal Mortality Surveillance System (MMSS). This study aimed to determine the status of information management in the Iranian Maternal Mortality Surveillance System (IMMSS). The population of this descriptive and analytical study, which was conducted in 2016, included 96 administrative staff of health and treatment deputies of universities of medical sciences and the Ministry of Health in Iran. Data were gathered by a five-part questionnaire with confirmed validity and reliability. A total of 76 questionnaires were completed, and data were analyzed using SPSS software, version 19, by descriptive and inferential statistics. The relationship between variables "organizational unit" and the four studied axes was studied using Kendall's correlation coefficient test. The status of information management in IMMSS was desirable. Data gathering and storage axis and data processing and compilation axis achieved the highest (2.7±0.46) and the lowest (2.4±0.49) mean scores, respectively. The data-gathering method, control of a sample of women deaths in reproductive age in the universities of medical sciences, use of international classification of disease, and use of this system information by management teams to set resources allocation achieved the lowest mean scores in studied axes. Treatment deputy staff had a more positive attitude toward the status of information management of IMMSS than the health deputy staff (p=0.004). Although the status of information management in IMMSS was desirable, it could be improved by modification of the data-gathering method; creating communication links between different data resources; a periodic sample control of women deaths in reproductive age in the universities of medical sciences; and implementing ICD-MM and integration of its rules on a unified system of death.

  8. Radiation management system for the HIMAC

    International Nuclear Information System (INIS)

    Kono, Toshiyuki; Matsumoto, Takashi; Namiki, Hidefumi.

    1994-01-01

    In recent years, cancer is the worst cause of death. In order to exterminate cancer, the National Institute of Radiological Sciences has built HIMAC (Heavy Ion Medical Accelerator in Chiba). This plant can destroy the cells of cancer directly by irradiation of accelerated heavy ion beams such as Helium, Carbon, and Neon. Because those can intensively irradiate just the cell of cancer without destroying the other cells, this plant is especially effective to treat the pancreas cancer and brain tumor, which had been hard to treat. As this is the first plant in the world, exclusively for the medical use, we must try to experiment many times in order to call this plant 'the Saver'. The Radiation Safety Management System, in this report, was designed, producted and delivered by Fuji Electric Co., which has many achievements of the radiation management system for nuclear power plants and other radioisotope handling facilities. (author)

  9. Cannabis Use, Medication Management and Adherence Among Persons Living with HIV.

    Science.gov (United States)

    Vidot, Denise C; Lerner, Brenda; Gonzalez, Raul

    2017-07-01

    Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.

  10. Development of Quality Management Systems for Clinical Practice Guidelines in Korea.

    Science.gov (United States)

    Jo, Heui-Sug; Kim, Dong Ik; Chang, Sung-Goo; Shin, Ein-Soon; Oh, Moo-Kyung

    2015-11-01

    This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers.

  11. Electronic hand-drafting and picture management system.

    Science.gov (United States)

    Yang, Tsung-Han; Ku, Cheng-Yuan; Yen, David C; Hsieh, Wen-Huai

    2012-08-01

    The Department of Health of Executive Yuan in Taiwan (R.O.C.) is implementing a five-stage project entitled Electronic Medical Record (EMR) converting all health records from written to electronic form. Traditionally, physicians record patients' symptoms, related examinations, and suggested treatments on paper medical records. Currently when implementing the EMR, all text files and image files in the Hospital Information System (HIS) and Picture Archiving and Communication Systems (PACS) are kept separate. The current medical system environment is unable to combine text files, hand-drafted files, and photographs in the same system, so it is difficult to support physicians with the recording of medical data. Furthermore, in surgical and other related departments, physicians need immediate access to medical records in order to understand the details of a patient's condition. In order to address these problems, the Department of Health has implemented an EMR project, with the primary goal of building an electronic hand-drafting and picture management system (HDP system) that can be used by medical personnel to record medical information in a convenient way. This system can simultaneously edit text files, hand-drafted files, and image files and then integrate these data into Portable Document Format (PDF) files. In addition, the output is designed to fit a variety of formats in order to meet various laws and regulations. By combining the HDP system with HIS and PACS, the applicability can be enhanced to fit various scenarios and can assist the medical industry in moving into the final phase of EMR.

  12. [Hygiene and security management in medical biology laboratory].

    Science.gov (United States)

    Vinner, E; Odou, M F; Fovet, B; Ghnassia, J C

    2013-06-01

    Risk management in Medical Biology Laboratory (MBL) which includes hygiene and waste management, is an integrated process to the whole MBL organisation. It is composed of three stages: risks factors identification, grading and prioritization, and their evaluation in the system. From the legislation and NF EN ISO 15189 standard's requirements viewpoint, prevention and protection actions to implement are described, at premises level, but also at work station environment's one (human resources and equipments) towards biological, chemical, linked to gas, to ionizing or non ionizing radiations and fire riks, in order not to compromise patients safety, employees safety, and quality results. Then, although NF EN 15189 standard only enacts requirements in terms of prevention, curative actions after established blood or chemical exposure accident are defined.

  13. An Examination of Safety Management Systems and Aviation Technologies in the Helicopter Emergency Medical Services Industry

    Science.gov (United States)

    Buckner, Steven A.

    The Helicopter Emergency Medical Service (HEMS) industry has a significant role in the transportation of injured patients, but has experienced more accidents than all other segments of the aviation industry combined. With the objective of addressing this discrepancy, this study assesses the effect of safety management systems implementation and aviation technologies utilization on the reduction of HEMS accident rates. Participating were 147 pilots from Federal Aviation Regulations Part 135 HEMS operators, who completed a survey questionnaire based on the Safety Culture and Safety Management System Survey (SCSMSS). The study assessed the predictor value of SMS implementation and aviation technologies to the frequency of HEMS accident rates with correlation and multiple linear regression. The correlation analysis identified three significant positive relationships. HEMS years of experience had a high significant positive relationship with accident rate (r=.90; paviation technologies from a systems engineering application. Recommendations for practice included the adoption of existing regulatory guidance for a SMS program. A qualitative analysis was also recommended for future study SMS implementation and HEMS accident rate from the pilot's perspective. A quantitative longitudinal study would further explore inferential relationships between the study variables. Current strategies should include the increased utilization of available aviation technology resources as this proactive stance may be beneficial for the establishment of an effective safety culture within the HEMS industry.

  14. Effectiveness of nursing management information systems: a systematic review.

    Science.gov (United States)

    Choi, Mona; Yang, You Lee; Lee, Sun-Mi

    2014-10-01

    The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag(*) and admin(*), and nurs(*) were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs.

  15. A cloud system for mobile medical services of traditional Chinese medicine.

    Science.gov (United States)

    Hu, Nian-Ze; Lee, Chia-Ying; Hou, Mark C; Chen, Ying-Ling

    2013-12-01

    Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system

  16. Medication therapy management and condition care services in a community-based employer setting.

    Science.gov (United States)

    Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

    2010-08-15

    A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical

  17. Integration of SNOMED CT into the OpenMRS electronic medical record system framework

    CSIR Research Space (South Africa)

    Gerber, A

    2008-11-01

    Full Text Available Integrating a mechanism to store, retrieve and use clinical data with a system to manage medical records enables better utilisation of medical data and improved healthcare. This poster introduces a research project that aims to extend Open...

  18. Implementation of an Interorganizational System: The Case of Medical Insurance E-Clearance

    Science.gov (United States)

    Bose, Indranil; Liu, Han; Ye, Alex

    2012-01-01

    The patients receiving treatment from a hospital need to interact with multiple entities when claiming reimbursements. The complexities of the medical service supply chain can be simplified with an electronic clearance management system that allows hospitals, medical insurance bureau, bank, and patients to interact in a seamless and cashless…

  19. Improving post-hospital medication management in a Danish municipality

    DEFF Research Database (Denmark)

    Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

    2018-01-01

    implementation rate, which involved 31 out of the 38 patients in the target group. CONCLUSION: For patients with complex care needs, post-hospital medication management may be improved by a reconsideration of the activity-based funding of home healthcare, a recognition of the importance of organising work......AIMS AND OBJECTIVES: This study evaluates an intervention developed to improve patient safety in post-hospital medication management carried out by visiting nurses working in a municipality in Denmark. The intervention consisted of three elements: an initial inter-disciplinary home visit by nurses...... management is identified as the most challenging component of a discharge from the hospital to the home, in which discrepancies have been found in up to 94% of medication lists. DESIGN: A process evaluation inspired by the UK Medical Research Council's guidance. METHODS: The process evaluation was conducted...

  20. Ethical challenges for medical professionals in middle manager positions: a debate article.

    Science.gov (United States)

    Schnoor, Joerg; Heyde, Christoph-Eckhard; Ghanem, Mohamed

    2015-01-01

    Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company's success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field. While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of "independence" of the medical profession and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Above all, the character of "independence" of the medical profession and its ethical values justifies medical action that is based on the patient's well-being and not exclusively on economic outcomes. In the future, medical middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become "value-added bridge-builders".

  1. Evaluation of Medical Faculty Students's Time Management Skills

    Directory of Open Access Journals (Sweden)

    Umit Yavas

    2012-02-01

    Full Text Available SUMMARY AIM: This study was carried out in order to determine medical faculty students� time management skills. METHOD: This is a cross sectional study and was carried out between 13 -31 May 2010. The universe of the study comprised 513 medical faculty students and data collection was performed by using the Time Management Inventory (TMI from 420 students (%81,9 of the universe. For statistical analyses of data percentage, Kruskal-Wallis, One-way Anova, Mann-Whitney U, Student-t test and Pearson correlation analysis were used. RESULTS: Students� total time management points were minimum 44 and maximum 122. Total points� mean was 79,06±14,07 and also the median was 78 of Time Management Inventory. Total time management points of the fifth class students were higher than the others. There was no correlation between total time management points and ages of the students. Also there is no statistically significant difference between the males and females at the TMI points. CONCLUSION: According to the other studies the medical faculty students� total TMI mean points are low. The reason of this situation may be the pension school that someone else is planning most of students� time and inadequacy of awareness, knowledge and skills about time management. Enhancing awareness with useful knowledge and being full of resource about time management is essential. [TAF Prev Med Bull 2012; 11(1.000: 5-10

  2. An international course on strategic information management for medical informatics students: aim, content, structure, and experiences

    NARCIS (Netherlands)

    Haux, R.; Ammenwerth, E.; ter Burg, W. J.; Pilz, J.; Jaspers, M. W. M.

    2004-01-01

    We report on a course for medical informatics students on hospital information systems, especially on its strategic information management. Starting as course at the Medical Informatics Program of the University of Heidelberg/University of Applied Sciences Heilbronn, it is now organized as

  3. Impact of information technology on the role of medical libraries in information managment: normative background

    Directory of Open Access Journals (Sweden)

    Anamarija Rožić-Hristovski

    1998-01-01

    Full Text Available Exponential growth of biomedical knowledge and information technology development is changing the infrastructure of health care systems, education and research. So medical libraries roles have shifted from managing containers of information toward influencing biomedical information resource content and education. These new tasks are formalised in modem American standards for medical libraries, stressing information management role in evolving environment.In Slovenia medical libraries also are aware of development imperative of information activities for advances in medicine. At one side they are faced with lack of specific guidelines for proactive action and on the other with inadequate assessment in legal documents and insufficient funding.

  4. Managing medical equipment used by technology-dependent children: evaluation of an instructional tool for pediatric residents and medical students.

    Science.gov (United States)

    Jackson, Jennifer M; Radulovic, Andrea; Nageswaran, Savithri

    2012-08-01

    To evaluate the effectiveness of a workshop on managing medical devices used in technology-dependent children. Study participants included residents and medical students rotating in the pediatrics department at the time of the study. A workshop was conducted consisting of learning stations for common medical devices, including brief presentations and opportunities for hands-on practice with each device. Participants completed surveys before and after the workshop assessing their perceived ability to manage medical equipment before and after the workshop and their ongoing learning needs. All participants indicated a substantial need for training on how to manage medical devices used by technology-dependent patients. Scores for perceived ability to manage the devices improved significantly after workshop participation for nearly all devices taught. Medical trainees have significant learning needs for managing devices used by technology-dependent patients. Hands-on, small-group training can be an effective instructional tool for improving confidence in these skills.

  5. Medical waste management in Jordan: A study at the King Hussein Medical Center

    International Nuclear Information System (INIS)

    Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

    2005-01-01

    As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel

  6. Teaching emergency medical services management skills using a computer simulation exercise.

    Science.gov (United States)

    Hubble, Michael W; Richards, Michael E; Wilfong, Denise

    2011-02-01

    Simulation exercises have long been used to teach management skills in business schools. However, this pedagogical approach has not been reported in emergency medical services (EMS) management education. We sought to develop, deploy, and evaluate a computerized simulation exercise for teaching EMS management skills. Using historical data, a computer simulation model of a regional EMS system was developed. After validation, the simulation was used in an EMS management course. Using historical operational and financial data of the EMS system under study, students designed an EMS system and prepared a budget based on their design. The design of each group was entered into the model that simulated the performance of the EMS system. Students were evaluated on operational and financial performance of their system design and budget accuracy and then surveyed about their experiences with the exercise. The model accurately simulated the performance of the real-world EMS system on which it was based. The exercise helped students identify operational inefficiencies in their system designs and highlighted budget inaccuracies. Most students rated the exercise as moderately or very realistic in ambulance deployment scheduling, budgeting, personnel cost calculations, demand forecasting, system design, and revenue projections. All students indicated the exercise was helpful in gaining a top management perspective, and 89% stated the exercise was helpful in bridging the gap between theory and reality. Preliminary experience with a computer simulator to teach EMS management skills was well received by students in a baccalaureate paramedic program and seems to be a valuable teaching tool. Copyright © 2011 Society for Simulation in Healthcare

  7. Professional career management and personal development for the employees of the Romanian medical system

    OpenAIRE

    Mirica Dumitrescu Catalina-Oana

    2017-01-01

    The purpose of this article is to inform as many persons as possible on the present situation of doctors in Romania, to present more theoretical and practical elements that lead to the development of a sustainable career in the Romanian medical system. So I tried to get as much information about the current situation of the medical system, to obtain a certain confirmation of what was said by those working in the system. Gradually, I found out about the hospital problems, the insufficient budg...

  8. 78 FR 57159 - Scientific Information Request on Medication Therapy Management

    Science.gov (United States)

    2013-09-17

    ... Information Request on Medication Therapy Management AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Request for scientific information submissions. SUMMARY: The Agency for Healthcare... therapy management Scientific information is being solicited to inform our review of Medication Therapy...

  9. Medical wastes management in the south of Brazil

    International Nuclear Information System (INIS)

    Silva, C.E. da; Hoppe, A.E.; Ravanello, M.M.; Mello, N.

    2005-01-01

    In developing countries, solid wastes have not received sufficient attention. In many countries, hazardous and medical wastes are still handled and disposed together with domestic wastes, thus creating a great health risk to municipal workers, the public and the environment. Medical waste management has been evaluated at the Vacacai river basin in the State of Rio Grande do Sul, Brazil. A total of 91 healthcare facilities, including hospitals (21), health centers (48) and clinical laboratories (22) were surveyed to provide information about the management, segregation, generation, storage and disposal of medical wastes. The results about management aspects indicate that practices in most healthcare facilities do not comply with the principles stated in Brazilian legislation. All facilities demonstrated a priority on segregation of infectious-biological wastes. Average generation rates of total and infectious-biological wastes in the hospitals were estimated to be 3.245 and 0.570 kg/bed-day, respectively

  10. Medical Errors Management Before and After Implementation of Accreditation in Hospital

    Directory of Open Access Journals (Sweden)

    Ghassem Abedi

    2014-12-01

    Full Text Available Background and purpose: This study aimed to manage medical errors before and after the implementation of accreditation in public, private, and social security hospitals of Mazandaran, Iran. Materials and Methods: This descriptive study has been done in 38 hospitals. Data were collected through documents reviewed relating to 2013 and 2014. The paired t-test and Friedman test were used by statistical software SPSS. Results: Results showed that the most and the least percent of reported errors, before accreditation, in sequence, were related to public clinical unit (55.9% and operating rooms (0.6%, and after accreditation in public clinical unit (46.6% and operating rooms (2.3% in teaching centers. The most errors (before accreditation occurred in the morning (62% and the least, in the evening (8.3% in teaching centers. Furthermore, after accreditation, the most errors occurred in the morning (64.8% and the least, in the night (17.3% in therapeutic hospitals. Paired t-test showed that there is no significant difference between medical errors before and after accreditation. Friedman test showed that structural/systemic errors reported were the most important medical errors in teaching centers after accreditation and therapeutic hospitals before accreditation (P < 0.05. Conclusion: There is no significant difference between the rate of reported errors before and after the implementation of accreditation. This illustrates that the role of management in controlling of medical errors has been poor, and stronger management should be applied in providing health care services.

  11. A National Medical Information System for Senegal: Architecture and Services.

    Science.gov (United States)

    Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou

    2016-01-01

    In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.

  12. Anatomy of an anesthesia information management system.

    Science.gov (United States)

    Shah, Nirav J; Tremper, Kevin K; Kheterpal, Sachin

    2011-09-01

    Anesthesia information management systems (AIMS) have become more prevalent as more sophisticated hardware and software have increased usability and reliability. National mandates and incentives have driven adoption as well. AIMS can be developed in one of several software models (Web based, client/server, or incorporated into a medical device). Irrespective of the development model, the best AIMS have a feature set that allows for comprehensive management of workflow for an anesthesiologist. Key features include preoperative, intraoperative, and postoperative documentation; quality assurance; billing; compliance and operational reporting; patient and operating room tracking; and integration with hospital electronic medical records. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Baseline Antihypertensive Drug Count and Patient Response to Hypertension Medication Management.

    Science.gov (United States)

    Crowley, Matthew J; Olsen, Maren K; Woolson, Sandra L; King, Heather A; Oddone, Eugene Z; Bosworth, Hayden B

    2016-04-01

    Telemedicine-based medication management improves hypertension control, but has been evaluated primarily in patients with low antihypertensive drug counts. Its impact on patients taking three or more antihypertensive agents is not well-established. To address this evidence gap, the authors conducted an exploratory analysis of an 18-month, 591-patient trial of telemedicine-based hypertension medication management. Using general linear models, the effect of medication management on blood pressure for patients taking two or fewer antihypertensive agents at study baseline vs those taking three or more was compared. While patients taking two or fewer antihypertensive agents had a significant reduction in systolic blood pressure with medication management, those taking three or more had no such response. The between-subgroup effect difference was statistically significant at 6 months (-6.4 mm Hg [95% confidence interval, -12.2 to -0.6]) and near significant at 18 months (-6.0 mm Hg [95% confidence interval, -12.2 to 0.2]). These findings suggest that baseline antihypertensive drug count may impact how patients respond to hypertension medication management and emphasize the need to study management strategies specifically in patients taking three or more antihypertensive medications. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  14. The effectiveness of risk management program on pediatric nurses' medication error.

    Science.gov (United States)

    Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat

    2013-09-01

    Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P error-reporting rate was higher (P medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation.

  15. Stepped-wedge cluster randomised controlled trial to assess the effectiveness of an electronic medication management system to reduce medication errors, adverse drug events and average length of stay at two paediatric hospitals: a study protocol.

    Science.gov (United States)

    Westbrook, J I; Li, L; Raban, M Z; Baysari, M T; Mumford, V; Prgomet, M; Georgiou, A; Kim, T; Lake, R; McCullagh, C; Dalla-Pozza, L; Karnon, J; O'Brien, T A; Ambler, G; Day, R; Cowell, C T; Gazarian, M; Worthington, R; Lehmann, C U; White, L; Barbaric, D; Gardo, A; Kelly, M; Kennedy, P

    2016-10-21

    Medication errors are the most frequent cause of preventable harm in hospitals. Medication management in paediatric patients is particularly complex and consequently potential for harms are greater than in adults. Electronic medication management (eMM) systems are heralded as a highly effective intervention to reduce adverse drug events (ADEs), yet internationally evidence of their effectiveness in paediatric populations is limited. This study will assess the effectiveness of an eMM system to reduce medication errors, ADEs and length of stay (LOS). The study will also investigate system impact on clinical work processes. A stepped-wedge cluster randomised controlled trial (SWCRCT) will measure changes pre-eMM and post-eMM system implementation in prescribing and medication administration error (MAE) rates, potential and actual ADEs, and average LOS. In stage 1, 8 wards within the first paediatric hospital will be randomised to receive the eMM system 1 week apart. In stage 2, the second paediatric hospital will randomise implementation of a modified eMM and outcomes will be assessed. Prescribing errors will be identified through record reviews, and MAEs through direct observation of nurses and record reviews. Actual and potential severity will be assigned. Outcomes will be assessed at the patient-level using mixed models, taking into account correlation of admissions within wards and multiple admissions for the same patient, with adjustment for potential confounders. Interviews and direct observation of clinicians will investigate the effects of the system on workflow. Data from site 1 will be used to develop improvements in the eMM and implemented at site 2, where the SWCRCT design will be repeated (stage 2). The research has been approved by the Human Research Ethics Committee of the Sydney Children's Hospitals Network and Macquarie University. Results will be reported through academic journals and seminar and conference presentations. Australian New Zealand

  16. The Effectiveness of the Community Medicine Undergraduate Program in Medical Schools on Enabling Medical Graduates to Work in the Health Systems

    Directory of Open Access Journals (Sweden)

    Hossein Jabbari Bayrami

    2013-05-01

    Full Text Available Introduction: The main mission of medical schools is to train competent medical trainees for providing primary health care services, management of health care team and improving the health status of the population. The aim of this study was to determine the effectiveness of the undergraduate program of community medicine department among the graduates as general (family physicians in health system of East Azerbaijan, North-West of` Iran. Methods: In this cross- sectional study all family physicians of East Azerbaijan province were included. A questionnaire on the views of graduates about the effectiveness of community medicine undergraduate program was used for gathering data. Data were analyzed by T-test, ANOVA, and Pearson correlation. Results: Performance of community medicine department in creating competency for providing effective health services among physicians was 2.13 and management competency was 1.96 out of 4. To teach the necessary skills to meet the professional needs in Primary Health Care (PHC, Tabriz Community Medicine Department was better compared to Azad and other medical schools (p<0.001. Conclusions: The results of the study showed that the community medicine program in undergraduate medical education was effective for future career of physicians in the health system. There is a need to revise the health management courses in community medicine program.

  17. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  18. Time management tips, tricks, and exercises for busy medical practice employees.

    Science.gov (United States)

    Hills, Laura

    2012-01-01

    Working in a busy medical practice requires excellent time management skills and an ability to handle those unanticipated emergencies, urgencies, and monkey-wrenches that can and often do throw a well-planned day out of whack. This article offers busy medical practice employees 50 time management tips to help them manage their time well. It focuses specifically on eliminating time wasters, working more efficiently, and developing personal goals and habits that can increase productivity, reduce stress, and make working in the practice more enjoyable. This article also offers several hands-on time management exercises, including a time management self-assessment quiz, a multitasking exercise, and a time drain exercise. These can be completed individually or collaboratively with other members of the medical practice team. Finally, this article explores 12 popular time management myths and how a medical practice employee can increase his or her productivity by identifying and harnessing his or her productivity "happy hour(s)".

  19. Radiation exposure and management of medical employes

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, C [Nagoya Univ. (Japan)

    1981-11-01

    Medical employes handling medical radiation are increasing in recent years. In connection with the radiation exposure management, it was surveyed how much their cumulative exposure doses are and how many employes distribute in respective exposure levels. The medical employes surveyed are physicians, radiation technicians and nurses, working in the hospitals of educational institutions. The period of survey is every three years, from 1962 to 1977. For X-ray and ..gamma..-ray, respectively, the yearly cumulative exposure doses were measured by film badges, stepwise starting from below 500 mrem upward to over 5000 mrem; for the respective groups of employes, the percentage in each dose level was shown. The percentage in the level below 500 mrem was the largest in all groups, and in both X-ray and ..gamma..-ray, the percentages in higher levels decreased sharply to less than 7%. The exposure management has been improved in recent years.

  20. Shared decision making for psychiatric medication management: beyond the micro-social.

    Science.gov (United States)

    Morant, Nicola; Kaminskiy, Emma; Ramon, Shulamit

    2016-10-01

    Mental health care has lagged behind other health-care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self-management and recovery-oriented practice, and growing policy-level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals' needs. This conceptual review argues that several aspects of mental health care that differ from other health-care contexts (e.g. forms of coercion, questions about service users' insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health-care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro-social focus of a medical consultation. Contextualizing specific medication-related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM. A broad conceptualization of decision making for psychiatric medication that moves beyond the micro-social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  1. The German emergency and disaster medicine and management system-history and present.

    Science.gov (United States)

    Hecker, Norman; Domres, Bernd Dieter

    2018-04-01

    As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach. Copyright © 2018. Production and hosting by Elsevier B.V.

  2. A Systematic Review of Stress-Management Programs for Medical Students

    Science.gov (United States)

    Shiralkar, Malan T.; Harris, Toi B.; Eddins-Folensbee, Florence F.; Coverdale, John H.

    2013-01-01

    Objective: Because medical students experience a considerable amount of stress during training, academic leaders have recognized the importance of developing stress-management programs for medical students. The authors set out to identify all controlled trials of stress-management interventions and determine the efficacy of those interventions.…

  3. Medication management in North Carolina elementary schools: Are pharmacists involved?

    Science.gov (United States)

    Stegall-Zanation, Jennifer; Scolaro, Kelly L

    2010-01-01

    To determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina. Prospective survey of 153 (130 public and 23 private) elementary schools in four counties of North Carolina. A 21-question survey was e-mailed to the head administrator of each school (e.g., principal, headmaster) containing a Qualtrics survey link. Questions were designed to elicit information on school policies and procedures for medication management and use of health care providers, including pharmacists, in the schools. Responses were collected during a 2-month period. Representatives from 29 schools participated in the survey (19% response rate). All 29 schools reported having a school policy regarding medication administration during school hours. Of those, 27 schools reported consulting with nurses on their policies. Only 1 of 27 respondents reported consulting with pharmacists on medication management policies. The majority of the respondents (93.1%) stated that administrative staff was responsible for medication administration at the schools. Use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. The findings in this study reinforce the findings in previous studies that pharmacists are not being used and are not a major presence in elementary school health.

  4. Medication Therapy Management and Preconception Care: Opportunities for Pharmacist Intervention

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro

    2014-01-01

    Full Text Available As medication therapy management (MTM continues to grow in the profession of pharmacy, careful consideration as to areas for positive patient impact is warranted. Given the current gaps in preconception care in the United States, and the accessibility and expertise of the pharmacist, MTM interventions related to preconception care may be valuable. This paper describes potential for pharmacist intervention in several different areas of preconception care. Notably, targeted medication reviews may be appropriate for interventions such as folic acid recommendations, teratogenic/category X medication management, immunizations, and disease state management. Comprehensive medication reviews may be warranted for selected disease states due to complexity of interventions, such the management of diabetes. Comprehensive medication reviews may also be warranted if several targeted interventions are necessary, or if there are a several medications or disease states requiring intervention. Pharmacists also have important roles in screening, support, and referrals needed for preconception care in the context of MTM. Patients may benefit substantially from pharmacist-directed MTM services related to preconception care. In addition, depending on clinical pharmacy service contracts and billing opportunities, pharmacists may be reimbursed for providing these services, generating sustainable revenue while fulfilling an important public health need.   Type: Idea Paper

  5. Knowledge management systems success in healthcare: Leadership matters.

    Science.gov (United States)

    Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga

    2017-01-01

    To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Medication Therapy Management after Hospitalization in CKD: A Randomized Clinical Trial.

