Workplace violence and associations with health outcomes in public health administration agencies in Taiwan: a survey during the COVID-19 pandemic

Objectives: To investigate the prevalence of workplace violence in public health administration agencies and its effects on health outcomes. Methods: A survey was conducted in March 2022. Staff who had been working for at least one year in the Ministry of Health and Welfare or its subordinate agencies, the Department of Health, or in public health centers were recruited. Data were collected anonymously with a structured, online questionnaire. A total of 492 valid questionnaires were collected. Results: A total of 48.17% participants reported having experienced workplace violence (physical, psychological, verbal, or sexual). The most common type of violence was verbal (43.50%), followed by psychological (31.71%). Supervisors were the primary perpetrators of verbal and psychological violence, followed by clients and colleagues. Staff reported long working hours and high levels of psychological and physical stress. Furthermore, 22.97% of workers reported poor self-rated health, 60.57% had personal burnout levels higher than 50, and 63.41% reported poor mental health. Regression analyses showed that low workplace justice was most strongly associated with internal verbal and psychological violence, whereas routine work requiring interaction with the public was most strongly associated with external verbal violence. Staff who had experienced workplace violence in the past year had significantly higher risks of poor self-rated health, mental health, and personal burnout, and poor health was more strongly associated with workplace violence that originated inside the organization than with workplace violence that originated from outside the organization. Conclusions: This survey was conducted on-line anonymously, so the representativeness of our findings might be limited. However, heavy workloads and workplace violence in public health administration agencies during the COVID-19 pandemic are important issues deserving urgent attention. (Taiwan J Public Health. 2023;42(1) :42-61)

2023 ACHE Hudgens Award Recipient: Baljeet S. Sangha, FACHE, COO, San Francisco Health Network

The integrated, safety-net healthcare system for the City and County of San Francisco includes the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco's only Level 1 trauma center, and the Laguna Honda Hospital and Rehabilitation Center. [...]even when folks can't get out of their home, we at the San Francisco Health Network know we can still reach out to them with access to substance abuse and mental health support as well as other critical preventive screenings. Dr. Ford: A few years ago, San Francisco enacted a law directing firms that employ 20 or more employees, most notably food service workers, to contribute a minimum amount to health benefits per employee hour. [...]many of them are doing two or three jobs to support their families, so it is impossible for them to get healthcare during periods that may be "normal” for the rest of us.

Do hospitals need to establish multiple hospital districts? A hospital-based perspective on the benefits of scale.

Background: During the fight against COVID-19, China's public hospitals played the main role in taking on the most urgent, dangerous and arduous medical treatment and work. Therefore, in order to promote the high-quality development of hospitals, it is necessary to support some potential public hospitals to build and develop a "One Hospital with Multiple Campuses System" (OHMC) based on controlling the size of single hospitals, and to quickly convert their functions in the event of a severe epidemic. Methods: The Cobb-Douglas production function and log-transformed production function were used to measure the appropriate hospital size for 22 public hospitals in a region of China. Results: The eight OHMC hospitals that planned to be build are basically qualified to handle the conditions and potential of multi-districts from the perspective of economy of scale. The OHMC hospitals in operation appear to have weakened incremental scale rewards, because they are in the process of development, but they are still higher than the overall level of single-campus hospitals. Conclusion: The expansion of hospital scale may bring the advantages of group development, but it may also bring about problems including rising hospital cost, increasing management and operation cost, inefficient allocation of medical resources and unbalanced development.

