Journal articles on the topic 'Hospital-based clinical staff'
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Jack, Barbara, Jackie Oldham, and Anne Williams. "Do hospital-based palliative care clinical nurse specialists de-skill general staff?" International Journal of Palliative Nursing 8, no. 7 (July 2002): 336–40. http://dx.doi.org/10.12968/ijpn.2002.8.7.10674.
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Dewi, Pratiti Swesti Komala, Christyana Sandra, and Eri Witcahyo. "RESOURCES REQUIRED IN CLINICAL PATHWAY FOR TYPHOID FEVER TREATMENT AT KALIWATES GENERAL HOSPITAL IN 2017." Jurnal Administrasi Kesehatan Indonesia 7, no. 2 (October 28, 2019): 155. http://dx.doi.org/10.20473/jaki.v7i2.2019.155-161.
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Background: A clinical pathway is a concept of an integrated service which describes the stages of healthcare services from the admission until the return of patients based on the medical service standards and evidence-based nursing care with measurable results. Kaliwates General Hospital is an accredited hospital with a clinical pathway. Typhoid case was the highest disease in 2017 at Kaliwates General Hospital.Aims: This study aims to describe the resources at Kaliwates General Hospital in the implementation of clinical pathways, especially typhoid fever treatment.Method: This study was a descriptive and qualitative study. Nine respondents were selected using purposive sampling, including one internist and the quality team at Kaliwates General Hospital. The variables studied include human resource factors, budget factors, method factors, and time factors.Results: The results suggested that the human resources at Kaliwates General Hospital had high commitment, motivation, and moderate knowledge in the implementation of clinical pathways. All equipment and documents were considered adequate. The communication among the implementers was good, but compliance and training for staffs were considered less prominent. The task division of each staff was fairly distributed even though the pharmacy unit perceived that the division was quite unfair.Conclusion: The implementation of the clinical pathway for typhoid fever treatment at Kaliwates General Hospital runs quite well. The hospital must identify and plan staff training regularly, prepare the job description appropriately, and perform performance appraisal based on the job description that has been developed.Keywords: clinical pathway, typhoid fever, resource.
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Laustsen, Sussie, Elisabeth Lund, Bo Martin Bibby, Brian Kristensen, Ane Marie Thulstrup, and Jens Kjølseth Møller. "Cohort Study of Adherence to Correct Hand Antisepsis Before and After Performance of Clinical Procedures." Infection Control & Hospital Epidemiology 30, no. 2 (February 2009): 172–78. http://dx.doi.org/10.1086/593206.
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Objective.To investigate the rate of adherence by hospital staff members to the correct use of alcohol-based hand rub before and after performance of clinical procedures.Design.A cohort study conducted during the period from 2006 through 2007 and 2 cross-sectional studies conducted in 2006 and 2007.Setting.Århus University Hospital, Skejby, in Århus, Denmark.Participants.Various hospital staff members.Methods.Following an ongoing campaign promoting the correct use of alcohol-based hand rub, we observed rates of adherence by hospital staff to the correct use of alcohol-based hand rub. Observations were made before and after each contact with patients or patient surroundings during 5 weekdays during the period from 2006 through 2007 in 10 different hospital units. A logistic regression model was used to estimate the rate of adherence to the correct use of alcohol-based hand rub before and after performance of a clinical procedure.Results.A total of 496 participants were observed during 22,906 opportunities for hand hygiene (ie, 11,177 before and 11,729 after clinical procedures) that required the use of alcohol-based hand rub. The overall rates of adherence to the correct use of alcohol-based hand rub were 62.3% (6,968 ofthe 11,177 opportunities) before performance and 68.6% (8,041 ofthe 11,729 opportunities) after performance of clinical procedures. Compared with male participants, female participants were significantly better at adhering to the correct use of alcohol-based hand rub before performance (odds ratio [OR] 1.51 [95% confidence interval {CI}, 1.09–2.10]) and after performance (OR, 1.73 [95% CI, 1.27–2.36]) of clinical procedures. In general, the rate of adherence was significantly higher after the performance of clinical procedures, compared with before (OR, 1.43 [95% CI, 1.35–1.52]). For our cohort of 214 participants who were observed during 14,319 opportunities, the rates of adherence to the correct use of alcohol-based hand rub were 63.2% (4,469 of the 7,071 opportunities) before performance and 69.3% (5,021 of the 7,248 opportunities) after performance of clinical procedures, and these rates increased significantly from 2006 to 2007, except for physicians.Conclusion.We found a high and increasing rate of adherence to the correct use of alcohol-based hand rub before and after performance of clinical procedures following a campaign that promoted the correct use of alcohol-based hand rub. More hospital staff performed hand hygiene with alcohol-based hand rub after performance of clinical procedures, compared with before performance. Future campaigns to improve the rate of adherence to the correct use of alcohol-based hand rub ought be aware that certain groups of hospital staff (eg, male staff members) are known to exhibit a low level of adherence to the correct use of alcohol-based hand rub.
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Yellowlees, Peter, and Craig Kennedy. "Telemedicine applications in an integrated mental health service based at a teaching hospital." Journal of Telemedicine and Telecare 2, no. 4 (December 1, 1996): 205–9. http://dx.doi.org/10.1258/1357633961930086.
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Psychiatric applications have predominated in Australian telemedicine in recent years. This paper describes the development of the first telemedicine system for an integrated mental health service based at a teaching hospital. Much effort was devoted to training and education for staff. Within about six weeks of the system being installed, over 80 of all clinical administrative staff, from all the mental health disciplines of the integrated service, had completed a formal training programme. Applications within the service included direct clinical work and the use of videoconferencing in preference to standard telephony over short distances. Applications external to the service, over distances of thousands of kilometres, included clinical supervision and teaching. Evaluation is continuing.
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Marini, Gabriele, Benjamin Tag, Jorge Goncalves, Eduardo Velloso, Raja Jurdak, Daniel Capurro, Clare McCarthy, William Shearer, and Vassilis Kostakos. "Measuring Mobility and Room Occupancy in Clinical Settings: System Development and Implementation." JMIR mHealth and uHealth 8, no. 10 (October 27, 2020): e19874. http://dx.doi.org/10.2196/19874.
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Background The use of location-based data in clinical settings is often limited to real-time monitoring. In this study, we aim to develop a proximity-based localization system and show how its longitudinal deployment can provide operational insights related to staff and patients' mobility and room occupancy in clinical settings. Such a streamlined data-driven approach can help in increasing the uptime of operating rooms and more broadly provide an improved understanding of facility utilization. Objective The aim of this study is to measure the accuracy of the system and algorithmically calculate measures of mobility and occupancy. Methods We developed a Bluetooth low energy, proximity-based localization system and deployed it in a hospital for 30 days. The system recorded the position of 75 people (17 patients and 55 staff) during this period. In addition, we collected ground-truth data and used them to validate system performance and accuracy. A number of analyses were conducted to estimate how people move in the hospital and where they spend their time. Results Using ground-truth data, we estimated the accuracy of our system to be 96%. Using mobility trace analysis, we generated occupancy rates for different rooms in the hospital occupied by both staff and patients. We were also able to measure how much time, on average, patients spend in different rooms of the hospital. Finally, using unsupervised hierarchical clustering, we showed that the system could differentiate between staff and patients without training. Conclusions Analysis of longitudinal, location-based data can offer rich operational insights into hospital efficiency. In particular, they allow quick and consistent assessment of new strategies and protocols and provide a quantitative way to measure their effectiveness.
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De Pedro-Gómez, Joan, José Miguel Morales-Asencio, Miquel Bennasar-Veny, Guillem Artigues-Vives, Catalina Perelló-Campaner, and Patricia Gómez-Picard. "Determining factors in evidence-based clinical practice among hospital and primary care nursing staff." Journal of Advanced Nursing 68, no. 2 (August 16, 2011): 452–59. http://dx.doi.org/10.1111/j.1365-2648.2011.05733.x.
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Petrik, M. E., and L. M. Heitshusen. "TRAINING DIETETIC CLINICAL STAFF FOR COMPUTER-BASED DOCUMENTATION IN A LARGE TERTIARY CARE HOSPITAL." Journal of the American Dietetic Association 103 (September 2003): 134. http://dx.doi.org/10.1016/s0002-8223(08)70213-x.