    Science.gov (United States)

    Tuttle, Katherine R; Alicic, Radica Z; Short, Robert A; Neumiller, Joshua J; Gates, Brian J; Daratha, Kenn B; Barbosa-Leiker, Celestina; McPherson, Sterling M; Chaytor, Naomi S; Dieter, Brad P; Setter, Stephen M; Corbett, Cynthia F

    2018-02-07

    CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited. The intervention was designed to improve posthospitalization care by medication therapy management. A pharmacist delivered the intervention as a single home visit within 7 days of discharge. The intervention included these fundamental elements: comprehensive medication review, medication action plan, and a personal medication list. The primary outcome was a composite of acute care utilization (hospital readmissions and emergency department and urgent care visits) for 90 days after hospitalization. Baseline characteristics of participants ( n =141) included the following: age, 69±11 (mean±SD) years old; women, 48% (67 of 141); diabetes, 56% (79 of 141); hypertension, 83% (117 of 141); eGFR, 41±14 ml/min per 1.73 m 2 (serum creatinine-based Chronic Kidney Disease Epidemiology Collaboration equation); and urine albumin-to-creatinine ratio median, 43 mg/g (interquartile range, 8-528) creatinine. The most common primary diagnoses for hospitalization were the following: cardiovascular events, 36% (51 of 141); infections, 18% (26 of 141); and kidney diseases, 12% (17 of 141). The primary outcome occurred in 32 of 72 (44%) of the medication intervention group and 28 of 69 (41%) of those in usual care (log rank P =0.72). For only hospital readmission, the rate was 19 of 72 (26%) in the medication intervention group and 18 of 69 (26%) in the usual care group (log rank P =0.95). There was no between-group difference in achievement of guideline-based goals for use of renin-angiotensin system inhibition or for BP

  7. Medical negligence--prevention and management.

    Science.gov (United States)

    Chao, T C

    1987-04-01

    The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

  8. [Medical safety management in the setting of a clinical reference laboratory--risk management efforts in clinical testing].

    Science.gov (United States)

    Seki, Akira; Miya, Tetsumasa

    2011-03-01

    As a result of recurring medical accidents, risk management in the medical setting has been given much attention. The announcement in August, 2000 by the Ministry of Health committee for formulating a standard manual for risk management, of a "Risk management manual formulation guideline" has since been accompanied by the efforts of numerous medical testing facilities to develop such documents. In 2008, ISO/TS 22367:2008 on "Medical laboratories-Reduction of error through risk management and continual improvement" was published. However, at present, risk management within a medical testing facility stresses the implementation of provisional actions in response to a problem after it has occurred. Risk management is basically a planned process and includes "corrective actions" as well as "preventive actions." A corrective action is defined as identifying the root cause of the problem and removing it, and is conducted to prevent the problem from recurring. A preventive action is defined as identifying of the any potential problem and removing it, and is conducted to prevent a problem before it occurs. Presently, I shall report on the experiences of our laboratory regarding corrective and preventive actions taken in response to accidents and incidents, respectively.

  9. Definition of information technology architectures for continuous data management and medical device integration in diabetes.

    Science.gov (United States)

    Hernando, M Elena; Pascual, Mario; Salvador, Carlos H; García-Sáez, Gema; Rodríguez-Herrero, Agustín; Martínez-Sarriegui, Iñaki; Gómez, Enrique J

    2008-09-01

    The growing availability of continuous data from medical devices in diabetes management makes it crucial to define novel information technology architectures for efficient data storage, data transmission, and data visualization. The new paradigm of care demands the sharing of information in interoperable systems as the only way to support patient care in a continuum of care scenario. The technological platforms should support all the services required by the actors involved in the care process, located in different scenarios and managing diverse information for different purposes. This article presents basic criteria for defining flexible and adaptive architectures that are capable of interoperating with external systems, and integrating medical devices and decision support tools to extract all the relevant knowledge to support diabetes care.

  10. Adoption of medication alert systems in hospital outpatient departments in Taiwan.

    Science.gov (United States)

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

    The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Lived Experiences of Educational Leaders in Iranian Medical Education System: A Qualitative Study.

    Science.gov (United States)

    Sohrabi, Zohreh; Kheirkhah, Masoomeh; Vanaki, Zohreh; Arabshahi, Kamran Soltani; Farshad, Mohammad Mahdi; Farshad, Fatemeh; Farahani, Mansoureh Ashgale

    2015-12-18

    High quality educational systems are necessary for sustainable development and responding to the needs of society. In the recent decades, concerns have increased on the quality of education and competency of graduates. Since graduates of medical education are directly involved with the health of society, the quality of this system is of high importance. Investigation in the lived experience of educational leaders in the medical education systems can help to promote its quality. The present research examines this issue in Iran. The study was done using content-analysis qualitative approach and semi-structured interviews. The participants included 26 authorities including university chancellors and vice-chancellors, ministry heads and deputies, deans of medical and basic sciences departments, education expert, graduates, and students of medical fields. Sampling was done using purposive snowball method. Data were analyzed using conventional content analysis. Five main categories and 14 sub-categories were extracted from data analysis including: quantity-orientation, ambiguity in the trainings, unsuitable educational environment, personalization of the educational management, and ineffective interpersonal relationship. The final theme was identified as "Education in shadow". Personalization and inclusion of personal preferences in management styles, lack of suitable grounds, ambiguity in the structure and process of education has pushed medical education toward shadows and it is not the first priority; this can lead to incompetency of medical science graduates.

  12. In Connecticut: improving patient medication management in primary care.

    Science.gov (United States)

    Smith, Marie; Giuliano, Margherita R; Starkowski, Michael P

    2011-04-01

    Medications are a cornerstone of the management of most chronic conditions. However, medication discrepancies and medication-related problems-some of which can cause serious harm-are common. Pharmacists have the expertise to identify, resolve, monitor, and prevent these problems. We present findings from a Centers for Medicare and Medicaid Services demonstration project in Connecticut, in which nine pharmacists worked closely with eighty-eight Medicaid patients from July 2009 through May 2010. The pharmacists identified 917 drug therapy problems and resolved nearly 80 [corrected] percent of them after four encounters. The result was an estimated annual saving of $1,123 per patient on medication claims and $472 per patient on medical, hospital, and emergency department expenses-more than enough to pay for the contracted pharmacist services. We recommend that the Center for Medicare and Medicaid Innovation support the evaluation of pharmacist-provided medication management services in primary care medical homes, accountable care organizations, and community health and care transition teams, as well as research to explore how to enhance team-based care.

  13. ReTrust: attack-resistant and lightweight trust management for medical sensor networks.

    Science.gov (United States)

    He, Daojing; Chen, Chun; Chan, Sammy; Bu, Jiajun; Vasilakos, Athanasios V

    2012-07-01

    Wireless medical sensor networks (MSNs) enable ubiquitous health monitoring of users during their everyday lives, at health sites, without restricting their freedom. Establishing trust among distributed network entities has been recognized as a powerful tool to improve the security and performance of distributed networks such as mobile ad hoc networks and sensor networks. However, most existing trust systems are not well suited for MSNs due to the unique operational and security requirements of MSNs. Moreover, similar to most security schemes, trust management methods themselves can be vulnerable to attacks. Unfortunately, this issue is often ignored in existing trust systems. In this paper, we identify the security and performance challenges facing a sensor network for wireless medical monitoring and suggest it should follow a two-tier architecture. Based on such an architecture, we develop an attack-resistant and lightweight trust management scheme named ReTrust. This paper also reports the experimental results of the Collection Tree Protocol using our proposed system in a network of TelosB motes, which show that ReTrust not only can efficiently detect malicious/faulty behaviors, but can also significantly improve the network performance in practice.

  14. Radiation exposure and management of medical employes

    International Nuclear Information System (INIS)

    Yamamoto, Chiaki

    1981-01-01

    Medical employes handling medical radiation are increasing in recent years. In connection with the radiation exposure management, it was surveyed how much their cumulative exposure doses are and how many employes distribute in respective exposure levels. The medical employes surveyed are physicians, radiation technicians and nurses, working in the hospitals of educational institutions. The period of survey is every three years, from 1962 to 1977. For X-ray and ν-ray, respectively, the yearly cumulative exposure doses were measured by film badges, stepwise starting from below 500 mrem upward to over 5000 mrem; for the respective groups of employes, the percentage in each dose level was shown. The percentage in the level below 500 mrem was the largest in all groups, and in both X-ray and ν-ray, the percentages in higher levels decreased sharply to less than 7%. The exposure management has been improved in recent years. (J.P.N.)

  15. Managing High Blood Pressure Medications

    Science.gov (United States)

    ... pharmacist to help you come up with a coding system for your medications that makes them easier to take. Some pharmacists will prepare blister packs for daily or weekly medications. Make an instruction sheet for yourself by taping a sample of each ...

  16. How to manage a claim for medical and technical error

    International Nuclear Information System (INIS)

    Nguyen, T.D.

    2012-01-01

    Purpose. - The fast modifications in French medical legislation, the increasing number of litigations and the professional consequences for the practitioner warrant the necessity to recall the 'how to manage' a claim for medical error. Patients and methods. - Four cases of legal action against oncologists are presented. Results and discussion. - The importance of quality and traceability of the given information, the essential pieces of the medical file, the description of the different process steps and of the contradictory meeting are presented and discussed. Conclusion. - Beyond the control of medical and technical risks, the practitioners in general and the radiation oncologist in particular should learn on the daily management of the risk related to medical claim. (authors)

  17. Expanding management and leadership education in medical schools

    Directory of Open Access Journals (Sweden)

    Chaudry A

    2018-04-01

    Full Text Available Aqib Chaudry, Amar Sodha, Ahmed Nur Faculty of Medicine, Imperial College London, London, UK We read with great interest the article by Rouhani et al1 exploring the perceptions, attitudes, and interest of UK medical students toward medical leadership. As medical students who recently completed an intercalated degree in health care management at Imperial College London, we can offer a unique perspective on this important issue.Authors' responseMaral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,51Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK We read with great interest the response to our article1 by Chaudry et al. Their group have contemporary insight and valuable experience in this subject which can be attributed to the intercalated degrees they have undertaken in health care management. We are acutely aware that very few UK medical schools actually offer such an intercalated degree. However, we believe the proposal of Singh et al2 of a compulsory health care management BSc is a counterproductive one. Basic science and clinically orientated intercalated degrees expose the medical student to research techniques and methodology. At their very core, they inspire the medical mind and are not designed to instruct all doctors to be academic research scientists, but rather ensure that every clinician’s mind is tuned to continually evaluate standard practice, and ask can we do better? View the original paper by Rouhani and colleagues.

  18. Medical leadership and management: An international revolution

    Directory of Open Access Journals (Sweden)

    Alex Till

    2015-01-01

    Full Text Available Medical leadership and management are increasingly receiving widespread attention internationally. Significant focus has been paid as to the style of leadership within healthcare and how to develop both leadership and management skills and competencies (the two are inseparable yet distinct throughout the careers of all healthcare professionals. This article discusses how leadership and management development is being considered internationally, both at an organisational and personal level, helpful models and frameworks and challenges and opportunities.

  19. Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

    Science.gov (United States)

    Sasnett, Bonita; Harris, Susie T; White, Shelly

    Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

  20. Creation of a Book Order Management System Using a Microcomputer and a DBMS.

    Science.gov (United States)

    Neill, Charlotte; And Others

    1985-01-01

    Describes management decisions and resultant technology-based system that allowed a medical library to meet increasing workloads without accompanying increases in resources available. Discussion covers system analysis; capabilities of book-order management system, "BOOKDIRT;" software and training; hardware; data files; data entry;…

  1. Utilization of a Clinical Trial Management System for the Whole Clinical Trial Process as an Integrated Database: System Development.

    Science.gov (United States)

    Park, Yu Rang; Yoon, Young Jo; Koo, HaYeong; Yoo, Soyoung; Choi, Chang-Min; Beck, Sung-Ho; Kim, Tae Won

    2018-04-24

    Clinical trials pose potential risks in both communications and management due to the various stakeholders involved when performing clinical trials. The academic medical center has a responsibility and obligation to conduct and manage clinical trials while maintaining a sufficiently high level of quality, therefore it is necessary to build an information technology system to support standardized clinical trial processes and comply with relevant regulations. The objective of the study was to address the challenges identified while performing clinical trials at an academic medical center, Asan Medical Center (AMC) in Korea, by developing and utilizing a clinical trial management system (CTMS) that complies with standardized processes from multiple departments or units, controlled vocabularies, security, and privacy regulations. This study describes the methods, considerations, and recommendations for the development and utilization of the CTMS as a consolidated research database in an academic medical center. A task force was formed to define and standardize the clinical trial performance process at the site level. On the basis of the agreed standardized process, the CTMS was designed and developed as an all-in-one system complying with privacy and security regulations. In this study, the processes and standard mapped vocabularies of a clinical trial were established at the academic medical center. On the basis of these processes and vocabularies, a CTMS was built which interfaces with the existing trial systems such as the electronic institutional review board health information system, enterprise resource planning, and the barcode system. To protect patient data, the CTMS implements data governance and access rules, and excludes 21 personal health identifiers according to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule and Korean privacy laws. Since December 2014, the CTMS has been successfully implemented and used by 881 internal and

  2. Personnel Risks in Ensuring Safety of Medical Activity

    Directory of Open Access Journals (Sweden)

    O. L. Zadvornaya

    2017-01-01

    Full Text Available Purpose: modern strategies of management of the organization require the formation of special management approaches based on the analysis of the mechanisms and processes of the organization of medical activities related to possible risks in activity of medical personnel. Based on international experience and own research the authors have identified features of a system of management of personnel risk in medical activities, examined approaches showing the sequence and contents of the main practical activities of the formation, maintenance and development of the system of management of personnel risks. Emphasized is the need for further research and implementation of the system of management of personnel risk in health care organizations. Study and assessment of personnel risks affecting the security of medical activities aimed at the development of the system of personnel risk management, development of a system of identification and monitoring of HR risk indicators with a purpose to improve institutional management and increase efficiency of activity of medical organizations. Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, method of statistical processing of information. Results: approaches to predict the occurrence and development of personnel risks have been reviewed and proposed. Conclusions and Relevance: patient safety is a global issue affecting countries at all levels of development. Each year, the WHO identifies a number of systemic and technical aspects and trends in the field of patient safety related to actions of medical workers. Existing imbalances in the staffing of the health system of the Russian Federation increase the probability of potential risks in medical practice. The personnel policy of healthcare of the Russian Federation requires further improvement and

  3. Medical and surgical management of esophageal and gastric motor dysfunction.

    Science.gov (United States)

    Awad, R A

    2012-09-01

    he occurrence of esophageal and gastric motor dysfunctions happens, when the software of the esophagus and the stomach is injured. This is really a program previously established in the enteric nervous system as a constituent of the newly called neurogastroenterology. The enteric nervous system is composed of small aggregations of nerve cells, enteric ganglia, the neural connections between these ganglia, and nerve fibers that supply effectors tissues, including the muscle of the gut wall. The wide range of enteric neuropathies that includes esophageal achalasia and gastroparesis highlights the importance of the enteric nervous system. A classification of functional gastrointestinal disorders based on symptoms has received attention. However, a classification based solely in symptoms and consensus may lack an integral approach of disease. As an alternative to the Rome classification, an international working team in Bangkok presented a classification of motility disorders as a physiology-based diagnosis. Besides, the Chicago Classification of esophageal motility was developed to facilitate the interpretation of clinical high-resolution esophageal pressure topography studies. This review covers exclusively the medical and surgical management of the esophageal and gastric motor dysfunction using evidence from well-designed studies. Motor control of the esophagus and the stomach, motor esophageal and gastric alterations, treatment failure, side effects of PPIs, overlap of gastrointestinal symptoms, predictors of treatment, burden of GERD medical management, data related to conservative treatment vs. antireflux surgery, and postsurgical esophagus and gastric motor dysfunction are also taken into account.

  4. Defining the management role of the department medical director.

    Science.gov (United States)

    Brady, T F; Carpenter, C R

    1986-01-01

    Through analysis of medical and administrative director positions it is possible to identify an organizational structure for medical departments that enhances departmental operations. Possible roles and tasks that describe managerial responsibilities are considered, and a review of the literature identifies options for how these roles or tasks can be shared between medical and nonmedical managers at the departmental level. These options are refined based on interviews with department-level managers at a case study hospital. Three models are then explored: unity of command, shared accountability, and split accountability. The unity of command model is recommended. In this model, the medical director assumes total authority and accountability for departmental operations through some sort of "enfranchisement." A more formal planning process and a review of job descriptions are also recommended.

  5. Safe medication management in specialized home healthcare - an observational study.

    Science.gov (United States)

    Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

    2017-08-24

    Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

  6. Human engineering design of medical x-ray system

    International Nuclear Information System (INIS)

    Tohma, Hideo

    1981-01-01

    There have been remarkable progress in the area of X-ray diagnosis technology in recent years. However, there have been some cases of accident. Such accidents included those due to defective apparatus such as defects in apparatus and poor safety system, those caused by incorrect handling of apparatus by radiologic technologist, and those originating in a poor surrounding condition or bad management of apparatus. In this report, the following subjects are statistically studied: 1. Analysis of radiographic error. 2. Analysis of failure in medical X-ray systems. (author)

  7. Integrated therapy safety management system.

    Science.gov (United States)

    Podtschaske, Beatrice; Fuchs, Daniela; Friesdorf, Wolfgang

    2013-09-01

    The aim is to demonstrate the benefit of the medico-ergonomic approach for the redesign of clinical work systems. Based on the six layer model, a concept for an 'integrated therapy safety management' is drafted. This concept could serve as a basis to improve resilience. The concept is developed through a concept-based approach. The state of the art of safety and complexity research in human factors and ergonomics forms the basis. The findings are synthesized to a concept for 'integrated therapy safety management'. The concept is applied by way of example for the 'medication process' to demonstrate its practical implementation. The 'integrated therapy safety management' is drafted in accordance with the six layer model. This model supports a detailed description of specific work tasks, the corresponding responsibilities and related workflows at different layers by using the concept of 'bridge managers'. 'Bridge managers' anticipate potential errors and monitor the controlled system continuously. If disruptions or disturbances occur, they respond with corrective actions which ensure that no harm results and they initiate preventive measures for future procedures. The concept demonstrates that in a complex work system, the human factor is the key element and final authority to cope with the residual complexity. The expertise of the 'bridge managers' and the recursive hierarchical structure results in highly adaptive clinical work systems and increases their resilience. The medico-ergonomic approach is a highly promising way of coping with two complexities. It offers a systematic framework for comprehensive analyses of clinical work systems and promotes interdisciplinary collaboration. © 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.

  8. Brief review: Adoption of electronic medical records to enhance acute pain management.

    Science.gov (United States)

    Goldstein, David H; Phelan, Rachel; Wilson, Rosemary; Ross-White, Amanda; VanDenKerkhof, Elizabeth G; Penning, John P; Jaeger, Melanie

    2014-02-01

    The purpose of this paper is to examine physician barriers to adopting electronic medical records (EMRs) as well as anesthesiologists' experiences with the EMRs used by the acute pain management service at two tertiary care centres in Canada. We first review the recent literature to determine if physician barriers to adoption are changing given the exponential growth of information technology and the evolving healthcare environment. We next report on institutional experience from two academic health sciences centres regarding the challenges they encountered over the past ten years in developing and implementing an electronic medical record system for acute pain management. The key identified barriers to adoption of EMRs are financial, technological, and time constraints. These barriers are identical to those reported in a systematic review performed prior to 2009 and remain significant factors challenging implementation. These challenges were encountered during our institution's process of adopting EMRs specific to acute pain management. In addition, our findings emphasize the importance of physician participation in the development and implementation stages of EMRs in order to incorporate their feedback and ensure the EMR system is in keeping with their workflow. Use of EMRs will inevitably become the standard of care; however, many barriers persist to impede their implementation and adoption. These challenges to implementation can be facilitated by a corporate strategy for change that acknowledges the barriers and provides the resources for implementation. Adoption will facilitate benefits in communication, patient management, research, and improved patient safety.

  9. Embedding a Learning Management System Into an Undergraduate Medical Informatics Course in Saudi Arabia: Lessons Learned

    Science.gov (United States)

    2013-01-01

    Background Public universities in Saudi Arabia today are making substantial investments in e-learning as part of their educational system, especially in the implementation of learning management systems (LMS). To our knowledge, this is the first study conducted in Saudi Arabia exploring medical students’ experience with an LMS, particularly as part of a medical informatics course. Objective This study investigates students’ use of various features of the LMS embedded in a recently implemented medical informatics course. Methods A mixed methodology approach was employed. Survey questionnaires were distributed to all third year medical informatics students at the end of the course. In addition, two focus group sessions were conducted with twelve students. A thematic analysis of the focus group was performed. Results A total of 265 third year medical student surveys (167/265, 63% male and 98/265, 37% female) were completed and analyzed. Overall, 50.6% (134/265) of the students agreed that the course was well planned and up-to-date, had clearly stated objectives and clear evaluation methods, appropriate course assignment, and that the LMS offered easy navigation. Most of the students rated the course as good/fair overall. In general, females were 10.4% more likely to prefer the LMS, as revealed by higher odd ratios (odds ratio [OR] 1.104, 95% CI 0.86-1.42) compared to males. Survey results showed that students’ use of LMS tools increased after taking the course compared to before taking the course. The full model containing all items were statistically significant (χ2 25=69.52, Pstudents who had positive attitudes towards LMS and those who did not. The focus group, however, revealed that the students used social networking for general use rather than learning purposes, but they were using other Internet resources and mobile devices for learning. Male students showed a higher preference for using technology in general to enhance learning activities. Overall

  10. Embedding a learning management system into an undergraduate medical informatics course in Saudi Arabia: lessons learned.

    Science.gov (United States)

    Zakaria, Nasriah; Jamal, Amr; Bisht, Shekhar; Koppel, Cristina

    2013-01-01

    Public universities in Saudi Arabia today are making substantial investments in e-learning as part of their educational system, especially in the implementation of learning management systems (LMS). To our knowledge, this is the first study conducted in Saudi Arabia exploring medical students' experience with an LMS, particularly as part of a medical informatics course. This study investigates students' use of various features of the LMS embedded in a recently implemented medical informatics course. A mixed methodology approach was employed. Survey questionnaires were distributed to all third year medical informatics students at the end of the course. In addition, two focus group sessions were conducted with twelve students. A thematic analysis of the focus group was performed. A total of 265 third year medical student surveys (167/265, 63% male and 98/265, 37% female) were completed and analyzed. Overall, 50.6% (134/265) of the students agreed that the course was well planned and up-to-date, had clearly stated objectives and clear evaluation methods, appropriate course assignment, and that the LMS offered easy navigation. Most of the students rated the course as good/fair overall. In general, females were 10.4% more likely to prefer the LMS, as revealed by higher odd ratios (odds ratio [OR] 1.104, 95% CI 0.86-1.42) compared to males. Survey results showed that students' use of LMS tools increased after taking the course compared to before taking the course. The full model containing all items were statistically significant (χ(2) 25=69.52, Pstudents who had positive attitudes towards LMS and those who did not. The focus group, however, revealed that the students used social networking for general use rather than learning purposes, but they were using other Internet resources and mobile devices for learning. Male students showed a higher preference for using technology in general to enhance learning activities. Overall, medical student attitudes towards the LMS

  11. Evacuation support system for improved medical documentation and information flow in the field.

    Science.gov (United States)

    Walderhaug, Ståle; Meland, Per Håkon; Mikalsen, Marius; Sagen, Terje; Brevik, John Ivar

    2008-02-01

    Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care

  12. Medical device risk management and its economic impact

    Directory of Open Access Journals (Sweden)

    Katerina Krsteva Jakimovska

    2013-10-01

    Full Text Available The importance of medical devices in everyday users/patients lives is imensse. This is the reason why emphasis must be put on safety during their use. Satisfactory safety level can be achived by implementation of quality and risk management standards. Medical device manufacturers must learn to deal with the potential risks by using theoretical and practical examples and measures in order to protect their users/patients and themselves from suffering huge losses arising from adverse events or recall of their products. The best moment for implementation of risk management methods and analysis begins from the device design and development through manufacturing, sales and distribution. These way medical device manufacturers will succseed in protecting their users/patients from serious adverse events and at the same time protect their brand and society status, while minimizing economic losses.

  13. Disclosing medical mistakes: a communication management plan for physicians.

    Science.gov (United States)

    Petronio, Sandra; Torke, Alexia; Bosslet, Gabriel; Isenberg, Steven; Wocial, Lucia; Helft, Paul R

    2013-01-01

    There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate, but such disclosures are made difficult by medical traditions of concern about medical malpractice suits and by physicians' own emotional reactions. Because the physician may have compelling reasons both to keep the information private and to disclose it to the patient or family, these situations can be conceptualized as privacy dilemmas. These dilemmas may create barriers to effectively addressing the mistake and its consequences. Although a number of interventions exist to address privacy dilemmas that physicians face, current evidence suggests that physicians tend to be slow to adopt the practice of disclosing medical mistakes. This discussion proposes a theoretically based, streamlined, two-step plan that physicians can use as an initial guide for conversations with patients about medical mistakes. The mistake disclosure management plan uses the communication privacy management theory. The steps are 1) physician preparation, such as talking about the physician's emotions and seeking information about the mistake, and 2) use of mistake disclosure strategies that protect the physician-patient relationship. These include the optimal timing, context of disclosure delivery, content of mistake messages, sequencing, and apology. A case study highlighted the disclosure process. This Mistake Disclosure Management Plan may help physicians in the early stages after mistake discovery to prepare for the initial disclosure of a medical mistakes. The next step is testing implementation of the procedures suggested.