Healthcare management and COVID-19: data-driven bibliometric analytics

Healthcare management and COVID-19 has been broadly studied during the recent few days, especially after declaration of the COVID-19 outbreak in almost all countries in the world. Therefore, the present research article aims to provide an extensive overview of the scientific literature about the study of healthcare management and COVID-19 for choosing the new topic of related research. It conducts four types of analyses where the first analysis is a trend analysis and other three analyses are related to network and density maps. The second analysis is analyzed decisively in order to produce all keywords, author keywords and index keywords co-occurrence network map and country co-authorship network map and tables summarizing the significant scientific trends under the present topics. The third analysis is analyzed purposefully in order to produce all documents, journals, authors and countries bibliographic coupling network maps and tables summarizing the significant scientific trends. The last analysis provides valuable approaching of the most significant used keywords on the research topic and the links among them using keyword co-occurrence network and density maps respectively.

Burnout and leadership development among clinical staff administration: A qualitative descriptive study

Burnout represents a major and debilitating response to on-going job stress. Particularly with the pressures brought on by the COVID-19 pandemic, the medical profession has seen a dramatic critical rise in the level of stress and the frequency of burnout. A significant amount of research focusing on healthcare has been conducted over the last several years primarily directed to those members of the medical profession who provide direct services to patients. Unfortunately, hospital executives, administrators, and administrative teams have been largely excluded from this research. To rectify this problem, this study explores the way administrative team members describe their experiences with burnout in terms of educational growth and leadership development.The results of this study provide insights into three main areas: the perception of burnout as a health issue, the causes, sources, and effects of burnout among administrative healthcare administrators, and the effects of burnout on education and training. By better understanding the causes and consequences of burnout at the executive level and the training and leadership development interventions that can successfully address the sources of that burnout, healthcare leadership can be in a better position to guide and direct their organizations to provide the highest quality of care to their clients: the patients and their families who rely on the American health care system, often in life and death situations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

While You Were(n't) Sleeping: The Future of Health Administration Education

The COVID-19 pandemic had an immediate and enduring impact on society at-large and specifically on health administration education. Initially, the priority was to survive the pandemic by abandoning all levels of normalcy, and then, rather quickly, it shifted to finding new ways to maintain some level of normalcy as the higher education community transitioned to remote and hybrid modalities. The effects of this shift on health administration students were captured by Louis et al. (2021), and similar effects have been captured on health administration faculty as well (Brooks et al., 2021). But, as we have adapted to new ways of living during a pandemic, other societal forces and phenomena have begun to emerge that may prove to have durable effects on health administration education for decades to come. The following is the result of a discussion of a brain trust of health administration faculty, representing various health administration program levels (undergraduate, graduate, and executive) from various regions of the United States, who have enumerated areas of concern (and opportunity) for health administration education over the next 10 years. The topics discussed include (a) course delivery and modali ties;(b) diversity, equity, inclusion and justice;(c) wellness and well-being;and (d) the evolving professional field of health administration in an effort to understand what the future may hold for health administration education.

How Has the Pandemic Affected Career Satisfaction and Employment Perceptions of Faculty in Health Administration?

Employee satisfaction has been shown to affect productivity and turnover among faculty in higher education. The COVID-19 pandemic has required significant organizational changes in higher education, including hiring freezes, furloughs, and a rapid move to online teaching. Little is known about the effects of these changes on health administration faculty. Therefore, the current study utilizes data from a national survey of health administration faculty conducted in 2018 and 2021 to perform three analyses: quantification of the proportion of faculty respondents experiencing furloughs or whose depart ments implemented a hiring freeze brought upon by the pandemic;changes in career satisfaction and employment perceptions between the years 2018 and 2021;and a cross-sectional analysis of the relationship between furloughs and/ or hiring freezes and 2021 career satisfaction and employment perceptions. Overall, 17.9% experienced a furlough and 81.4% indicated their department had a hiring freeze. We observed no significant changes in career satisfaction or employment perceptions from 2018 to 2021. However, receipt of furloughs was negatively associated with multiple indicators of career satisfaction and employment perceptions. The results of this study will be of interest to health administration program administrators and faculty as well as leaders in higher education who would benefit from understanding the impact of the pandemic on faculty more broadly.

Usage of the Internet of Things in Medical Institutions and its Implications.