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Ghamri, Ranya Alawy, Noor Jamal Baamir, and Basma Salah Bamakhrama. "Cardiovascular health and lifestyle habits of hospital staff in Jeddah: A cross-sectional survey." SAGE Open Medicine 8 (January 2020): 205031212097349. http://dx.doi.org/10.1177/2050312120973493.
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Objectives: Cardiovascular disease is a major cause of morbidity and mortality worldwide. Cardiovascular disease was responsible for over 17.9 million deaths in 2016, accounting for 31% of deaths globally and 37% of deaths in Saudi Arabia. With a lifetime risk exceeding 60% for the general population, healthcare professionals are continuously monitoring the health of others but often do not find time to care for themselves. This study aimed to assess the prevalence of cardiovascular risk factors; medical conditions, such as, hypertension and diabetes mellitus; stress; and attitudes and barriers against healthy lifestyle choices among healthcare professionals at King Abdulaziz University Hospital. Methods: A cross-sectional study based on a self-administered questionnaire was conducted among the staff at King Abdulaziz University Hospital over a period of 12 weeks. A validated questionnaire was adopted from a study that had previously been conducted in the United Kingdom. Results: The study included 400 healthcare workers, of whom, 78% were clinical staff and 22% were non-clinical staff. Approximately, two-thirds of the clinical staff were aged ⩽25 years, whereas 43.2% of the non-clinical staff were aged 26–35 years. Most of the clinical staff (70.5%) were female, compared to 56.8% of the non-clinical staff. Significantly higher rates of hypertension and smoking were observed among the non-clinical staff than among the clinical staff. However, no other significant differences were observed in the prevalence of diseases between the groups. Overall, poor lifestyle, in terms of low compliance with the recommended dietary and physical activity guidelines, was observed in both groups. Conclusion: The prevalence of cardiovascular risk factors among the clinical staff at King Abdulaziz University Hospital was not markedly different from that among the non-clinical staff, except the prevalence of hypertension and smoking, which was significantly higher among the non-clinical staff. Further studies that include staff from other institutions are recommended.
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Hills, Madeleine, Stephanie Wai Khuan Teoh, and Tamara Lebedevs. "Evaluation of the effectiveness and staff acceptance of education strategies to improve medication safety." Pharmacy Education 22, no. 1 (May 28, 2022): 428–35. http://dx.doi.org/10.46542/pe.2022.221.428435.
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Background: The pharmacy department at the study site provides ongoing education on medication safety to the hospital staff through a variety of means. Objectives: The study aimed to evaluate and compare various forms of education and the clinical impact and satisfaction reported by staff. Methods: A survey was disseminated to staff across the hospital, and 81 responses were collected. Results: Staff preferred learning through a combination of teaching methods rather than individual modalities. The majority of respondents stated that they felt their knowledge of medication safety improved after education and that the content was actionable. Most staff also agreed or strongly agreed that education positively impacted their clinical practice. Staff preferences regarding education were also themed around different learning modalities, quick and concise messages, topics of medication updates, and relevance to practice. Preferences of the hospital staff will be aligned with education strategies based on this evaluation.
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Laustsen, Sussie, Elisabeth Lund, Bo Martin Bibby, Brian Kristensen, Ane Marie Thulstrup, and Jens Kjølseth Møller. "Effect of Correctly Using Alcohol-Based Hand Rub in a Clinical Setting." Infection Control & Hospital Epidemiology 29, no. 10 (October 2008): 954–56. http://dx.doi.org/10.1086/590393.
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We evaluated hand antisepsis in clinical practice at Aarhus University Hospital in Skejby, Denmark. The rate of compliance with the correct use of alcohol-based hand rub exceeded 55% of all routine clinical procedures observed. With the correct use of alcohol-based hand rub by hospital staff, bacterial counts were reduced by 90% before and 82% after a clinical procedure; with incorrect use, the bacterial counts were reduced by 60% before and 54% after a clinical procedure.
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Dwyer, Alison J., Gavin Becker, Cindy Hawkins, Lisa McKenzie, and Malcolm Wells. "Engaging medical staff in clinical governance: introducing new technologies and clinical practice into public hospitals." Australian Health Review 36, no. 1 (2012): 43. http://dx.doi.org/10.1071/ah10952.
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Introduction. To enhance patient care, medical staff at major tertiary teaching hospitals are encouraged to innovate through introducing new technologies and clinical practices. However, such introduction must be safe, efficient, effective and appropriate for patients and the organisation, and actively lead by engage medical staff. Method. This study outlines the development, implementation and evaluation of a framework for introducing new technologies and clinical practice to a major tertiary health service. Evaluation includes survey of medical Heads of Units (HOUs) for framework’s effectiveness, and comparison of level of medical staff engagement against a best-practice model. Results. Over 2-year period: 19 applications, 7 approved. Successful external funding of $1.993 million achieved. Survey of HOUs in June 2009: response rate 59% (25 of 42 HOUs), with 11 of 25 respondents utilised the committee. Of those 14 of 25 who had not utilised the committee, low awareness of the committee’s existence (2 respondents). Most elements of the best-practice model for engaging medical staff were achieved. Recommendations include improvements to committee process and raising profile with medical staff. Discussion. This study demonstrates an effective and successful clinical governance process for introducing new technologies and clinical practice into a major tertiary teaching hospital, supported by moderate levels of medical staff engagement. What is known about the topic? To enhance patient care in an innovative research and teaching environment, medical staff at major tertiary teaching hospitals are encouraged to innovate and introduce new technologies and clinical practices. However, such introduction needs to be safe, efficient, effective and appropriate for patients and the organisation, and actively engage medical staff in overseeing such responsibility. What does this paper add? This study demonstrates an effective and successful clinical governance process for introducing new technologies and clinical practice into a major tertiary teaching hospital, supported by moderate levels of medical staff engagement. What are the implications for practitioners? All health services or hospitals with a focus for medical research and innovation, that incorporate new technologies into their clinical practice, should ensure governance processes similar to those outlined, to ensure best-practice evidence-based clinical and corporate governance. Effective engagement of medical staff in such processes is essential.
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T.K., Jayalakshmi, Bhumika Madhav, Narendra Patil, Dipti Dhanwate, Prakash Cherath, Dhanaji Revande, Jay Shinde, and Monhiki Pasweti. "Study of Likelihood of Infection with COVID 19 Based on Source of Exposure to Infection among Hospital Staff." Journal of Evolution of Medical and Dental Sciences 10, no. 45 (December 21, 2021): 3849–52. http://dx.doi.org/10.14260/jemds/2021/778.
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BACKGROUND The corona virus disease - 19 (COVID - 19) pandemic has caused significant morbidity and mortality throughout the world, as well as major social, educational and economic disruptions. Hospital staff have maximum exposure making it extremely crucial to find a solution to reduce the disease burden among the hospital staff. A sample of 170 consecutive hospital staff infected with COVID in the months from May 2020 to December 2020 was studied. It was a retrospective study done by analysis of out-patient department (OPD) and indoor patient records in that time period.The purpose of this study was to assess different sources and types of exposure of hospital staff to COVID 19 infection and prevent episodes of infection in hospital staff. METHODS Survey of 170 COVID positive staff at a tertiary hospital was conducted and their potential sources of infection were documented. Source of infection could be other staff in hospital, room mates, patients, patient relatives, family, personal protective equipment (PPE) donning and doffing errors. Types of interaction could be in covid or non-covid areas of the hospital or during clinical encounters or social encounters within the hospital. RESULTS Nurses (46 %) and doctors (29 %) constitute 75 % of the total heath care staff infections in the hospital. Desk job staff, attendants, food and beverage workers and drivers together constitute 25 % of the total health care staff infections in the hospital. The most common sources of infection were found to be social interaction and patient interaction. The infections were acquired much more in the non-covid areas of the hospital than in the covid areas. 65 % of infections were acquired within three days of exposure and 87 % of total infections were acquired within 6 days of exposure. 77 % of infections were acquired within the hospital premises in patient and social interaction cases. CONCLUSIONS Staff acquisition of COVID was found to be significantly higher in non-covid than in covid areas. Social distancing measures, mask use, hand hygiene, attention to PPE would help in significant drop in new COVID infections in hospital. KEY WORDS COVID 19, Infection, Health Care Workers, Pandemic Prevention
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Pulamte, Rothangpui, Geeta Thiyam, and Zothansung Joute. "Clinical profile in metabolic syndrome." International Journal of Scientific Reports 1, no. 5 (October 3, 2015): 220. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20150894.