  14. Human System Risk Management for Space Flight

    Science.gov (United States)

    Davis, Jeffrey

    2015-01-01

    This brief abstract reviews the development of the current day approach to human system risk management for space flight and the development of the critical components of this process over the past few years. The human system risk management process now provides a comprehensive assessment of each human system risk by design reference mission (DRM) and is evaluated not only for mission success but also for long-term health impacts for the astronauts. The discipline of bioastronautics is the study of the biological and medical effects of space flight on humans. In 1997, the Space Life Sciences Directorate (SLSD) initiated the Bioastronautics Roadmap (Roadmap) as the "Critical Path Roadmap", and in 1998 participation in the roadmap was expanded to include the National Space Biomedical Research Institute (NSBRI) and the external community. A total of 55 risks and 250 questions were identified and prioritized and in 2000, the Roadmap was base-lined and put under configuration control. The Roadmap took into account several major advisory committee reviews including the Institute of Medicine (IOM) "Safe Passage: Astronaut care for Exploration Missions", 2001. Subsequently, three collaborating organizations at NASA HQ (Chief Health and Medical Officer, Office of Space Flight and Office of Biological & Physical Research), published the Bioastronautics Strategy in 2003, that identified the human as a "critical subsystem of space flight" and noted that "tolerance limits and safe operating bands must be established" to enable human space flight. These offices also requested a review by the IOM of the Roadmap and that review was published in October 2005 as "A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA's Bioastronautics Roadmap", that noted several strengths and weaknesses of the Roadmap and made several recommendations. In parallel with the development of the Roadmap, the Office of the Chief Health and Medical Officer (OCHMO) began a process in

  15. A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.

    Science.gov (United States)

    Abrecht, Christopher R; Brovman, Ethan Y; Greenberg, Penny; Song, Ellen; Rathmell, James P; Urman, Richard D

    2017-11-01

    Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). The goal of this study was to identify patient medical comorbidities and aberrant drug behaviors, as well as prescriber practices associated with patient injury and malpractice claims. Another objective was to identify claims most likely to result in payments and use this information to propose a strategy for reducing medicolegal risk. The CRICO Strategies Comparative Benchmarking System is a database of claims drawing from >350,000 malpractice claims from Harvard-affiliated institutions and >400 other academic and community institutions across the United States. This database was queried for closed claims from January 1, 2009, to December 31, 2013, and identified 37 cases concerning noninterventional, outpatient chronic pain management. Each file consisted of a narrative summary, including expert witness testimony, as well as coded fields for patient demographics, medical comorbidities, the alleged damaging event, the alleged injurious outcome, the total financial amount incurred, and more. We performed an analysis using these claim files. The mean patient age was 43.5 years, with men representing 59.5% of cases. Payments were made in 27% of cases, with a median payment of $72,500 and a range of $7500-$687,500. The majority of cases related to degenerative joint disease of the spine and failed back surgery syndrome; no patients in this series received treatment of malignant pain. Approximately half (49%) of cases involved a patient death. The use of long

  16. The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

    Science.gov (United States)

    Kerr, Bernard J

    2007-01-01

    Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

  17. A preliminary study of medical waste management in Lagos metropolis, Nigeria

    Directory of Open Access Journals (Sweden)

    E. O. Longe, A. Williams

    2006-04-01

    Full Text Available A survey of medical waste management (MWM practices and their implications to health and environment was carried out in metropolitan Lagos. Lagos is currently the most populous and urbanized city in the country with an estimated population of over 13 million people. The study assessed management practices in four (2 privates and 2 publics hospitals ranging in capacity from 40 to 600 beds. Empirical data was obtained on medical waste generation, segregation, storage, collection, transportation and disposal. The observed MWM practices in all hospitals indicate absence of full compliance with the protocol for handling medical waste as stipulated in the relevant sections of the guidelines and standards for environmental pollution control in Nigeria. Three hospitals demonstrated high priority for segregation of infectious medical waste. Average generation rate of medical waste in the investigated hospitals ranged from 0.562 kg/bed.day to 0.670 kg/bed.day. Infectious waste accounts for between 26 to 37% of this volume. Only two of the hospitals investigated carry out treatment of their infectious and sharp waste types by incineration before final disposal. Burning and burial of medical waste is an unusual but common practice among the hospitals. All the hospitals employ the services of the state owned solid waste management company, the Lagos State Waste Management Authority (LAWMA for final collection, and disposal of their medical waste at government approved sites.

  18. The Management of Infertility | Jimoh | Nigerian Medical Practitioner

    African Journals Online (AJOL)

    A clinical approach to the management of infertility in Africa is discussed. The role of Assisted Reproductive Techniques (ART), adoption and cloning in management of infertility in Africa is discussed. Key Words: Local Tetanus, Recurrence Piercing Injury, Foreign Objects Nigerian Medical Practitioner Vol. 46 No 1, 2004 ...

  19. Retrospective review of the medical management of ectopic ...

    African Journals Online (AJOL)

    Medical management of ectopic pregnancies is a safe and effective management option, as proven by international data, but at Tygerberg Hospital the safety of this treatment modality cannot be guaranteed because of poor follow-up. Improvement in patient selection with consideration of predictors of success and thorough ...

  20. [The realization way and lean management about medical consumable material in clinical use].

    Science.gov (United States)

    Shang, Changhao; Cheng, Junpei; Xu, Hailin; Wang, Xiaoguang

    2015-01-01

    The medical consumable material management is an important part of logistic support in the management of hospital, but the hospital has many weak links in the management of supplies. This paper aims to explore the common problems (especially in clinical use) existing in the management of medical consumables and years of management experience in Changhai hospital's practice, then discusses lean management from the perspective of lean management

  1. Medical management and planning for radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2001-01-01

    Radiation Emergencies which result as a consequence of nuclear or radiological accidents can produce a spectrum of different types of radiation injuries which could include cases of whole body irradiation causing Acute Radiation Syndrome, partial body irradiation, radiation burns (localized irradiation), radioactive contamination and combined injuries having component of conventional injuries. General principles of managing these cases entail doing triage, offering immediate emergency care and instituting definitive treatment. Infra-structural facilities which are required to facilitate their management include first aid post at plant site, personnel decontamination centre, site clinic and specialized hospital which can offer comprehensive investigational and treatment modalities. Training of medical and paramedical personnel is crucial as part of emergency preparedness programme and if needed, help can be sought from WHO's Radiation Emergency Medical Preparedness and Assistance Network Centres. (author)

  2. OSPACS: Ultrasound image management system

    Directory of Open Access Journals (Sweden)

    Bessant Conrad

    2008-06-01

    Full Text Available Abstract Background Ultrasound scanning uses the medical imaging format, DICOM, for electronically storing the images and data associated with a particular scan. Large health care facilities typically use a picture archiving and communication system (PACS for storing and retrieving such images. However, these systems are usually not suitable for managing large collections of anonymized ultrasound images gathered during a clinical screening trial. Results We have developed a system enabling the accurate archiving and management of ultrasound images gathered during a clinical screening trial. It is based upon a Windows application utilizing an open-source DICOM image viewer and a relational database. The system automates the bulk import of DICOM files from removable media by cross-validating the patient information against an external database, anonymizing the data as well as the image, and then storing the contents of the file as a field in a database record. These image records may then be retrieved from the database and presented in a tree-view control so that the user can select particular images for display in a DICOM viewer or export them to external media. Conclusion This system provides error-free automation of ultrasound image archiving and management, suitable for use in a clinical trial. An open-source project has been established to promote continued development of the system.

  3. A qualitative study exploring issues related to medication management in residential aged care facilities.

    Science.gov (United States)

    Ahmad Nizaruddin, Mariani; Omar, Marhanis-Salihah; Mhd-Ali, Adliah; Makmor-Bakry, Mohd

    2017-01-01

    Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs). A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner. Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes. There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.

  4. Exploration Medical System Technical Architecture Overview

    Science.gov (United States)

    Cerro, J.; Rubin, D.; Mindock, J.; Middour, C.; McGuire, K.; Hanson, A.; Reilly, J.; Burba, T.; Urbina, M.

    2018-01-01

    The Exploration Medical Capability (ExMC) Element Systems Engineering (SE) goals include defining the technical system needed to support medical capabilities for a Mars exploration mission. A draft medical system architecture was developed based on stakeholder needs, system goals, and system behaviors, as captured in an ExMC concept of operations document and a system model. This talk will discuss a high-level view of the medical system, as part of a larger crew health and performance system, both of which will support crew during Deep Space Transport missions. Other mission components, such as the flight system, ground system, caregiver, and patient, will be discussed as aspects of the context because the medical system will have important interactions with each. Additionally, important interactions with other aspects of the crew health and performance system are anticipated, such as health & wellness, mission task performance support, and environmental protection. This talk will highlight areas in which we are working with other disciplines to understand these interactions.

  5. Further insights into the roles of the medical educator: the importance of scholarly management.

    Science.gov (United States)

    Bligh, John; Brice, Julie

    2009-08-01

    Medical educators need to be able to define excellence within the various roles they occupy so that they can demonstrate internationally recognized, high-quality scholarship. Previous definitions of scholarship have focused on research and teaching but have been unable to integrate other roles such as leadership, management, and administration. Clearer definition of the various roles of the medical educator, coupled with a broader understanding of medical education scholarship that is able to encompass management, as well as teaching and research, will help institutions to evaluate and reward faculty members appropriately. We propose that management should now be introduced as a third "priority of the professoriate." We outline the concept of the scholarly manager, particularly as it applies to management in medical education. We offer a new conceptual model which situates the role of the academic manager within the scholarship of medical education and shows it to be an essential part of the skills and competences of the excellent medical educator. We emphasize that at the heart of all scholarly activity in medical education lie the core skills, values, and behaviors shared by all involved in the education of doctors and medical students. Future research is needed to explore and, where possible, achieve consensus on the core skills, values, and behaviors of an excellent medical educator. In addition, work should commence to define and categorize the various stages in the development of a significant management portfolio in medical education teaching and research.

  6. A cloud medication safety support system using QR code and Web services for elderly outpatients.

    Science.gov (United States)

    Tseng, Ming-Hseng; Wu, Hui-Ching

    2014-01-01

    Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

  7. User-centered design of a mobile medication management.

    Science.gov (United States)

    Sedlmayr, Brita; Schöffler, Jennifer; Prokosch, Hans-Ulrich; Sedlmayr, Martin

    2018-03-05

    The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative. The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information. The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS). Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications.

  8. Management system of personnel dosimetry based on ISO 9001:2008 for medical diagnostic

    International Nuclear Information System (INIS)

    Queiroz, Carlos E.B.; Gerber Junior, Walmoli; Jahn, Tiago R.; Hahn, Tiago T.; Fontana, Thiago S.; Bolzan, Vagner

    2013-01-01

    MDose is a computer management system of personal dosimetry in diagnostic radiology services physician based on ISO 9001:9008 management system. According to Brazilian law all service radiology should implement a control of personal dosimetry in addition to radiation doses greater than 1.5 mSv/year service should do research of high dose, which is to identify the causes the resulting dose increase professional. This work is based on the use of the PDCA cycle in a JAVA software developed as a management method in the analysis of high doses in order to promote systematic and continuous improvement within the organization of radiological protection of workers

  9. The relationship between managers' leadership styles and emergency medical technicians' job satisfaction.

    Science.gov (United States)

    Ghorbanian, Azimeh; Bahadori, Mohammadkarim; Nejati, Mostafa

    2012-01-01

    Leadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers' leadership styles and emergency medical technicians' job satisfaction. This is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction. Among both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (Pleadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction. Considering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

  10. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  11. A qualitative study exploring issues related to medication management in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Ahmad Nizaruddin M

    2017-11-01

    Full Text Available Mariani Ahmad Nizaruddin, Marhanis-Salihah Omar, Adliah Mhd-Ali, Mohd Makmor-Bakry Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs.Participants and methods: A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.Results and discussion: Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.Conclusion: There are important issues

  12. Data bank applications of a nuclear medical computer system

    International Nuclear Information System (INIS)

    Hale, T.I.; Jucker, A.; Haering, W.; Schmid, B.

    1980-01-01

    Computer systems in nuclear medicine are normally not used for data bank applications. A concept for a PDP-11-34 with RK 05 disc is presented, which serves the needs of data manipulations of a medium sized hospital including management of patient data, pharma stock control etc. besides specific use for nuclear medical work with absolute priority. The program is available upon request. (orig.) [de

  13. [Marketing as a tool in the medical institution management].

    Science.gov (United States)

    Petrova, N G; Balokhina, S A

    2009-01-01

    The contemporary social economic conditions dictate the necessity to change tactics and strategy of functioning of medical institutions of different property forms. Marketing, alongside with management is to become a leading concept of administration of medical institutions. It should be a framework for systematic collection, registration and analysis of data relevant to the medical services market. The issues of the implementation of marketing concept in the practical everyday activities of commercial medical organization providing cosmetology services to population of metropolis.

  14. A System for Information Management in BioMedical Studies—SIMBioMS

    Science.gov (United States)

    Krestyaninova, Maria; Zarins, Andris; Viksna, Juris; Kurbatova, Natalja; Rucevskis, Peteris; Neogi, Sudeshna Guha; Gostev, Mike; Perheentupa, Teemu; Knuuttila, Juha; Barrett, Amy; Lappalainen, Ilkka; Rung, Johan; Podnieks, Karlis; Sarkans, Ugis; McCarthy, Mark I; Brazma, Alvis

    2009-01-01

    Summary: SIMBioMS is a web-based open source software system for managing data and information in biomedical studies. It provides a solution for the collection, storage, management and retrieval of information about research subjects and biomedical samples, as well as experimental data obtained using a range of high-throughput technologies, including gene expression, genotyping, proteomics and metabonomics. The system can easily be customized and has proven to be successful in several large-scale multi-site collaborative projects. It is compatible with emerging functional genomics data standards and provides data import and export in accepted standard formats. Protocols for transferring data to durable archives at the European Bioinformatics Institute have been implemented. Availability: The source code, documentation and initialization scripts are available at http://simbioms.org. Contact: support@simbioms.org; mariak@ebi.ac.uk PMID:19633095

  15. Medical cyber-physical systems: A survey.

    Science.gov (United States)

    Dey, Nilanjan; Ashour, Amira S; Shi, Fuqian; Fong, Simon James; Tavares, João Manuel R S

    2018-03-10

    Medical cyber-physical systems (MCPS) are healthcare critical integration of a network of medical devices. These systems are progressively used in hospitals to achieve a continuous high-quality healthcare. The MCPS design faces numerous challenges, including inoperability, security/privacy, and high assurance in the system software. In the current work, the infrastructure of the cyber-physical systems (CPS) are reviewed and discussed. This article enriched the researches of the networked Medical Device (MD) systems to increase the efficiency and safety of the healthcare. It also can assist the specialists of medical device to overcome crucial issues related to medical devices, and the challenges facing the design of the medical device's network. The concept of the social networking and its security along with the concept of the wireless sensor networks (WSNs) are addressed. Afterward, the CPS systems and platforms have been established, where more focus was directed toward CPS-based healthcare. The big data framework of CPSs is also included.

  16. [Wound information management system: a standardized scheme for acquisition, storage and management of wound information].

    Science.gov (United States)

    Liu, Hu; Su, Rong-jia; Wu, Min-jie; Zhang, Yi; Qiu, Xiang-jun; Feng, Jian-gang; Xie, Ting; Lu, Shu-liang

    2012-06-01

    To form a wound information management scheme with objectivity, standardization, and convenience by means of wound information management system. A wound information management system was set up with the acquisition terminal, the defined wound description, the data bank, and related softwares. The efficacy of this system was evaluated in clinical practice. The acquisition terminal was composed of the third generation mobile phone and the software. It was feasible to get access to the wound information, including description, image, and therapeutic plan from the data bank by mobile phone. During 4 months, a collection of a total of 232 wound treatment information was entered, and accordingly standardized data of 38 patients were formed automatically. This system can provide standardized wound information management by standardized techniques of acquisition, transmission, and storage of wound information. It can be used widely in hospitals, especially primary medical institutions. Data resource of the system makes it possible for epidemiological study with large sample size in future.

  17. Infectious waste management in Japan: A revised regulation and a management process in medical institutions

    International Nuclear Information System (INIS)

    Miyazaki, M.; Une, H.

    2005-01-01

    In Japan, the waste management practice is carried out in accordance with the Waste Disposal Law of 1970. The first rule of infectious waste management was regulated in 1992, and infectious wastes are defined as the waste materials generated in medical institutions as a result of medical care or research which contain pathogens that have the potential to transmit infectious diseases. Revised criteria for infectious waste management were promulgated by the Ministry of Environment in 2004. Infectious waste materials are divided into three categories: the form of waste; the place of waste generation; the kind of infectious diseases. A reduction of infectious waste is expected. We introduce a summary of the revised regulation of infectious waste management in this article

  18. Managing the culturally diverse medical practice team: twenty-five strategies.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

  19. Optimizing urine drug testing for monitoring medication compliance in pain management.

    Science.gov (United States)

    Melanson, Stacy E F; Ptolemy, Adam S; Wasan, Ajay D

    2013-12-01

    It can be challenging to successfully monitor medication compliance in pain management. Clinicians and laboratorians need to collaborate to optimize patient care and maximize operational efficiency. The test menu, assay cutoffs, and testing algorithms utilized in the urine drug testing panels should be periodically reviewed and tailored to the patient population to effectively assess compliance and avoid unnecessary testing and cost to the patient. Pain management and pathology collaborated on an important quality improvement initiative to optimize urine drug testing for monitoring medication compliance in pain management. We retrospectively reviewed 18 months of data from our pain management center. We gathered data on test volumes, positivity rates, and the frequency of false positive results. We also reviewed the clinical utility of our testing algorithms, assay cutoffs, and adulterant panel. In addition, the cost of each component was calculated. The positivity rate for ethanol and 3,4-methylenedioxymethamphetamine were us to optimize our testing panel for monitoring medication compliance in pain management and reduce cost. Wiley Periodicals, Inc.

  20. Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods.

    Science.gov (United States)

    Khorrami, F; Ahmadi, M; Alizadeh, A; Roozbeh, N; Mohseni, S

    2015-01-01

    Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy in hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems.

  1. Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods

    Science.gov (United States)

    Khorrami, F; Ahmadi, M; Alizadeh, A; Roozbeh, N; Mohseni, S

    2015-01-01

    Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was “the number of bed and bed occupancy in hospitals”. Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems. PMID:28255389

  2. An intelligent medical system for diagnosis of bone diseases

    International Nuclear Information System (INIS)

    Hatzilygeroudis, I.; Vassilakos, P.J.; Tsakalidis, A.

    1994-01-01

    In this paper, aspects of the design of an intelligent medical system for diagnosis of bone diseases that can be detected by scintigraphic images are presented. The system comprises three major parts: a user interface (UI), a database management system (DBMS), and an expert system (ES). The DBMS is used for manipulation of various patient data. A number of patient cases are selected as prototype and stored in separate database. Diagnosis is performed via the ES, called XBONE, based on patient data. Knowledge is represented via an integrated formalism that combines production rules and a neural network. This results in better representation, and facilitates knowledge acquisition and maintenance. (authors)

  3. Data-mining of medication records to improve asthma management.

    Science.gov (United States)

    Bereznicki, Bonnie J; Peterson, Gregory M; Jackson, Shane L; Walters, E Haydn; Fitzmaurice, Kimbra D; Gee, Peter R

    2008-07-07

    To use community pharmacy medication records to identify patients whose asthma may not be well managed and then implement and evaluate a multidisciplinary educational intervention to improve asthma management. We used a multisite controlled study design. Forty-two pharmacies throughout Tasmania ran a software application that "data-mined" medication records, generating a list of patients who had received three or more canisters of inhaled short-acting beta(2)-agonists in the preceding 6 months. The patients identified were allocated to an intervention or control group. Pre-intervention data were collected for the period May to November 2006 and post-intervention data for the period December 2006 to May 2007. Intervention patients were contacted by the community pharmacist via mail, and were sent educational material and a letter encouraging them to see their general practitioner for an asthma management review. Pharmacists were blinded to the control patients' identities until the end of the post-intervention period. Dispensing ratio of preventer medication (inhaled corticosteroids [ICSs]) to reliever medication (inhaled short-acting beta(2)-agonists). Thirty-five pharmacies completed the study, providing 702 intervention and 849 control patients. The intervention resulted in a threefold increase in the preventer-to-reliever ratio in the intervention group compared with the control group (P < 0.01) and a higher proportion of patients in the intervention group using ICS therapy than in the control group (P < 0.01). Community pharmacy medication records can be effectively used to identify patients with suboptimal asthma management, who can then be referred to their GP for review. The intervention should be trialled on a national scale to determine the effects on clinical, social, emotional and economic outcomes for people in the Australian community, with a longer follow-up to determine sustainability of the improvements noted.

  4. Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

    Science.gov (United States)

    Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

    2017-03-01

    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Impact of an automated dispensing system for medical devices in cardiac surgery department].

    Science.gov (United States)

    Clou, E; Dompnier, M; Kably, B; Leplay, C; Poupon, E; Archer, V; Paul, M

    2018-01-01

    To secure medical devices' management, the implementation of automated dispensing system in surgical service has been realized. The objective of this study was to evaluate security, organizational and economic impact of installing automated dispensing system for medical devices (ASDM). The implementation took place in a cardiac surgery department. Security impact was assessed by comparing traceability rate of implantable medical devices one year before and one year after installation. Questionnaire on nurses' perception and satisfaction completed this survey. Resupplying costs, stocks' evolution and investments for the implementation of ASDM were the subject of cost-benefit study. After one year, traceability rate is excellent (100%). Nursing staffs were satisfied with 87.5% by this new system. The introduction of ASDM allowed a qualitative and quantitative decrease in stocks, with a reduction of 30% for purchased medical devices and 15% for implantable medical devices in deposit-consignment. Cost-benefit analysis shows a rapid return on investment. Real stock decrease (purchased medical devices) is equivalent to 46.6% of investment. Implementation of ASDM allows to secure storage and dispensing of medical devices. This system has also an important economic impact and appreciated by users. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  6. [Monitoring medication errors in personalised dispensing using the Sentinel Surveillance System method].

    Science.gov (United States)

    Pérez-Cebrián, M; Font-Noguera, I; Doménech-Moral, L; Bosó-Ribelles, V; Romero-Boyero, P; Poveda-Andrés, J L

    2011-01-01

    To assess the efficacy of a new quality control strategy based on daily randomised sampling and monitoring a Sentinel Surveillance System (SSS) medication cart, in order to identify medication errors and their origin at different levels of the process. Prospective quality control study with one year follow-up. A SSS medication cart was randomly selected once a week and double-checked before dispensing medication. Medication errors were recorded before it was taken to the relevant hospital ward. Information concerning complaints after receiving medication and 24-hour monitoring were also noted. Type and origin error data were assessed by a Unit Dose Quality Control Group, which proposed relevant improvement measures. Thirty-four SSS carts were assessed, including 5130 medication lines and 9952 dispensed doses, corresponding to 753 patients. Ninety erroneous lines (1.8%) and 142 mistaken doses (1.4%) were identified at the Pharmacy Department. The most frequent error was dose duplication (38%) and its main cause inappropriate management and forgetfulness (69%). Fifty medication complaints (6.6% of patients) were mainly due to new treatment at admission (52%), and 41 (0.8% of all medication lines), did not completely match the prescription (0.6% lines) as recorded by the Pharmacy Department. Thirty-seven (4.9% of patients) medication complaints due to changes at admission and 32 matching errors (0.6% medication lines) were recorded. The main cause also was inappropriate management and forgetfulness (24%). The simultaneous recording of incidences due to complaints and new medication coincided in 33.3%. In addition, 433 (4.3%) of dispensed doses were returned to the Pharmacy Department. After the Unit Dose Quality Control Group conducted their feedback analysis, 64 improvement measures for Pharmacy Department nurses, 37 for pharmacists, and 24 for the hospital ward were introduced. The SSS programme has proven to be useful as a quality control strategy to identify Unit

  7. Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients

    Directory of Open Access Journals (Sweden)

    Shinya Yamazaki

    2008-09-01

    Full Text Available Shinya Yamazaki, Hiroyoshi Kawaai, Shigeo Sasaki, Kazuhiro Shimamura, Hiroshi Segawa, Takahiro SaitoSpecial Care Department in Dentistry, Ohu University Dental Hospital, Koriyama city, Fukushima prefecture, JapanAbstract: The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases. The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%, checking vital signs after an interview (15.3%, and monitoring under sedation (13.3%. There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management.Keywords: online, high-risk patient, dental treatment, medical cooperation, medical accident, risk management

  8. Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.

    Science.gov (United States)

    Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia

    2017-04-01

    Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.

  9. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  10. Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership.

    Science.gov (United States)

    Hills, Laura

    2016-01-01

    Medical practice.managers spend their days surrounded by people, so the last thing they may expect to feel is lonely. Yet for many, being the manager of a medical practice can lead to feelings of isolation from the rest of the staff, and loneliness. This article explores the many reasons that managing a medical practice can be a lonely business. It considers the risks when a practice manager's loneliness goes unchecked, both to the individual and to the practice. It suggests 10 effective and healthy strategies for preventing and managing the leadership loneliness that medical practice managers sometimes experience. Next, this article argues that acceptance is the first step in overcoming loneliness in the workplace. It offers guidance for medical practice managers who wish to help lonely members of their teams. It describes the benefits of having a confidant to help support the medical practice manager, and the characteristics of an ideal confidant. Finally, this article suggests a strategy for combatting loneliness by interacting with the staff more frequently.

  11. Comprehensive Medical Management of Rosacea: An Interim Study Report and Literature Review

    OpenAIRE

    Del Rosso, James Q.; Baum, Eric W.

    2008-01-01

    Rosacea is a common inflammatory facial dermatosis seen in adults that exhibits considerable variety in clinical presentation. Multiple medical therapeutic options are available including topical and oral treatments. Optimal medical management of rosacea includes assessment of subtype and disease severity and use of appropriate skin care to reduce epidermal barrier dysfunction. This article provides an overall discussion of the medical management of rosacea and reviews interim results from a ...

  12. Introduction of a learning management system at the Kilimanjaro ...

    African Journals Online (AJOL)

    Background. Medical schools in Africa face daunting challenges including faculty shortages, growing class sizes, and inadequate resources. Learning management systems (LMS) may be powerful tools for organising and presenting curricular learning materials, with the potential for monitoring and evaluation functions.

  13. Performance management of nuclear medical apparatuses in Osaka University Hospital

    International Nuclear Information System (INIS)

    Ikehara, Katsuhiro; Kusumi, Yoshimi; Hayashi, Makoto; Miharu, Tomoyoshi; Masuda, Kazutaka

    1975-01-01

    Nuclear medical out side-body measuring equipments in Osaka University Hospital consist of scinticamera, scintiscanner and movement-measuring equipment as measuring equipments, and central processing equipment, CRT attached with Polaroid camera, data typewriter, X-Y recorder, and high speed tape reader as data processing equipments. Daily and monthly management items are set up to maintain the best function of these equipments. The data processing room is air-conditioned to keep temperature at 25 0 C and humidity at 60% constantly, and they are confirmed with a temperature and humidity self-recorder. Computer system is used for the homogeneity control and the correction to counting failure of the scinticamera. As the repair of nuclear medical apparatuses needs long period and because of the special circumstances of radioactive drugs, very close cooperation among technicians, doctors and equipment makers is required. (Kobatake, H.)

  14. Training of medical teams on-site for individual and coordinated response in emergency management

    DEFF Research Database (Denmark)

    Andersen, Verner

    2003-01-01

    A system for training of coordination and cooperation of decision makers in emergency management has been under construction for some time. A first prototype of the system was developed in the MUSTER system. The system is being developed modularly with one module for each of the suborganisations...... involved in the complete preparedness: fire brigade, police, medical team, civil defence, etc. All these modules will in the end be integrated on a common integration platform, either to a fully-fledged system covering all aspects of training for the complete preparedness, or for creating a dedicated...

  15. Implementing Management Systems-Based Assessments

    International Nuclear Information System (INIS)

    Campisi, John A.; Reese, Robert T.