OBJECTIVES: The purpose of this study was to explore new ways of creating value in the medical field and to derive recommendations for the role of medical institutions and the government. METHODS: In this paper, based on expert discussion, we classified Internet of Things (IoT) technologies into four categories according to the type of information they collect (location, environmental parameters, energy consumption, and biometrics), and investigated examples of application. RESULTS: Biometric IoT diagnoses diseases accurately and offers appropriate and effective treatment. Environmental parameter measurement plays an important role in accurately identifying and controlling environmental factors that could be harmful to patients. The use of energy measurement and location tracking technology enabled optimal allocation of limited hospital resources and increased the efficiency of energy consumption. The resulting economic value has returned to patients, improving hospitals' cost-effectiveness. CONCLUSIONS: Introducing IoT-based technology to clinical sites, including medical institutions, will enhance the quality of medical services, increase patient safety, improve management efficiency, and promote patient-centered medical services. Moreover, the IoT is expected to play an active role in the five major tasks of facility hygiene in medical fields, which are all required to deal with the COVID-19 pandemic: social distancing, contact tracking, bed occupancy control, and air quality management. Ultimately, the IoT is expected to serve as a key element for hospitals to perform their original functions more effectively. Continuing investments, deregulation policies, information protection, and IT standardization activities should be carried out more actively for the IoT to fulfill its expectations.

What happens to the hospital under neoliberal management? Interview with Stephane Velut

