ABSTRACT
Background Emergency Departments (EDs) are increasingly pivotal, with a constant increment in their use, despite stable or declining fundings. Crowding can lead to disruptions and the COVID-19 epidemic has further burdened ED services. However, the pandemic has seen an increased use of telemedicine and digital health tools, which may be notably beneficial for EDs. This study offers a review of the latest available digital health technologies and their effectiveness to improve ED performance. Methods We performed a narrative review to identify digital and technological innovations in EDs. The themes of interest were defined in 4 areas: Patient Assessment, Patient Experience, Resource Allocation, and Discharge. Data was analyzed by 5 independent reviewers who focused on different macro-areas. Disagreement on data was discussed with 2 independent tiebreakers. Results Our search yielded 25 articles addressing 4 topics: Patient Assessment, Resource Allocation, Patient Experience, Discharge. We found that digital tools and Artificial Intelligence are powerful tools to detect, collect, and process data from patients, to improve healthcare delivery in EDs. The Resource Allocation category showed to be key in optimizing services already in place. New technologies showed effective to improve Patient Experience by curbing pain and anxiety. Innovative technologies demonstrated efficacy after Discharge when patients need guidance from clinicians for follow-up care. Conclusions Our review shows evidence of increasing effectiveness of innovative tools in reducing wait time and improving performance and patient experience in EDs. Technology applied to resource allocation appeared to be the most effective category. Prediction algorithms could be used to improve workforce allocation and bed management. Critical care systems must meet the challenge of innovative technologies which can lead to a new era in healthcare delivery with improvements for patients and healthcare professionals. Key messages • Digital innovation will have a significant impact on several dimensions of healthcare in the near future. • Healthcare systems and EDs must meet the challenge of innovative technologies which can lead to a new era in healthcare delivery with improvements for both patients and healthcare professionals.
ABSTRACT
ABSTRACT: Background. Vaccination is one of the most effective tools available to Public Health. Its potential usefulness is threatened by the rise of vaccine hesitancy among the general population, which has grown as much as to prompt the World Health Organization to express its concerns on the matter. The risk posed by vaccine hesitancy is even more concerning in the light of the efforts to curb the ongoing COVID-19 pandemic, which focus mainly on mass vaccination campaigns. This holds especially true when applied to healthcare professionals, among whom vaccine hesitancy can be particularly detrimental. For these reasons, our study focuses on potential determinants of vaccine hesitancy among healthcare professionals. Study design. The study is a cross-sectional study. Methods. Data were collected from January 1st to February 16th, by means of a self-administered online questionnaire in a cohort of Italian healthcare professionals. Results. Overall, 10,898 questionnaires were collected. Among the respondents, 1.1% expressed vaccine hesitancy. Hesitancy was less frequent in professionals involved in Primary Care and in the Clinical Scien-ces/Public Health group. Among clinicians, paediatricians, oncologists, and geriatrists showed especially accepting attitudes towards vaccination. Lower hesitancy rates were also registered among the respondents who already had received influenza vaccination and who never had any adverse effects following vaccination. Higher hesitancy rates were observed among individuals who had family members aged >65 years and with a history of severe adverse reactions to vaccination. Conclusion. Vaccine hesitancy rates were extremely low among participants in our study. Some medical specialties shown were particularly accepting towards vaccination. The potential predictors and protective factors pointed out by our analysis might allow more refined targets.