    1999-01-01

    A management system approach for evaluating environment, safety, health, and quality is in use at Sandia National Laboratories (SNL). Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy under contract DE-AC04-94AL85000. As a multi-program national laboratory, SNL has many diverse operations including research, engineering development and applications, production, and central services supporting all activities and operations. Basic research examples include fusion power generation, nuclear reactor experiments, and investigation of combustion processes. Engineering development examples are design, testing, and prototype developments of micro-mechanical systems for safe'arding computer systems, air bags for automobiles, satellite systems, design of transportation systems for nuclear materials, and systems for use in medical applications such as diagnostics and surgery. Production operations include manufacture of instrumented detection devices, radioisotopes, and replacement parts for previously produced engineered systems. Support services include facilities engineering, construction, and site management, site security, packaging and transportation of hazardous materials wastes, ES ampersand H functional programs to establish requirements and guidance to comply with federal, state, local, and contractual requirements and work safety. In this diverse environment, unlike more traditional single function business units, an integrated consistent management system is not typical. Instead, each type of diverse activity has its own management system designed and distributed around the operations, personnel, customers, and facilities (e.g., hazards involved, security, regulatory requirements, and locations). Laboratory managers are not likely to have experience in the more traditional hierarchical or command and control structures and thus do not share oversight expectations found in

  16. Implementing Management Systems-Based Assessments

    Energy Technology Data Exchange (ETDEWEB)

    Campisi, John A.; Reese, Robert T.

    1999-05-03

    A management system approach for evaluating environment, safety, health, and quality is in use at Sandia National Laboratories (SNL). Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy under contract DE-AC04-94AL85000. As a multi-program national laboratory, SNL has many diverse operations including research, engineering development and applications, production, and central services supporting all activities and operations. Basic research examples include fusion power generation, nuclear reactor experiments, and investigation of combustion processes. Engineering development examples are design, testing, and prototype developments of micro-mechanical systems for safe'~arding computer systems, air bags for automobiles, satellite systems, design of transportation systems for nuclear materials, and systems for use in medical applications such as diagnostics and surgery. Production operations include manufacture of instrumented detection devices, radioisotopes, and replacement parts for previously produced engineered systems. Support services include facilities engineering, construction, and site management, site security, packaging and transportation of hazardous materials wastes, ES&H functional programs to establish requirements and guidance to comply with federal, state, local, and contractual requirements and work safety. In this diverse environment, unlike more traditional single function business units, an integrated consistent management system is not typical. Instead, each type of diverse activity has its own management system designed and distributed around the operations, personnel, customers, and facilities (e.g., hazards involved, security, regulatory requirements, and locations). Laboratory managers are not likely to have experience in the more traditional hierarchical or command and control structures and thus do not share oversight expectations found in

  17. Effectiveness of an interprofessional workshop on pain management for medical and nursing students.

    Science.gov (United States)

    Erickson, Jeanne M; Brashers, Valentina; Owen, John; Marks, Jennifer R; Thomas, Shannon M

    2016-07-01

    Interprofessional (IP) care is critical for effective pain management, but evidence is lacking about the best way to teach pain management skills to medical and nursing students using IP strategies. In 2013 and 2014, 307 medical and 169 nursing students participated in an IP case-based pain management workshop. The aims of this study were to determine (1) if students who participate in IP case-based learning groups will have improved pain management skills compared to students who participate in uniprofessional case-based learning groups, and (2) if students mentored by faculty with IP training will have improved pain management skills compared to students who are not mentored by IP-trained faculty. Student learning was assessed and compared using scored checklists for each group's pain management plans. Findings show that IP mentorship and IP group participation improved medical students' pain management skills but did not have the same effect on nursing student performance. Continued work is needed to develop, refine, and integrate innovative and tailored IP strategies into the curricula of medical and nursing schools to advance the pain management competencies of students before they enter clinical practice.

  18. The medical story. [of Skylab

    Science.gov (United States)

    Johnston, R. S.; Dietlein, L. F.; Michel, E. L.

    1975-01-01

    The paper discusses the medical program of the Skylab missions. The major medical systems discussed include the food system, the waste-management system, the personal-hygiene system, and the inflight medical support system. The life-sciences experiments conducted on Skylab are reviewed. These dealt with the cardiovascular system, mineral balance and bioassay of fluids, sleep, blood, metabolic activity, vestibular function, and time and motion studies. The medical operations were accomplished with only minor problems.

  19. Medical Equipment Management through the Use of Radio Frequency Identification (RFID)

    National Research Council Canada - National Science Library

    Sanchez, Joaquin

    2004-01-01

    ...) in the management of medical equipment at Naval Medical Center San Diego (NMCSD). In doing so, the project seeks to derive potential benefits through the use of RFID technology by comparing a group of medical equipment items that are tracked within NMCSD...

  20. Medical Big Data Warehouse: Architecture and System Design, a Case Study: Improving Healthcare Resources Distribution.

    Science.gov (United States)

    Sebaa, Abderrazak; Chikh, Fatima; Nouicer, Amina; Tari, AbdelKamel

    2018-02-19

    The huge increases in medical devices and clinical applications which generate enormous data have raised a big issue in managing, processing, and mining this massive amount of data. Indeed, traditional data warehousing frameworks can not be effective when managing the volume, variety, and velocity of current medical applications. As a result, several data warehouses face many issues over medical data and many challenges need to be addressed. New solutions have emerged and Hadoop is one of the best examples, it can be used to process these streams of medical data. However, without an efficient system design and architecture, these performances will not be significant and valuable for medical managers. In this paper, we provide a short review of the literature about research issues of traditional data warehouses and we present some important Hadoop-based data warehouses. In addition, a Hadoop-based architecture and a conceptual data model for designing medical Big Data warehouse are given. In our case study, we provide implementation detail of big data warehouse based on the proposed architecture and data model in the Apache Hadoop platform to ensure an optimal allocation of health resources.

  1. Medical Data Architecture Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  2. The Perceived Medical Condition Self-Management Scale can be applied to patients with chronic kidney disease.

    Science.gov (United States)

    Wild, Marcus G; Wallston, Kenneth A; Green, Jamie A; Beach, Lauren B; Umeukeje, Ebele; Wright Nunes, Julie A; Ikizler, T Alp; Steed, Julia; Cavanaugh, Kerri L

    2017-10-01

    Chronic Kidney Disease (CKD) is a major burden on patients and the health care system. Treatment of CKD requires dedicated involvement from both caretakers and patients. Self-efficacy, also known as perceived competence, contributes to successful maintenance of patient's CKD self-management behaviors such as medication adherence and dietary regulations. Despite a clear association between self-efficacy and improved CKD outcomes, there remains a lack of validated self-report measures of CKD self-efficacy. To address this gap, the Perceived Kidney/Dialysis Self-Management Scale (PKDSMS) was adapted from the previously validated Perceived Medical Condition Self-Management Scale. We then sought to validate this using data from two separate cohorts: a cross-sectional investigation of 146 patients with end-stage renal disease receiving maintenance hemodialysis and a longitudinal study of 237 patients with CKD not receiving dialysis. The PKDSMS was found to be positively and significantly correlated with self-management behaviors and medication adherence in both patient cohorts. The PKDSMS had acceptable reliability, was internally consistent, and exhibited predictive validity between baseline PKDSMS scores and self-management behaviors across multiple time points. Thus, the PKDSMS is a valid and reliable measure of CKD patient self-efficacy and supports the development of interventions enhancing perceived competence to improve CKD self-management. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  3. Healers, deities, saints and doctors: elements for the analysis of medical systems.

    Science.gov (United States)

    Pedersen, D; Baruffati, V

    1989-01-01

    This article provides the basic elements for the discussion and analysis of medical systems and their inter-dependency, with special reference to Latin America and, in particular, to the Andean countries. In a culturally diverse and socially stratified population, such as in contemporary Latin America, medical systems constitute a social representation resulting from the historical relationship between autochtonous medical cultures and those from other latitudes. The impregnation of scientific and popular knowledge results not only in the incorporation (and often expropriation) of folk in professional or scientific medicine, but also in the increasing 'medicalisation' of popular and traditional therapeutic practices. The emergent 'popular' medical system draws from both the professional and folk models, and in its actual practice, integrates both popular beliefs and materia medica with elements drawn from popular religions and pre-Hispanic deities. The degree of competitiveness, co-operation or 'integration' among medical systems depends mainly on the asymmetrical distribution of power and resources, and is conditioned by the population's behaviour in the management of disease. Existing pluralist systems of health care reveal a valuable array of survival strategies, which far outreach the proposals for integration called for by official sectors. On the other hand, knowledge derived from traditional medicine can contribute to the development of new models of clinical practice and to the expansion of the conventional epidemiological model.

  4. An intelligent medical system for diagnosis of bone diseases

    Energy Technology Data Exchange (ETDEWEB)

    Hatzilygeroudis, I [University of Patras, School of Engineering, Department of Computer Engineering and Informatics, 26500 Patras, Greece (Greece); Vassilakos, P J [Regional University Hospital of Patras, Department of Nuclear Medicine, Patras Greece (Greece); Tsakalidis, A [Computer Technology Institute, P.O. Box 1122, 26110 Patras, Greece (Greece)

    1994-12-31

    In this paper, aspects of the design of an intelligent medical system for diagnosis of bone diseases that can be detected by scintigraphic images are presented. The system comprises three major parts: a user interface (UI), a database management system (DBMS), and an expert system (ES). The DBMS is used for manipulation of various patient data. A number of patient cases are selected as prototype and stored in separate database. Diagnosis is performed via the ES, called XBONE, based on patient data. Knowledge is represented via an integrated formalism that combines production rules and a neural network. This results in better representation, and facilitates knowledge acquisition and maintenance. (authors). 10 refs., 2 figs.

  5. Implementing electronic medical record systems in developing countries

    Directory of Open Access Journals (Sweden)

    Hamish Fraser

    2005-06-01

    Full Text Available The developing world faces a series of health crises including HIV/AIDS and tuberculosis that threaten the lives of millions of people. Lack of infrastructure and trained, experienced staff are considered important barriers to scaling up treatment for these diseases. In this paper we explain why information systems are important in many healthcare projects in the developing world. We discuss pilot projects demonstrating that such systems are possible and can expand to manage hundreds of thousands of patients. We also pass on the most important practical lessons in design and implementation from our experience in doing this work. Finally, we discuss the importance of collaboration between projects in the development of electronic medical record systems rather than reinventing systems in isolation, and the use of open standards and open source software.

  6. Using description logics for managing medical terminologies

    NARCIS (Netherlands)

    Cornet, R.; Abu-Hanna, A.

    2003-01-01

    Medical terminological knowledge bases play an increasingly important role in medicine. As their size and complexity are growing, the need arises for a means to verify and maintain the consistency and correctness of their contents. This is important for their management as well as for providing

  7. Restraining Factors and Improving Paths for the Operation Mechanism of New Rural Cooperative Medical System in China

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The new rural cooperative medical system has achieved periodical achievements since its establishment.Nevertheless,there are many factors hampering the development of the new system,such as the high cost,the difficulties in fund procurement,the lack of management,the narrow coverage of benefit,the ineffective constraint to the designated medical institutions,the high fund balance rate,and the poor medical facilities and services in rural areas.Countermeasures are put forward to solve these problems,including improving the system design,expanding the coverage of the system,expanding the fund sources,reducing the financing costs,strengthening the fund supervision,enhancing the supervision of designated medical institutions,and improving the capacity of health services in rural areas.

  8. Medical ethics and new public management in Sweden.

    Science.gov (United States)

    Hansson, Sven Ove

    2014-07-01

    In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.

  9. Medical imaging systems

    Science.gov (United States)

    Frangioni, John V

    2013-06-25

    A medical imaging system provides simultaneous rendering of visible light and diagnostic or functional images. The system may be portable, and may include adapters for connecting various light sources and cameras in open surgical environments or laparascopic or endoscopic environments. A user interface provides control over the functionality of the integrated imaging system. In one embodiment, the system provides a tool for surgical pathology.

  10. Medical management of youth baseball and softball tournaments.

    Science.gov (United States)

    Kanaan, Matthew; Ray, Tracy R

    2013-01-01

    The medical management of youth baseball and softball tournaments requires both proper planning and a basic awareness of commonly seen sport-specific injuries. While youth sporting events are designed to be a fun experience for all, injuries and emergencies will occur. With proper planning, and supplies, the impact of these issues can be minimized. This article will outline some basic principles for the medical personnel that may be involved in youth baseball and softball events.

  11. Quality management system

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mu Sung

    2009-08-15

    This book deals with ISO9001 quality management system which includes summary of this system such as classification of quality, principle of quality management, and definition, requirement and procedure of quality management system, introduction of ISO9001 system like model of ISO9001 quality management system, ISO certificate system, structure of ISO9001 standard, requirement of ISO9001 quality management system, process approach and documentation of system, propel cases of ISO9001 quality management system.

  12. Quality management system

    International Nuclear Information System (INIS)

    Lee, Mu Sung

    2009-08-01

    This book deals with ISO9001 quality management system which includes summary of this system such as classification of quality, principle of quality management, and definition, requirement and procedure of quality management system, introduction of ISO9001 system like model of ISO9001 quality management system, ISO certificate system, structure of ISO9001 standard, requirement of ISO9001 quality management system, process approach and documentation of system, propel cases of ISO9001 quality management system.

  13. Preventing Medication Error Based on Knowledge Management Against Adverse Event

    OpenAIRE

    Hastuti, Apriyani Puji; Nursalam, Nursalam; Triharini, Mira

    2017-01-01

    Introductions: Medication error is one of many types of errors that could decrease the quality and safety of healthcare. Increasing number of adverse events (AE) reflects the number of medication errors. This study aimed to develop a model of medication error prevention based on knowledge management. This model is expected to improve knowledge and skill of nurses to prevent medication error which is characterized by the decrease of adverse events (AE). Methods: This study consisted of two sta...

  14. MANAGEMENT ACCOUNTING SYSTEM OF PUBLIC OFF-BUDGET FUNDS AS AN INFORMATIONAL BASIS FOR PUBLIC INSURANCE MECHANISMS FORMATION (CASE STUDY OF FEDERAL COMPULSORY MEDICAL INSURANCE FUND

    Directory of Open Access Journals (Sweden)

    Anatoly A. Kozlov

    2014-01-01

    Full Text Available The article justifies the introduced proposals for a management accounting of theFederal Compulsory Medical InsuranceFund formation and the characteristics and principles of management accounting forms for the analysis of the territorialcompulsory medical insurance programs.

  15. SEM Model Medical Solid Waste Hospital Management In Medan City

    Science.gov (United States)

    Simarmata, Verawaty; Pandia, Setiaty; Mawengkang, Herman

    2018-01-01

    In daily activities, hospitals, as one of the important health care unit, generate both medical solid waste and non-medical solid waste. The occurrence of medical solid waste could be from the results of treatment activities, such as, in the treatment room for a hospital inpatient, general clinic, a dental clinic, a mother and child clinic, laboratories and pharmacies. Most of the medical solid waste contains infectious and hazardous materials. Therefore it should be managed properly, otherwise it could be a source of new infectious for the community around the hospital as well as for health workers themselves. Efforts surveillance of various environmental factors need to be applied in accordance with the principles of sanitation focuses on environmental cleanliness. One of the efforts that need to be done in improving the quality of the environment is to undertake waste management activities, because with proper waste management is the most important in order to achieve an optimal degree of human health. Health development in Indonesian aims to achieve a future in which the Indonesian people live in a healthy environment, its people behave clean and healthy, able to reach quality health services, fair and equitable, so as to have optimal health status, health development paradigm anchored to the healthy. The healthy condition of the individual and society can be influenced by the environment. Poor environmental quality is a cause of various health problems. Efforts surveillance of various environmental factors need to be applied in accordance with the principles of sanitation focuses on environmental cleanliness. This paper proposes a model for managing the medical solid waste in hospitals in Medan city, in order to create healthy environment around hospitals.

  16. Specialty pharmacy: an emerging area of interest for medical management.

    Science.gov (United States)

    Dong, Xiaoli; Fetterolf, Donald

    2005-04-01

    Specialty pharmaceuticals are expensive injectable and infusion therapies used to treat patients with chronic or life-threatening diseases. The high cost of these agents and their frequent usage in chronic diseases represent not only challenges, but also opportunities for medical management programs to improve the quality of care and moderate the rapid cost escalation seen in the industry. The number and variety of these agents have been increasing significantly, with hundreds of drug candidates in the development pipeline. The specialty pharmacy industry also is going through a consolidation stage, both horizontally and vertically. Industry approaches to medical management include the acquisition of specialty pharmacy companies, restrictive contracting to achieve concentrated buying power, and the development of utilization management strategies.

  17. Optimizing medication safety in the home.

    Science.gov (United States)

    LeBlanc, Raeanne Genevieve; Choi, Jeungok

    2015-06-01

    Medication safety among community-dwelling older adults in the United States is an ongoing health issue impacting health outcomes, chronic disease management, and aging in place at home. This article describes a medication safety improvement project that aimed to: (1) Increase the ability of participants to manage medications, (2) Identify and make necessary medication changes, (3) Create an accurate up-to-date medication list to be available in the home, and (4) Provide communication between the primary care provider, participant, and case manager. An in-home medication assessment was completed for 25 participants using an evidence-based medication management software system. This process was used to review medications; identify medication-related problems; create a shared medication list; and convey this information to the primary care provider, case manager, and client while addressing needed medication changes. Educational interventions on management and understanding of medications were provided to participants to emphasize the correct use of medications and use of a personal medication record. Outcome improvements included provision of an accurate medication list, early identification of medication-related problems, identification of drug duplication, and identification of medication self-management challenges that can be useful for optimizing medication safety-related home healthcare and inform future interventions.

  18. Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

    Science.gov (United States)

    2014-01-01

    Background The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. Discussion The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. Summary In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor. PMID:25023339

  19. Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics.

    Science.gov (United States)

    Turillazzi, Emanuela; Neri, Margherita

    2014-07-15

    The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor's own, and the other's (the patient's) dignity and liberty; on the other is the physician's developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor.

  20. Quality management of eLearning for medical education: current situation and outlook.

    Science.gov (United States)

    Abrusch, Jasmin; Marienhagen, Jörg; Böckers, Anja; Gerhardt-Szép, Susanne

    2015-01-01

    In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. We approached all medical universities in Germany (n=35), using an anonymous questionnaire (8 domains, 50 items). Our results (response rate 46.3%) indicated very reluctant application of QMS in eLearning and a major information deficit at the various institutions. Authors conclude that under the limitations of this study there seems to be a considerable need to improve the current knowledge on QMS for eLearning, and that clear guidelines and standards for their implementation should be further defined.

  1. The manager role in relation to the medical profession

    OpenAIRE

    Knorring, Mia von

    2012-01-01

    Background: Managers and physicians have two important roles in healthcare organisations. However, several studies have identified problems in the manager–physician relationship and more knowledge is needed to improve the situation. Using theories on organisation, professions, and role taking to inform thinking, this thesis addresses one aspect of the manager-physician relationship, namely how managers handle their role in relation to the medical profession. This was studied in the context of...

  2. Management of non-traumatic chest pain by the French Emergency Medical System: Insights from the DOLORES registry.

    Science.gov (United States)

    Manzo-Silberman, Stéphane; Assez, Nathalie; Vivien, Benoît; Tazarourte, Karim; Mokni, Tarak; Bounes, Vincent; Greffet, Agnès; Bataille, Vincent; Mulak, Geneviève; Goldstein, Patrick; Ducassé, Jean Louis; Spaulding, Christian; Charpentier, Sandrine

    2015-03-01

    The early recognition of acute coronary syndromes is a priority in health care systems, to reduce revascularization delays. In France, patients are encouraged to call emergency numbers (15, 112), which are routed to a Medical Dispatch Centre where physicians conduct an interview and decide on the appropriate response. However, the effectiveness of this system has not yet been assessed. To describe and analyse the response of emergency physicians receiving calls for chest pain in the French Emergency Medical System. From 16 November to 13 December 2009, calls to the Medical Dispatch Centre for non-traumatic chest pain were included prospectively in a multicentre observational study. Clinical characteristics and triage decisions were collected. A total of 1647 patients were included in the study. An interview was conducted with the patient in only 30.5% of cases, and with relatives, bystanders or physicians in the other cases. A Mobile Intensive Care Unit was dispatched to 854 patients (51.9%) presenting with typical angina chest pains and a high risk of cardiovascular disease. Paramedics were sent to 516 patients (31.3%) and a general practitioner was sent to 169 patients (10.3%). Patients were given medical advice only by telephone in 108 cases (6.6%). Emergency physicians in the Medical Dispatch Centre sent an effecter to the majority of patients who called the Emergency Medical System for chest pain. The response level was based on the characteristics of the chest pain and the patient's risk profile. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Development of a Laboratory Information Management System for Medical Genetic Investigations (LIMS)

    OpenAIRE

    Albers, K.

    2006-01-01

    Studying the genetic factor underlying a set of diseases with modern high- throughput techniques generates huge amounts of data, posing a challenge for data management. In this thesis a database management system called FIDB based on MySQL was developed to handle clinical and experimental genetic data. For the convenience of the users, a web interface was developed to insert, update, delete and display the data. In addition security aspects were taken care of. Currently FIDB is able to organi...

  4. STRATEGY AND EVALUATION OF THE OPERATION OF QUALITY MANAGEMENT SYSTEMS MEDICAL EDUCATION. THE FIRST MESSAGE. PROBLEM FORMULATION

    Directory of Open Access Journals (Sweden)

    O. P. Mintser

    2015-09-01

    Full Text Available The article is devoted to functioning of the quality management by ISO 9001 standard. The problem of inefficient and non-working systems is pointed out, the causes of their inefficiency are investigated. The phenomenon of simultaneous existence of two parallel management systems: formal quality management system and living systems of managerial decisions making is studied. To study this situation the measure of «efficiency of quality management system» is introduced; further tasks for creating indicators and mechanisms for its evaluation are defined.

  5. The concept of marketing in the public-private partnership in the medical system in Romania.

    Science.gov (United States)

    Purcărea, V L; Coculescu, B I; Coculescu, E C

    2014-01-01

    During the transition period, the Romanian medical system, subject (like other areas) to a process of reform, had to go through a difficult path, not without obstacles (malpractice, underfunding, embezzlement scandals in the media etc.). Consequently, Romania has faced (and unfortunately still is still facing) the massive exodus of health professionals to countries where they can benefit from better working conditions and payment, and those who suffer from health care crisis are the patients. Reform means "the people in the system for the people", which requires a change of mindset within the medical staff, especially in the continuous professional development. However, to talk about the quality of the medical act requires that all those involved in the medical system should create appropriate conditions - i.e. advanced technical equipment and appropriate salaries. In addition, as underfunding is the main cause of failure in the health system, that management remains the only tool that can lead to the appropriate use of the existing resources and the quality of health services. Therefore, the idea of public-private partnership - which occurred as a challenge, especially after the EU accession - can be considered a solution designed to improve the quality and cost of health services. In other words, the cooperation of the private sector with the public authority means increasing the rigor of the medical equipment performance, fostering professional competition, and an increased attention to the patient, in a word: performance. Currently, more and more frequently, the management has studied to identify opportunities for innovation in health care services in an attempt to bring together patients and practitioners in the field by resorting to the identification of the ways they can receive health care services promptly, fairly and efficiently. Therefore, a clear and responsible design in the spirit of ethics and medical ethic will help the marketing manager solve many

  6. Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

    Directory of Open Access Journals (Sweden)

    Alagiakrishnan K

    2016-01-01

    Full Text Available Kannayiram Alagiakrishnan,1 Patricia Wilson,2 Cheryl A Sadowski,3 Darryl Rolfson,1 Mark Ballermann,4,5 Allen Ausford,6,7 Karla Vermeer,7 Kunal Mohindra,8 Jacques Romney,9 Robert S Hayward10 1Department of Medicine, Division of Geriatric Medicine, 2Department of Medicine, 3Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 4Chief Medical Information Office, Alberta Health Services, 5Division of Critical Care, Department of Medicine, University of Alberta, 6Department of Family Medicine, University of Alberta, 7Lynwood Family Physician, 8eClinician EMR, Alberta Health Services-Information Systems, 9Department of Medicine, Division of Endocrinology, 10Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada Background: Elderly people (aged 65 years or more are at increased risk of polypharmacy (five or more medications, inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS within an electronic medical record (EMR could improve medication safety.Methods: Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR. The “Seniors Medication Alert and Review Technologies” (SMART intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages and active (order-entry alerts prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed.Results: Analysis of

  7. Organizing and managing care in a changing health system.

    Science.gov (United States)

    Kohn, L T

    2000-04-01

    To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

  8. The University of Maryland Medical System invests in its community's minorities.

    Science.gov (United States)

    Schimpff, S C; Rapoport, M I; O'Keefe, S L; Grote, D A; Snow, L K

    1996-06-01

    As a private, non-state-owned teaching hospital adjacent to a predominately low income African American community in Baltimore, the University of Maryland Medical System (hereafter called the Medical System) in partnership with the state's medical school has historically provided excellent medical care to the community's residents regardless of their ability to pay. Nevertheless, executive leadership recognized that the Medical System needed to be even more socially and economically responsible to the minority community by investing more of the system's resources in that community. Doing so would improve the economic strength of the community, and this strength would help the Medical System to continue to thrive and expand its business in Baltimore City. Therefore, in the late 1980s, the Medical System created a program that focuses on greater inclusion of minorities particularly African Americans, in personnel, construction, purchasing, and community outreach. In the area of personnel, recruitment efforts have focused on increasing the representation of minorities, particularly African Americans, in management and residency positions. The result has been the creation of a more supportive environment for minority personnel throughout the organization as well as for minority patients and vendors who have dealings with the medical system. In the area of construction, minority development efforts have included the establishment of a flexible bid-award policy and a partnership with the minority business community. As a result, total construction dollars spent with minority-owned firms increased from $2 million to $18 million over seven years, and the portion of these dollars spent with African American-owned firms increased sixfold. In the area of purchased goods and services, more creative approaches to improving minority participation have been necessary. These have included partnering minority distributors with major suppliers and literally assisting in the creation

  9. A questionnaire survey of medical physicist and quality manager for radiation therapy

    International Nuclear Information System (INIS)

    Nishio, Teiji; Ashino, Yasuo; Onishi, Hiroshi

    2008-01-01

    A questionnaire survey of medical physicists and quality managers for radiation therapy was performed by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Future Planning Committee. We mailed the questionnaire to 726 radiotherapy facilities with the answers returned from 353 radiotherapy facilities. The result showed 178 facilities were staffed by radiotherapy workers who were licensed medical physicists or quality managers. A staff of 289 was licensed radiotherapy workers. Most of the staff were radiotherapy technologists. Quality control for radiation therapy was rated satisfactory according to each facility's assessment. Radiation therapy of high quality requires continued education of medical physicists and quality managers, in addition to keeping up with times for quality control. (author)

  10. Implementation of Indigenous Electronic Medical Record System to Facilitate Care of Sickle Cell Disease Patients in Chhattisgarh.