Objectives: This interview with Professor Stephane Velut, neurosurgeon and writer, is an occasion to reflect on the current challenges of transforming the functioning of public hospitals today. In recent years, he has made his voice heard in public debate by publishing several essays and tracts. This interview allows him to expand upon some of his theses, by giving voice to his experience. Professor Velut's lively and passionate speech is in constant dialogue with the human sciences and literature. His taste for words led him in particular to develop a sensitivity to and a critique of the rhetoric employed by contemporary hospital administrators. Methods: This dialogue is based on open questioning. Professor Velut is asked about his own experience as head of department and surgeon. The interview makes it possible to explore the many influences, from Victor Klemperer to Regis Debray, which help him think about the era and the issues specific to it. The analysis of the social and political context of French medicine over the last forty years is widely discussed: from the emergence of health democracy with the AIDS epidemic to the most recent upheavals caused by the SARS-CoV-2 pandemic. Results: The new logics of care, evolving towards an ever greater requirement of technicality, systematicity, and evaluability, lead to a standardization of medical practice, which tends to eliminate any singularity, both that of the patient and the clinician. Discussion: Today, it is administrators, economists, and communicators who seem to hold the power to decide what is desirable for the hospital. The analysis of their "metalanguage" reveals a singular enterprise of watering down, which de-realizes the reality of the concrete objects of the caregiver: illness, care, death. This metalanguage contrasts with the language of clinicians, grappling with a reality other than that of evaluation and quantification, in their proximity to the suffering of each patient. Conclusion: The neoliberal management of the hospital, controlled by economic imperatives;modern forms of management, indexed against the principle of subsidiarity;finally, the new systematized and protocolized conceptions of care lead to a loss of autonomy for clinicians and caregivers who are no longer expected to be actors capable of thinking for themselves. In contrast, the concrete, even artisanal exercise of surgeon, in which the work of the surgeon's hand (like that of the craftsman) is irreplaceable, is a form of clinical practice that preserves the singularity of the encounter and the possibility of inventiveness. The practice of surgery allows the practitioner to take the singularity of each participant into account;in this, it can be compared to the practice of psychiatry. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (French) Objectifs: Cet entretien cherche a reflechir sur les enjeux actuels de transformation du fonctionnement de l'hopital public aujourd'hui, a partir d'une rencontre avec le Professeur Stephane Velut, neurochirurgien et ecrivain. Ces dernieres annees, il a fait entendre sa parole dans le debat public en publiant plusieurs essais et tracts. Cet entretien est l'occasion d'approfondir certaines de ses theses, en donnant a entendre son experience sous la forme d'une parole vive et passionnee, en constant dialogue avec les sciences humaines et la litterature. Son gout des mots l'amene notamment a developper une sensibilite et une critique a l'egard des formes rhetoriques des enonces employes par les administrateurs contemporains de l'hopital. Methode: Ce dialogue est fonde sur un questionnement libre, S. Velut est interroge sur sa propre experience de chef de service et de chirurgien. L'entretien permet de croiser de nombreuses influences, de Victor Klemperer a Regis Debray, qui l'aident a penser l'epoque et les problematiques qui lui sont specifiques. L'analyse du contexte social et politique de la medecine francaise de ses quarante dernieres annees est largement evoquee : de l'emergence de la democratie sanitaire avec l'epidemie de SIDA aux plus recents bouleversements engendres par la pandemie du SARS-CoV-2. Resultats: Les nouvelles logiques de soin, qui evoluent vers une toujours plus grande exigence de technicite, de systematicite et d'evaluabilite, aboutissent a une normalisation de l'exercice medical, qui tend a faire disparaitre toute singularite, aussi bien celle du patient que du soignant. Discussion: Les administratifs, les economistes et les communicants semblent aujourd'hui detenir le pouvoir de decider de ce qui est souhaitable pour l'hopital. L'analyse de leur langage, nomme par S. Velut << metalangage fait apparaitre une entreprise singuliere d'edulcoration, qui irrealise le reel des objets concrets du soignant : la maladie, le soin, la mort. Ce metalangage s'oppose a celui des cliniciens, qui sont aux prises avec une autre realite que celle de l'evaluation et de la quantification, quand ils sont au plus pres de la souffrance de chaque patient. Conclusion: La gestion neoliberale de l'hopital, subordonnee a des imperatifs economiques ;les formes modernes de management, indexees contre le principe de subsidiarite ;enfin, les nouvelles conceptions systematisees et protocolisees des soins amenent a une perte d'autonomie des cliniciens et des soignants qui ne sont plus envisages comme des acteurs susceptibles de penser par eux-memes. L'exercice concret de la chirurgie, qui donne une place irremplacable au travail de la main, et qui se rapproche en cela du metier d'artisan, trouve au contraire a valoriser la dimension de la clinique comme rencontre singuliere, propice a l'invention et a la prise en compte du plus singulier de chacun, dans une perspective qui trouve de nombreux points communs avec la pratique de la psychiatrie. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study.

BACKGROUND: Biologics are an effective therapy for severe asthma. Home administration of biologics by patients is likely to facilitate their accessibility. Yet little is known about patients' and health care providers' (HCPs) perceptions regarding home administration of biologics. OBJECTIVE: The aim of this study is to create more insight into the perceptions and experiences of patients and HCPs regarding home administration of biologics in the context of the treatment of severe asthma. METHODS: A qualitative international study was performed in the Netherlands, United States, Australia, and United Kingdom. In each country, 2 focus groups were held with potential/recent and long-term users of biologics at home. Prior to the focus groups, patients were prompted with themes on online forums. For triangulation purposes, interviews were held with HCPs to discuss salient findings from forums and focus groups. Data were analyzed with qualitative content analysis. RESULTS: In total, 75 patients participated in the forums, of which 40 participated in the focus groups. Furthermore, 12 HCPs were interviewed. The following overarching themes were identified: living with severe asthma; practical aspects of using biologics; the role of HCPs regarding biologics; social support from family, friends, and others; effectiveness of biologics and other treatments; side effects of biologics. CONCLUSIONS: This study showed that, for those using biologics for severe asthma, the benefits of home administration of biologics usually outweigh inconvenience and side effects. Guided practice, accessible support contact, and monitoring including social support should be central in the transition from hospital to home administration of asthma biologics.