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<p class="abstract"><strong>Background:</strong> The metabolic syndrome is a condition characterized by a constellation of metabolic disorders including: abdominal obesity, insulin resistance/glucose intolerance, atherogenic dyslipidemia [elevated Triglyceride (TG), and lower High Density Lipoprotein (HDL-c)], raised blood pressure, proinflammatory and prothrombotic state. It was referred to as the “X syndrome” by Kylin in the 1920’s and described as a phenomenon of the clustering of obesity, hypertension, and gout.<sup>1</sup> Aims and objects:<strong> </strong>To correlate different clinical and biochemical parameters in metabolic syndrome among the staff of Hospital in Imphal. </p><p class="abstract"><strong>Methods:</strong> A total of 239 staffs were selected randomly from the Hospital, Imphal, Manipur. Sample size was calculated based on the prevalence of metabolic syndrome of 33.2%<sup>4</sup> with 95% precision, coming to a sample size of 237.</p><p class="abstract"><strong>Results:</strong> Metabolic syndrome was found in 49 out of 239 staffs and its prevalence was 21% which increased with age. There was a strong association between metabolic syndrome and obesity. There is lower prevalence rate of metabolic syndrome among the staff compared to other studies. This may have resulted from a number of factors including younger age, physical activities and ethnic origin.</p><p><strong>Conclusions:</strong> Measuring MetS components is necessary for the early detection of this abnormal condition and early intervention.</p><p> </p>
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Supri, Aisyah, Rini Rachmawaty, and Syahrul Syahrul. "Nurses’ Performance Assessment Based On Nursing Clinical Authority: A Qualitative Descriptive Study." Journal of Nursing Practice 2, no. 2 (April 1, 2019): 80–90. http://dx.doi.org/10.30994/jnp.v2i2.48.
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Background: One of nursing management functions is organizing nursing staff through assessing their working performances. Managing nursing staff in order to improve their working performance is vital. Thus, it needs to be well-designed to meet the patients’ expectation on health care quality. Nurses’ performance is defined as the action, achievement, or fulfillment of nurses’ responsibilities based on their tasks that have been assigned to them.
Purpose: The aim of this study was to describe the nurses’ performance assessment and the nurse activities based on nursing clinical authority at the Dr. Wahidin Sudirohusodo hospital Makassar.
Methods: This research is a qualitative descriptive study. Data were gathered from Focus Group Discussion (FGD), individual interviews, and document analysis.
Results: The study results showed that generally the assessment of the nurses’ performances at the Dr. Wahidin Sudirohusodo hospital has been conducted since 2015. However, there were still some areas that need to be improved, such as the quantity indicator assessment that is currently not developed based on the nursing clinical authority. In fact, the assessment of nurses' performance for quantity indicators should be adjusted to the nursing clinical authority that has been assigned to them after completing the credentialing process as stated in the Nurse Clinical Assignment Letter.
Conclusion: The assessment of nurses’ performance should be adhered to the nursing clinical authority and it is better if hospital managers may synchronize the nursing clinical authority with the online nursing logbook provided in the Hospital Information System
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McKenzie, Gordon Arthur George. "Evidence-based out-of-hours hospital medicine." Postgraduate Medical Journal 94, no. 1116 (October 2018): 588–95. http://dx.doi.org/10.1136/postgradmedj-2017-135049.
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Out-of-hours (OOH) hospital ward cover is generally provided by junior doctors and is typified by heavy workloads, reduced staff numbers and various non-urgent nurse-initiated requests. The present inefficiencies and management problems with the OOH service are reflected by the high number of quality improvement projects recently published. In this narrative review, five common situations peculiar to the OOH general ward setting are discussed with reference to potential areas of inefficiency and unnecessary management steps: (1) prescription of hypnotics and sedatives; (2) overnight fluid therapy; (3) fever; (4) overnight hypotension and (5) chasing outstanding routine diagnostic tests. It is evident that research and consensus guidelines for many clinical situations in the OOH setting are a neglected arena. Many recommendations made herein are based on expert opinion or first principles. In contrast, the management of significant abnormalities in outstanding blood results is based on well-established guidelines using high-quality systematic reviews.
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Kaasalainen, Sharon, Tamara Sussman, Pamela Durepos, Lynn McCleary, Jenny Ploeg, and Genevieve Thompson. "What Are Staff Perceptions About Their Current Use of Emergency Departments for Long-Term Care Residents at End of Life?" Clinical Nursing Research 28, no. 6 (December 22, 2017): 692–707. http://dx.doi.org/10.1177/1054773817749125.
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The goal of this study was to examine current rates of resident deaths, Emergency Department (ED) use within the last year of life, and hospital deaths for long-term care (LTC) residents. Using a mixed-methods approach, we compared these rates across four LTC homes in Ontario, Canada, and explored potential explanations of variations across homes to stimulate staff reflections and improve performance based on a quality improvement approach. Chart audits revealed that 59% of residents across sites visited EDs during the last month of life and 26% of resident deaths occurred in hospital. Staff expressed surprise at the amount of hospital use during end of life (EOL). Reflections suggested that clinical expertise, comfort with EOL communication, clinical resources (i.e., equipment), and family availability for EOL decision making could all affect nondesirable hospital transfers at EOL. Staff appeared motivated to address these areas of practice following this reflective process.
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Tonne, Heidi, Theresa Woodrum, and Michael Romano. "Transforming a unit’s culture to improve clinical outcomes." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 243. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.243.
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243 Background: Leadership identified an unhealthy work environment existed in our Oncology Hematology Special Care Unit (OHSCU). This was evidenced by increased turnover, low National Database of Nursing Quality Indicators (NDNQI), and nurse sensitive quality indicator scores. In the fall of 2014 changes were made to the unit with a goal of creating within the unit a culture of clinical excellence, engagement, professionalism, accountability, and improve staff satisfaction. Methods: Leadership met to define the future state of the unit and develop a vision statement. The Quality Manager met with our Unit based Council (UBC) to review data, discuss shared accountability between leadership, and staff and the impact each individual can have on culture and clinical outcomes. Organizational Development facilitated staff focus groups without unit leadership present. Questions asked included: What behaviors would you like to see more or less of? What is your role in supporting change? Focus group results were shared with staff, and guided the development of an OHSCU Guidelines for Professional Behavior. Leadership met with lead staff nurses to discuss their willingness to embrace cultural change and unit vision. Leads completed the Crucial Conversations Class to help them provide immediate, direct, and specific feedback to staff. Leadership met with each staff member to review the guidelines and discuss their commitment to support change. The unit vision was incorporated in all written and verbal communication with staff. Changes in leadership behaviors included increased leadership presence on nights and weekends, daily rounding with patients and staff, and increased amount of positive feedback. Results: Fall injury scores were decreased from 1.55 to 0.25 per 1,000 patient days, target of 0.72. OHSCU has had no catheter associated urinary tract infections (CAUTI) or pressure ulcers in the last 17 months. Patient satisfaction scores have consistently improved over the last nine months. Response of hospital staff scores have increased from 53.6 to 70.9 and currently 90% of patients rate the hospital as a 9 or 10. Conclusions: Through focused efforts and thoughtful actions, it is possible to change the culture of a unit and have a positive impact on quality metrics.
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Walker, Rae, and Jenny Adam. "Approaches to changing the use of time in a public hospital." Australian Health Review 23, no. 1 (2000): 34. http://dx.doi.org/10.1071/ah000034.
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This article describes a qualitative study that used documentary sources and interviews witha cross-section of clinical managers and staff to identify the ways in which use of time changedin two clinical units following the introduction of casemix-based funding in Victoria.For staff at all levels within the hospital system, changes in the use of time were experiencedthat affected both the organisation of work and the care provided. The two units approachedthe management of time in different ways. From the introduction of casemix-based fundingto the conclusion of this study there were improvements in efficiency in both clinical units.The case studies are compared and the consequences of different approaches to managing timein clinical units are described.
