Overcoming challenges in implementing measures across multiple centers of a chain of hospitals to combat COVID-19 pandemic

Purpose:Coronavirus outbreak was first reported towards the end of 2019 and has now been declared a pandemic by the World Health Organization. Post declaration, India announced lockdown and various guidelines were issued by Health authorities worldwide for the organizations to function in this emergency aeon. Different organizations strategized differently to respond to COVID 19 pandemic. The aim was to implement COVID 19 guidelines across all the centres of a chain of Eye hospitals in India in short span of time overcoming the challenges.Methods:A SMART strategy was confabulated within the team. There were numerous challenges like lack of time, rapidly changing guidelines, no travelling scenarios, training and educating the staff in huge numbers, rapidly evolving situation, change management, need of increased vigilance, and language barrier at certain centres, sustaining quality assurance and motivating the staff in stressful times. The challenges were surpassed using a power packed strategy, dedicated efforts and team work grasping the available tools and technology from a single location. This template can serve us and other hospitals to respond in a better way for similar future challenges.Results:The COVID 19 protocols were implemented across all the centres successfully. The entire Quality assurance system drifted to online platform and education and awareness methods took the digital thread. Teamwork synergized with the aforementioned things and we came out with flying colours achieving the goals in short span of time overcoming all the barriers.Conclusion:Difficult times bring challenges and challenges teach us the innovative ways to convert them into opportunities. A well planned strategy, best utilization of available resources, team work and continuous monitoring can bring the best outcomes forward.     

企业医院面临的挑战及发展思路

目的针对企业医院面临改制分离的现实，探讨今后发展的方向。方法分析面对挑战的五个不利因素和对医院今后发展进行了八条思路的论述。结果将在现实工作中进一步探索、实施和完善。结论处在困境中的企业医院，应在国家宏观卫生政策的指导下，在激烈的医疗市场竞争中运用各种竞争战略，增强医院的社会服务能力和自我生存能力。     

新世纪医院面临的挑战与对策

作者首先阐述了新世纪医院面临的挑战：一是社会保障制度改革对医院的影响；二是中国加入WTO后对我国医院产生的影响；三是人们需求多样性对医院建设的影响。其次提出了新世纪医院的发展策略；（1）树立新的理念；（2）强化四个意识，即管理意识、竞争意识、服务意识、创新意识；（3）医院建设要注重系统性，即以市场和战场为导向调整学科布局，适应市场需求抓好人才队伍建设，以新的质量观抓医疗质量建设；（4）建立灵活高效的管理机制，即建立快速高效的决策程序、建立以人为本的管理机制、以市场经济的规则改革分配机制，政府对非营利性医院要解决资金补偿问题。     

Transitioning through a Bachelor of Nursing program: The enrolled nurse experience

ProblemA lack of understanding of the challenges that Enrolled Nurses experience as they transition to Registered Nurse may prevent the development of resources and strategies necessary to ensure their success in the program.QuestionWhat are the experiences of nursing students who are enrolled in a Bachelor of Nursing program as they transition from Enrolled Nurse to Registered Nurse?MethodsA qualitative interpretive approach, influenced by phenomenology and underpinned by Schlossberg’s Transition theory, was used in this study. Data was collected from Enrolled Nurses (n = 7) using individual interviews and enriched with additional context from a focus group of nursing academics (n = 4).FindingsFive themes were identified: ‘Standing out from the crowd’, ‘struggling with the academic demands’, ‘seeking personal and professional balance’, ‘moving beyond the constraints of being an EN’ and ‘growing within the program’.DiscussionThe challenges experienced by the Enrolled Nurses, such as adapting to the requirements of the tertiary program and balancing study with their other life responsibilities, were identified as being exacerbated by the 12 months of advanced standing that they receive. Strategies to overcome these challenges included accessing academic and personal resources. Success within the program was discussed by these students as empowering their personal and professional lives.ConclusionThe challenges the Enrolled Nurses encountered and strategies they employed to succeed in the program are identified in this study. Recommendations to improve the transition of Enrolled Nurses through a Bachelor of Nursing program are proposed.     

我国基层卫生人才队伍建设的进展与挑战

近年来,国家和各地积极采取措施,加强基层医疗卫生人才队伍建设。以基层医疗卫生人才支持计划为抓手,将强化基层作为今后卫生人才工作的指导原则和重要任务,基层卫生人才培养开发、评价使用、流动配置以及激励保障机制不断创新,基层卫生人才发展的政策环境逐步得到完善。同时,我国基层卫生人才队伍建设的任务依然十分艰巨,需要进一步完善政策,通过项目和工程,加强吸引和稳定基层卫生人才队伍。     

Applications and Challenges for the Use of Phosphatidylethanol Testing in Liver Disease Patients (Mini Review)

Phosphatidylethanol (PEth) is a direct nonoxidative metabolite of ethanol that may be measured in clinical samples as a marker for monitoring alcohol consumption. It has been used in a wide variety of clinical and nonclinical settings; however, its investigation in relation to liver disease has been limited. This study aims at providing a short review on the applications and challenges for the incorporation of PEth testing in identifying alcohol intake in this patient population.     

Applications,opportunities, and challenges in using Telehealth for burn injury management: A systematic review

IntroductionBurns are global public health devastating and life-threatening injuries. Telehealth can be an appropriate answer for the effective utilization of health care resources, prevention referrals and reduce socio-economic burden of burns injuries. Thus, this study aimed to systematically evaluate the applications, opportunities, and challenges of using telehealth in burn injuries management.MethodsA structured search was conducted according to PRISMA statement guidelines in the Web of Science, PubMed, Scopus, and Science Direct as well as the Google Scholar for studies published until June 28, 2022. Of the total 2301 yielded studies, 36 articles were included in the final review. Quality appraisal was done according to the Mixed Methods Appraisal Tool (MMAT) version 2018. Thematic analysis was applied for data analysis.ResultsPatient triage, transfer, and referral (38.9%) follow-up (22%), care (22%), consultation (9%), education (3%), and rehabilitation (3%) were the most prevalent application of telehealth, respectively. Our findings identified 72 unique concepts, eight initial themes, and two clinical and administrative final themes for opportunities of using telehealth in burn injury management. Furthermore, we identified 27 unique concepts, three initial themes, and two clinical and administrative final themes for remaining challenges.ConclusionsDespite providing pivotal opportunities such as improving burn injury diagnosis and quality of care, increasing patient and provider satisfaction, and cost containment using telehealth in burn injuries management, the concept faces challenges such as the impossibility of the physical examination of patients and technological difficulties. Our findings provide valuable information for policymakers and decision-makers infield of burn injuries and effective planning for using telehealth technology.     

我国全科医学发展的现状与挑战

培养大批合格全科医生、推进分级诊疗制度是深化医药卫生体制改革，实施“健康中国战略”的关键举措。历经30年发展，我国全科医学在人才队伍建设、培养体系建立、服务模式探索、科学研究开展等方面取得显著成效。但我国全科医学事业起步晚、基础差，目前仍面临人才数量与质量有待提升、师资队伍与培养模式有待优化、分级诊疗制度落实不到位、科研项目申请渠道不畅通、职业吸引力低下等挑战。建议多措并举使全科医生培养量质齐增，舆论引导转换大众就医观念，增设全科医学科研专项拓宽科研通道，改革激励与晋升机制增强职业吸引力以促进学科持续发展。