Recommendations for the transformation of patient rooms into isolated patient rooms in the process of the COVID-19 pandemic.

In order to prevent the spread of Covid-19 and improve the treatment process, interest in hospital design and in-hospital transformation has increased worldwide. Since Covid-19 is not believed to be the last infectious health threat for communities around the world, it is of great importance to study existing hospital adaptations and work on obtaining more planning and design strategies for treatment and wellbeing areas. In this study it is aimed to make constructive recommendations on the basis of in-space planning and mechanical ventilation, which can be applied in hospital transformations for pandemic processes. Published guidelines and literature studies for hospitals to prevent the spread of infection have been examined, structured and unstructured interviews were conducted with architects and engineers specialized in hospital design. Also, a survey was conducted with 35 hospital workers and 4 people from the hospital management to analyze the changes made in the hospital during the Covid-19 process. Afterwards, the design plans of one of the two private hospitals studied in Turkey and the steps that can be applied in the transformation of patient rooms were explained in this article with the case study. Interdisciplinary work was carried in order to ensure infection control in hospital transformations, since it is required to make in-hospital space planning (separation/transformation of spaces, interior zoning) and ventilation (filtration, zoning of mechanical ventilation) in harmony. Suggestions were developed that could play a role in ensuring the consistency of mechanical and architectural planning in order to successfully complete hospital transformation practices to prevent the spread of infections in pandemic processes. As the transformation scenarios in this study were performed through an exemplary private hospital room in accordance with the criteria of the Turkish Ministry of Health, ventilation plans on the standard room project were detailed and shown in the conclusion section, where the transformation steps can also be adapted to other hospitals. (English) [ FROM AUTHOR] Covid-19 salgınının yayılmasını önlemek, tedavi sürecini iyileştirmek için hastane içi dönüşümlere olan ilgi dünya çapında artmıştır. Covid-19'un son bulaşıcı sağlık tehdidi olduğu düşünülmediğinden mevcut hastane uyarlamalarını incelemek, tedavi ve dinlenme alanları için gereksinime dayalı çeşitli planlama ve tasarım stratejileri geliştirme üzerine çalışmak büyük önem taşımaktadır. Bu çalışmada, pandemi süreçlerinde hastane içi dönüşümlerde uygulanabilecek mekân içi planlama ve takiben mekanik havalandırma özelinde yapıcı önerilerde bulunabilmek amaçlanmıştır. Enfeksiyonun yayılmasını önlemek için hastane kılavuz şartnameleri ve literatürdeki çalışmalar incelenmiş, hastane tasarımı üzerine uzmanlaşmış kişilerle çeşitli görüşmeler gerçekleştirilmiştir. Covid-19 sürecinde hastanelerde yapılan değişikliklerin analiz edilebilmesi içinse 35 hastane çalışanı ve 4 hastane yönetim personeliyle anket çalışması yapılmıştır. Veriler ışığında, Türkiye'de üzerinde çalışılmış iki özel-hastaneden birinin tasarım planları ile hasta odalarının dönüşümünde uygulanabilecek adımlar alan çalışmasıyla aktarılmıştır. Hastane içi dönüşümlerde enfeksiyon kontrolünün sağlanabilmesi adına mekân planlaması (alanların ayrıştırılması/dönüştürülmesi, mekân içi zonlama) ve havalandırmanın (filtrasyon, mekanik havalandırma için zonlama) uyum içinde olması gerektiğinden, dönüşümlerin planlanması aşamasında disiplinlerarası çalışma yapılmıştır. Pandemi süreçlerinde enfeksiyonun yayılmasının önlenebilmesi için hastane dönüşüm uygulamalarının mekanik ve mimari planlamalarında tutarlılığın sağlanabilmesi adına öneriler geliştirilmiştir. Dönüşüm senaryoları Türkiye Cumhuriyeti Sağlık Bakanlığı kriterlerine uygun örnek bir özel-hastane odası üzerinden gerçekleştirildiği için diğer hastanelere de uyarlanabileceği sonuç bölümünde tip proje üzerinde havalandırma planları detaylandırılarak gösterilmiştir. (Turkish) [ FROM AUTHOR] Copyright of Journal of the Faculty of Engineering & Architecture of Gazi University is the property of Gazi University, Faculty of Engineering & Architecture and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Predictors of professional burnout and fulfilment in a longitudinal analysis on nurses and healthcare workers in the COVID-19 pandemic.