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Pishgar, Farnaz. "The Effect of Living in the Present Time, Healthy Character Development and Social Character Growth of Staff on their Performance (Case Study: Clinical and Paraclinical Areas of Ahwaz Imam Khomeini Hospital)." International Letters of Social and Humanistic Sciences 61 (October 2015): 53–59. http://dx.doi.org/10.18052/www.scipress.com/ilshs.61.53.
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The aim of the present research was to investigate the effect of living in the present, healthy character development and social character growth of staff on their performance in clinical and para-clinical fields of Ahvwaz Imam Khomeini hospital. In this research, the descriptive research method was of the correlational type. Necessary information was prepared from selected sample from the research statistical population, namely clinical and para-clinical staff of Ahwaz Imam Khomeini Hospital who was 1000 ones and 280 of them was selected as volume of the sample based on Cochran formula using available sampling. Data were collected using a researcher-built questionnaire based on Fordyce’s 14-point model with 42 questions and performance questionnaire and Stephen E. Candrie performance questionnaire with 10 aspects and 32 questions. Cronbach alpha coefficient for questionnaire and performance questionnaire were 0.97 and 0.94, respectively indicating acceptable reliability. Also, validity of the questionnaire was confirmed based on supervisors and number of experts in the field of management through content validity. Data analyses were done in to levels of descriptive and inferential statistics. In inferential part, regression analysis and Pearson correlation test were done using SPSS software. The results of the present study showed that living in the present, healthy character development and social character growth of Ahwaz Imam Khomeini Hospital staff have a positive effect on their performance and whatever staff live in the present and develop their character and be more social, their performance will increase.
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Trong Tuan, Luu, and Luu Thi Bich Ngoc. "CSR-based model of clinical governance." International Journal of Pharmaceutical and Healthcare Marketing 8, no. 1 (April 1, 2014): 62–97. http://dx.doi.org/10.1108/ijphm-05-2013-0026.
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Purpose – Clinical governance effectiveness is built on the responsibility of clinical members towards other stakeholders inside and outside the hospital. Through the testing of the hypotheses on the relationships between clinical governance and its antecedents, this paper aims to corroborate that emotional intelligence is the first layer of bricks, ethics and trust the second layer, and corporate social responsibility (CSR) the third layer of the entire architecture of clinical governance. Design/methodology/approach – A total of 409 responses in completed form returned from self-administered structured questionnaires dispatched to 705 clinical staff members underwent the structural equation modeling (SEM)-based analysis. Findings – Emotional intelligence among clinicians, as the data reveals, is the lever for ethics of care and knowledge-based or identity-based trust to thrive in hospitals, which in turn activate ethical CSR in clinical activities. Ethical CSR in clinical deeds will heighten clinical governance effectiveness in hospitals. Originality/value – The journey to test research hypotheses has built layer-by-layer of CSR-based model of clinical governance in which high concentration of emotional intelligence among clinical members in the hospital catalyzes ethics of care and knowledge-based or identity-based trust, without which, CSR initiatives to cultivate ethical values cannot be successfully implemented to optimize clinical governance effectiveness in Vietnam-based hospitals.
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Brandis, Susan, Stephanie Schleimer, and John Rice. "Bricks-and-mortar and patient safety culture." Journal of Health Organization and Management 31, no. 4 (June 19, 2017): 459–70. http://dx.doi.org/10.1108/jhom-04-2017-0072.
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Purpose Building a new hospital requires a major investment in capital infrastructure. The purpose of this paper is to investigate the impact of bricks-and-mortar on patient safety culture before and two years after the move of a large tertiary hospital to a greenfield site. The difference in patient safety perceptions between clinical and non-clinical staff is also explored. Design/methodology/approach This research uses data collected from the same workforce across two time periods (2013 and 2015) in a large Australian healthcare service. Validated surveys of patient safety culture (n=306 and 246) were analysed using descriptive and inferential statistics. Findings Using two-way analysis of variance, the authors found that perceived patient safety culture remains unchanged for staff despite a major relocation and upgrade of services and different perceptions of patient safety culture between staff groups remains the same throughout change. Practical implications A dramatic change in physical context, such as moving an entire hospital, made no measurable impact on perceived patient safety culture by major groups of staff. Improving patient safety culture requires more than investment in buildings and infrastructure. Understanding differences in professional perspectives of patient safety culture may inform organisational management approaches, and enhance the targeting of specific strategies. Originality/value The authors believe this to be the first empirically based paper that investigates the impact of a large investment into hospital capital and a subsequent relocation of services on clinical and non-clinical staff perceptions of patient safety culture.
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Hughes, Damien M., Maria McGinnity, John Kell, Oscar Kennedy, and Michael Donnelly. "Costing the hospital-based process of resettling people with learning disability in the community." Irish Journal of Psychological Medicine 20, no. 2 (June 2003): 41–44. http://dx.doi.org/10.1017/s079096670000759x.
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AbstractObjectives: Much has been written about the costs and cost-effectiveness of community care for people with learning disabilities resettled from long stay hospital care. However, comparatively little has been published about the cost of hospital services relating to the preparatory process before eventual resettlement and the disengagement of formal, sustained input from hospital staff. This study describes and costs the input provided by a hospital based multi-disciplinary team into the resettlement of adults with learning disabilities from long stay wards in Muckamore Abbey Hospital in Northern Ireland between 1996 and 1999 (n = 71).Method: The study employs a retrospective survey design. Information about the nature and frequency of the input of each member of hospital multi-disciplinary team was collected for each former client. According to the level of professional resources expended during the resettlement process, each former client was then categorised into one of three categories. One case was then selected at random to represent each category. A summary of clinical information, a description of the resettlement process and an estimate of the cost of the process was provided for each case.Results: Approximately 55% of people resettled in the community during the study period did so with a modest degree of input from hospital staff. For 18% resettlement proved to be a demanding and prolonged process, requiring intensive input from hospital staff. Financial costs of the resettlement process ranged from approximately stg£1,500 to stg£8,000, with an average of stg£3,400 for each person.Conclusion: This study provides evidence of the input by hospital staff into the process of community resettlement of long stay hospital clients and the associated costs. These costs must be included in service budgets if quality care and appropriate service provision is to be maintained in resettlement practice.
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Bozorgnejad, Mehri, Tahere Najafi, Shima Haghani, and Peyman Nazari. "The Impact of Trauma Simulation on Pre-Hospital Emergency Operations Staff." Iran Journal of Nursing 35, no. 135 (April 21, 2022): 106–17. http://dx.doi.org/10.32598/ijn.35.1.2915.1.
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Background & Aims: Trauma is the main cause of death and disability in the world. Pre-hospital care is the first line of trauma care and treatment. Pre-hospital emergency services include immediate actions to save lives. Simulation allows employees to acquire basic skills in thinking, evaluating, solving problems, making decisions and analyzing data. Materials & Methods: This is a quasi-experimental study with a pre-test/post-test design. The participants were 60 pre-hospital emergency staff selected from among 200 staff of Fars pre-hospital emergency center . The simulation training was based on an educational model. The clinical skills of the participants in dealing with trauma patients was evaluated by the Objective Structured Clinical Skills Evaluation method in nine areas. After the training, the skills were re-evaluated and analyzed in SPSS v. 22 software. Results: The lowest mean score (from 0 to 100) was related to the skill of using traction splint (71.01±18.73) and the highest score was related to the skill of bleeding control and shock treatment (81.04±22.75). The results of the paired t-test showed that the overall clinical skill and nine standard skills of dealing with trauma patients were significantly increased after simulation training (P<0.001). Conclusion: The simulation training can increase the skills of pre-hospital emergency staff in dealing with trauma patients.
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Torres, Adalberto, David E. Milov, Daniela Melendez, Joseph Negron, John J. Zhao, and Stephen T. Lawless. "A new approach to alarm management: mitigating failure-prone systems." Journal of Hospital Administration 3, no. 6 (October 9, 2014): 79. http://dx.doi.org/10.5430/jha.v3n6p79.
