Distribution of hospital beds across Saudi Arabia from 2015 to 2019: a cross-sectional study

Background: Adequate access to health care systems is considered a basic human right. Therefore, it is important that health care services be delivered to those who need them most in the most efficient manner possible. Aims: We evaluated the distribution of hospital beds across Saudi Arabia from 2015 to 2019 to assess inequalities in hospital resource allocation. Methods: This cross-sectional study utilized data from the Health Statistical Yearbook published by the Ministry of Health during the period 2015–2019. The number of hospital beds per 100 000 population was calculated for the 20 health regions. Generation of other parameters, such as the Gini index and the Lorenz curve, was performed to assess the distribution of beds. The Pearson coefficient was calculated to assess the correlation between beds and population in each health region Results: The ratio of hospital beds to population improved from 2015 to 2019 in areas such as Ha’il, Tabouk and Ta’if, which increased by 89.6, 72.5 and 32.5 respectively. The calculated mean Gini index for bed distribution in the public sector was 0.21; in the private sector it was 0.53. There was a strong positive correlation between population and hospital beds in Riyadh, Qaseem, Eastern and Ha’il regions. Conclusion: In Saudi Arabia the observed inequalities in hospital bed distributions lie mainly in the private sector. It is recommended that policymakers be aware of such inequalities and work on possible reforms to achieve the goals of Saudi Vision 2030.

Pediatric intensive care hybrid-style clinical round during COVID-19 pandemic: A pilot study

BackgroundWith the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted utilization of Zoom online into the clinical rounds to enhance communication among the treating team. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients from the HCWs perspective. MethodsA mixed quantitative and qualitative deductive thematic content analysis of narrative responses from pediatric intensive care HCWs were analyzed, descriptive statistics were used ResultsA total of 31 HCW were included in the analysis; the mean time of the virtual round was 72.45 minutes vs. 34.68 for physical rounds, the most shared component in the virtual round was CXR (93.5%). Some of the HCWs perceived advantages of the hybrid rounds were enabling the multidisciplinary discussions, lesser round interruptions, and practicality of the virtual discussions. The perceived challenges were the difficulty of the bedside nurse to attend the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if the video streaming was not utilized. ConclusionHybrid virtual and physical clinical rounds in PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round could be optimized to facilitate the virtual team-members interactions and enhance the teaching experience.

Experiences and needs of patients with lower limb amputation in Saudi Arabia: a qualitative study

Background: The effect of amputation on the social and psychological well-being of patients has been established. How- ever, the experiences and needs of amputees for the process of adjustment varies among individuals and cultures. Aims: This study aimed to explore the experiences and needs of lower limb amputees for social and psychological adjustment in Saudi Arabia, according to their own perspective. Methods: Thirteen patients with lower limb amputation (mean age 47 years) were recruited from a large rehabilitation center in Saudi Arabia for participation in interviews. A focus group discussion with 6 amputees was followed by individual, semi structured interviews with 8 amputees (which included 1 from the focus group) between November 2017 and March 2018. Results: Patients’ needs and reactions prior to and after amputation were controlled by the surrounding support system. Hopelessness and depression, body image distress, religious attitude, and family and community support all contributed to shape the overall patient experience, including psychological and physical adjustment. Conclusions: Facilitating the re-integration of patients with lower limb amputation patients into their communities, as well as providing the required support system, is crucial to ensure a healthy adjustment process for amputees.

Virtual handover of patients in the pediatric intensive care unit during COVID-19 crisis

ObjectivesA key measure to mitigate coronavirus disease 2019 (COVID-19) has been social distancing. Incorporating video-conferencing applications in the patient handover process between healthcare workers can enhance social distancing while maintaining handover elements. This study describes pediatric intensive care unit (PICU) physicians experience of using an online video-conferencing application for handover during the COVID-19 pandemic. Design: qualitative content analysis SettingPICU at a university hospital in Riyadh, Saudi Arabia Subjects: PICU Physicians InterventionsDue to the pandemic, the hospitals PICU used Zoom(R) as a remote conferencing application, instead of a face-to-face handover. Following institutional review board approval, data were collected over two weeks (July 1, 2020 to July 14, 2020). Measurements: Demographic data and narrative descriptions of the perceived efficacy of remote handover were collected using open-ended questions through a created online link. The analysis process included open coding, creating categories, and abstraction. Main ResultsAll 37 PICU physicians who participated in the handover completed the survey. The participants comprised six attendings, nine specialists, and 22 residents. They had variable previous teleconferencing experiences. Most physicians (78.4%) were comfortable conducting a remote endorsement. Most found that Situation-Background- Assessment-Recommendation handover elements were properly achieved through this remote handover process. The perceived advantages of online handover included fewer interruptions, time efficiency, and facilitation of social distancing. The perceived disadvantages were the paucity of nonverbal communication and teaching during virtual meetings. ConclusionsVideo-conferencing applications used for online handovers could supplement traditional face-to-face intensive care unit patient endorsement during outbreaks of infectious diseases. The use of video streaming and more emphasis on teaching should be encouraged to optimize the users experience.