AIMS AND OBJECTIVES: (1) To investigate the vulnerability of nurses to experiencing professional burnout and low fulfilment across 5 months of the COVID-19 pandemic. (2) To identify modifiable variables in hospital leadership and individual vulnerabilities that may mitigate these effects. BACKGROUND: Nurses were at increased risk for burnout and low fulfilment prior to the COVID-19 pandemic. Hospital leadership factors such as organisational structure and open communication and consideration of employee opinions are known to have positive impacts on work attitudes. Personal risk factors for burnout include symptoms of depression and anxiety. METHODS: Healthcare workers (n = 406 at baseline, n = 234 longitudinal), including doctors (n = 102), nurses (n = 94), technicians (n = 90) and non-clinical administrative staff (n = 120), completed 5 online questionnaires, once per month, for 5 months. Participants completed self-report questionnaires on professional fulfilment and burnout, perceptions of healthcare leadership, and symptoms of anxiety and depression. Participants were recruited from various healthcare settings in the southeastern United States. The STROBE checklist was used to report the present study. RESULTS: Both at baseline and across the 5 months, nurses working during the COVID-19 pandemic reported increased burnout and decreased fulfilment relative to doctors. For all participants, burnout remained largely steady and fulfilment decreased slightly. The strongest predictors of both burnout and fulfilment were organisational structure and depressive symptoms. Leadership consideration and anxiety symptoms had smaller, yet significant, relationships to burnout and fulfilment in longitudinal analyses. CONCLUSIONS: Burnout and reduced fulfilment remain a problem for healthcare workers, especially nurses. Leadership styles and employee symptoms of depression and anxiety are appropriate targets for intervention. RELEVANCE TO CLINICAL PRACTICE: Leadership wishing to reduce burnout and increase fulfilment among employees should increase levels of organisational support and consideration and expand supports to employees seeking treatment for depression and anxiety.

EFFICIENCY OF MANAGEMENT COMPETENCIES OF DIRECTORS DURING THE COVID-19 PANDEMIC

Purpose: At global and national level, the COVID-19 pandemic is influencing the public to increasingly speak of and recognize the importance of preserving the healthcare system. In addition to the solutions found in the formation of new healthcare policies, legal regulations, the role of the director is increasingly recognized, which is important for achieving goals and success as well as for preserving the healthcare system. Methodology: The study involved 27 respondents, i.e. directors of healthcare institutions at the primary level in the Republic of Croatia. All collected data were processed using the IBM SPSS Statistics statistical software. Results: Research results and the theoretical framework of the paper will present the factors influencing the management process of directors in the health system and the importance of the need to revise legislation and the education system aimed at ensuring the sustainability of public health. Conclusion: The paper will present which competencies of directors of healthcare institutions are crucial for crisis management during the COVID-19 pandemic.

Reflecting back to move forward: Lessons learned about COVID-19 safety protocols from pediatric anesthesiologists.