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Alarm management that effectively reduces alarm fatigue and improves patient safety has yet to be convincingly demonstrated. The leaders of our newly constructed children’s hospital envisioned and created a hospital department dedicated to tackling this daunting task. The Clinical Logistics Center (CLC) is the hospital’s hub where all of its monitoring technology is integrated and tracked twenty-four hours a day, seven days a week by trained paramedics. Redundancy has been added to the alarm management process through automatic escalation of alarms from bedside staff to CLC staff in a timely manner. The paramedic alerting the bedside staff to true alarms based on good signal quality and confirmed by direct visual confirmation of the patient through bedside cameras distinguishes true alarms from nuisance/false alarms in real time. Communication between CLC and bedside staff occurs primarily via smartphone texts to avoid disruption of clinical activities. The paramedics also continuously monitor physiologic variables for early indicators of clinical deterioration, which leads to early interventions through mechanisms such as rapid response team activation. Hands-free voice communication via room intercoms facilitates CLC logistical support of the bedside staff during acute clinical crises/resuscitations. Standard work is maintained through protocol-driven process steps and serial training of both bedside and CLC staff. This innovative approach to prioritize alarms for the bedside staff is a promising solution to improving alarm management.
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Huber, Steve, and Nicky Dozier. "Monitoring Antibiotic Usage in the Hospital." DICP 23, no. 7-8 (July 1989): S13—S15. http://dx.doi.org/10.1177/106002808902300703.
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The authors outline the quality indicators being developed by the Joint Commission on Accreditation of Health Care Organizations to compare hospital performance. The Joint Commission has provided several incentives to encourage antibiotic monitoring based on criteria derived from standard practice, as defined in the literature, and on the clinical judgment of the medical staff. In addition, the drug review process should be continuous and should encompass all areas of drug use in the hospital, including effectiveness in terms of disease outcome as well as cost efficiency. The authors discuss procedures under development in their institution to promote cost efficiency and informed discussion regarding clinical use of antibiotics on the formulary. Microbiology reporting, drug use, requests for nonformulary drugs, and unusual patterns of infection and sensitivities are tracked to identify problem areas and a feedback loop is used to inform the medical staff.
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Lavender, Steven A., Carolyn M. Sommerich, Elizabeth B. N. Sanders, Kevin D. Evans, Jing Li, Radin Zaid Radin Umar, and Emily S. Patterson. "Developing Evidence-Based Design Guidelines for Medical/Surgical Hospital Patient Rooms That Meet the Needs of Staff, Patients, and Visitors." HERD: Health Environments Research & Design Journal 13, no. 1 (June 13, 2019): 145–78. http://dx.doi.org/10.1177/1937586719856009.
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Objectives: This research investigated medical/surgical (Med/Surg) patient room design to accommodate the needs of hospital staff, while at the same time accommodating the needs of patients and their visitors. Background: Designing hospital patient rooms that provide a comfortable healing experience for patients, while at the same time meeting the needs of the hospital staff, is a challenging process. Prior research has shown that many hospital patient room designs adversely affect the ability of hospital staff to perform their tasks effectively, efficiently, and safely. Method: Twenty-seven design sessions were conducted in which 104 participants, representing 24 different occupations, worked in small mixed occupational groups to design an ideal single patient Med/Surg patient room to fit their collective needs using a full-scale mock-up. During analysis, the investigators reduced the resulting 27 room designs to 5 hybrid designs that were sequentially reviewed by patients and visitors and by staff to address design conflicts. Results: This design process identified 51 desirable room design features that were incorporated into 66 evidence-based design guidelines for the different areas within the Med/Surg patient room including the entry way (16 guidelines), the patient clinical area (22 guidelines), the bathroom (17 guidelines), the family area (8 guidelines), and storage areas for patients and their visitors (3 guidelines). Conclusions: The guidelines developed through this study identified many opportunities for improving the design of hospital Med/Surg rooms to allow staff to be more effective, efficient, and safer, while at the same time addressing the design needs of patients and their visitors.
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Ito-Hamerling, Gayle, Lindsay Emanuel, and Finly Zachariah. "Effectiveness of an advance care planning patient navigator on advance directive completion by electronic versus staff-based referrals at a major cancer hospital." Journal of Clinical Oncology 35, no. 31_suppl (November 1, 2017): 20. http://dx.doi.org/10.1200/jco.2017.35.31_suppl.20.
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20 Background: Advance Care Planning (ACP) is a central component of patient-centered care, helping ensure patient values and preferences guide clinical decisions. Patient navigators have been utilized effectively in healthcare for numerous roles, and more recently for ACP. At City of Hope National Medical Center (COH), an ACP-focused navigator was hired to support patients, families, and staff with Advance Directive (AD) notarization and primary ACP conversations. Methods: The Department of Supportive Care Medicine at COH with significant institutional collaboration and administrative support created a patient-centered ACP program and marketing campaign, called “Plan Today for Tomorrow.” In 2016, an ACP navigator joined the team to facilitate AD completion. Referral to the ACP navigator occurred either through staff endorsement and/or the institution’s technological screening platform deployed in a majority of COH outpatient clinics. Staff referrals came from physicians, clinical social workers, nurses, or from the Sheri & Les Biller Patient and Family Resource Center. Prior to the ACP navigator, all referrals were addressed by Clinical Social Workers (CSWs). Results: In a review of 14 months of data, the ACP navigator followed up on 1,125 referrals, 574 were from staff, while 551 were from the institutional tablet-based screening platform. Follow-up on staff referrals resulted in an 86% AD completion rate. Follow-up on tablet-based screening resulted in a 23% AD completion rate. Conclusions: The presence of an available onsite ACP-focused navigator was more effective in facilitating AD completion of staff generated AD referrals as compared to AD completion of tablet-based patient screening AD referrals. The presence of the ACP navigator to facilitate AD completion decreased workload for CSWs, creating increased opportunity for CSWs to work at the top of their professional license. Further work is needed to increase the effectiveness of AD completion from tablet-based screening referrals.
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Waitt, Peter, Shillah Nakato, Rodgers Ayebare, Umaru Ssekabira, Judith Nanyondo, Catriona Waitt, Stephen Okoboi, and Mohammed Lamorde. "Onsite Mentorship Model for Isolation and Management of Viral Hemorrhagic Fever Syndromes at a Ugandan Hospital." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s491—s492. http://dx.doi.org/10.1017/ice.2020.1167.
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Background:Uganda is prone to viral hemorrhagic fever (VHF) outbreaks. Infection prevention and control capacity is critical to supporting patient care, to preventing nosocomial transmission to health workers, and to limiting spread within the community. Offsite didactic training may increase healthcare worker knowledge, but this approach may be inadequate for assuring confident execution of practical clinical tasks in patient care settings. We aimed to develop a competency-based, onsite mentorship model for sentinel case isolation and management of viral hemorrhagic fever syndromes in Uganda. Methods: The Naguru Regional Referral Hospital (China Uganda Friendship Hospital) Kampala was selected as a site for training after its designation by the Uganda Ministry of Health (MoH) as facility for isolation of healthcare workers with suspected or confirmed VHF. The need for mentorships was determined from information from training providers, MoH assessments, hospital management, and key hospital staff. A list of skills was developed by reviewing WHO case management guidelines and Uganda-approved VHF trainings. The skills, exercised using scenario-based drills, focused on safety practices, identification and isolation of suspect cases, and delivery of optimized clinical care to suspected cases of VHF, among others. Trained facilitators (n = 2–4) supervised drills attended by staff from Naguru and other Kampala-based health facilities. Drills were scheduled weekly and were ordered to progressively increase in complexity. Specific drills could be repeated at the subsequent mentorship visit if gaps were identified. Results: Over 3 months, 12 drills were completed (Table 1). Cadres trained included 10 medical doctors, 12 nurses, 3 clinical officers, 5 laboratory technicians, 6 hygienists, 2 security officers, and 3 administrative officers. On average, 8 hospital staff attended weekly drills. During 3 months of the intervention, 1 suspected case of VHF and 3 cases with laboratory confirmed cholera were managed by the hospital team, and staff demonstrated the capacity for safe handling of patients with infectious bodily fluids. Barriers encountered included practice fatigue from repeated drills, challenges with team cohesion since members were from different institutions, limited personal protective equipment for repeated trainings, and competing routine hospital activities that reduced numbers of staff available for training. Repeated drills included clinical management, cadaver management, and infectious spills. Conclusions: This onsite mentorship project supported healthcare workers to gain confidence in the management of suspected VHF infection and other highly infectious diseases. Continued mentorship, hospital administration support and increase in exercise complexity are needed to consolidate on these gains.Funding: NoneDisclosures: Mohammed Lamorde reports contract research for Janssen Pharmaceutica, ViiV, and Mylan.