    Science.gov (United States)

    Choubey, Mona; Mishra, Hrishikesh; Soni, Khushboo; Patra, Pradeep Kumar

    2016-02-01

    Sickle cell disease (SCD) is prevalent in central India including Chhattisgarh. Screening for SCD is being carried out by Government of Chhattisgarh. Electronic Medical Record (EMR) system was developed and implemented in two phases. Aim was to use informatics techniques and indigenously develop EMR system to improve the care of SCD patients in Chhattisgarh. EMR systems had to be developed to store and manage: i) huge data generated through state wide screening for SCD; ii) clinical data for SCD patients attending the outpatient department (OPD) of institute. 'State Wide Screening Data Interface' (SWSDI) was designed and implemented for storing and managing data generated through screening program. Further, 'Sickle Cell Patients Temporal Data Management System' (SCPTDMS) was developed and implemented for storing, managing and analysing sickle cell disease patients' data at OPD. Both systems were developed using VB.Net and MS SQL Server 2012. Till April 2015, SWSDI has data of 1294558 persons, out of which 121819 and 4087 persons are carriers and patients of sickle cell disease respectively. Similarly till June 2015, SCPTDMS has data of 3760 persons, of which 923 are sickle cell disease patients (SS) and 1355 are sickle cell carriers (AS). Both systems are proving to be useful in efficient storage, management and analysis of data for clinical and research purposes. The systems are an example of beneficial usage of medical informatics solutions for managing large data at community level.

  11. [Introduction of hospital information system and anesthesia information management system into the perianesthetic practice at Osaka City University Hospital].

    Science.gov (United States)

    Shimizu, Motoko; Tanaka, Katsuaki; Hagiwara, Chie; Ikenaga, Kazutake; Yoshioka, Miwako; Asada, Akira

    2011-06-01

    Recently, the hospital information systems (HIS) and anesthesia information management systems (AIMS) have been rapidly improved and have been introduced into the clinical practice in Japan drastically; however, few reports have detailed their influences on clinical practice. We here report our experience. We introduced HIS (EGMAIN-EX, Fujitsu Co., Ltd.) in our preoperative evaluation clinic and in the postoperative care unit. AIMS (ORSYS, Philips Electronics Japan) was introduced almost only to the intraoperative management. It became easy for us to acquire patient's information and to share it with the medical staffs in the other departments. However, we had to invest large human resources for the introduction and maintenance of the HIS and the AIMS. Though AIMS is more useful in anesthetic management than HIS, it seems to be more suitable for coordination with the medical staffs in the other departments to use HIS for perioperative management than to use AIMS.

  12. Teaching Laboratory Management Principles and Practices Through Mentorship and Graduated Responsibility: The Assistant Medical Directorship.

    Science.gov (United States)

    Hanley, Timothy; Sowder, Aleksandra M; Palmer, Cheryl Ann; Weiss, Ronald L

    2016-01-01

    With the changing landscape of medicine in general, and pathology in particular, a greater emphasis is being placed on laboratory management as a means of controlling spiraling medical costs and improving health-care efficiency. To meet this challenge, pathology residency programs have begun to incorporate formal laboratory management training into their curricula, using institutional curricula and/or online laboratory management courses offered by professional organizations. At the University of Utah, and its affiliated national reference laboratory, ARUP Laboratories, Inc, interested residents are able to supplement the departmental lecture-based and online laboratory management curriculum by participating in assistant medical directorship programs in one of several pathology subspecialty disciplines. The goals of many of the assistant medical directorship positions include the development of laboratory management skills and competencies. A survey of current and recent assistant medical directorship participants revealed that the assistant medical directorship program serves as an excellent means of improving laboratory management skills, as well as improving performance as a fellow and practicing pathologist.

  13. Medication management in the making

    DEFF Research Database (Denmark)

    Andersen, Tariq Osman

    2013-01-01

    this by the case of how the concept of 'medication management' has been performed differently on a combined CSCW and participatory design project in healthcare. It is suggested that through design interventions with working prototypes; prospective analysis and participatory design can be fruitfully assembled...... of creating a better understanding or description of the user. Inspired by later developments in Science and Technology Studies I engage an ontological reconceptualization and turn to consider and practice the relation as performative - thus making ethnography, design and users' practices converge. I show...

  14. The medical management of attention-deficit/hyperactivity disorder ...

    African Journals Online (AJOL)

    Adele

    medical management options, their advantages or disadvantages, their clinical application ..... (irritability, sadness) and the rebound effect, where children appear to be even worse in the ..... The latter fear has been put to rest.67,68 One recent ...

  15. A Technology Acceptance Model for Inter-Organisational Electronic Medical Records Systems

    Directory of Open Access Journals (Sweden)

    Jocelyn Handy

    2001-11-01

    Full Text Available This article reports the findings of the first stage of an ongoing, longitudinal study into the implementation of an interorganisational electronic medical records (EMR system. The study adapted and expanded Davis' (1993 technology acceptance model (TAM to investigate the attitudes of primary care practitioners towards a proposed system for maternity patients. All doctors and midwives holding maternity care contracts with a large urban hospital in New Zealand were sent a questionnaire soliciting their views on a planned EMR system linking the hospital and the primary care sectors. The results showed that whilst Davis' two key factors of perceived ease of use and perceived usefulness were important to medical professionals, another key factor, perceived system acceptability, which concerns control and management of information is vitally important to the acceptance of the system. The study also showed that the two groups of professionals had differing requirements due to different levels of experience and practice computerisation. Finally, the research highlights a number of wider organisational issues particularly relevant to the use of inter organisational systems in general and healthcare systems in particular.

  16. Managing medical groups: 21st century challenges and the impact of physician leadership styles.

    Science.gov (United States)

    Martin, William E; Keogh, Timothy J

    2004-01-01

    Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

  17. [Mobile phone-computer wireless interactive graphics transmission technology and its medical application].

    Science.gov (United States)

    Huang, Shuo; Liu, Jing

    2010-05-01

    Application of clinical digital medical imaging has raised many tough issues to tackle, such as data storage, management, and information sharing. Here we investigated a mobile phone based medical image management system which is capable of achieving personal medical imaging information storage, management and comprehensive health information analysis. The technologies related to the management system spanning the wireless transmission technology, the technical capabilities of phone in mobile health care and management of mobile medical database were discussed. Taking medical infrared images transmission between phone and computer as an example, the working principle of the present system was demonstrated.

  18. Guidelines on the medical management of tritiated water overexposures

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab.

  19. Guidelines on the medical management of tritiated water overexposures

    International Nuclear Information System (INIS)

    1995-09-01

    The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab

  20. Guidelines on the medical management of tritiated water overexposures

    International Nuclear Information System (INIS)

    1996-04-01

    The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab

  1. Analysing patient queue system in an imaging department: a step toward total quality management

    International Nuclear Information System (INIS)

    Kumar, Pratik; Pandey, A.K.

    2008-01-01

    Medical imaging has become an inevitable part of any diagnosis and/or management of the disease. This has put tremendous work-load on the medical imaging machines. The crowd of waiting patients at any busy imaging centre or rooms has become a common scene. This is especially true for any Government hospital or medical college in India since they cater to bulk of patients. As a part of total quality management we attempted to record, investigate, analyse and suggest on the state of patients' queue system at radiological imaging rooms

  2. Assessment of obesity management in medical examination

    Directory of Open Access Journals (Sweden)

    Treyzon Leo

    2005-03-01

    Full Text Available Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training. One particular shortfall is the lack of representation of obesity on standardized medical examinations. Physician attitudes toward obesity are influenced by their lack of familiarity with the management of the disease. This may include dietary restriction, increasing physical activity, behavior modification, pharmacotherapy, and surgical interventions. Thus, curricular changes in the medical education of obesity could help reduce morbidity and mortality associated with this disease.

  3. Medical Robots: Current Systems and Research Directions

    Directory of Open Access Journals (Sweden)

    Ryan A. Beasley

    2012-01-01

    Full Text Available First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

  4. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

  5. Medical Data Architecture (MDA) Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  6. Management of functional disturbances of the stomatognathic system

    International Nuclear Information System (INIS)

    Piehslinger, E.

    2001-01-01

    In the management of functional disturbances of the stomatognathic system symptomatic and causal therapeutic methods can be distinguished. Symptomatic therapy encompasses medication, physical methods (heat, cold, radiation, TENS) in combination with physiotherapy and emergency splint. After one or two weeks of symptomatic therapy the patient should be free of pain allowing precise diagnostic procedures followed by causal therapy managing muscular problems, joint pathology and occlusal disturbances. Splint therapy is used to establish a therapeutic joint position according to articulator mounting. After splint therapy prosthodontic and/or orthodontic treatment is needed to restore occlusion. Interdisciplinary management in the therapy of functional disturbances of the stomatognathic system is of utmost importance due to the relationship between chewing muscles, neck muscles and body posture. In addition to splint therapy, physiotherapy, logopedic therapy, myofunctional therapy, psychologic and psychiatric intervention is performed. (orig.) [de

  7. A smartphone-based system for the automated management of point-of-care test results in hospitals.

    Science.gov (United States)

    Jang, Dasom; Shin, Soo-Yong; Seo, Dong-Woo; Joo, Segyeong; Huh, Soo-Jin

    2015-04-01

    Managing test results is an important issue in hospitals because of the increasing use of point-of-care testing (POCT). Here, we propose a smartphone-based system for automatically managing POCT test results. We developed the system to provide convenience to the medical staffs. The system recognizes the patient identification or prescription number of the test by reading barcodes and provides a countdown to indicate when the results will be ready. When the countdown in finished, a picture of the test result is transferred to the electronic medical record server using the Health Level 7 protocol. Human immunodeficiency virus (HIV) kits were selected in this research because HIV is a life-threatening infectious virus, especially for the medical staff who treat undiagnosed patients. The performance of the system was verified from a survey of the users. The performance of the system was tested at the emergency room (ER) for 10 months using commercially available POCT kits for detecting HIV. The survey showed that, in total, 80% and 0% of users reported positive or negative feedback, respectively. The staff also reported that the system reduced total processing time by approximately 32 min, in addition to reducing workload. The developed automated management system was successfully tested at an ER for 10 months. The survey results show that the system is effective and that medical staff members who used the system are satisfied with using the system at the ER.

  8. Open source electronic health record and patient data management system for intensive care.

    Science.gov (United States)

    Massaut, Jacques; Reper, Pascal

    2008-01-01

    In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management Systems (PDMS) and electronic health records (EHR). To respond to the needs of an Intensive Care Unit and not to be locked with proprietary software, we developed a PDMS and EHR based on open source software and components. The software was designed as a client-server architecture running on the Linux operating system and powered by the PostgreSQL data base system. The client software was developed in C using GTK interface library. The application offers to the users the following functions: medical notes captures, observations and treatments, nursing charts with administration of medications, scoring systems for classification, and possibilities to encode medical activities for billing processes. Since his deployment in February 2004, the PDMS was used to care more than three thousands patients with the expected software reliability and facilitated data management and review processes. Communications with other medical software were not developed from the start, and are realized by the use of the Mirth HL7 communication engine. Further upgrade of the system will include multi-platform support, use of typed language with static analysis, and configurable interface. The developed system based on open source software components was able to respond to the medical needs of the local ICU environment. The use of OSS for development allowed us to customize the software to the preexisting organization and contributed to the acceptability of the whole system.

  9. Managing cliques and exclusionary behavior within your medical practice team.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    Unfortunately, cliques aren't a problem that you left behind in high school. Workplace cliques can be just as or even more troubling for you today, especially if they have the potential to affect your career, employee morale and performance, and your medical practice more broadly. This article describes workplace cliques in detail. It provides examples of exclusionary and ostracizing behaviors that are often associated with cliques. And it describes the prevalence and effects of cliques in today's workplace. This article also provides practice managers with 10 tips for discouraging and managing cliques. It describes five common workplace cliques: management, veteran, prior relationship, status, and homophily. It offers medical staff employees 10 strategies for working effectively alongside of a clique. Finally this article describes the pitfalls and risks of belonging to a workplace clique.

  10. [Medical waste management in healthcare centres in the occupied Palestinian territory].

    Science.gov (United States)

    Al-Khatib, Issam A

    2007-01-01

    Medical waste management in primary and secondary healthcare centres in the occupied Palestinian territory was assessed. The overall monthly quantity of solid healthcare waste was estimated to be 512.6 tons. Only 10.8% of the centres completely segregated the different kinds of healthcare waste and only 15.7% treated their medical waste. In the centres that treated waste, open burning was the main method of treatment. The results indicate that Palestinians are exposed to health and environmental risks because of improper disposal of medical waste and steps are needed to improve the situation through the establishment and enforcement of laws, provision of the necessary infrastructure for proper waste management and training of healthcare workers and cleaners.

  11. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    Science.gov (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  12. Analysis and design of hospital management information system based on UML

    Science.gov (United States)

    Ma, Lin; Zhao, Huifang; You, Shi Jun; Ge, Wenyong

    2018-05-01

    With the rapid development of computer technology, computer information management system has been utilized in many industries. Hospital Information System (HIS) is in favor of providing data for directors, lightening the workload for the medical workers, and improving the workers efficiency. According to the HIS demand analysis and system design, this paper focus on utilizing unified modeling language (UML) models to establish the use case diagram, class diagram, sequence chart and collaboration diagram, and satisfying the demands of the daily patient visit, inpatient, drug management and other relevant operations. At last, the paper summarizes the problems of the system and puts forward an outlook of the HIS system.

  13. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  14. Shared decision making and medication management in the recovery process.

    Science.gov (United States)

    Deegan, Patricia E; Drake, Robert E

    2006-11-01

    Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence. The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine. Using medication is an active process that involves complex decision making and a chance to work through decisional conflicts. It requires a partnership between two experts: the client and the practitioner. Shared decision making provides a model for them to assess a treatment's advantages and disadvantages within the context of recovering a life after a diagnosis of a major mental disorder.

  15. Management of Tooth Wear: A Holistic, Dental, Medical, and Mental Healthcare Approach.

    Science.gov (United States)

    Ahmed, Khaled E

    2016-08-01

    Tooth wear is a condition that affects a substantial cohort of dental patients. It has a measurable impact on patients' satisfaction, and overall quality of life. Recently, with growing evidence, our understanding of the aetiology, progression, and management of tooth wear has evolved. The paper argues that pathological tooth wear should not be solely considered as a dental condition, but rather a dental manifestation of other mental and medical disorders. As such, successful management of tooth wear, and its underlying aetiology, requires a holistic, multidisciplinary management approach, involving dental, medical, and mental healthcare providers.

  16. Six Sigma Quality Management System and Design of Risk-based Statistical Quality Control.

    Science.gov (United States)

    Westgard, James O; Westgard, Sten A

    2017-03-01

    Six sigma concepts provide a quality management system (QMS) with many useful tools for managing quality in medical laboratories. This Six Sigma QMS is driven by the quality required for the intended use of a test. The most useful form for this quality requirement is the allowable total error. Calculation of a sigma-metric provides the best predictor of risk for an analytical examination process, as well as a design parameter for selecting the statistical quality control (SQC) procedure necessary to detect medically important errors. Simple point estimates of sigma at medical decision concentrations are sufficient for laboratory applications. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Factors Influencing Enrollment in the Medication Therapy Management Clinic at an Academic Ambulatory Care Clinic.

    Science.gov (United States)

    Shah, Mansi; Tilton, Jessica; Kim, Shiyun

    2016-04-01

    In 2001, the University of Illinois Hospital and Health Sciences System (UI Health) established a pharmacist-run, referral-based medication therapy management clinic (MTMC). Referrals are obtained from any UI Health provider or by self-referral. Although there is a high volume of referrals, a large percentage of patients do not enroll. This study was designed to determine the various factors that influence patient enrollment in the MTMC. This study was a retrospective chart review of demographic and patient variable data during years 2010 and 2011. Disabilities, distance from MTMC, mode of transportation, past medical history, and appointment dates were extracted from the medical records. Results were analyzed using descriptive statistics and logistic regression analysis. A total of 103 referrals were made; however, only 17% of patients remain enrolled in MTMC. The baseline demographics included a mean age of 63 years, 68% female, 70% African American, and 81% English speaking. Patients lived an average of 8 miles from MTMC; most utilized public or government-supplemented transport services; 24% of patients reported some type of disability, most commonly utilizing a walker or a wheelchair. On average, patients were prescribed 13 medications with hypertension (70%), diabetes (56%), and hyperlipidemia (48%) being the most common chronic disease states. The reason for referral included medication management, education, medication reconciliation, and disease state management. Five patients were unable to be contacted to schedule an initial appointment. Additionally, 18 patients failed their scheduled initial appointment and did not reschedule. Logistic regression analysis demonstrated distance traveled for clinic visit, age, and history of hypertension affected the probability of patients showing for their appointments (chi-square = 19.7, P < .001). This study demonstrated that distance from MTMC is the most common barrier in patient enrollment; therefore, strategies

  18. Management of systemic lupus erythematosus during pregnancy: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Knight CL

    2017-03-01

    Full Text Available Caroline L Knight, Catherine Nelson-Piercy Division of Women’s Health, Women’s Health Academic Centre, King’s College London and King’s Health Partners, St Thomas’ Hospital, London, UK Abstract: Systemic lupus erythematosus (SLE is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal–neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy. In pregnancy, early referral for hospital-coordinated care, involvement of obstetricians and rheumatologists (and other specialists as required, an individual management plan, regular reviews, and early recognition of flares and complications are all important. Women are at risk of lupus flares, worsening renal impairment, onset of or worsening hypertension, preeclampsia, and/or venous thromboembolism, and miscarriage, intrauterine growth restriction, preterm delivery, and/or neonatal lupus syndrome (congenital heart block or neonatal lupus erythematosus. A cesarean section may be required in certain obstetric contexts (such as urgent preterm delivery for maternal and/or fetal well-being, but vaginal birth should be the aim for the majority of women. Postnatally, an ongoing individual management plan remains important, with neonatal management where necessary and rheumatology follow-up. This article explores the challenges at each stage of pregnancy, discusses the effect of SLE on pregnancy and

  19. New hospital payment systems: comparing medical strategies in The Netherlands, Germany and England.

    Science.gov (United States)

    van Essen, Anne Marije

    2009-01-01

    This paper seeks to identify different medical strategies adopted in relation to the new hospital payment systems in Germany, The Netherlands and England and analyse how the medical strategies have impacted on the emergence of these New Public Management policy tools between 2002 and 2007. A comparative approach is applied. In addition to secondary sources, the study uses publications in professional journals, official publications of the (national) physician organisations and a (non-random) expert questionnaire to obtain the views of the medical corporate bodies in the three countries. The results reveal differences in the medical strategies in the three countries that point towards the significance of institutional and interest configurations. The Dutch corporate medical body was most willing to solve the conflict, while the German and English corporate medical bodies seem to be keen to use a strategy of confrontation. The differences in medical strategies also impact on the ways in which hospital payment systems have emerged in the three countries. Further research is necessary to study the medical strategies in healthcare reforms from a broader perspective, for instance by including other countries. The paper gives insights into the interplay between the medical profession and the government in the context of new managerial governance practices in the hospital sector. It adds to the scholarly debates about the role of the medical profession in health policy-making.

  20. Strength and Weakness of Crisis Management in Hormozgan Medical University’s Hospitals

    Directory of Open Access Journals (Sweden)

    Zahra Mastane

    2012-02-01

    Full Text Available Background & Objective: Various communities continuously try to manage the unexpected events. In this regard, hospitals with providing timely health care services has transformed to the most pragmatic unit of health system. Planning and preparation of them should be strategic policy of health system. This paper aimed to investigate the strength and weakness of crisis management in training hospitals of Hormozgan University of Medical Sciences. Materials & Methods: This is descriptive-analytic research. Research statistical population includes managers, nursing directors, financial directors and masters of crises committee of hospitals, totally 34 persons. Data collected with questionnaire in 8 domains and demographic information. Questionnaire was validated and reliabled. Collected data entered to SPSS and analyzed by descriptive & inferential statistics. Results: Preparedness Rate of Hospitals encounters Unexpected Events was average (50%. Preparedness rate in managerial policies (44.1%, structural and non-structural stability (41.2% and register & informed (47% domains were in average level. In this regard HEICS (32.3%, maneuvers (55.9% and use of relative technologies were in very low grade. Between preparedness rate with crises committee function, training and maneuvers there were meaningful relations (P<0.05. Conclusion: Suitable crises management will be feasible by documented planning, preparing intra and extra organizational relations, reinforcing human resources with organizing, delivering of training and durational maneuvers to them. Keywords: Strength, Weakness, Crisis, Crisis Management Type of Article: Original Article

  1. Wearable medical systems for p-Health.

    Science.gov (United States)

    Teng, Xiao-Fei; Zhang, Yuan-Ting; Poon, Carmen C Y; Bonato, Paolo

    2008-01-01

    Driven by the growing aging population, prevalence of chronic diseases, and continuously rising healthcare costs, the healthcare system is undergoing a fundamental transformation, from the conventional hospital-centered system to an individual-centered system. Current and emerging developments in wearable medical systems will have a radical impact on this paradigm shift. Advances in wearable medical systems will enable the accessibility and affordability of healthcare, so that physiological conditions can be monitored not only at sporadic snapshots but also continuously for extended periods of time, making early disease detection and timely response to health threats possible. This paper reviews recent developments in the area of wearable medical systems for p-Health. Enabling technologies for continuous and noninvasive measurements of vital signs and biochemical variables, advances in intelligent biomedical clothing and body area networks, approaches for motion artifact reduction, strategies for wearable energy harvesting, and the establishment of standard protocols for the evaluation of wearable medical devices are presented in this paper with examples of clinical applications of these technologies.

  2. Selected medical management of the older rehabilitative patient.

    Science.gov (United States)

    Lin, John L; Armour, Doris

    2004-07-01

    This self-directed learning module highlights present practices of geriatric medicine that are commonly seen in an inpatient rehabilitation setting. It is a part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. In particular, attention is given to update physiatrists in the geriatric medical advances in pharmacotherapeutic considerations, the management of hypertension, diabetes mellitus, urinary tract infections, and sleep disorders. To update the common present-day medical practices for older persons seen in a rehabilitation setting.

  3. Disaster healthcare system management and crisis intervention leadership in Thailand--lessons learned from the 2004 Tsunami disaster.

    Science.gov (United States)

    Peltz, Rami; Ashkenazi, Issac; Schwartz, Dagan; Shushan, Ofer; Nakash, Guy; Leiba, Adi; Levi, Yeheskel; Goldberg, Avishay; Bar-Dayan, Yaron

    2006-01-01

    Quarantelli established criteria for evaluating the effectiveness of disaster management. The objectives of this study were to analyze the response of the healthcare system to the Tsunami disaster according to the Quarantelli principles, and to validate these principles in a scenario of a disaster due to natural hazards. The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research team to study the response of the Thai medical system to the disaster. The analysis of the disaster management was based on Quarantelli's 10 criteria for evaluating the management of community disasters. Data were collected through personal and group interviews. The three most important elements for effective disaster management were: (1) the flow of information; (2) overall coordination; and (3) leadership. Although pre-event preparedness was for different and smaller scenarios, medical teams repeatedly reported a better performance in hospitals that recently conducted drills. In order to increase effectiveness, disaster management response should focus on: (1) the flow of information; (2) overall coordination; and (3) leadership.

  4. Strategic management of medical tourism in Iran based on SWOT model

    OpenAIRE

    Majid Daeichini; Rasool Abedini; Siavash DanaeiMehr

    2014-01-01

    Medicine and related services worldwide, branches of tourism as medical tourism, have created. Every year, thousands of tourists have access to modern medical services, and of course reasonably priced way to Iran, the more they attract and develop medical tourism, a comprehensive review is necessary. This study, based on an analytical method - a description, and utilization of available resources in the field of tourism management, tourism, and its role in the development of medical tourism i...

  5. Environmental Management System

    Science.gov (United States)

    Goals Recycling Green Purchasing Pollution Prevention Reusing Water Resources Environmental Management Stewardship » Environmental Protection » Environmental Management System Environmental Management System An Environmental Management System is a systematic method for assessing mission activities, determining the

  6. Systemic Medication and Intraocular Pressure in a British Population

    Science.gov (United States)

    Khawaja, Anthony P.; Chan, Michelle P.Y.; Broadway, David C.; Garway-Heath, David F.; Luben, Robert; Yip, Jennifer L.Y.; Hayat, Shabina; Wareham, Nicholas J.; Khaw, Kay-Tee; Foster, Paul J.

    2014-01-01

    Objective To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women. Design Population-based, cross-sectional study. Participants We included 7093 participants from the European Prospective Investigation into Cancer–Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48–92) and 56% were women. Methods We measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, α-blockers, β-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels. Main Outcome Measures Mean IOP of the right and left eyes. Results Use of systemic β-blockers (−0.92 mmHg; 95% CI, −1.19, −0.65; Pnitrates (−0.63 mmHg; 95% CI, −1.12, −0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for β-blocker use. Conclusions This is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic β-blockers or

  7. An online app platform enhances collaborative medical student group learning and classroom management.

    Science.gov (United States)

    Peacock, Justin G; Grande, Joseph P

    2016-01-01

    The authors presented their results in effectively using a free and widely-accessible online app platform to manage and teach a first-year pathology course at Mayo Medical School. The authors utilized the Google "Blogger", "Forms", "Flubaroo", "Sheets", "Docs", and "Slides" apps to effectively build a collaborative classroom teaching and management system. Students were surveyed on the use of the app platform in the classroom, and 44 (94%) students responded. Thirty-two (73%) of the students reported that "Blogger" was an effective place for online discussion of pathology topics and questions. 43 (98%) of the students reported that the "Forms/Flubaroo" grade-reporting system was helpful. 40 (91%) of the students used the remote, collaborative features of "Slides" to create team-based learning presentations, and 39 (89%) of the students found those collaborative features helpful. "Docs" helped teaching assistants to collaboratively create study guides or grading rubrics. Overall, 41 (93%) of the students found that the app platform was helpful in establishing a collaborative, online classroom environment. The online app platform allowed faculty to build an efficient and effective classroom teaching and management system. The ease of accessibility and opportunity for collaboration allowed for collaborative learning, grading, and teaching.

  8. [Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

    Science.gov (United States)

    Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

    2015-06-01

    The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

  9. The Function Analysis of Informationization in New Rural Cooperatives Medical Service Management

    Science.gov (United States)

    Zhou, Yuefeng; Liu, Min

    The establishment of new rural cooperative medical system is an important action for comprehensive affluent society. It is an important measure for Central Party Committee and State Council to solve "three rural" issue effectively and to overall urban and rural, regional, coordinated economic and social development, building a well-off society in the new situation. It has important role to alleviate farmers to see a doctor expensively, see a doctor difficultly, reduce the burden on farmers and improve their level of health protection and quality of life, solve the problem of poor because of illness and the problem of returning poor due to illness, promote the production and rural economic development and stability in the rural areas. This article will analyze the function of informationization in new rural cooperative medical service management selectively.