BACKGROUND: The COVID-19 pandemic brought about the immediate need for enhanced safety protocols in health care centers. These protocols had to evolve as knowledge and understanding of the disease quickly broadened. AIMS: Through this study, the researchers aimed to understand the experiences of pediatric anesthesiologists at the Montreal Children's Hospital and the Shriners' Hospital Canada as they navigated the first wave of COVID-19 at their institutions. METHODS: Nine participants from the Montreal Children's Hospital and the Shriners' Hospital were interviewed. Interviews were recorded, transcribed verbatim, and then analyzed using an applied philosophical hermeneutics approach. FINDINGS: Participants expressed their wish for simple and easy-to-apply protocols while recognizing the challenge of keeping up with evolving knowledge on the disease and its transmission. They pointed to some limitations and unintended consequences of the safety protocols and the system-wide flaws that the COVID-19 pandemic helped bring to light. They described their frustrations with some aspects of the safety protocols, which they at times felt could be more efficient or better suited for their daily practice. CONCLUSIONS: The findings of this study highlighted the importance of listening to and empowering anesthesiology staff working in the field during crises, the implications of shifting from patient-centered care to community-centered care, and the fine line between sharing as much emerging information as possible and overwhelming staff with information.

Hospital accreditation systems and salience of organisational tensions

Purpose>This study examines how an externally imposed management control system (MCS) – hospital accreditation – influences the salience of organisational tensions and consequently attitudes of management towards the system.Design/methodology/approach>Data are collected using a case study of a large public hospital in Spain. In-depth interviews were conducted with 27 senior and middle managers across different functions. Relying on the organisational dualities classification in the literature, tensions are unpacked and analysed.Findings>Evidence is presented of how hospital accreditation increases the salience of organisational tensions arising from exposition of the organisational dualities of learning, performing, organising and belonging. Salient tensions were evident in the ambivalent attitudes of management towards the hospital accreditation system.Practical implications>The role of mandatory external control systems in exposing ambivalence and tensions will be of interest to organisational managers.Originality/value>The study extends the management control literature by identifying an active role for an external MCS (accreditation) in increasing the salience of organisational tensions and triggering ambivalence. Contrary to the prior literature, the embedding of both poles of an organisational duality into the MCS is not a necessary precondition for increased tension salience. The range of attitudes towards MCSs beyond those specified in the previous literature (positive/negative/neutral) is extended to include ambivalence.

Surgical cancellation: a challenge for clinical management post Covid 19

Aim: To determine the frequency, the causes and the associated factors of the surgical cancellation of scheduled surgeries at the Hospital Base Valdivia between the years 2014 and 2018. Materials and Method: A descriptive cross-sectional study was carried out. Were described the frequency of suspension of scheduled surgeries of the establishment, by specialty and their main causes, identifying those that can be avoided. In addition, the factors associated with suspension were identified by logistic regression. Results: The suspension rate in the 5 years of study was 11.2%. Neurosurgery and Traumatology had the highest frequency of surgical cancellation (18.8% y 13.9%, respectively), Obstetrics, and Gynecology the lowest (4.1%). The most frequent causes of suspension were the absence of the patient (16.9%), the prolongation of the previous surgery (16.4%) and the suspension of activities due to Union reasons (7.9%). 80.1% of the causes were avoidable. The age and surgical specialty were the most relevant associated factorsmDiscussion: A high rate of surgical suspensions and most for avoidable reasons were evident. Reducing surgical cancellations can be the most cost effective intervention to help reduce the extensive post-health crisis surgical waiting lists by COVID 19, as it only requires optimizing existing resources. Conclusions: Surgical suspension is a common problem in the surgical process. Our results allow to identify the groups most at risk of suspension, assign responsibilities to surgical teams and develop effective strategies for their prevention. © 2022, Sociedad de Cirujanos de Chile. All rights reserved.

