Methods for living guidelines: early guidance based on practical experience. Paper 4: search methods and approaches for living guidelines.

OBJECTIVES: To describe the key features of a continual evidence surveillance process that can be implemented for living guidelines and to outline the considerations and trade-offs in adopting different approaches. STUDY DESIGN AND SETTING: Members of the Australian Living Evidence Consortium (ALEC), National Institute of Health and Care Excellence (NICE), and the US GRADE Network (USGN) shared their practical experiences of and approaches to establishing surveillance systems for living guidelines. We identified several common components of evidence surveillance and listed the key features and considerations for each component drawn from case studies, highlighting differences with standard guidelines. RESULTS: We developed guidance that covers the initial information needed to support decisions around suitability for living mode and the practical considerations in setting up continual search surveillance systems (search frequency, sources to search, use of automation, reporting the search, ongoing resources, and evaluation). The case studies draw on our experiences with developing guidelines for COVID-19, as well as for other conditions such as stroke and diabetes, and cover a range of practical approaches, including the use of automation. CONCLUSION: This paper highlights different approaches to continual evidence surveillance that can be implemented in living guidelines.

Copy and paste in the electronic medical record: A scoping review

Copy and paste (CPF) can be defined as the act of duplicating medical documentation from one section of the electronic medical record (EMR) and placing it verbatim in another section. The objective of this scoping review is to 1) describe the prevalence of copy and paste usage in EMR documentation, 2) detail the known measurable safety hazards associated with its use, and 3) identify potential solutions and/or strategies that can be used to mitigate the negative consequences of the CPF while preserving its essential role in documentation efficiency. The Joanna Briggs Institute guidelines were used to identify, screen, and assess the text of articles for final inclusion in CPF article review. The primary search strategy for copy-paste articles was developed in PubMed® and then translated to CINAHL®, ScienceDirect®, and IEEExplore® to extract additional articles. Identified copy-paste articles were imported into Covidence®. Two reviewers determined the final articles that were included in the review. The search retrieved 63 publications of which 17 were identified for final inclusion. The scoping review revealed CPF of medical text is a common occurrence that cuts across all clinician types (e.g., physicians and nurses). The scoping review revealed that automated methods for finding duplication in electronic documentation had emerged. A limited number of studies with quantifiable harms associated with CPF were found. Clinicians stated that CPF 1) had a negative impact on critical thinking, 2) led to medical complications being more likely to be overlooked, and 3) led to safety issues being missed with copy-paste content. A few different approaches were tested by researchers as alternatives to CPF. They included dictation systems, practice guidelines, note templates, highlighting of copied information, note splitting, and text insertion. CPF is long overdue for innovative approaches to minimizing patient risk and maximizing provider efficiency. https//doi.org/10.34105/j.kmel.2021.13.028

Comparison Of Optimal Distribution Route For Personal Protection Equipment By Saving Matrix And Tabu Search Methods Using Nearest Neighbor Approach At Covid-19 Referral Hospitals In West Java

At the beginning of COVID-19 pandemic in 2020, the disease was spread across the universe. This virus has level of blistering transmission because it can be transmitted through the air. To contain the outbreak, the people need to be self-isolated to minimize interaction with other people. In this case, the health workers are on the front line to combat this COVID-19 pandemic. It is because they must be dealing with the affected patients directly by taking care of them during their self-isolation period. The health workers must wear personal protective equipment (PPE) to avoid the virus transmission. In this turmoil, the availability of personal protective equipment or PPE is quite worrying. Therefore, the Indonesian government and every government around the world are arm in arm organize a worldwide aid in the form of PPE distribution through referral hospitals, with the objective of making the health workers safer. This research is aimed at conducting a simulation of distribution to obtain PPE route distribution in a more effective and efficient ways to get an optimal route. In this case, this research had been conducted by comparing two methods: saving matrix and tabu search for Hazmat suit distribution. Apart from getting an optimal route, the cost and time could be pushed more effectively to clock the fastest time in distribution with the fewest cost of distribution. The simulation of distribution point used was Distribution Center of West Java as an origin point, specifically at the COVID-19 referral hospitals in West Java, which was listed on the PIKOBAR site as the beneficiary of the PPE and the data of health workers in West Java mentioned in Central Agency on Statistics or locally known as BPS as the determinant of the requested PPE numbers. The result of this research showed that Tabu Search method was more optimal compared to Saving Matrix method based on similar approach, Nearest Neighbor, in determining the route that resulted in four distribution routes. This study showed that Saving Matrix research method concluded a mileage of 2.404 km in 80 hours at the cost of Rp. 10.505.968, while Tabu Search concluded a mileage of 2.351 km in 78 hours at the cost of Rp. 10.437.492.