Optimization Model Applied to the Distribution of Covid-19 Vaccines in Lima and Callao

Currently, Peru has started a vaccination plan to face the crisis generated by Covid-19;however, it has not been the most efficient. The current study seeks to reduce vaccine distribution times and costs in Lima and Callao by applying a mathematical optimization model. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Using a Design Thinking Framework to Create User-Centered ICU-Ward Handoffs from Intensive Care Resident Teams to Academic Hospitalist Teams

RATIONALE: The discharge of patients from the ICU to the hospital ward is a high-risk period. Previously, we used Human-Centered Design - an iterative, collaborative process for user-focused solutions - to develop a prototype structured ICU-ward transfer communication tool for clinicians by focusing on resident-to-resident communication. We describe here an approach to rapid prototyping with the specific focus on meeting the needs academic Hospitalists. METHODS: In winter 2021, we conducted a voluntary focus group of Hospitalists at the University of Chicago to ensure that a recently developed ICU- ward transfer tool created through prior focus groups with resident also met the needs of hospital medicine clinicians. The focus group was conducted via videoconference due to the COVID-19 pandemic. With participants' consent, we recorded and transcribed the focus group discussions conducted over the Zoom platform. Following transcription, qualitative analysis on the transcript was used to look for common themes and concerns. Coding was performed using both a theory driven (deductive) and data driven (inductive) approach. RESULTS: The focus group identified several main themes around the role, content, and workflows related to an ideal ICU-wards handoff tool: (1) how the tool can communicate the patient course clearly through multiple verbal hand-offs;(2) that the ICU-ward handoff process must balance thoroughness, usability, and reducing the propagation of copy/paste errors;and (3) that design and implementation should provide hand-off communication between providers and patient families. Under these themes, participants identified specific attributes of an ideal handoff tool (Table 1), which coalesced around 3 main goals: (1) to synthesize key details and communicate the ICU team's thought process and follow up tasks (summarized in Table 1A);(2) to integrate the new tool into the EHR that minimizes documentation errors and communicates transfer status in the EHR to help handoffs between shifts (1B);and (3) to serve as a standardized process to ensure communication is bridged between teams and patient families (1C). CONCLUSIONS: Participants valued organization of handoff information, succinct information, EHR integration, and standardization of family communication when modifying a framework. One notable difference is our Hospitalist group focused on brevity while our resident group preferred a longer detailed course. Further work will need to be performed to find balance the needs between these two groups to ensure efficient handoffs.

Knowledge management, digital competence and reflective teaching practice in the Covid-19 context

The objective of this article is to define the relationship between “Knowledge Management”, “Digital Competence” and “Reflective Practice” in the personal teacher belonging to an educational network made up of public institutions of regular basic education located in the city of Lima Peru. The study follows a quantitative approach methodology, the research is of a basic type, hypothetical deductive method, and presents a non-experimental design and correlationalcausal level of the research variables. 225 teachers belonging to a network of public educational institutions were taken as a sample. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Design thinking to create user-centered icu-ward handoffs at three academic hospitals

RATIONALE: Patient transfers from the intensive care unit (ICU) to the hospital ward are a vulnerable time for patients recovering from critical illness. Our prior work showed that ICU-ward transfers vary widely across sites. Previously, we used Human-Centered Design-an iterative, collaborative process for user-focused solutions-to develop a prototype structured ICU-ward transfer communication tool for clinicians at three academic Internal Medicine residency programs. We describe here an iterative approach to rapid prototyping and updating of this novel tool for integration into the electronic health record (EHR), based on structured focus groups using Design Thinking methodology. METHODS: In spring 2020, we conducted voluntary focus groups of PGY-2 and PGY-3 Internal Medicine Residents to co-create new iterations of an ICUward transfer tool created through prior focus groups. Each site conducted 2 focus groups with 4-10 participants per session. All focus groups were conducted via videoconference due to the COVID-19 pandemic. We used participant feedback to iteratively modify the ICU-ward transfer tool towards an ideal state. With participants' consent, we recorded and anonymously transcribed the focus group discussions conducted over the Zoom platform. We performed qualitative inquiry on transcripts for coding and thematic content analysis. Coding was performed independently by two coders (LS, BG) using both a theory-driven (deductive) and data-driven (inductive) approach;disparate coding was reconciled via in-depth discussion between coders. RESULTS: Focus groups identified several main themes around the role, content, and workflows related to an ideal ICU-wards handoff tool: (1) how the tool can best serve the needs of ICU and wards teams;(2) that the ICU-ward handoff process must balance thoroughness and usability;and (3) that design and implementation must consider user experience and training in best practices. Under these themes, participants identified specific attributes of an ideal handoff tool (Table 1), which coalesced around 3 main goals: (1) to synthesize key details and communicate the ICU team's thought process (summarized in Table 1A);(2) to integrate the new tool into the EHR within a customizable note template that minimizes click burden and redundancy (1B);and (3) to serve as a standardized outline to reduce errors of omission in written and verbal handoffs processes (1C). CONCLUSIONS: Participants valued organization of handoff information, EHR integration and user experience, and standardization and adaptability of workflows when modifying a framework based on prior resident user input to create a more user-friendly ICU-ward transfer tool using a Design Thinking Methodology.