MDCALC LAUNCHES COVID-19 RESOURCE CENTER AND FREE TOOLKIT FOR THE EHR

CORE COVID-19 CALCS Overall Hospital Management * Brescia-COVID Severity Scale/Algorithm - Italian step-wise approach to managing all COVID-19 inpatients. * MuLBSTA Score - Only score specific for viral pneumonia;not yet externally validated. * PSI/PORT Score - Well-studied pneumonia score for all-comers. * Absolute Lymphocyte Count - Lymphopenia appears to suggest COVID infection. Through a partnership with TheNNT.com, MDCalc has incorporated relevant information regarding the most up-to-date knowledge on mortality and risk factors odds ratios for COVID-19, which combine both laboratory and field measurements to provide a comprehensive overview of how these factors affect the risk to patients (https://www.mdcalc.com/covid-19/indicators-mortality-data-china-south-korea). COVID-19 Resource Center Calculators (mdcalc.com/covid-19) Core COVID-19 Calcs Overall Hospital Management * Brescia-COVID Severity Scale/Algorithm - https:// www.mdcalc.com/brescia-covid-respiratory-severityscale-bcrss-algorithm * MuLBSTA Score-https://www.mdcalc.com/mulbstascore * PSI/PORT Score - https://www.mdcalc.com/psiport-score-pneumonia-severity-index-cap * Absolute Lymphocyte Count - https://www.mdcalc .com/absolute-lymphocyte-count-alc ICU - Respiratory * A-a O2 Gradient - https://www.mdcalc.com/a-a-o2gradient * Rapid Shallow Breathing Index (RSBI) - https://www .mdcalc.com/rapid-shallow-breathing-index-rsbi ARDS and ECMO Outcomes * Horowitz Index for Lung Function (P/F Ratio) - https://www.mdcalc.com/horowitz-index-lungfunction-p-f-ratio * HScore - https://www.mdcalc.com/hscore-reactivehemophagocytic-syndrome * Murray Score for Acute Lung Injury - https://www .mdcalc.com/murray-score-acute-lung-injury * RESP Score - https://www.mdcalc.com/resp -respiratory-ecmo-survival-prediction-score Scarce Resource Allocation * SOFA Score - https://www.mdcalc.com/sequential -organ-failure-assessment-sofa-score * mSOFA - https://www.mdcalc.com/modifiedsequential-organ-failure-assessment-msofa-score * Charlson Comorbidity Index - https://www .mdcalc.com/charlson-comorbidity-index-cci * RESP Score - https://www.mdcalc.com/resp-respi ratory-ecmo-survival-prediction-score Other COVID-19 Calcs Scarce Resource Situations * MuLBSTA Score for Viral Pneumonia Severity - https://www.mdcalc.com/mulbsta-score * PSI/PORT Score: Pneumonia Severity Index for CAP - https://www.mdcalc.com/psi-port-score-pneumonia -severity-index-cap * CURB-65 Score for Pneumonia Severity - https:// www.mdcalc.com/curb-65-score-pneumonia -severity Additional Calcs * SMART-COP Score for Pneumonia Severity - https://www.mdcalc.com/smart-cop-score-pneu monia-severity * Severe Community Acquired Pneumonia (SCAP) - https://www.mdcalc.com/severe-community -acquired-pneumonia-scap-score.

The impact of Coronavirus disease 19 on emergency volume in Northern Taiwan

The coronavirus disease 2019 (COVID-19) has changed the way communities and groups use the emergency department (ED). The purpose of this study is to evaluate changes in ED volume for different triage categories in three tertiary Chang Gung Memorial Hospital branches in Northern Taiwan before and after the spread of COVID-19. A decline of ED volume of about 20 to 25 percent was observed for all three branches during the study period. Statistically significant decline in total ED volume in all triage categories across the three branches was observed except triage category 1 for Keelung and triage category 5 for Linko. These exceptions were most likely due to the geographical location and proximity to other hospitals. The trends observed in this study regarding ED use during the COVID-19 pandemic period could better prepare resource management in hospitals, allocate medical staff, and may guide future pandemic planning. [ FROM AUTHOR] Copyright of Signa Vitae is the property of Pharmamed Mado Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic.

PURPOSE: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. FINDINGS: The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. PRACTICAL IMPLICATIONS: Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. ORIGINALITY/VALUE: Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.