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Abor, Patience Aseweh. "Exploring clinical communication in a teaching hospital in Ghana." International Journal of Health Governance 24, no. 2 (May 22, 2019): 155–68. http://dx.doi.org/10.1108/ijhg-10-2018-0058.
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Purpose The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case. Design/methodology/approach The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication. Findings The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients’ reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment. Practical implications Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers. Originality/value It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals.
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Sumner, Jennifer, Jason Phua, and Yee Wei Lim. "Hospital-based chronic disease care model: protocol for an effectiveness and implementation evaluation." BMJ Open 10, no. 7 (July 2020): e037843. http://dx.doi.org/10.1136/bmjopen-2020-037843.
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IntroductionNovel and efficient healthcare approaches are needed to better serve increasingly older chronic disease patients. Many effective integrated chronic disease management strategies have emerged from the primary care sector. However, in many Asian and developing countries, primary care is underdeveloped, and patients prefer secondary-based services. The Integrated Generalist-led Hospital (IGH) care model is a new approach, which may be better suited for chronic disease patients in the local context.Methods and analysisA hybrid type I study on the effectiveness and implementation of the IGH care model will be conducted. Implementation evaluation will be informed by the Consolidated Framework of Implementation Research (CFIR). Quantitative and qualitative data will be collected through in-depth interviews and focus group discussions with staff, a staff survey, patient interviews, clinical outcomes and cost data. Clinical outcomes include the length of stay, readmission, emergency room visit rate and mortality. Clinical outcomes will be summarised and compared with a propensity-matched ‘usual care’ group (derived from the general medicine ward(s) at a separate hospital). The Kaplan-Meier approach will be used to estimate time until death and time until first readmission (both within 30 days of discharge) and time until discharge. Multivariate regression models will be used to investigate the association between the care model and occurrence of readmission, emergency room visit and death, all within 30 days of discharge. Qualitative data will be analysed using a thematic analysis method. Qualitative and quantitative data will also be coded according to the five domains of the CFIR.Ethics and disseminationThis protocol was reviewed and approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB 2019/00308). Results will be published in peer-reviewed scientific journals and conference presentations. Findings will also be discussed with key stakeholders through local dissemination events.
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May, Nicholas, Jeanne Young, and Lucia Gillman. "Take 5: Designing and evaluating 5-minute eLearning for busy hospital staff." Focus on Health Professional Education: A Multi-Professional Journal 22, no. 2 (July 30, 2021): 60–71. http://dx.doi.org/10.11157/fohpe.v22i2.505.
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Introduction: Ongoing professional education is an essential activity to ensure that hospital staff are using the best available evidence to deliver healthcare. Hospital staff from a range of professional groups cite increasing work volume and being too time poor to complete or attend education. To address this issue, a new 5-minute online education format (Take 5) was developed.Methods: A descriptive study using a short evaluation survey was undertaken at Royal Perth Hospital in Perth, Western Australia, to evaluate interprofessional healthcare staffs’ levels of engagement with the new education format.Results: The Take 5 education format facilitated the development of over 120 topics available via an intranet library page. During the study, it received 26,623 hits, averaging 19.3 visits per day. Topics were downloaded 45,611 times. Medication discrepancies (n = 1,326) and personal protective equipment (PPE) conservation (n = 1,115) were the most frequently downloaded. A total of 2,001 evaluation surveys were received, with nursing and medicine having the highest participation. The majority of staff (n = 1,895; 94.4%) rated the resource as having “good” to “high” quality content. Qualitative data showed that the topics were informative, easy to access and understand and perceived to help the participants change their clinical practice.Conclusion: The Take 5 uptake has been strong and sustained, as highlighted by the substantive utilisation and evaluation. The concept was not designed to replace formal education but to act as an adjunct, providing key education to meet staff demands. It provided immediacy of information and quality evidence-based content and directed the learner to more formal learning content and resources.
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Sasahara, Tomoyo, Mitsunori Miyashita, Megumi Umeda, Hitomi Higuchi, Junko Shinoda, Masako Kawa, and Keiko Kazuma. "Multiple evaluation of a hospital-based palliative care consultation team in a university hospital: Activities, patient outcome, and referring staff's view." Palliative and Supportive Care 8, no. 1 (February 18, 2010): 49–57. http://dx.doi.org/10.1017/s1478951509990708.
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AbstractObjective:Although the number of hospital-based palliative care consultation teams (PCCTs) is rapidly increasing in Japan, there is limited information available concerning the activities and usefulness of PCCT in the country. The aim of this study is to clarify the activities, patient outcome, and referring staff's view of an established PCCT in Japan.Method:This was a prospective study to follow patients referred to a PCCT for 28 days over a 1-year period. Patients were assessed by the Support Team Assessment Schedule–Japanese version (STAS-J) and EORTC QLQ C-30 at the time of referral and on days 7, 14, and 28. A staff survey was implemented using a questionnaire after each observation period.Results:Of 180 patients referred, 53 patients were eligible for the study. Although the median of the number of the reasons for referral was 1, the PCCT provided several kinds of support: pain management, 94%; emotional support for the patient, 49%; and emotional support for the family, 36%. On day 7 after referral, of the items of STAS-J and the EORTC QLQ C-30 subscales, only insomnia improved significant whereas “other physical symptoms” and constipation were significantly exacerbated. In the staff survey, of the 98 respondents, more than 90% considered the effect of the PCCT as “excellent” or “good” and were satisfied with the support provided.Significance of results:This study showed that the PCCT performed comprehensive assessments on referred patients and provided extra support. No patient's QOL 1 week after referral was improved with the exception of insomnia. Referring staff highly evaluated the activities of the PCCT. In the evaluation of PCCTs, further research about the variation of clinical activities of PCCTs, their applicability, and benefit is needed.
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Albanese, Francesca, Rachel Hurcombe, and Helen Mathie. "Towards an integrated approach to homeless hospital discharge." Journal of Integrated Care 24, no. 1 (February 15, 2016): 4–14. http://dx.doi.org/10.1108/jica-11-2015-0043.
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Purpose – The purpose of this paper is to present the findings of a small-scale evaluation of the Department of Health “Homeless Hospital Discharge Fund” (HHDF) in England. Design/methodology/approach – The paper is based on a mixed-method approach comprising 52 telephone interviews with project staff, 48 responses from an online survey with staff, outcomes data collected by projects, 30 semi-structured interviews with patients and nine in-depth telephone interviews with staff and commissioners. Findings – Overall the 52 pilots funded under the “HHDF” provided positive health and accommodation outcomes for homeless people admitted and discharged from hospital. In contrast to previous studies patients described not feeling judged during their stay, however the admission process was a more mixed experience due to communication breakdown by hospital staff. Integrating housing and clinical staff in the hospital discharge projects produced better outcomes for patients and the availability of accommodation as part of the model allowed improved and more stable housing outcomes. We recommend integrated commissioning takes place for future funding of any hospital discharge projects. Research limitations/implications – The study was small in scale and carried out before some of the projects had become fully established. The data were self-reported and the quality and completeness varied between projects. Originality/value – This is one of the few examples of hospital discharge outcomes for homeless people across a number of different localities and project models which examine the role of both health and housing professionals in the process.
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Brown, Rachel, Sharon Markman, Amanda Brown, Rukhshan Mian, Vineet Arora, and Craig Umscheid. "428. Assessing the Confidence, Knowledge and Preferences of Hospital Staff with Regards to Personal Protective Equipment (PPE) Practices During the COVID-19 Pandemic." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S314—S316. http://dx.doi.org/10.1093/ofid/ofab466.628.