  10. Medical Management of the Severe Traumatic Brain Injury Patient.

    Science.gov (United States)

    Marehbian, Jonathan; Muehlschlegel, Susanne; Edlow, Brian L; Hinson, Holly E; Hwang, David Y

    2017-12-01

    Severe traumatic brain injury (sTBI) is a major contributor to long-term disability and a leading cause of death worldwide. Medical management of the sTBI patient, beginning with prehospital triage, is aimed at preventing secondary brain injury. This review discusses prehospital and emergency department management of sTBI, as well as aspects of TBI management in the intensive care unit where advances have been made in the past decade. Areas of emphasis include intracranial pressure management, neuromonitoring, management of paroxysmal sympathetic hyperactivity, neuroprotective strategies, prognostication, and communication with families about goals of care. Where appropriate, differences between the third and fourth editions of the Brain Trauma Foundation guidelines for the management of severe traumatic brain injury are highlighted.

  11. The "implicit" Ethics of a Systemic Approach to the Medical Praxis

    Science.gov (United States)

    Ricciuti, Alberto

    The unstoppable acceleration of the scientific and technological development that is revolutionizing our socioeconomic systems in recent years has made the critical aspects and the inadequacy of medical epistemology more and more evident. Several elements have underlined the insufficiency of traditional ethical points of reference in Medicine, like the change of individual needs, the technical possibility of long-term management of heavy diseases, the change of the social and health systems caused by the interaction of different ethnic groups and cultures, several problems linked to the fair distribution of resources in regime of fiscal scarcity involving all the industrialized countries of our world. This brought to the necessity for Medicine to modify its coordinates, adjusting them on the person, and not on the disease. In order to reach this objective, the author strategically suggests Systemics as the epistemological guidance of the knowledge process, which can make the scientific method operate in an ethical and cultural horizon centered on the human being valorization, on the respect of his/her needs and the respect of his/her environment. A systemic approach of the medical thought can allow the re-orientation of the clinical look from a biological to a biographic one, the re-definition of the aim of the medical intervention as the restoration and support of self-organizing and self-regulating processes of the biological system, the achieving of a social and health expenditure's saving through a major appropriateness of prescription and an inherent preventive valence of medical interventions, the offer of new and larger horizons for the development of scientific research.

  12. The current medical education system in the world.

    Science.gov (United States)

    Nara, Nobuo; Suzuki, Toshiya; Tohda, Shuji

    2011-07-04

    To contribute to the innovation of the medical education system in Japan, we visited 35 medical schools and 5 institutes in 12 countries of North America, Europe, Australia and Asia in 2008-2010 and observed the education system. We met the deans, medical education committee and administration affairs and discussed about the desirable education system. We also observed the facilities of medical schools.Medical education system shows marked diversity in the world. There are three types of education course; non-graduate-entry program(non-GEP), graduate-entry program(GEP) and mixed program of non-GEP and GEP. Even in the same country, several types of medical schools coexist. Although the education methods are also various among medical schools, most of the medical schools have introduced tutorial system based on PBL or TBL and simulation-based learning to create excellent medical physicians. The medical education system is variable among countries depending on the social environment. Although the change in education program may not be necessary in Japan, we have to innovate education methods; clinical training by clinical clerkship must be made more developed to foster the training of the excellent clinical physicians, and tutorial education by PBL or TBL and simulation-based learning should be introduced more actively.

  13. Health software: a new CEI Guide for software management in medical environment.

    Science.gov (United States)

    Giacomozzi, Claudia; Martelli, Francesco

    2016-01-01

    The increasing spread of software components in the healthcare context renders explanatory guides relevant and mandatory to interpret laws and standards, and to support safe management of software products in healthcare. In 2012 a working group has been settled for the above purposes at Italian Electrotechnical Committee (CEI), made of experts from Italian National Institute of Health (ISS), representatives of industry, and representatives of the healthcare organizations. As a first outcome of the group activity, Guide CEI 62-237 was published in February 2015. The Guide incorporates an innovative approach based on the proper contextualization of software products, either medical devices or not, to the specific healthcare scenario, and addresses the risk management of IT systems. The Guide provides operators and manufacturers with an interpretative support with many detailed examples to facilitate the proper contextualization and management of health software, in compliance with related European and international regulations and standards.

  14. Risk Information Management Resource (RIMR): modeling an approach to defending against military medical information assurance brain drain

    Science.gov (United States)

    Wright, Willie E.

    2003-05-01

    As Military Medical Information Assurance organizations face off with modern pressures to downsize and outsource, they battle with losing knowledgeable people who leave and take with them what they know. This knowledge is increasingly being recognized as an important resource and organizations are now taking steps to manage it. In addition, as the pressures for globalization (Castells, 1998) increase, collaboration and cooperation are becoming more distributed and international. Knowledge sharing in a distributed international environment is becoming an essential part of Knowledge Management. This is a major shortfall in the current approach to capturing and sharing knowledge in Military Medical Information Assurance. This paper addresses this challenge by exploring Risk Information Management Resource (RIMR) as a tool for sharing knowledge using the concept of Communities of Practice. RIMR is based no the framework of sharing and using knowledge. This concept is done through three major components - people, process and technology. The people aspect enables remote collaboration, support communities of practice, reward and recognize knowledge sharing while encouraging storytelling. The process aspect enhances knowledge capture and manages information. While the technology aspect enhance system integration and data mining, it also utilizes intelligent agents and exploits expert systems. These coupled with supporting activities of education and training, technology infrastructure and information security enables effective information assurance collaboration.

  15. Embedding care management in the medical home: a case study.

    Science.gov (United States)

    Daaleman, Timothy P; Hay, Sherry; Prentice, Amy; Gwynne, Mark D

    2014-04-01

    Care managers are playing increasingly significant roles in the redesign of primary care and in the evolution of patient-centered medical homes (PCMHs), yet their adoption within day-to-day practice remains uneven and approaches for implementation have been minimally reported. We introduce a strategy for incorporating care management into the operations of a PCMH and assess the preliminary effectiveness of this approach. A case study of the University of North Carolina at Chapel Hill Family Medicine Center used an organizational model of innovation implementation to guide the parameters of implementation and evaluation. Two sources were used to determine the effectiveness of the implementation strategy: data elements from the care management informatics system in the health record and electronic survey data from the Family Medicine Center providers and care staff. A majority of physicians (75%) and support staff (82%) reported interactions with the care manager, primarily via face-to-face, telephone, or electronic means, primarily for facilitating referrals for behavioral health services and assistance with financial and social and community-based resources. Trend line suggests an absolute decrease of 8 emergency department visits per month for recipients of care management services and an absolute decrease of 7.5 inpatient admissions per month during the initial 2-year implementation period. An organizational model of innovation implementation is a potentially effective approach to guide the process of incorporating care management services into the structure and workflows of PCMHs.

  16. Medication Management, Use and Safety in Non- Communicable ...

    African Journals Online (AJOL)

    ... combination of the efforts from government, health professionals and the individual patients. Adequate education of the patients and the public can lead to behavioral change and reduction in NCDs while at the same time improving medication use behaviours. Keywords: NCDs, Drug management, Drug safety, Drug Use, ...

  17. [Effects of gout web based self-management program on knowledge related to disease, medication adherence, and self-management].

    Science.gov (United States)

    Oh, Hyun Soo; Park, Won; Kwon, Seong Ryul; Lim, Mie Jin; Suh, Yeon Ok; Seo, Wha Sook; Park, Jong Suk

    2013-08-01

    This study was conducted to examine the changing patterns of knowledge related to disease, medication adherence, and self-management and to determine if outcomes were more favorable in the experimental group than in the comparison group through 6 months after providing a web-based self-management intervention. A non-equivalent control group quasi-experimental design was used and 65 patients with gout, 34 in experimental group and 31 in comparison group, were selected from the rheumatic clinics of two university hospitals. Data were collected four times, at baseline, at 1 month, 3 months, and 6 months after the intervention. According to the study results, the changing patterns of knowledge and self-management were more positive in the experimental group than in the control group, whereas difference in the changing pattern of medication adherence between two groups was not significant. The results indicate that the web-based self-management program has significant effect on improving knowledge and self-management for middle aged male patients with gout. However, in order to enhance medication adherence, the web-based intervention might not be sufficient and other strategies need to be added.

  18. Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative

    Science.gov (United States)

    2007-06-01

    AD_________________ Award Number: W81XWH-06-2-0045 TITLE: Mass Medication Clinic (MMC) Patient ...SUBTITLE 5a. CONTRACT NUMBER Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative 5b. GRANT NUMBER W81XWH-06-2...sections will describe the events, results, and accomplishments of this study. With validation through this project the Patient Medical Assistant

  19. AACE/ACE Disease State Clinical Review: Medical Management of Cushing Disease.

    Science.gov (United States)

    Hamrahian, Amir H; Yuen, Kevin C J; Hoffman, Andrew R

    2014-07-01

    To review available medical therapies for patients with Cushing disease and to provide a roadmap for their use in clinical practice. PubMed searches were performed to identify all of the available published data on medical management of Cushing disease. Medical therapy is usually not the first-line treatment for patients with Cushing disease but may be used to improve clinical manifestations of Cushing disease in patients who are not suitable candidates for surgery, following unsuccessful surgery or recurrence, or as a "bridge therapy" in those who have undergone radiotherapy. Medical therapy may also be used in preoperative preparation of patients with severe disease. Current available medical options for patients with Cushing disease include centrally acting agents, steroidogenesis inhibitors, and a glucocorticoid receptor antagonists. At present, there are no head-to-head studies comparing the efficacy, tolerability, and safety of different U.S. Food and Drug Administration (FDA)- and non-FDA-approved drugs in patients with Cushing disease. With the initiation of new studies and the completion of ongoing clinical trials, the number of FDA-approved drugs for medical treatment of Cushing disease is expected to increase. Medical therapy has an important adjunctive role in the management of patients with Cushing disease. The decision to initiate medical treatment depends on many factors, including patient characteristics and preference. Long-term studies are needed to better define the clinical efficacy, safety, and tolerability of medical treatment of Cushing disease, including the role of combination therapies.

  20. [Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

    Science.gov (United States)

    Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

    2009-10-01

    The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

  1. [Design of an anesthesia and micro-environment information management system in mobile operating room].

    Science.gov (United States)

    Wang, Xianwen; Liu, Zhiguo; Zhang, Wenchang; Wu, Qingfu; Tan, Shulin

    2013-08-01

    We have designed a mobile operating room information management system. The system is composed of a client and a server. A client, consisting of a PC, medical equipments, PLC and sensors, provides the acquisition and processing of anesthesia and micro-environment data. A server is a powerful computer that stores the data of the system. The client gathers the medical device data by using the C/S mode, and analyzes the obtained HL7 messages through the class library call. The client collects the micro-environment information with PLC, and finishes the data reading with the OPC technology. Experiment results showed that the designed system could manage the patient anesthesia and micro-environment information well, and improve the efficiency of the doctors' works and the digital level of the mobile operating room.

  2. Evaluation and comparison of medical records department of Iran university of medical sciences teaching hospitals and medical records department of Kermanshah university of medical sciences teaching hospitals according to the international standards ISO 9001-2000 in 2008

    Directory of Open Access Journals (Sweden)

    maryam ahmadi

    2010-04-01

    Conclusion: The rate of final conformity of medical records system by the criteria of the ISO 9001-2000 standards in hospitals related to Iran university of medical sciences was greater than in hospitals related to Kermanshah university of medical sciences. And total conformity rate of medical records system in Kermanshah hospitals was low. So the regulation of medical records department with ISO quality management standards can help to elevate its quality.

  3. The medical management of attention-deficit / hyperactivity disorder ...

    African Journals Online (AJOL)

    This paper focuses specifically on the medical management of attention-deficit / hyperactivity disorder (ADHD) and the options currently available in South Africa. References are made to current thinking on the etiology of this disorder and the pharmacological principles involved in its treatment. This review will not try to ...

  4. Utilization technique of 'radiation management manual in medical field (2012).' What should be learnt from the Fukushima nuclear accident

    International Nuclear Information System (INIS)

    Kikuchi, Toru

    2014-01-01

    From the abstract of contents of the 'Radiation management manual in medical field (2012),' the utilization technique of the manual is introduced. Introduced items are as follows: (1) Exposure management; exposure management for radiation medical workers, patients, and citizens in the medical field, and exposure management for radiation workers and citizens involved in the emergency work related to the Fukushima nuclear accident, (2) Health management; health management for radiation medical workers, (3) Radiation education: Education/training for radiation medical workers, and radiation education for health care workers, (4) Accident and emergency measures; emergency actions involved in the radiation accidents and radiation medicine at medical facilities

  5. Possibilities of radiation sterilization for re-usage of medical devices in the medical management

    International Nuclear Information System (INIS)

    Tabei, Masae; Kudo, Hisaaki; Katsumura, Yosuke

    2004-01-01

    The rule for re-usage of medical single-use devices was established in US in 2000 based on the concept of Managed Care (total management of medicare on cost, quality and patients' satisfaction) and 20-30% of those devices are re-used at present. The re-usage is conducted in not only US but also Canada, Denmark, UK, India, China etc. Standing on the viewpoint, this paper described and discussed the possibility of re-usage of the single-use devices now prohibited in Japan, possible re-sterilization, possible re-usage of hollow fiber-type hemodialyzer following γ-ray sterilization with consideration for D-values against bacteria and viruses, cost estimation of electron beam sterilization for re-usage, and radiation sterilization of waste water and plastic materials. Radiation sterilization for re-usage of medical devices was concluded possible if their materials and records for their usage processes are proper, and should be conducted in a large scale after sufficient examinations by industries/government/academia. (N.I.)

  6. Linking a Medical User Survey to Management for Library Effectiveness: II, A Checkland Soft Systems Study.

    Science.gov (United States)

    Brember, V. L.

    1985-01-01

    Presents Checkland's soft systems methodology, discusses it in terms of the systems approach, and illustrates how it was used to relate evidence of user survey to practical problems of library management. Difficulties in using methodology are described and implications for library management and information science research are presented. (8…

  7. Improvised explosive devices: pathophysiology, injury profiles and current medical management.

    Science.gov (United States)

    Ramasamy, A; Hill, A M; Clasper, J C

    2009-12-01

    The improvised explosive device (IED), in all its forms, has become the most significant threat to troops operating in Afghanistan and Iraq. These devices range from rudimentary home made explosives to sophisticated weapon systems containing high-grade explosives. Within this broad definition they may be classified as roadside explosives and blast mines, explosive formed pojectile (EFP) devices and suicide bombings. Each of these groups causeinjury through a number of different mechanisms and can result in vastly different injury profiles. The "Global War on Terror" has meant that incidents which were previously exclusively seen in conflict areas, can occur anywhere, and clinicians who are involved in emergency trauma care may be required to manage casualties from similar terrorist attacks. An understanding of the types of devices and their pathophysiological effects is necessary to allow proper planning of mass casualty events and to allow appropriate management of the complex poly-trauma casualties they invariably cause. The aim of this review article is to firstly describe the physics and injury profile from these different devices and secondly to present the current clinical evidence that underpins their medical management.

  8. Managing complex processing of medical image sequences by program supervision techniques

    Science.gov (United States)

    Crubezy, Monica; Aubry, Florent; Moisan, Sabine; Chameroy, Virginie; Thonnat, Monique; Di Paola, Robert

    1997-05-01

    Our objective is to offer clinicians wider access to evolving medical image processing (MIP) techniques, crucial to improve assessment and quantification of physiological processes, but difficult to handle for non-specialists in MIP. Based on artificial intelligence techniques, our approach consists in the development of a knowledge-based program supervision system, automating the management of MIP libraries. It comprises a library of programs, a knowledge base capturing the expertise about programs and data and a supervision engine. It selects, organizes and executes the appropriate MIP programs given a goal to achieve and a data set, with dynamic feedback based on the results obtained. It also advises users in the development of new procedures chaining MIP programs.. We have experimented the approach for an application of factor analysis of medical image sequences as a means of predicting the response of osteosarcoma to chemotherapy, with both MRI and NM dynamic image sequences. As a result our program supervision system frees clinical end-users from performing tasks outside their competence, permitting them to concentrate on clinical issues. Therefore our approach enables a better exploitation of possibilities offered by MIP and higher quality results, both in terms of robustness and reliability.

  9. Improving the medical records department processes by lean management.

    Science.gov (United States)

    Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine

    2015-01-01

    Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. The study represents one of the few attempts trying to eliminate wastes in the MRD.

  10. Medical management of motor manifestations of Huntington disease.

    Science.gov (United States)

    McCusker, Elizabeth A; Loy, Clement T

    2017-01-01

    The motor and movement disorders of Huntington disease (HD) are managed in the context of the other disease features. Chorea and dystonia are the most common HD-associated movement disorders, and they can be assessed on research rating scales. However other motor manifestations have a significant impact. In particular, dysphagia influences choice and tolerance of treatment for the movement disorder, as will comorbidities, patient awareness, and distress related to the motor feature or movement. Treatment for other disease features may aggravate the motor disorder, e.g., increased swallowing difficulty associated with antipsychotic agents. Basic principles in deciding to institute a treatment are outlined as well as treatment of specific motor manifestations and movements. There is a paucity of evidence to support the treatments available for the motor disorder, with only one agent with class 1 evidence, tetrabenazine, for chorea. There are, however, treatments informed by expert opinion which reflect the management of a wider HD phenotype than that represented in clinical trials. Some treatments are based on evidence from use in other conditions. Medical management is usually undertaken later in the disease with concurrent nonmedical interventions after multidisciplinary assessments. Medication review with HD progression is essential. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

    Science.gov (United States)

    Curran, Jeffrey; Ritchie, Stephen D.; Beardy, Jackson; VanderBurgh, David; Born, Karen; Lewko, John; Orkin, Aaron M.

    2018-01-01

    (1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help. PMID:29401706

  12. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies.

    Science.gov (United States)

    Haddad, Peter M; Brain, Cecilia; Scott, Jan

    2014-01-01

    Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness's association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive

  13. Medical Management of Ulcerative Colitis with a Specific Focus on 5-Aminosalicylates

    Directory of Open Access Journals (Sweden)

    Hugh James Freeman

    2012-01-01

    Full Text Available Medical management of ulcerative colitis has continued to evolve over more than half of a century. Perhaps, the important advance was the development of sulfasalazine, a drug initially used for the treatment of inflammatory joint disease and only later in the treatment of inflammatory bowel disease. Sulfasalazine was a combination designer drug consisting of sulfapyridine, a sulfa-containing antibacterial agent, and 5-amino-salicylate (5-ASA, an anti-inflammatory agent. Its value appeared to be its ability to target a therapeutic concentration of the 5-ASA component of the medication primarily in the colon, largely avoiding proximal small intestinal absorption. With increasing experience, however, it also became evident that many patients treated with sulfasalazine developed intolerance to the drug and, in some rare instances, serious drug-induced hypersensitivity reactions, largely to the sulfapyridine portion. As a result, a number of alternative forms of delivery of 5-ASA were developed consisting of either a similar sulfasalazine-like prodrug formulation requiring luminal destruction of an azo-bond releasing the 5-ASA or a pH-dependent 5-ASA packaging system that permitted release in the distal intestine, particularly in the colon. As a result, 5-ASA—containing medications continue to provide a valuable management tool for remission induction in mildly to moderately active distal or extensive ulcerative colitis, an additional option for more severely symptomatic disease and value for maintenance therapy with limited potential side effects, even with long-term use.

  14. Medical management of ulcerative colitis with a specific focus on 5-aminosalicylates.

    Science.gov (United States)

    Freeman, Hugh James

    2012-01-01

    Medical management of ulcerative colitis has continued to evolve over more than half of a century. Perhaps, the important advance was the development of sulfasalazine, a drug initially used for the treatment of inflammatory joint disease and only later in the treatment of inflammatory bowel disease. Sulfasalazine was a combination designer drug consisting of sulfapyridine, a sulfa-containing antibacterial agent, and 5-amino-salicylate (5-ASA), an anti-inflammatory agent. Its value appeared to be its ability to target a therapeutic concentration of the 5-ASA component of the medication primarily in the colon, largely avoiding proximal small intestinal absorption. With increasing experience, however, it also became evident that many patients treated with sulfasalazine developed intolerance to the drug and, in some rare instances, serious drug-induced hypersensitivity reactions, largely to the sulfapyridine portion. As a result, a number of alternative forms of delivery of 5-ASA were developed consisting of either a similar sulfasalazine-like prodrug formulation requiring luminal destruction of an azo-bond releasing the 5-ASA or a pH-dependent 5-ASA packaging system that permitted release in the distal intestine, particularly in the colon. As a result, 5-ASA-containing medications continue to provide a valuable management tool for remission induction in mildly to moderately active distal or extensive ulcerative colitis, an additional option for more severely symptomatic disease and value for maintenance therapy with limited potential side effects, even with long-term use.

  15. Maintenance management systems

    International Nuclear Information System (INIS)

    Rohan, M. de

    1989-01-01

    This paper is concerned principally with Maintenance Management systems and their effective introduction into organisations. Maintenance improvement is basically a problem of managing the maintenance department in the broadest sense. Improvement does not only lie in the area of special techniques, systems or procedures; although they are valuable tools, but rather in a balanced attack, carefully guided by management. Over recent years, maintenance systems have received the major emphasis and in many instances the selection of the system has become a pre-occupation, whereas the importance of each maintenance function must be recognised and good management practices applied to all maintenance activities. The ingredients for success in the implementation of maintenance management systems are summarised as: having a management committee, clear objectives, project approach using project management techniques and an enthusiastic leader, user managed and data processing supported project, realistic budget and an understanding of the financial audit requirements. (author)

  16. Thoracoscopy: medical versus surgical—in the management of pleural diseases

    Science.gov (United States)

    2015-01-01

    Diseases of the pleura continue to affect a large population of patients worldwide and in the United States. Pleural fluid analysis and accompanying imaging of the pleura including chest X-rays, chest computed tomography (CT) scan and chest ultrasonography are among the first steps in the management of pleural effusions. When further diagnostic or therapeutic work up is necessary, open thoracotomy and thoracoscopy come to mind. However, given the significant morbidity and mortality associated with open thoracotomy, and the advances in medicine and medical instruments, thoracoscopy has now become a routine procedure in the management of the disease of the chest including pleura. Debates about surgical vs. medical thoracoscopy (MT) are ongoing. In the following pages we review the literature and discuss the similarities and differences between the two procedures, as well as their indications, contraindications, complications and efficacy in the management of pleural diseases. PMID:26807282

  17. Publication ethics and the ghost management of medical publication.

    Science.gov (United States)

    Sismondo, Sergio; Doucet, Mathieu

    2010-07-01

    It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.

  18. [How management teams use information and control systems to manage hospitals].

    Science.gov (United States)

    Naranjo-Gil, David

    2016-01-01

    To analyze the relationship between the characteristics of top management teams and the different use of management information and control systems (MICS) to implement policies that encourage cooperation and activity coordination in public hospitals. Data were collected through a questionnaire sent to each member of the top management teams of 231 Spanish public hospitals (chief executive director, medical director, nursing director and director for financial and social issues). A total of 457 valid questionnaires were returned, composing 86 full top management teams (37.23%). Top management team diversity was positively related to the interactive use of MICS. Management teams composed of younger members and members with longer service used MICS interactively. Top management teams with a predominantly clinical education and experience used MICS interactively, while top teams with a predominantly administrative education and experience used MICS diagnostically. The results also showed that cooperation and coordination in hospitals were positively related to the interactive use of MICS and were negatively related to the diagnostic use of MICS. The interactive use of MICS is an important mediator in the relationship between top team diversity and policies focused on hospital decentralization. Top management teams with diverse characteristics (e.g. age, length of service, education and experience) use management information interactively to enhance activity coordination and resource allocation in hospitals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. Family Physicians Managing Medical Requests From Family and Friends.

    Science.gov (United States)

    Giroldi, Esther; Freeth, Robin; Hanssen, Maurice; Muris, Jean W M; Kay, Margareth; Cals, Jochen W L

    2018-01-01

    Although guidelines generally state that physicians should not treat their family members or friends (nonpatients), physicians regularly receive medical requests from nonpatients. We aimed to explore junior and senior family physicians' experiences with and attitudes toward managing medical requests from nonpatients. We conducted a qualitative study with 7 focus groups with junior and senior physicians. We performed a thematic analysis during an iterative cycle of data collection and analysis. When confronted with a medical request from a nonpatient, physicians first oriented themselves to the situation: who is this person, what is he or she asking of me, and where are we? Physicians next considered the following interrelated factors: (1) nature/strength of the relationship with the nonpatient, (2) amount of trust in his/her own knowledge and skills, (3) expected consequences of making mistakes, (4) importance of work-life balance, and (5) risk of disturbing the physician-patient process. Senior physicians applied more nuanced considerations when deciding whether to respond, whereas junior physicians experienced more difficulties dealing with these requests, were less inclined to respond, and were more concerned about disturbing the existing relationship that a person had with his/her own physician. This study provides insight into the complexity that physicians face when managing medical questions and requests from nonpatients. Facilitated group discussions during which experiences are shared can help junior physicians become more confident in dealing with these complex issues as they formulate their own personal strategy regarding provision of medical advice or treatment to family and friends. © 2018 Annals of Family Medicine, Inc.

  20. Bridge Management Systems

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    In this paper bridge management systems are discussed with special emphasis on management systems for reinforced concrete bridges. Management systems for prestressed concrete bridges, steel bridges, or composite bridges can be developed in a similar way....

  1. Medical management of radiological accidents in non-specialized clinics: mistakes and lessons

    International Nuclear Information System (INIS)

    Jikia, D.

    2009-01-01

    In 1996-2002 three radiological accidents were developed in Georgia. There were some people injured in those accidents. During medical management of the injured some mistakes and errors were revealed both in diagnostics and scheme of the treatment. The goal of this article is to summarize medical management of the mentioned radiological accidents, to estimate reasons of mistakes and errors, to present the lessons drawn in result of Georgia radiological accidents. There was no clinic with specialized profile and experience. Accordingly due to having no relevant experience late diagnosis can be considered as the main error. It had direct influence on the patients' health and results of treatment. Lessons to be drawn after analyzing Georgian radiological accidents: 1. informing medical staff about radiological injuries (pathogenesis, types, symptoms, clinical course, principles of treatment and etc.); 2. organization of training and meetings in non-specialized clinics or medical institutions for medical staff; 3. preparation of informational booklets and guidelines.(author)

  2. Management system of organizational and economic changes in health services

    Directory of Open Access Journals (Sweden)

    Natalya Vasilyevna Krivenko

    2013-03-01

    Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

  3. Emergency preparedness: medical management of nuclear accidents involving large groups of victims

    International Nuclear Information System (INIS)

    Parmentier, N.; Nenot, J.C.

