Assessing the potential use of blockchain technology to improve the sharing of public health data in a western Canadian province.

This exploratory, qualitative study set out to identify the encountered and perceived barriers to public health (PH) data sharing in a Canadian province with a view to assessing blockchain technology as a potential solution. A topic guide was developed, based on previous research in the area. This was then utilised for ten in-depth, semi-structured interviews with PH professionals between 27 May and 18 June 2019. Each stage of research was congruent with the philosophical underpinning of Gadamerian hermeneutic phenomenology. The major themes that emerged from the data collected were related to the information systems in use, data quality and ownership, as well as client identity management. The recurring core theme throughout all interviews was related to ineffective leadership and management, contributing to each major theme. Overwhelmingly the results show that the majority of barriers faced in this province are human-related. It is concluded that while blockchain technology shows promise for enhancing data sharing in healthcare, it is still many years away from being implemented in this Canadian province. As the results of this study indicate, there are human related barriers that could be addressed in the meantime, which are outside the scope of a technical solution. Future work should explore the perspectives of other stakeholders, such as the provincial government to fully understand the potential for using blockchain to share PH data in this province.

Using Six Sigma to Reduce the Utilization of Continuous Observations (1: 1) for Safety Precautions.

The need for continuous observation (1:1) of patients for safety precautions, including fall risk, elopement risk, confusion, and aggressive behavior, is highly variable, and it is therefore difficult to plan accurate staffing levels. The high variability in determining when 1:1 staffing for safety is indicated, and for how long, leads to resource strain and high cost to the hospital. A multidisciplinary team analyzed current processes for assigning, monitoring, and discontinuing safety 1:1 care for nonsuicidal patients using Six Sigma methodologies. The team implemented a standardized weaning process to reduce the duration of time on continuous observation and a standardized 4-hour reassessment using a behavior observation-tracking tool to validate the continued need for 1:1 coverage. The interventions resulted in reducing average monthly safety 1:1 staffing hours by 25.6% and saving an estimated $142 000 annually across 6 units. Phase 2 of the project integrated the observation-tracking tool and reassessment check-in into the hospital's electronic medical record for improved tracking and documentation.

Preparing for Emerging Infectious Diseases in the Perinatal Population.

The unprecedented scale of the 2014-2015 Ebola virus outbreak in West Africa and the recent emergence and rapid spread of Zika virus infection and resultant neonatal sequelae show that the geographic range, spread, and effect of emerging infections are unpredictable. Lessons learned from analyzing the response of an academic medical center to care for pregnant women with suspected or confirmed Ebola virus disease can help health care professionals address future threats from emerging infections.

Ischemic Stroke.

Each year, more than 795,000 people in the United States suffer a stroke and by 2030, it is estimated that 4% of the U.S. population will have had a stroke. Home healthcare clinicians will be increasingly called upon to assist stroke survivors and their caregivers adjust to disability and assist the survivor during their reintegration into the community. Therapeutic modalities are changing with advanced technology. Great strides are being made in the treatment of acute stroke; particularly endovascular interventions. More patients are surviving the acute stroke event and therefore will need to learn how to live with various degrees of disability. It is important for home healthcare clinicians to understand the process from acute event to medical stabilization, and from rehabilitation to long-term adaptation.