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Abstract Background Effective use of personal protective equipment (PPE) by hospital staff is critical to prevent transmission of COVID-19. This study examines hospital staff confidence in and knowledge of effective PPE use, and their preferences for learning about PPE practices. Methods Three isolation precautions signs were created for use in the care of those with or under investigation for COVID-19 infection: first, a special respiratory precautions sign designed by infection control; and next, two signs outlining proper donning and doffing practices – one created internally with the support of health literacy, and another developed with a design firm (IDEO) using principles of human-centered design (Figure 1). All signs were used for ≥ 10 weeks prior to distribution of a questionnaire (REDCap) to clinical and non-clinical hospital staff. Those who had not worked on hospital units during the pandemic (after March 15, 2020) were excluded. The 38-item survey was sent by supervisors over email between July 14-31, 2020, and examined demographics, confidence in and knowledge of PPE best practices, and preferences for each precaution sign with regards to trustworthiness, ease of following, informative content, and clarity of image/layout. Responses were reported using descriptive statistics. A non-parametric test of trends compared staff preferences across signs. Logistic regression examined the association between answering all knowledge-based questions correctly and staff role and confidence in PPE practices (Stata). Results Of the 531 respondents, 461 were eligible for inclusion. The majority were female, white, and not high risk for COVID-19 (Table 1). Most were confident about PPE use, correctly answered questions examining knowledge of PPE best practices, and found PPE signage helpful (Table 2). Staff preferred the professionally designed sign for informative content (p< 0.01) and clear imagery/layout (p=0.01) (Table 3). Confidence in PPE practices and physician or nurse roles were associated with answering all knowledge-based questions correctly (p< 0.001 and p=0.04, respectively). Conclusion In a convenience sample of hospital staff, most were confident and knowledgeable about PPE use, found PPE signage helpful, and preferred professionally designed signs. Disclosures All Authors: No reported disclosures
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So, Eric H. K., N. H. Chia, George W. Y. Ng, Osburga P. K. Chan, S. L. Yuen, David C. Lung, W. C. Li, S. S. So, and Victor K. L. Cheung. "Multidisciplinary simulation training for endotracheal intubation during COVID-19 in one Hong Kong regional hospital: strengthening of existing procedures and preparedness." BMJ Simulation and Technology Enhanced Learning 7, no. 6 (May 25, 2021): 501–9. http://dx.doi.org/10.1136/bmjstel-2020-000766.
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IntroductionIn early 2020, our hospital responded with high alertness when novel coronavirus SARS-CoV-2 appeared. A hospital-based training programme was rapidly arranged to prepare staff for the imminent threat.ObjectiveWe developed a hospital-wide multidisciplinary infection control training programme on endotracheal intubation for healthcare workers to minimise nosocomial spread of COVID-19 during this high-stress and time-sensitive risky procedure.MethodologyMajor stakeholders (Quality & Safety Department, Infection Control Team, Central Nursing Division, high-risk clinical departments and hospital training centre) formed a training programme task group. This group was tasked with developing high-fidelity scenario-based simulation training curriculum for COVID-19 endotracheal intubation with standard workflow and infection control practice. This group then implemented and evaluated the training programme for its effectiveness.Results101 training classes of 2-hour session were conducted from 5 February to 18 March 2020, involving 1415 hospital staff (~81% of target participants with training needs) either inside the hospital training centre or as in situ simulation training (intensive care unit or accident and emergency department). Learners’ satisfaction was reflected by overall positive response percentage at 90%. Opinions of participating staff were incorporated into the standard airway management and infection control practice for endotracheal intubation of adult patients with COVID-19. Thirty-five patients with COVID-19 were intubated with the current workflow and guideline without any nosocomial transmission.ConclusionAn early planned and well-structured multidisciplinary hospital-wide simulation training programme was organised expeditiously to provide extensive staff coverage. The insight and experience gained from this project is valuable for future infectious disease challenges.
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Stacy, Kathleen M. "Challenges in Hospital-Associated Infection Management." AACN Advanced Critical Care 26, no. 3 (July 1, 2015): 252–61. http://dx.doi.org/10.4037/nci.0000000000000097.
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Maintaining a successful unit-based continuous quality improvement program for managing hospital-associated infections is a huge challenge and an overwhelming task. It requires strong organizational support and unit leadership, human and fiscal resources, time, and a dedicated and motivated nursing staff. A great deal of effort goes into implementing, monitoring, reporting, and evaluating quality improvement initiatives and can lead to significant frustration on the part of the leadership team and nursing staff when quality improvement efforts fail to produce the desired results. Each initiative presents its own unique set of challenges; however, common issues influence all initiatives. These common issues include organization and unit culture, current clinical practice guidelines being used to drive the initiatives, performance discrepancies on the part of nursing staff, availability of resources including equipment and supplies, monitoring of the data, and conflicting quality improvement priorities.
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Baxter, Ruth, Jane O’Hara, Jenni Murray, Laura Sheard, Alison Cracknell, Robbie Foy, John Wright, and Rebecca Lawton. "Partners at Care Transitions: exploring healthcare professionals’ perspectives of excellence at care transitions for older people." BMJ Open 8, no. 9 (September 2018): e022468. http://dx.doi.org/10.1136/bmjopen-2018-022468.
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IntroductionHospital admissions are shorter than they were 10 years ago. Notwithstanding the benefits of this, patients often leave hospital requiring ongoing care. The transition period can therefore be risky, particularly for older people with complex health and social care needs. Previous research has predominantly focused on the errors and harms that occur during transitions of care. In contrast, this study adopts an asset-based approach to learn from factors that facilitate safe outcomes. It seeks to explore how staff within high-performing (‘positively deviant’) teams successfully support transitions from hospital to home for older people.Methods and analysisSix high-performing general practices and six hospital specialties that demonstrate exceptionally low or reducing 30-day emergency hospital readmission rates will be invited to participate in the study. Healthcare staff from these clinical teams will be recruited to take part in focus groups, individual interviews and/or observations of staff meetings. Data collection will explore the ways in which teams successfully deliver exceptionally safe transitional care and how they overcome the challenges faced in their everyday clinical work. Data will be thematically analysed using a pen portrait approach to identify the manifest (explicit) and latent (abstract) factors that facilitate success.Ethics and disseminationEthical approval was obtained from the University of Leeds. The study will help develop our understanding of how multidisciplinary staff within different healthcare settings successfully support care transitions for older people. Findings will be disseminated to academic and clinical audiences through peer-reviewed articles, conferences and workshops. Findings will also inform the development of an intervention to improve the safety and experience of older people during transitions from hospital to home.
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Correa, Daniel J., Daniel L. Labovitz, Mark J. Milstein, Renee Monderer, and Sheryl R. Haut. "Folding a neuroscience center into streamlined COVID-19 response teams." Neurology 95, no. 13 (July 30, 2020): 583–92. http://dx.doi.org/10.1212/wnl.0000000000010542.
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In response to the COVID-19 pandemic epicenter in Bronx, NY, the Montefiore Neuroscience Center required rapid and drastic changes when considering the delivery of neurologic care, health and safety of staff, and continued education and safety for house staff. Health care leaders rely on principles that can be in conflict during a disaster response such as this pandemic, with equal commitments to ensure the best care for those stricken with COVID-19, provide high-quality care and advocacy for patients and families coping with neurologic disease, and advocate for the health and safety of health care teams, particularly house staff and colleagues who are most vulnerable. In our attempt to balance these principles, over 3 weeks, we reformatted our inpatient neuroscience services by reducing from 4 wards to just 1, in the following weeks delivering care to over 600 hospitalized patients with neuro-COVID and over 1,742 total neuroscience hospital bed days. This description from members of our leadership team provides an on-the-ground account of our effort to respond nimbly to a complex and evolving surge of patients with COVID in a large urban hospital network. Our efforts were based on (1) strategies to mitigate exposure and transmission, (2) protection of the health and safety of staff, (3) alleviation of logistical delays and strains in the system, and (4) facilitating coordinated communication. Each center's experience will add to knowledge of best practices, and emerging research will help us gain insights into an evidence-based approach to neurologic care during and after the COVID-19 pandemic.
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Vohra, Saifi, and Joann Fox. "Clinical Intervention: Positive Outcome Based on Improved Communication with Physicians in a Community Hospital." Journal of Pharmacy Practice 9, no. 3 (June 1996): 188–201. http://dx.doi.org/10.1177/089719009600900306.