    1988-01-01

    The treatment of overexposed individuals implies hospitalisation in a specialized unit applying hematological intense care. If the accident results in a small number of casualties, the medical management does not raise major problems in most of the countries, where specialized units exist, as roughly 7% of the beds are available at any time. But an accident which would involved tens or hundreds of people raises much more problems for hospitalization. Such problems are also completely different and will involve steps in the medical handling, mainly triage, (combined injuries), determination of whole body dose levels, transient hospitalization. In this case, preplanning is necessary, adapted to the system of medical care in case of a catastrophic event in the given Country, with the main basic principles : emergency concerns essentially the classical injuries (burns and trauma) - and contamination problems in some cases - treatment of radiation syndrome is not an emergency during the first days but some essential actions have to be taken such as early blood sampling for biological dosimetry and for HLa typing

  4. Radiation dosimetry for medical management in nuclear/radiological disaster

    International Nuclear Information System (INIS)

    Narayan, Pradeep

    2012-01-01

    Medical Management of radiation exposed victims depends on the amount of radiation doses received in their body and individual organs. The severity of radiation sickness; and early/late biological effects of radiation can be judged on the basis of absorbed dose level of the exposed individual. Radiation Dosimetry is a scientific technique for estimating radiation doses in material and living being. It is an important task for managing radiation effects/injuries to the living being in case of radiological accidents/disasters. In such scenario occupational radiation workers as well as public in general may be exposed with ionizing radiations such as; gamma, alpha, beta and neutron. Radiation dosimetric equipment's are available for occupational radiation workers, however, public in general may not have any dosimetry system with them. Therefore, absorbed dose estimation to the public on individual basis is a challenge to the society. The ambient environment materials in close proximity to the exposed individual may be analyzed using scientific techniques to estimate their personal radiation doses. The blood sample from exposed individual can be examined in laboratory using citometry techniques for dose estimation, however these techniques are very time consuming and may not be suitable for quick radiation management. The other human biological material such as; tooth, hair, and bone etc., can be examined using Electron Spin Resonance (ESR) spectrometry techniques. This technique is very efficient and capable in measuring radiation doses of the order of 20-30 mGy in very less time typically 2-3 min. In reality, this technique is costly affair and available mostly in developed countries. Thermoluminescence (TL) technique is very versatile and cost effective for routine personal dose estimation, This technique has been found suitable for measuring TL in many accidentally exposed environmental materials. The radiation exposed natural environmental materials, such as

  5. Milestones in Implementation of an Integrated Management System in the Health Sector. Case Study Radiologische Netzwerk Rheinland

    Directory of Open Access Journals (Sweden)

    Claus Nagel-Picioruş

    2016-05-01

    Full Text Available Healthcare organizations in Germany exploit the benefits of the ISO 9000 family of international standards as it became compulsory to implement a quality management system in accordance with ISO 9001 requirements. Until the innovative ISO 9001:2015 proposal it was no direct connection to the other management systems like risk management, knowledge management or environmental management. So far, only few bodies ensured interconnections between different systems of management or associated the quality management system with the strategic planning process. However, healthcare encapsulates supplementary requirements which affect a number of different systems. Additionally, the financial crisis has encouraged the trend to operate integrated reporting beyond financial aspects. This paper aims at presenting the experience on the development of integrated management and reporting system integrated in an organization belonging to the health sector. The work clarifies the steps towards merging distinctly regulated management systems (quality, health or environmental management with strategic planning and controlling, via a Balanced Dashboard (Balanced Scorecard - BSC as well as integrated reporting according to the model International Integrated Reporting Initiative (IIRI in a German medical company - Radiologische Netzwerk Rheinland - RNR AG. Using the case study method, the paper's purpose is to highlight approaches and results of the company that could support practitioners from medical area and bezound. The literature review clarified theoretical concepts while the case study allowed converging comprehensive information and knowledge accumulated by RNR AG, thus helping to bridge the gap between literature on total integrated management reporting and reporting system in healthcare.

  6. Relationship between National Institutes of Health research awards to US medical schools and managed care market penetration.

    Science.gov (United States)

    Moy, E; Mazzaschi, A J; Levin, R J; Blake, D A; Griner, P F

    1997-07-16

    Medical research conducted in academic medical centers is often dependent on support from clinical revenues generated in these institutions. Anecdotal evidence suggests that managed care has the potential to affect research conducted in academic medical centers by challenging these clinical revenues. To examine whether empirical evidence supports a relationship between managed care and the ability of US medical schools to sustain biomedical research. Data on annual extramural research grants awarded to US medical schools by the National Institutes of Health (NIH) from fiscal years 1986 to 1995 were obtained, and each medical school was matched to a market for which information about health maintenance organization (HMO) penetration in 1995 was available. Growth in total NIH awards, traditional research project (R01) awards, R01 awards to clinical and basic science departments, and changes in institutional ranking by NIH awards were compared among schools located in markets with low, medium, and high managed care penetration. Medical schools in all markets had comparable rates of growth in NIH awards from 1986 to 1990. Thereafter, medical schools in markets with high managed care penetration had slower growth in the dollar amounts and numbers of NIH awards compared with schools in markets with low or medium managed care penetration. This slower growth for schools in high managed care markets was associated with loss of share of NIH awards, equal to $98 million in 1995, and lower institutional ranking by NIH awards. Much of this revenue loss can be explained by the slower growth of R01 awards to clinical departments in medical schools in high managed care markets. These findings provide evidence of an inverse relationship between growth in NIH awards during the past decade and managed care penetration among US medical schools. Whether this association is causal remains to be determined.

  7. The Medical Examiner/Coroner's Guide for Contaminated Deceased Body Management.

    Science.gov (United States)

    Hanzlick, Randy; Nolte, Kurt; deJong, Joyce

    2009-12-01

    In the past few years, a number of publications and other resources have appeared concerning the management of mass fatality incidents. Some are geared toward the general management of incidents while others cover more specific topics such as decontamination procedures. Still others cover selected agents, including chemical, biologic, or radiologic ones. Few publications have been written specifically for medical examiners and coroners. The Medical Examiner and Coroner's Guide for Contaminated Deceased Body Management is written specifically for the medical examiner or coroner who will be in charge of investigations of fatalities that result from terrorism or other events that result in contaminated remains. In some such cases, agents may be used that will require mitigation of environmental hazards and decontamination of human bodies. To that end, this Guide provides information and suggestions that may be useful in understanding the principles involved in decontamination procedures, recognizing that it may not be the medical examiner or coroner staff who actually conducts decontamination procedures. The suggestions in this guide may differ slightly from those in other publications. However, those who have contributed to this guide believe that the recommendations are practical, workable, have a scientific basis, and do not differ much in substance when compared with other relevant publications. The contents of this Guide may be reproduced for practical use but the Guide may not be sold and it may not be cited for advertisement purposes. Reference to specific commercial products is for informational purposes only and does not constitute endorsement of the product or company which produces the product. The recommendations contained in this Guide are not mandated nor are they required by federal, state, or local law. Rather, the recommendations are intended to assist medical examiners and coroners for the purposes of planning and providing a set of reasonable

  8. On Robust Methodologies for Managing Public Health Care Systems

    Directory of Open Access Journals (Sweden)

    Shastri L. Nimmagadda

    2014-01-01

    Full Text Available Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems.

  9. The impact of closed-loop electronic medication management on time to first dose: a comparative study between paper and digital hospital environments.

    Science.gov (United States)

    Austin, Jodie A; Smith, Ian R; Tariq, Amina

    2018-01-22

    Closed-loop electronic medication management systems (EMMS) are recognised as an effective intervention to improve medication safety, yet evidence of their effectiveness in hospitals is limited. Few studies have compared medication turnaround time for a closed-loop electronic versus paper-based medication management environment. To compare medication turnaround times in a paper-based hospital environment with a digital hospital equipped with a closed-loop EMMS, consisting of computerised physician order entry, profiled automated dispensing cabinets packaged with unit dose medications and barcode medication administration. Data were collected during 2 weeks at three private hospital sites (one with closed-loop EMMS) within the same organisation network in Queensland, Australia. Time between scheduled and actual administration times was analysed for first dose of time-critical and non-critical medications located on the ward or sourced via pharmacy. Medication turnaround times at the EMMS site were less compared to the paper-based sites (median, IQR: 35 min, 8-57 min versus 120 min, 30-180 min, P medications, 77% were administered within 60 min of scheduled time at the EMMS site versus 38% for the paper-based sites. Similar difference was observed for non-critical medications, 80% were administered within 60 min of their scheduled time at the EMMS site versus 41% at the paper-based facilities. The study indicates medication turnaround times utilising a closed-loop EMMS are less compared to paper-based systems. This improvement may be attributable to increased accessibility of medications using automated dispensing cabinets and electronic medication administration records flagging tasks to nurses in real time. © 2018 Royal Pharmaceutical Society.

  10. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  11. Maintenance and management system

    International Nuclear Information System (INIS)

    Ando, Yasumasa.

    1992-01-01

    Since highly reliable operation is required in a nuclear power plant, monitoring during operation and periodical inspection are conducted carefully. The present invention provides maintenance and management systems for providing an aid so that these systems are combined effectively and operated rationally based on unified information management. That is, the system contains data bases comprising information for the design of the equipments and pipelines of a plant, information for the exchange of equipment parts, information for the history of plant operation, information for the monitoring and inspection, and information for the management of repair operation. In addition, it has an equipment part history management sub-system for managing equipment part exchange information, an operation history management sub-system for managing the operation state of the plant, an operation history management sub-system for managing equipment monitoring inspection data and operation management sub-system for managing periodical inspection/ repairing operation. These sub-systems are collectively combined to manage the maintenance and management jobs of the plant unitarily. (I.S.)

  12. The medical management of abnormal uterine bleeding in reproductive-aged women.

    Science.gov (United States)

    Bradley, Linda D; Gueye, Ndeye-Aicha

    2016-01-01

    In the treatment of women with abnormal uterine bleeding, once a thorough history, physical examination, and indicated imaging studies are performed and all significant structural causes are excluded, medical management is the first-line approach. Determining the acuity of the bleeding, the patient's medical history, assessing risk factors, and establishing a diagnosis will individualize their medical regimen. In acute abnormal uterine bleeding with a normal uterus, parenteral estrogen, a multidose combined oral contraceptive regimen, a multidose progestin-only regimen, and tranexamic acid are all viable options, given the appropriate clinical scenario. Heavy menstrual bleeding can be treated with a levonorgestrel-releasing intrauterine system, combined oral contraceptives, continuous oral progestins, and tranexamic acid with high efficacy. Nonsteroidal antiinflammatory drugs may be utilized with hormonal methods and tranexamic acid to decrease menstrual bleeding. Gonadotropin-releasing hormone agonists are indicated in patients with leiomyoma and abnormal uterine bleeding in preparation for surgical interventions. In women with inherited bleeding disorders all hormonal methods as well as tranexamic acid can be used to treat abnormal uterine bleeding. Women on anticoagulation therapy should consider using progestin-only methods as well as a gonadotropin-releasing hormone agonist to treat their heavy menstrual bleeding. Given these myriad options for medical treatment of abnormal uterine bleeding, many patients may avoid surgical intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. A major trauma course based on posters, audio-guides and simulation improves the management skills of medical students: Evaluation via medical simulator.

    Science.gov (United States)

    Cuisinier, Adrien; Schilte, Clotilde; Declety, Philippe; Picard, Julien; Berger, Karine; Bouzat, Pierre; Falcon, Dominique; Bosson, Jean Luc; Payen, Jean-François; Albaladejo, Pierre

    2015-12-01

    Medical competence requires the acquisition of theoretical knowledge and technical skills. Severe trauma management teaching is poorly developed during internship. Nevertheless, the basics of major trauma management should be acquired by every future physician. For this reason, the major trauma course (MTC), an educational course in major traumatology, has been developed for medical students. Our objective was to evaluate, via a high fidelity medical simulator, the impact of the MTC on medical student skills concerning major trauma management. The MTC contains 3 teaching modalities: posters with associated audio-guides, a procedural workshop on airway management and a teaching session using a medical simulator. Skills evaluation was performed 1 month before (step 1) and 1 month after (step 3) the MTC (step 2). Nineteen students were individually evaluated on 2 different major trauma scenarios. The primary endpoint was the difference between steps 1 and 3, in a combined score evaluating: admission, equipment, monitoring and safety (skill set 1) and systematic clinical examinations (skill set 2). After the course, the combined primary outcome score improved by 47% (P<0.01). Scenario choice or the order of use had no significant influence on the skill set evaluations. This study shows improvement in student skills for major trauma management, which we attribute mainly to the major trauma course developed in our institution. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  14. The impact of medical tourism on Thai private hospital management: informing hospital policy.

    Science.gov (United States)

    James, Paul T J

    2012-01-01

    The purpose of this paper is to help consolidate and understand management perceptions and experiences of a targeted group (n=7) of Vice-Presidents of international Private Thai hospitals in Bangkok regarding medical tourism impacts. The method adopted uses a small-scale qualitative inquiry. Examines the on-going development and service management factors which contribute to the establishment and strengthening of relationships between international patients and hospital medical services provision. Develops a qualitative model that attempts to conceptualize the findings from a diverse range of management views into a framework of main (8) - Hospital Management; Hospital Processes; Hospital Technology; Quality Related; Communications; Personnel; Financial; and Patients; and consequent sub-themes (22). Outcomes from small-scale qualitative inquiries cannot by design be taken outside of its topical arena. This inevitably indicates that more research of this kind needs to be carried out to understand this field more effectively. The evidence suggests that Private Thai hospital management have established views about what constitutes the impact of medical tourism on hospital policies and practices when hospital staff interact with international patients. As the private health service sector in Thailand continues to grow, future research is needed to help hospitals provide appropriate service patterns and appropriate medical products/services that meet international patient needs and aspirations. Highlights the increasing importance of the international consumer in Thailand's health industry. This study provides insights of private health service providers in Bangkok by helping to understand more effectively health service quality environments, subsequent service provision, and the integrated development and impacts of new medical technology.

  15. Diabetes: Christian Worldview, Medical Distrust & Self-Management

    Science.gov (United States)

    Newlin Lew, Kelley; Arbuah, Nancy; Banach, Paul; Melkus, Gail

    2015-01-01

    To inform development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N=44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical mistrust, and self-management as prominent themes. Findings suggest diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African American community to improve health outcomes. PMID:25735754

  16. Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

    Science.gov (United States)

    Swank, Morgan L; Harken, Tabetha R; Porto, Manuel

    2013-08-01

    Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

  17. Family Systems Training for Medical Students.

    Science.gov (United States)

    Thabrew, Hiran

    2018-05-01

    To evaluate whether a workshop on family systems delivered to medical students could improve participants' understanding of families from a systemic point of view and help them recognise and address systemic issues that may be affecting their patients. Fifth year (senior) medical students ( n = 36) from the University of Auckland participated in a 90-min workshop about family systems. Pre- and post-workshop, self-reported measures of knowledge and confidence were completed and qualitative feedback was also obtained from participants. The workshop was well received and its interactive and role-play based nature were particularly appreciated. Participants reported gains in all explored areas of knowledge and understanding, suggesting that the workshop met its desired aims. This workshop is an educationally effective and expedient way to equip medical students with some knowledge and understanding about family systems. It may benefit their future work with individual patients and families.

  18. 78 FR 35940 - Content of Premarket Submissions for Management of Cybersecurity in Medical Devices; Draft...

    Science.gov (United States)

    2013-06-14

    ...] Content of Premarket Submissions for Management of Cybersecurity in Medical Devices; Draft Guidance for... draft guidance entitled ``Content of Premarket Submissions for Management of Cybersecurity in Medical Devices.'' This guidance identifies cybersecurity issues that manufacturers should consider in preparing...

  19. COMPARATIVE ANALYSIS OF MEDICAL EQUIPMENT USED IN DIAGNOSTIC IMAGING IN BULGARIA AND COUNTRIES WORLDWIDE AND OPTIMIZATION AIMED AT IMPROVING THE HEALTH CARE SYSTEM MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Svetoslav Garov

    2016-07-01

    Full Text Available Purpose: to reveal the current condition of medical equipment in Bulgaria related to those major groups of socially significant diseases and to make an attempt to define guidelines for its optimization in view of improving the functioning and management of the healthcare system in this field. Material and methods: The following research methods have been applied: 1. Document review method – research, processing and analysis of medical statistical information taken from data from WHO and annual reports of NRA. The study includes data from 2009 - 2015. 2. Graphical method – summarizing data in relevant tables and diagram presentations. Results: The article analyzes the condition of medical equipment in the field of oncologic and cardiologic medical aid in Bulgaria based on data taken from WHO (World Health Organization and annual reports of NRA (Nuclear Regulatory Agency. Six types of diagnostic imaging and radiation therapy devices have been studied: Magnetic Resonance Imaging units (MRI; Computed Tomography Scanners (CT, Positron Emission Tomography Scanners, Mammographs, Linear accelerators and Telecobalt units (Cobalt-60. The condition of medical equipment since 2009 has been analyzed, results have been reported and trends - studied. Conclusion: The oncologic and cardiologic medical equipment in Bulgaria has been gradually improving in the last seven years, but quantitative indicators regarding the devices studied are still far away from the figures recommended by WHO with one single exception, i.e. Computed Tomography Scanners.

  20. Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

    Directory of Open Access Journals (Sweden)

    Nkokone S Z Tema

    2015-05-01

    Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

  1. Patients' Data Management System Protected by Identity-Based Authentication and Key Exchange.

    Science.gov (United States)

    Rivero-García, Alexandra; Santos-González, Iván; Hernández-Goya, Candelaria; Caballero-Gil, Pino; Yung, Moti

    2017-03-31

    A secure and distributed framework for the management of patients' information in emergency and hospitalization services is proposed here in order to seek improvements in efficiency and security in this important area. In particular, confidentiality protection, mutual authentication, and automatic identification of patients are provided. The proposed system is based on two types of devices: Near Field Communication (NFC) wristbands assigned to patients, and mobile devices assigned to medical staff. Two other main elements of the system are an intermediate server to manage the involved data, and a second server with a private key generator to define the information required to protect communications. An identity-based authentication and key exchange scheme is essential to provide confidential communication and mutual authentication between the medical staff and the private key generator through an intermediate server. The identification of patients is carried out through a keyed-hash message authentication code. Thanks to the combination of the aforementioned tools, a secure alternative mobile health (mHealth) scheme for managing patients' data is defined for emergency and hospitalization services. Different parts of the proposed system have been implemented, including mobile application, intermediate server, private key generator and communication channels. Apart from that, several simulations have been performed, and, compared with the current system, significant improvements in efficiency have been observed.

  2. Small supermarket management system

    Institute of Scientific and Technical Information of China (English)

    曹正

    2016-01-01

    This system USES the Java language in the MyEclipse platform development tool, SQL2005 as the database platform for data and data, the SQL2005 required for the user operating system. It mainly implements the daily management of goods, including purchase management, inventory management, sales management, personnel management and supplier management. The system can also complete the functions of browsing, querying, adding, deleting and modifying relevant information. This topic is the core of the stock management, inventory management and sales management, at the same time, the system also has the full user management and permissions management function..

  3. Developing a dashboard for benchmarking the productivity of a medication therapy management program.

    Science.gov (United States)

    Umbreit, Audrey; Holm, Emily; Gander, Kelsey; Davis, Kelsie; Dittrich, Kristina; Jandl, Vanda; Odell, Laura; Sweeten, Perry

    To describe a method for internal benchmarking of medication therapy management (MTM) pharmacist activities. Multisite MTM pharmacist practices within an integrated health care system. MTM pharmacists are located within primary care clinics and provide medication management through collaborative practice. MTM pharmacist activity is grouped into 3 categories: direct patient care, nonvisit patient care, and professional activities. MTM pharmacist activities were tracked with the use of the computer-based application Pharmacist Ambulatory Resource Management System (PhARMS) over a 12-month period to measure growth during a time of expansion. A total of 81% of MTM pharmacist time was recorded. A total of 1655.1 hours (41%) was nonvisit patient care, 1185.2 hours (29%) was direct patient care, and 1190.4 hours (30%) was professional activities. The number of patient visits per month increased during the study period. There were 1496 direct patient care encounters documented. Of those, 1051 (70.2%) were face-to-face visits, 257 (17.2%) were by telephone, and 188 (12.6%) were chart reviews. Nonvisit patient care and professional activities also increased during the period. PhARMS reported MTM pharmacist activities and captured nonvisit patient care work not tracked elsewhere. Internal benchmarking data proved to be useful for justifying increases in MTM pharmacist personnel resources. Reviewing data helped to identify best practices from high-performing sites. Limitations include potential for self-reporting bias and lack of patient outcomes data. Implementing PhARMS facilitated internal benchmarking of patient care and nonpatient care activities in a regional MTM program. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  4. Medical equipment management through the use of radio frequency identification (RFID)

    OpenAIRE

    Sanchez, Joaquin A.; Nixon, Richard A.; Chávez, Sergio

    2004-01-01

    MBA Professional Report Approved for public release, distribution is unlimited The purpose of this MBA project is to identify the potential value of Radio Frequency Identification (RFID) use in the management of medical equipment at Naval Medical Center San Diego (NMCSD). In doing so, our project seeks to derive potential benefits through the use of RFID technology by comparing a group of medical equipment items that are tracked within NMCSD. The project includes a discussion of additio...

  5. Information Management of a Structured Admissions Interview Process in a Medical College with an Apple II System

    Science.gov (United States)

    O'Reilly, Robert; Fedorko, Steve; Nicholson, Nigel

    1983-01-01

    This paper describes a structured interview process for medical school admissions supported by an Apple II computer system which provides feedback to interviewers and the College admissions committee. Presented are the rationale for the system, the preliminary results of analysis of some of the interview data, and a brief description of the computer program and output. The present data show that the structured interview yields very high interrater reliability coefficients, is acceptable to the medical school faculty, and results in quantitative data useful in the admission process. The system continues in development at this time, a second year of data will be shortly available, and further refinements are being made to the computer program to enhance its utilization and exportability.

  6. Assessment of medical waste management in seven hospitals in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Olufunsho Awodele

    2016-03-01

    Full Text Available Abstract Background Medical waste (MW can be generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Lagos Waste Management Authority (LAWMA intervention programs. A descriptive cross-sectional survey method was used. Methods Data were collected using three instrument (questionnaire, site visitation and in –depth interview. Two public (hospital A, B and five private (hospital C, D, E, F and G which provide services for low, middle and high income earners were used. Data analysis was done with SPSS version 20. Chi-squared test was used to determine level of significance at p < 0.05. Results The majority 56 (53.3 % of the respondents were females with mean age of 35.46 (±1.66 years. The hospital surveyed, except hospital D, disposes both general and medical waste separately. All the facilities have the same process of managing their waste which is segregation, collection/on-site transportation, on-site storage and off–site transportation. Staff responsible for collecting medical waste uses mainly hand gloves as personal protective equipment. The intervention programs helped to ensure compliance and safety of the processes; all the hospitals employ the services of LAWMA for final waste disposal and treatment. Only hospital B offered on-site treatment of its waste (sharps only with an incinerator while LAWMA uses hydroclave to treat its wastes. There are no policies or guidelines in all investigated hospitals for managing waste. Conclusions An awareness of proper waste management amongst health workers has been created in most hospitals through the initiative of LAWMA. However, hospital D still mixes municipal and hazardous wastes. The treatment of waste

  7. SatCom Systems for Health and Medical Care

    Science.gov (United States)

    Diez, Hubert

    2002-01-01

    Convinced since 1997 that the satellite was capable of providing a real added value either autonomously or as a complement to terrestrial infrastructures, CNES (the French Space Agency) began a determined study, validation and demonstration procedure for new satellite services. At a national but also European and worldwide level, several experiments or projects have been set-up. In each of them (tele-consultations, distant education, tele-epidemiology, tele-echography, assistance to people, training and therapeutic assistance, disaster telemedicine, etc...) well suited satcoms are used. (telecommunications for broadcasting, multicasting, downloading,...- localization, positioning, - low medium and high data rate bidirectional systems,). Medical reference people are associated in each pilot projects first to define the needs but also to manage the medical validation aspects. Our aim is always to test, validate and adapt these new services to bring them into line with the users' expectations. The value added of these technologies in sustainable healthcare services are systematically demonstrated in real situations, with real users, both in terms of quality of service and of economic validity. For several projects CNES has developed typical hardware, or technical on as technical platform. The main projects and their relevant satcom systems will be presented and discussed : - Tele-consultation, - Distance learning and training, - Assistance to people, - Tele-epidemiology, - Disaster telemedicine.

  8. Development of Patient Status-Based Dynamic Access System for Medical Information Systems

    Directory of Open Access Journals (Sweden)

    Chang Won Jeong

    2015-06-01

    Full Text Available Recently, the hospital information system environment using IT communication technology and utilization of medical information has been increasing. In the medical field, the medical information system only supports the transfer of patient information to medical staff through an electronic health record, without information about patient status. Hence, it needs a method of real-time monitoring for the patient. Also, in this environment, a secure method in approaching healthcare through various smart devices is required. Therefore, in this paper, in order to classify the status of the patients, we propose a dynamic approach of the medical information system in a hospital information environment using the dynamic access control method. Also, we applied the symmetric method of AES (Advanced Encryption Standard. This was the best encryption algorithm for sending and receiving biological information. We can define usefulness as the dynamic access application service based on the final result of the proposed system. The proposed system is expected to provide a new solution for a convenient medical information system.

  9. Characterization and management of solid medical wastes in the ...

    African Journals Online (AJOL)

    Background: Medical establishment such as hospitals and research institutes generate sizable amount of hazardous waste. Health care workers, patients are at risk of acquiring infection from sharps and contamination of environment with multiple drug resistant microorganisms if wastes are not properly managed.

  10. Integration of the enterprise electronic health record and anesthesia information management systems.

    Science.gov (United States)

    Springman, Scott R

    2011-09-01

    Fewer than 5% of anesthesia departments use an electronic medical record (EMR) that is anesthesia specific. Many anesthesia information management systems (AIMS) have been developed with a focus only on the unique needs of anesthesia providers, without being fully integrated into other electronic health record components of the entire enterprise medical system. To understand why anesthesia providers should embrace health information technology (HIT) on a health system-wide basis, this article reviews recent HIT history and reviews HIT concepts. The author explores current developments in efforts to expand enterprise HIT, and the pros and cons of full enterprise integration with an AIMS. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. High-Fidelity Simulation: Preparing Dental Hygiene Students for Managing Medical Emergencies.

    Science.gov (United States)

    Bilich, Lisa A; Jackson, Sarah C; Bray, Brenda S; Willson, Megan N

    2015-09-01

    Medical emergencies can occur at any time in the dental office, so being prepared to properly manage the situation can be the difference between life and death. The entire dental team must be properly trained regarding all aspects of emergency management in the dental clinic. The aim of this study was to evaluate a new educational approach using a high-fidelity simulator to prepare dental hygiene students for medical emergencies. This study utilized high-fidelity simulation (HFS) to evaluate the abilities of junior dental hygiene students at Eastern Washington University to handle a medical emergency in the dental hygiene clinic. Students were given a medical emergency scenario requiring them to assess the emergency and implement life-saving protocols in a simulated "real-life" situation using a high-fidelity manikin. Retrospective data were collected for four years from the classes of 2010 through 2013 (N=114). The results indicated that learning with simulation was effective in helping the students identify the medical emergency in a timely manner, implement emergency procedures correctly, locate and correctly utilize contents of the emergency kit, administer appropriate intervention/treatment for a specific patient, and provide the patient with appropriate follow-up instructions. For dental hygiene programs seeking to enhance their curricula in the area of medical emergencies, this study suggests that HFS is an effective tool to prepare students to appropriately handle medical emergencies. Faculty calibration is essential to standardize simulation.

