Optimization of the intravenous infusion workflow in the isolation ward for patients with coronavirus disease 2019

ObjectiveThis study aimed to evaluate the effect of optimization of the intravenous infusion workflow in isolation wards for patients with coronavirus disease 2019.MethodsThe infusion management group optimized the intravenous infusion workflow based on Hamer’s Process Reengineering Theory and applied it to the treatment of patients with coronavirus disease 2019. The work efficiency, patients’ satisfaction and economic indicators before and after optimization were compared.ResultsAfter the infusion workflow was optimized, average times for preparation drugs and intravenous admixture, and patients’ waiting time decreased from 4.84 min, 4.03 min, and 34.33 min to 3.50 min, 2.60 min, and 30.87 min, respectively, patients’ satisfaction increased from 66.7% to 93.3%, and the cost of personal protective equipment (PPE) decreased from 46.67 sets and 186.6 CNY per day to 36.17 sets and 144.6 CNY, with statistical significance.ConclusionThe optimization of the intravenous infusion workflow can effectively decrease the cost of PPE while improving the efficiency of infusion and patients’ satisfaction.     

Workflow interruptions,social stressors from supervisor(s) and attention failure in surgery personnel

Workflow interruptions and social stressors among surgery personnel may cause attention failure at work that may increase rumination about work issues during leisure time. The test of these assumptions should contribute to the understanding of exhaustion in surgery personnel and patient safety. Workflow interruptions and supervisor-related social stressors were tested to predict attention failure that predicts work-related rumination during leisure time. One hundred ninety-four theatre nurses, anaesthetists and surgeons from a Swiss University hospital participated in a cross-sectional survey. The participation rate was 58%. Structural equation modelling confirmed both indirect paths from workflow interruptions and social stressors via attention failure on rumination (both p<0.05). An alternative model, assuming the reversed indirect causation—from attention failure via workflow interruptions and social stressors on rumination—could not be empirically supported. Workflow interruptions and social stressors at work are likely to trigger attention failure in surgery personnel. Work redesign and team intervention could help surgery personnel to maintain a high level of quality and patient safety and detach from work related issues to recover during leisure time.     

Characterizing workflow for pediatric asthma patients in emergency departments using electronic health records

ObjectiveThe purpose of this study was to describe a workflow analysis approach and apply it in emergency departments (EDs) using data extracted from the electronic health record (EHR) system.Materials and MethodsWe used data that were obtained during 2013 from the ED of a children’s hospital and its four satellite EDs. Workflow-related data were extracted for all patient visits with either a primary or secondary diagnosis on discharge of asthma (ICD-9 code = 493). For each patient visit, eight different a priori time-stamped events were identified. Data were also collected on mode of arrival, patient demographics, triage score (i.e. acuity level), and primary/secondary diagnosis. Comparison groups were by acuity levels 2 and 3 with 2 being more acute than 3, arrival mode (ambulance versus walk-in), and site. Data were analyzed using a visualization method and Markov Chains.ResultsTo demonstrate the viability and benefit of the approach, patient care workflows were visually and quantitatively compared. The analysis of the EHR data allowed for exploration of workflow patterns and variation across groups. Results suggest that workflow was different for different arrival modes, settings and acuity levels.DiscussionEHRs can be used to explore workflow with statistical and visual analytics techniques novel to the health care setting. The results generated by the proposed approach could be utilized to help institutions identify workflow issues, plan for varied workflows and ultimately improve efficiency in caring for diverse patient groups.ConclusionEHR data and novel analytic techniques in health care can expand our understanding of workflow in both large and small ED units.     

应用卫生统计学方法优化病案信息管理工作流程

在分析病案信息管理的重要性与卫生统计学应用价值的基础上,提出将二者相结合,从统计方法设计、统计结果信息反馈等方面优化病案信息管理工作流程,从而提高医院对病案的管理水平和工作效率。     

基于Petri网的医用材料采购流程工作流建模分析

目的：在医用材料采购过程中合理设计、优化其各个环节,合理解决采购流程工作流建模所需要的资源配置问题。方法：在对当前工作流中的主要路由模型分析的基础上,结合Petri网的结构、形式化定义和流程建模方法,建立从工作流到Petri网的路由映射模型。结果：采用基于Petri网的工作流技术对医用材料采购流程进行工作流建模,并提出了一种工作流合理性验证算法和工作流的优化算法。结论：基于Petri网的工作流建模方法具有直观、简洁及实用等优点,可为医用材料采购软件的开发提供很好的理论支持。     

Selection and Implementation of New Information Systems

The single most important element to consider when evaluating clinical information systems for a practice is workflow. Workflow can be broadly defined as an orchestrated and repeatable pattern of business activity enabled by the systematic organization of resources into processes that transform materials, provide services, or process information.     

An optimization based on simulation approach to the patient admission scheduling problem using a linear programing algorithm

BackgroundAs patient’s length of stay in waiting lists increases, governments are looking for strategies to control the problem. Agreements were created with private providers to diminish the workload in the public sector. However, the growth of the private sector is not following the demand for care. Given this context, new management strategies have to be considered in order to minimize patient length of stay in waiting lists while reducing the costs and increasing (or at least maintaining) the quality of care.MethodAppointment scheduling systems are today known to be proficient in the optimization of health care services. Their utilization is focused on increasing the usage of human resources, medical equipment and reducing the patient waiting times. In this paper, a simulation-based optimization approach to the Patient Admission Scheduling Problem is presented. Modeling tools and simulation techniques are used in the optimization of a diagnostic imaging department.ResultsThe proposed techniques have demonstrated to be effective in the evaluation of diagnostic imaging workflows. A simulated annealing algorithm was used to optimize the patient admission sequence towards minimizing the total completion and total waiting of patients. The obtained results showed average reductions of 5% on the total completion and 38% on the patients’ total waiting time.