Readiness for Change in the Implementation of a 3D Printing Initiative in a Catalan Tertiary Hospital Using the Normalization Process Theory: Survey Study.

BACKGROUND: The high failure rate of innovation projects motivates us to understand the perceptions about resistances and barriers of the main stakeholders to improving success rates. OBJECTIVE: This study aims to analyze the readiness for change in the implementation of a 3D printing project in a Catalan tertiary hospital prior to its implementation. METHODS: We used a web-based, voluntary, and anonymous survey using the Normalization Measurement Development questionnaire (NoMAD) to gather views and perceptions from a selected group of health care professionals at Germans Trias i Pujol University Hospital. RESULTS: In this study, 58 professionals, including heads of service (n=30, 51%), doctors (n=18, 31%), nurses (n=7, 12%), and support staff (n=3, 5%), responded to the questionnaire. All groups saw the value of the project and were willing to enroll and support it. Respondents reported the highest scores (out of 5) in cognitive participation (mean 4.45, SD 0.04), coherence (mean 3.72, SD 0.13), and reflective monitoring (mean 3.80, SD 0.25). The weakest score was in collective action (mean 3.52, SD 0.12). There were no statistically significant differences in scores among professions in the survey. CONCLUSIONS: The 3D printing project implementation should pay attention to preparing, defining, sharing, and supporting the operational work involved in its use and implementation. It should also understand, assess, and communicate the ways in which the new set of practices can affect the users and others around them. We suggest that health officers and politicians consider this experience as a solid ground toward the development of a more efficient health innovation system and as a catalyst for transformation.

Digital transformation in organizational health and safety to mitigate Burnout Syndrome.

In 2000, the World Health Organization (WHO) identified Burnout Syndrome as an occupational risk factor, affecting an estimated 10% of workers, resulting in lost productivity and increased costs due to sick leave. Some claim that Burnout Syndrome has reached epidemic proportions in workplaces around the world. While signs of burnout are not difficult to identify and palliate, its real impact is not easy to measure, generating a number of risks for companies from possible loss of human talent to decreased productivity and diminished quality of life. Given the complexity of Burnout Syndrome, it must be addressed in a creative, innovative and systematic way; traditional approaches cannot be expected to deliver different results. This paper describes the experience where an innovation challenge was launched to collect creative ideas to identify, prevent or mitigate Burnout Syndrome through the use of technological tools and software. The challenge was endowed with an economic award and its guidelines stated that the proposals must be both creative and feasible from an economic and organizational point of view. A total of twelve creative projects were submitted, including each of them, the analysis, design and management plans, to envision an idea that is feasible and with the appropriate budget, implemented. In this paper, we present a summary of these creative projects and how the IRSST (Instituto Regional de Seguridad y Salud en el Trabajo) experts and leaders in OHS in the Madrid Region (Spain) envision their potential impact on improving the OHS landscape.

Agile Delphi methodology: A case study on how technology impacts burnout syndrome in the post-pandemic era.

Introduction: In the post-pandemic era, many habits in different areas of our lives have changed. The exponential growth in the use of technology to perform work activities is one of them. At the same time, there has been a marked increase in burnout syndrome. Is this a coincidence? Could they be two interconnected developments? What if they were? Can we use technology to mitigate this syndrome? This article presents the agile Delphi methodology (MAD), an evolved version of the Delphi method, adapted to the needs of modern-day society. Methods: To drive Occupational Health and Safety (OHS) experts to reach a consensus on what technological and non-technological factors could be causing the burnout syndrome experienced by workers in the post-pandemic era, MAD has been used in a specific case study. This study formally presents MAD and describes the stages enacted to run Delphi experiments agilely. Results: MAD is more efficient than the traditional Delphi methodology, reducing the time taken to reach a consensus and increasing the quality of the resulting products. Discussion: OHS experts identified factors that affect and cause an increase in burnout syndrome as well as mechanisms to mitigate their effects. The next step is to evaluate whether, as the experts predict, burnout syndrome decreases with the mechanisms identified in this case study.

Smart occupational health and safety for a digital era and its place in smart and sustainable cities.

As innovative technologies emerge, there is a need to evolve the environments in which these technologies are used. The trend has shifted from considering technology as a support service towards making it the means for transforming all complex systems. Smart cities focus their development on the use of technology to transform every aspect of society and embrace the complexity of these transformations towards something leading to the well-being and safety of people inhabiting these cities. Occupational Health and Safety (OHS) is an essential aspect to be considered in the design of a smart city and its digital ecosystems, however, it remains unconsidered in most smart city's frameworks, despite the need for a specific space for smart OHS. This paper summarizes a 9-month process of generation of a value proposition for evolving the sector of OHS based on a value-map in whose creation several stakeholders have participated. They focused on identifying the products, the methods, the organizational structures and the technologies required to develop an updated, dynamic and robust prevention model focused on workers in smart and complex contexts, and to improve the organizations' capability to guarantee safety even in the most changing, digital and disruptive settings. To assess the relevance and validity of this value-map, a study was carried out to match the set of its elements and its specific and conceptual products discovered, considering also the definition of the past needs and future trends of the sector that a set of renowned stakeholders and key opinion leaders (with mastery in OHS from several companies and industries) have recently defined for the decade of 2020. A prospective analysis of this match is presented, revealing that there is still an existing gap to be covered in the context of smart cities design: the explicit guarantee of safety for workers.

Cardiac valve replacement in patients with antiphospholipid syndrome.

OBJECTIVE: To analyze the results of cardiac valve replacement in a multicenter cohort of patients with antiphospholipid syndrome (APS) and to identify prognostic factors of poor outcome. METHODS: We performed a retrospective analysis of clinical manifestations (cardiac involvement and APS characteristics), operative and early postoperative courses, and long-term followup. All of the patients fulfilled the Sapporo criteria for APS. Logistic regression analyses were performed to identify those variables associated with adverse outcomes. RESULTS: Between 1981 and 2008, 33 valvular replacements were carried out in 32 patients with APS. The mean ± SD age at the time of surgery was 43.09 ± 14.08 years. Thirty patients were women. Primary APS was present in 21 patients. The median followup time after surgery was 33.5 months (range 0-192 months). The mitral valve was the most frequently replaced (22 of 33). Mechanical valve replacement was performed in 23 patients (71.9%). The mortality rate was 12.5% (1 cardiogenic shock, 1 septic shock, 1 following renal transplantation, and 1 hemorrhagic stroke). Fourteen patients experienced 20 complications (8 major bleeding, 5 thrombotic events, 2 valvular deteriorations, 2 third-degree atrioventricular block, 1 endocarditis, 1 cardiac tamponade, and 1 cardiac failure). Fifty percent of the patients had an uneventful outcome. CONCLUSION: Morbidity and mortality were high in APS patients undergoing valve replacement surgery. Most complications were related to thrombosis and bleeding. Anticoagulation must be carefully monitored to prevent hemorrhagic and thrombotic complications.