  12. How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System.

    Science.gov (United States)

    Gonzalo, Jed D; Dekhtyar, Michael; Hawkins, Richard E; Wolpaw, Daniel R

    2017-09-01

    As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education. In 2016, 32 U.S. medical schools in the American Medical Association's (AMA's) Accelerating Change in Education Consortium met for a two-day national meeting to explore value-added medical education; 121 educators, systems leaders, clinical mentors, AMA staff leadership and advisory board members, and medical students were included. A thematic qualitative analysis of workshop discussions and written responses was performed, which extracted key themes. In current clinical roles, students can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects. Novel value-added roles include students serving as patient navigators/health coaches, care transition facilitators, population health managers, and quality improvement team extenders. Six priority areas for advancing value-added roles are student engagement, skills, and assessments; balance of service versus learning; resources, logistics, and supervision; productivity/billing pressures; current health systems design and culture; and faculty factors. These findings provide a starting point for collaborative work to positively impact clinical care and medical education through the enhanced integration of value-added medical student roles into care delivery systems.

  13. Management of Holding and Evaluating Comprehensive System of Electronic Clinical Reasoning Exams (Sajab in the Sixth Nationwide Medical Sciences Students Olympiad

    Directory of Open Access Journals (Sweden)

    Manouchehr Khoshbaten

    2015-12-01

    Full Text Available Introduction: The Nationwide Medical Sciences Students purpose of the Olympiad is to discover student’s talents and encourage them to study. It seems that holding regional Olympiad exams to select students for the National Olympiad can help us to maintain fairness. The aim of this study is Management of Holding and Evaluating Clinical Reasoning Exams Using a Comprehensive System of Electronic Clinical Reasoning Exams. Methods: Study was carried out in 2013 at the University of Medical Sciences on 750 students, 250 question designers, 37 responsibles. The nationwide universities held regional exams for the Student Olympiad in the area of clinical reasoning on specific dates and times. A quality review of the exams was done to study the strengths and weaknesses and to eliminate shortcomings and problems. Therefore, a researcher created a questionnaire with a reliability of R= 0.86 and validity was confirmed by experts, which was then loaded into the system. The collected data were analyzed using SPSS and descriptive statistics (Percent, Average, standard deviation. Results: The multimedia educational quality of the system, with an average of 69.36 ±22.79, the students and faculty members evaluated as good, with averages of 64.30 ±23.48 and 67.28 ± 22.43, respectively. The quality of the exam was evaluated as excellent by faculty members, with an average of 94.63 ±16.60 and 59.52 ±27.46, by the students. Conclusion: Evaluating the quality of the system’s performance and its ability to assess students will lead to a clarification of its strengths and weaknesses. Finally, result in the creation of a high quality evaluation system.

  14. Guidelines for Management Information Systems in Canadian Health Care Facilities

    Science.gov (United States)

    Thompson, Larry E.

    1987-01-01

    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

  15. Using a Java Dynamic Tree to manage the terminology in a suite of medical applications.

    Science.gov (United States)

    Yang, K; Evens, M W; Trace, D A

    2008-01-01

    Now that the National Library of Medicine has made SNOMED-CT widely available, we are trying to manage the terminology of a whole suite of medical applications and map our terminology into that in SNOMED. This paper describes the design and implementation of the Java Dynamic Tree that provides structure to our medical terminology and explains how it functions as the core of our system. The tree was designed to reflect the stages in a patient interview, so it contains components for identifying the patient and the provider, a large set of chief complaints, review of systems, physical examination, several history modules, medications, laboratory tests, imaging, and special procedures. The tree is mirrored in a commercial DBMS, which also stores multi-encounter patient data, disorder patterns for our Bayesian diagnostic system, and the data and rules for other expert systems. The DBMS facilitates the import and export of large terminology files. Our Java Dynamic Tree allows the health care provider to view the entire terminology along with the structure that supports it, as well as the mechanism for the generation of progress notes and other documents, in terms of a single hierarchical structure. Changes in terminology can be propagated through the system under the control of the expert. The import/ export facility has been a major help by replacing our original terminology by the terminology in SNOMED-CT.

  16. Medical management of gastrinoma in a cat

    Directory of Open Access Journals (Sweden)

    Michael Lane

    2016-04-01

    Full Text Available Case summary A 7-year-old male castrated domestic short-haired cat was evaluated for a 4 week history of intermittent vomiting, ptyalism, lethargy and weight loss. Serum biochemistry revealed mild mixed hepatopathy. Abdominal ultrasonography identified multiple heterogeneous hepatic masses and a linear, hyperechoic focus with associated reverberation artifact in the wall of the stomach consistent with a gastric ulcer. Serum gastrin concentrations were markedly increased. Cytologic interpretation of a fine-needle aspirate of the hepatic masses was consistent with neuroendocrine neoplasia, and a diagnosis of gastrinoma was established. Deterioration of the cat’s condition, despite at-home acid-suppressant therapy, led to hospitalization. The cat was initially stabilized with intravenous crystalloid fluid therapy, maropitant, pantoprazole and octreotide. A continuous radiotelemetric intragastric pH monitoring system was used to monitor the response of intragastric pH to therapy. Long-term therapy was continued with omeprazole (orally q12h, octreotide (subcutaneously q8h and thrice-weekly toceranib administered orally. Toceranib therapy led to gastrointestinal upset and was discontinued. Gastric ulceration resolved within 8 weeks, and palliation of clinical signs was achieved for approximately 5 months. Relevance and novel information Including this report, only six cases of feline gastrinoma have been reported in the veterinary literature. Little is known regarding non-surgical therapy, and octreotide has not been previously reported for medical management of feline gastrinoma. Results of intragastric pH monitoring and clinical improvement suggest that medical therapy using octreotide and proton pump inhibitors represents a novel therapeutic option for cats with gastrinoma where surgical excision is not feasible.

  17. System theory in medical diagnostic devices: an overview.

    Science.gov (United States)

    Baura, Gail D

    2006-01-01

    Medical diagnostics refers to testing conducted either in vitro or in vivo to provide critical health care information for risk assessment, early diagnosis, treatment, or disease management. Typical in vivo diagnostic tests include the computed tomography scan, magnetic resonance imaging, and blood pressure screening. Typical in vitro diagnostic tests include cholesterol, Papanicolaou smear, and conventional glucose monitoring tests. Historically, devices associated with both types of diagnostics have used heuristic curve fitting during signal analysis. However, since the early 1990s, a few enterprising engineers and physicians have used system theory to improve their core processing for feature detection and system identification. Current applications include automated Pap smear screening for detection of cervical cancer and diagnosis of Alzheimer's disease. Future applications, such as disease prediction before symptom onset and drug treatment customization, have been catalyzed by the Human Genome Project.

  18. An Approach to Management of Health Care and Medical Diagnosis Using of a Hybrid Disease Diagnosis System

    Directory of Open Access Journals (Sweden)

    Hodjat Hamidi

    2017-02-01

    Full Text Available Introduction: In order to simplify the information exchange within the medical diagnosis process, a collaborative software agent’s framework is presented. The purpose of the framework is to allow the automated information exchange between different medicine specialists. Methods: This study presented architecture of a hybrid disease diagnosis system. The architecture employed a learning algorithm and used soft computing to build a medical knowledge base. These machine intelligences are combined in a complementary approach to overcome the weakness of each other. To evaluate the hybrid learning algorithm and compare it with other methods, 699 samples were used in each experiment, where 60% was for training, 20% was for cross validation, and 20% for testing. Results: The results were obtained from the experiments on the breast cancer dataset. Different methods of soft computing system were merged to create diagnostic software functionality. As it is shown in the structure, the system has the ability to learn and collect knowledge that can be used in the detection of new images. Currently, the system is at the design stage. The system is to evaluate the performance of hybrid learning algorithm. The preliminary results showed a better performance of this system than other methods. However, the results can be tested with hybrid system on larger data sets to improve hybrid learning algorithm. Conclusion: The purpose of this paper was to simplify the diagnosis process of a patient by splitting the medical domain concepts (e.g., causes, effects, symptoms, tests in human body systems (e.g., respiratory, cardiovascular, though maintaining the holistic perspective through the links between common concepts.

  19. Relationship Between Cybernetics Management and Organizational Trust Among Librarians of Mazandaran University of Medical Sciences.

    Science.gov (United States)

    Ghiasi, Mitra; Shahrabi, Afsaneh; Siamian, Hasan

    2017-12-01

    Organization must keep current skills, abilities, and in the current field of competition, and move one step ahead of other competitors; for this purpose, must be a high degree of trust inside the organization. Cybernetic management is a new approach in management of organizations that its main task according to internal issues. This study aimed to investigate the relationship between cybernetics management and organizational trust among librarians of Mazandaran University of Medical Sciences. This is applied and analytical survey. which its population included all librarians of Mazandaran University of Medical Sciences, amounting to 42 people which were selected by census and participated in this research. There has no relationship between components of Cybernetics management (participative decision making, commitment, pay equity, Correct flow of information, develop a sense of ownership, online education) with organizational trust amongst librarians of Mazandaran University of Medical Sciences. And there has a significant relationship between flat Structure of cybernetics management and organizational trust. For data analysis was used Kolmogorov-Smirnov test and linear regression. There is no significant relationship between Cybernetic management and organizational trust amongst librarians of Mazandaran University of Medical Sciences.

  20. Creating an effective system of quality management in health care organizations through the implementation of technology lean production

    Directory of Open Access Journals (Sweden)

    M. A. Gurina

    2017-01-01

    Full Text Available In the conditions of changing management paradigm in the public sphere, strengthening political, economic, social and technological risks on the part of stakeholders of medical organizations, there is a need to create an effective quality management system based on the technology of lean production. This system is aimed at increasing the satisfaction of consumers of medical services, reducing the labor losses of medical personnel, improving the quality and productivity of labor in medical organizations. The use of lin-production in the framework of pilot projects implemented in Russia for the last three years shows significant advantages in the work of medical organizations in comparison with traditional approaches in the organization of the provision of services by polyclinics. In the article, step-by-step organization of the work on creating a thrifty polyclinic is considered.

  1. Medical Management of Acute Radiation Syndromes : Immunoprophylaxis by Antiradiation Vaccine

    Science.gov (United States)

    Popov, Dmitri; Maliev, Vecheslav; Jones, Jeffrey; Casey, Rachael; Kedar, Prasad

    Introduction: Traditionally, the treatment of Acute Radiation Syndrome (ARS) includes supportive therapy, cytokine therapy, blood component transfusions and even stem cell transplantation. Recommendations for ARS treatment are based on clinical symptoms, laboratory results, radiation exposure doses and information received from medical examinations. However, the current medical management of ARS does not include immune prophylaxis based on antiradiation vaccines or immune therapy with hyperimmune antiradiation serum. Immuneprophylaxis of ARS could result from stimulating the immune system via immunization with small doses of radiation toxins (Specific Radiation Determinants-SRD) that possess significant immuno-stimulatory properties. Methods: Principles of immuno-toxicology were used to derive this method of immune prophylaxis. An antiradiation vaccine containing a mixture of Hematotoxic, Neurotoxic and Non-bacterial (GI) radiation toxins, underwent modification into a toxoid forms of the original SRD radiation toxins. The vaccine was administered to animals at different times prior to irradiation. The animals were subjected to lethal doses of radiation that induced different forms of ARS at LD 100/30. Survival rates and clinical symptoms were observed in both control and vaccine-treated animals. Results: Vaccination with non-toxic doses of Radiation toxoids induced immunity from the elaborated Specific Radiation Determinant (SRD) toxins. Neutralization of radiation toxins by specific antiradiation antibodies resulted in significantly improved clinical symptoms in the severe forms of ARS and observed survival rates of 60-80% in animals subjected to lethal doses of radiation expected to induce different forms of ARS at LD 100/30. The most effective vaccination schedule for the antiradiation vaccine consisted of repeated injections 24 and 34 days before irradiation. The vaccine remained effective for the next two years, although the specific immune memory probably

  2. Prospective memory in schizophrenia: relationship to medication management skills, neurocognition, and symptoms in individuals with schizophrenia.

    Science.gov (United States)

    Raskin, Sarah A; Maye, Jacqueline; Rogers, Alexandra; Correll, David; Zamroziewicz, Marta; Kurtz, Matthew

    2014-05-01

    Impaired adherence to medication regimens is a serious concern for individuals with schizophrenia linked to relapse and poorer outcomes. One possible reason for poor adherence to medication is poor ability to remember future intentions, labeled prospective memory skills. It has been demonstrated in several studies that individuals with schizophrenia have impairments in prospective memory that are linked to everyday life skills. However, there have been no studies, to our knowledge, examining the relationship of a clinical measure of prospective memory to medication management skills, a key element of successful adherence. In this Study 41 individuals with schizophrenia and 25 healthy adults were administered a standardized test battery that included measures of prospective memory, medication management skills, neurocognition, and symptoms. Individuals with schizophrenia demonstrated impairments in prospective memory (both time and event-based) relative to healthy controls. Performance on the test of prospective memory was correlated with the standardized measure of medication management in individuals with schizophrenia. Moreover, the test of prospective memory predicted skills in medication adherence even after measures of neurocognition were accounted for. This suggests that prospective memory may play a key role in medication management skills and thus should be a target of cognitive remediation programs.

  3. A systems approach to the management of radiation accidents

    International Nuclear Information System (INIS)

    Richter, L.L.; Berk, H.W.; Teates, C.D.; Larkham, N.E.; Friesen, E.J.; Edlich, R.F.

    1980-01-01

    Management of radiation accident patients should have a multidisciplinary approach that includes all health professionals as well as members of public safety agencies. Emergency plans for radiation accidents include detection of the ionizing radiation, patient evacuation, resuscitation, and decontamination. The resuscitated patient should be transported to a radiation control area located outside but adjacent to the emergency department. Ideally this area is accessed through an entrance separate from that used for the main flow of daily emergency department patients. The hospital staff, provided with protective clothing, dosimeters, and preprinted guidelines, continues the resuscitation and definitive care of the patient. This system approach to the management of radiation accidents may be tailored to meet the specific needs of other emergency medical systems

  4. Implementation of a web-based tool for patient medication self-management: the Medication Self-titration Evaluation Programme (Med-STEP for blood pressure control

    Directory of Open Access Journals (Sweden)

    Richard W Grant

    2013-12-01

    Full Text Available Background Informatics tools may help support hypertension management.Objective To design, implement and evaluate a web-based system for patient anti-hypertensive medication self-titration.Methods Study stages included: six focus groups (50 patients to identify barriers/facilitators to patient medication self-titration, software design informed by qualitative analysis of focus group responses and a six-month single-arm pilot study (20 patients to assess implementation feasibility.Results Focus groups emphasised patient need to feel confident that their own primary care providers were directly involved and approved of the titration protocol. Physicians required 3.3 ± 2.8 minutes/patient to create individualised six-step medication pathways for once-monthly blood pressure evaluations. Pilot participants (mean age of 51.5 ± 11 years, 45% women, mean baseline blood pressure 139/84 ± 12.2/7.5 mmHg had five medication increases, two non-adherence self-reports, 52months not requiring medication changes, 24 skipped months and 17 months with no evaluations due to technical issues. Four pilot patients dropped out before study completion. From baseline to study completion, blood pressure decreased among the 16 patients remaining in the study (8.0/4.7 mmHg, p = 0.03 for both systolic and diastolic pressures.Conclusions Lessons learned included the benefit of qualitative patient analysis prior to system development and the feasibility of physicians designing individual treatment pathways. Any potential clinical benefits were offset by technical problems, the tendency for patients to skip their monthly self-evaluations and drop outs. To be more widely adopted such systems must effectively generalise to a wider range of patients and be integrated into clinical workflow.

  5. Near field communications technology and the potential to reduce medication errors through multidisciplinary application

    LENUS (Irish Health Repository)

    O’Connell, Emer

    2016-07-01

    Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems.

  6. Hospital Information System and its Role in the Development of Medical and Health Services: A Review Article

    Directory of Open Access Journals (Sweden)

    Hosein Vakili Mofrad

    2012-12-01

    Full Text Available Increasing growth of communication industries and informatics, cause the world is facing with a new revolution. Revolution of information and communication technologies in all sectors of the economy, society, politic and security of countries has left a significant effect. One of the most important application areas of information technology is the field of health and treatment. Hospital information system is the first and most important system of health care delivery. Hospital information systems are the computer systems that are easy to manage medicine and hospital management information and are designed to improve health care. Investigations have shown that using a hospital information system caused to improve quality of health care and increase satisfaction of clients. Some problems of the health care system are distribution of patients’ information and Lack of access to their records, Weak cooperation between physicians and health care workers, and also weakness of access to necessary medical information. These problems are solvable through the development of information technology and especially hospital (Health information systems. This paper studies the hospital information systems, implementation of these systems and their role in the development of medical and health services.

  7. Impact of a medication therapy management intervention targeting medications associated with falling: Results of a pilot study.

    Science.gov (United States)

    Mott, David A; Martin, Beth; Breslow, Robert; Michaels, Barb; Kirchner, Jeff; Mahoney, Jane; Margolis, Amanda

    2016-01-01

    The use of fall risk-increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed. The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults. Randomized, controlled trial. One community pharmacy. Eighty older adults who completed a fall prevention workshop. The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers. Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  8. Implementing a Social Knowledge Networking (SKN) system to enable meaningful use of an EHR medication reconciliation system.

    Science.gov (United States)

    Rangachari, Pavani

    2018-01-01

    Despite the regulatory impetus toward meaningful use of electronic health record (EHR) Medication Reconciliation (MedRec) to prevent medication errors during care transitions, hospital adherence has lagged for one chief reason: low physician engagement, stemming from lack of consensus about which physician is responsible for managing a patient's medication list. In October 2016, Augusta University received a 2-year grant from the Agency for Healthcare Research and Quality to implement a Social Knowledge Networking (SKN) system for enabling its health system (AU Health) to progress from "limited use" of EHR MedRec technology to "meaningful use." The hypothesis is that SKN would bring together a diverse group of practitioners, to facilitate tacit knowledge exchange on issues related to EHR MedRec, which in turn is expected to increase practitioners' engagement in addressing those issues and enable meaningful use of EHR. The specific aims are to examine: 1) user-engagement in the SKN system, and 2) associations between "SKN use" and "meaningful use" of EHR. The 2-year project uses an exploratory mixed-method design and consists of three phases: 1) development; 2) SKN implementation; and 3) analysis. Phase 1, completed in May 2017, sought to identify a comprehensive set of issues related to EHR MedRec from practitioners directly involved in the MedRec process. This process facilitated development of a "Reporting Tool" on issues related to EHR MedRec, which, along with an existing "SKN/Discussion Tool," was integrated into the EHR at AU Health. Phase 2 (launched in June 2017) involves implementing the EHR-integrated SKN system over a 52-week period in inpatient and outpatient medicine units. The prospective implementation design is expected to generate context-sensitive strategies for meaningful use and successful implementation of EHR MedRec and thereby make substantial contributions to the patient safety and risk management literature. From a health care policy

  9. New Management Tools – From Video Management Systems to Business Decision Systems

    Directory of Open Access Journals (Sweden)

    Emilian Cristian IRIMESCU

    2015-06-01

    Full Text Available In the last decades management was characterized by the increased use of Business Decision Systems, also called Decision Support Systems. More than that, systems that were until now used in a traditional way, for some simple activities (like security, migrated to the decision area of management. Some examples are the Video Management Systems from the physical security activity. This article will underline the way Video Management Systems passed to Business Decision Systems, which are the advantages of use thereof and which are the trends in this industry. The article will also analyze if at this moment Video Management Systems are real Business Decision Systems or if there are some functions missing to rank them at this level.

  10. Integration of QR codes into an anesthesia information management system for resident case log management.

    Science.gov (United States)

    Avidan, Alexander; Weissman, Charles; Levin, Phillip D

    2015-04-01

    Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Contribution of Electronic Medical Records to the Management of Rare Diseases

    Directory of Open Access Journals (Sweden)

    Dominique Bremond-Gignac

    2015-01-01

    Full Text Available Purpose. Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients’ data with ophthalmology-specific EMR. Methods. Ophthalmology-specific EMR software (Softalmo software Corilus was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. Results. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. Discussion. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Conclusion. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

  12. Contribution of Electronic Medical Records to the Management of Rare Diseases.

    Science.gov (United States)

    Bremond-Gignac, Dominique; Lewandowski, Elisabeth; Copin, Henri

    2015-01-01

    Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

  13. [Sociocultural and medical management of hypertension in sub-Saharan Africa].

    Science.gov (United States)

    Lafay, V; Fourcade, L; Bertrand, E

    2014-01-01

    Hypertension has now become very prevalent in sub-Saharan Africa, in part due to the region's epidemiologic transition. Its long asymptomatic onset explains its late recognition and thus the high frequency of complications. Sociocultural conditions play an important role in the genesis of the disease in this region and in the difficulties encountered in its management. The breakdown of traditional ways of life, growing urbanization, and the switch to a western lifestyle and diet all have well-known deleterious effects on the cardiovascular system. High salt consumption, sedentarity, overweight and alcohol intake all promote these developments. The insufficient availability of medical care, poverty, and poor understanding of chronic diseases complicate the medical management of hypertension. In these regions, it is now a public health challenge that requires the training of healthcare workers and the involvement of the society as a whole, including political decisions, health education for school-children, and actions by social organizations and local officials and leaders. This communication must always respect traditional customs. Both curative measures and preventive actions are essential. Priority must be given to combatting excessive salt consumption, for the results of its reduction are known to be rapid and positive. Preventing or reducing overweight and obesity, sedentarity, and alcohol and tobacco consumption are effective steps against hypertension, but also atheromatous cardiovascular diseases and diabetes. Drug therapy must meet the three essential criteria: it must be effective, available, and inexpensive. Hypertension is not inevitable, but reflects changes in society. It appears to be transmitted in part by modern lifestyles, which can be modified.

  14. Leadership and management in UK medical school curricula.

    Science.gov (United States)

    Jefferies, Richard; Sheriff, Ibrahim H N; Matthews, Jacob H; Jagger, Olivia; Curtis, Sarah; Lees, Peter; Spurgeon, Peter C; Fountain, Daniel Mark; Oldman, Alex; Habib, Ali; Saied, Azam; Court, Jessica; Giannoudi, Marilena; Sayma, Meelad; Ward, Nicholas; Cork, Nick; Olatokun, Olamide; Devine, Oliver; O'Connell, Paul; Carr, Phoebe; Kotronias, Rafail Angelos; Gardiner, Rebecca; Buckle, Rory T; Thomson, Ross J; Williams, Sarah; Nicholson, Simon J; Goga, Usman

    2016-10-10

    Purpose Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues. Design/methodology/approach This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement. Findings Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods. Research limitations/implications There is widespread inclusion of MLM in UK medical schools' curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students' desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these. Originality/value This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.

  15. Managing complex therapies outside hospitals. An analysis of GPs practices of how to support medication at home.

    Science.gov (United States)

    Piras, Enrico Maria; Miele, Francesco; Bruni, Attila; Coletta, Claudio; Zanutto, Alberto

    2014-01-01

    Support systems for the management of prescriptions are commonplace in hospitals, whilst they are rarely found in general practice. This exploratory study draws on a qualitative survey conducted with focus groups to investigate the information needs of General Practitioners (GPs) in regard to the therapeutic management of complex patients, the purpose being to identify possible areas of application. The question addressed is whether the systems existing in hospitals can be usefully adapted and used by GPs or if a different approach needs to be adopted to design other tools. The analysis shows that the information needs of GPs relative to medication management are significantly different from those of their hospital colleagues because the former are not directly responsible for the administration but instead operate within a care network on which they cannot exercise direct control. This study suggests that support systems for therapy management should be designed on the assumption that it derives from cooperative work by a heterogeneous network of actors, and therefore with functionalities intended to satisfy the coordination needs of all the actors involved in the process.

  16. The practice and effect of combined duty of administrative management, medical treatment and nursing

    Directory of Open Access Journals (Sweden)

    Min HU

    2014-09-01

    Full Text Available Objective: To explore the effect of combined duty mode on discovery and control of medical nursing hidden trouble. Method: In order to make sure that patients are in the first place, we should take the mode of combined duty of administrative management, medical treatment and nursing. Results:The incidence of nursing errors and defects reduced, and patients’ satisfaction improved. the differences were statistically significant (P<0.01 or P<0.05.Results: Combined duty can the reduce medical nursing defects, improve the efficiency of quality health care services and the management efficiency.

  17. 20 CFR 405.10 - Medical and Vocational Expert System.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical and Vocational Expert System. 405.10... Vocational Expert System. (a) General. The Medical and Vocational Expert System is comprised of the Medical... Vocational Expert System. (3) Experts who provide evidence at your request. Experts whom you ask to provide...

  18. Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.

    Science.gov (United States)

    Crowley, Matthew J; Edelman, David; Voils, Corrine I; Maciejewski, Matthew L; Coffman, Cynthia J; Jeffreys, Amy S; Turner, Marsha J; Gaillard, Leslie A; Hinton, Teresa A; Strawbridge, Elizabeth; Zervakis, Jennifer; Barton, Anna Beth; Yancy, William S

    2017-07-01

    Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. We describe the rationale and design for a study evaluating a novel SMA intervention for diabetes that primarily emphasizes low-carbohydrate diet-focused weight management. Jump Starting Shared Medical Appointments for Diabetes with Weight Management (Jump Start) is a randomized, controlled trial that is allocating overweight Veterans (body mass index≥27kg/m 2 ) with type 2 diabetes into two arms: 1) a traditional SMA group focusing on medication management and self-management counseling; or 2) an SMA group that combines low-carbohydrate diet-focused weight management (WM/SMA) with medication management. Hemoglobin A1c reduction at 48weeks is the primary outcome. Secondary outcomes include hypoglycemic events, diabetes medication use, weight, medication adherence, diabetes-related quality of life, and cost-effectiveness. We hypothesize that WM/SMA will be non-inferior to standard SMA for glycemic control, and will reduce hypoglycemia, diabetes medication use, and weight relative to standard SMA, while also improving quality of life and costs. Jump Start targets two common problems that are closely related but infrequently managed together: diabetes and obesity. By focusing on diet and weight loss as the primary means to control diabetes, this intervention may improve several meaningful patient-centered outcomes related to diabetes. Copyright © 2017. Published by Elsevier Inc.

  19. Training in trauma management: the role of simulation-based medical education.

    Science.gov (United States)

    Berkenstadt, Haim; Ben-Menachem, Erez; Simon, Daniel; Ziv, Amitai

    2013-03-01

    Simulation-based medical education (SBME) offers a safe and "mistake-forgiving" environment to teach and train medical professionals. The diverse range of medical-simulation modalities enables trainees to acquire and practice an array of tasks and skills. SBME offers the field of trauma training multiple opportunities to enhance the effectiveness of the education provided in this challenging domain. Further research is needed to better learn the role of simulation-based learning in trauma management and education. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Defense Systems Management Review. Volume 3, Number 2, Spring 1980. Managing the Process.

    Science.gov (United States)

    1980-01-01

    and no one did. As a result, many literally curled up and died, and for no known medical reason. Major Mayer ended a lecture on the subject with a plea...November 6, 1978. 10. Fred E. Rosell, Jr., "’ rip Report-Visit to Defense Documentation Center (DDC), May 16, 1978," Defense Systems Management College...easily expandable to splits among three or more producers. To do this for three companies, you must determine the split between Companies A and B as a