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Establishment of a clinical intervention program and standardized drug information system in a community hospital is explained. The establishment of the program increased better communication among pharmacists, medical staff, and other health care professionals. An effective and consistent interaction with the physicians with respect to patient's drug therapy was developed. Medication misadventures are diminished in a positive communications environment. The total number of interventions increased to 4,275 in first year of program in 1992 and 6,700 in 1993. The first six months of 1994 yielded similar improvements with a total of 3,390 interventions. Before 1991, no documentation of interventions existed. This intervention program resulted in a great cost savings to the pharmacy department. An estimated $96,000 cost savings was observed in 1992 and $87,000 in 1993. In the first six months of 1994, a cost savings of $48,000 was observed. This program decreased drug inventory to the lowest level recorded at this institution over this 30 month period. Significant improvement in several intervention categories such as adverse drug reaction (ADR), conversion from parenteral to oral therapy, aminoglycoside and vancomycin monitoring were observed. Statistical analysis showed significant improvement in the intervention program over a three-year period with P value ranging from 0.00 to 0.012.
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Maina, Daniel, Geoffrey Omuse, George Ong’ete, Patrick Mugaine, Shahin Sayed, Zahir Moloo, Reena Shah, Anthony Etyang, and Rodney Adam. "Seroprevalence, correlates and kinetics of SARS-CoV-2 nucleocapsid IgG antibody in healthcare workers and nonclinical staff at a tertiary hospital: A prevaccine census study." PLOS ONE 17, no. 10 (October 27, 2022): e0267619. http://dx.doi.org/10.1371/journal.pone.0267619.
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Background Healthcare workers and nonclinical staff in medical facilities are perceived to be a high-risk group for acquiring SAR-CoV-2 infection, and more so in countries where COVID-19 vaccination uptake is low. Serosurveillance may best determine the true extent of SARS-CoV-2 infection since most infected HCWs and other staff may be asymptomatic or present with only mild symptoms. Over time, determining the true extent of SARS-CoV-2 infection could inform hospital management and staff whether the preventive measures instituted are effective and valuable in developing targeted solutions. Methods This was a census survey study conducted at the Aga Khan University Hospital, Nairobi, between November 2020 and February 2021 before the implementation of the COVID-19 vaccination. The SARS-CoV-2 nucleocapsid IgG test was performed using a chemiluminescent assay. Results One thousand six hundred thirty-one (1631) staff enrolled, totalling 60% of the workforce. The overall crude seroprevalence was 18.4% and the adjusted value (for assay sensitivity of 86%) was 21.4% (95% CI; 19.2–23.7). The staff categories with higher prevalence included pharmacy (25.6%), outreach (24%), hospital- based nursing (22.2%) and catering staff (22.6%). Independent predictors of a positive IgG result after adjusting for age, sex and comorbidities included prior COVID-19 like symptoms, odds ratio (OR) 2.0 [95% confidence interval (CI) 1.3–3.0, p = 0.001], a prior positive SARS-CoV-2 PCR result OR 12.0 (CI: 7.7–18.7, p<0.001) and working in a clinical COVID-19 designated area, OR 1.9 (CI 1.1–3.3, p = 0.021). The odds of testing positive for IgG after a positive PCR test were lowest if the antibody test was performed more than 2 months later; OR 0.7 (CI: 0.48–0.95, p = 0.025). Conclusions The prevalence of anti- SARS-CoV-2 nucleocapsid IgG among HCWs and nonclinical staff was lower than in the general population. Staff working in clinical areas were not at increased risk when compared to staff working in non-clinical areas.
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Fairchild, Roseanne, Shiaw-Fen Ferng, and Randi Zwerner. "Authentic leadership practices informed by a rural hospital study." Journal of Hospital Administration 4, no. 2 (March 9, 2015): 54. http://dx.doi.org/10.5430/jha.v4n2p54.
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The purpose of this study was to explore perceptions of work environment characteristics across employee groups in a rural hospital to determine if authentic leadership and management practices were perceived to be actualized in the organization. Creating a healthy work environment through authentic leadership practices is critical to sustaining care quality improvements (QIs) and patient safety. In light of fewer financial and educational resources, an academic-practice partnership provides evidencebased support for administrators in rural hospitals. This mixed methods study involved the following measures: 1) Descriptive cross-sectional survey of hospital employees regarding work environment characteristics (N = 139/188; 74% response rate), yielding statistical power of .95, and 2) multiple qualitative focus groups with employees (N = 37) to explore contextual factors potentially influencing perceptions of work environment. There were statistically significant differences among perceived levels of vitality for hospital administrative staff compared to clinical and ancillary staff (p < .000 – p < .026). Thematic content of qualitative data revealed issues regarding a perceived lack of authentic leadership and management behaviors. Adopting best practices related to QIs may first require a paradigm shift by hospital leadership and management through conscious promotion of mutual trust and healthy work behaviors. An academic-practice partnership can provide data-based insights into work environment characteristics that may need attention so that the hospital administrator may empower staff-driven, collaborative QIs from an evidence-based stance.
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Wareńczak, Agnieszka, Ewa Chlebuś, Przemysław Daroszewski, Dagna Dreczka, and Przemysław Lisiński. "STAFF ABSENTEEISM AND DELIVERY OF HEALTHCARE SERVICES DURING THE COVID-19 PANDEMIC AT WIKTOR DEGA ORTHOPEDIC AND REHABILITATION CLINICAL HOSPITAL IN POZNAŃ, POLAND." Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion – IRONS 36 (September 2021): 31–39. http://dx.doi.org/10.19271/irons-000142-2021-36.
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Introduction The COVID-19 pandemic has led to various interruptions in the implementation of healthcare services provided by hospitals. Aim The aim of this study was to evaluate the staff absenteeism during the COVID-19 pandemic at Wiktor Dega Orthopedic and Rehabilitation Clinical Hospital in Poznań as well as to present the standard of providing the healthcare services assigned to the Hospital under the contract with the National Health Fund. Material and methods Work attendance of more than 700 hospital employees at Wiktor Dega Orthopedic and Rehabilitation Clinical Hospital in Poznań was evaluated. The assessment of the number of medical services that were provided during the study time was based on monthly reports prepared for the national payer of health services. A retrospective analysis covered the period of JanuaryApril 2019 and January-April 2020. Results In the months of March and April 2020, a significant increase in staff absenteeism was reported. An evaluation of the relative values of the implementation rate of medical services for the months January-April of 2019 and 2020 showed that in April 2020, there was a substantial reduction (10%) in the implementation rate of medical services on orthopaedic wards, while on rehabilitation wards, the reduction in the implementation rate started in March 2020 and was also reported in April 2020 (6%). Conclusions The COVID-19 pandemic resulted in higher staff absenteeism rates in various professional groups working in our hospital. A reduction in the performance of healthcare procedures in our hospital, both orthopaedic and rehabilitation, will lead to a re-analysis of costs and will result in applying economizing mechanisms. Keywords:COVID-19, hospitals, health services, absenteeism, healthcare, hospital employees.
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Tagarakis, Georgios I., Costas Dikeos, Fani Tsolaki, Marios Daskalopoulos, Petros Bougioukakis, Nikolaos Tsilimingas, and Nikolaos Polyzos. "THE SIGNIFICANCE OF CLINICAL PROTOCOLS IN SURGICAL DISCIPLINES." JOURNAL OF SOCIAL SCIENCE RESEARCH 6, no. 1 (December 8, 2014): 927–33. http://dx.doi.org/10.24297/jssr.v6i1.6639.
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In the current article we aim to describe and show the significance of evidence-based medicine (EBM) in surgical disciplines, as this is expressed through the application of clinical protocols and clinical indicators of quality and outcome. We also probe the questions of clinical protocols assisting in hospital management, and moreover of the political and political-ethical issues for the implementation of clinical protocols in the pursuit of better hospital management. Clinical protocols are guidelines with broader scientific acceptance, helping physicians, surgeons and health staff in general, to perform a procedure or combination of procedures with the best possible results at the lowest possible cost. Clinical indicators are implemented in order to assess the achieved results; such indicators are in-hospital mortality, frequency of adverse events such as stroke or venous thromboembolism, duration of hospitalization, incidence of reoperation, incidence of re-admittance etc. The article also includes, for reasons of better understanding, two examples of clinical protocols (coronary artery surgery and total hip arthroplasty).
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Olsson, Helén, and Lisbeth Kristiansen. "Violence Risk Assessment in Forensic Nurses’ Clinical Practice: A Qualitative Interview Study." Global Journal of Health Science 9, no. 12 (October 16, 2017): 56. http://dx.doi.org/10.5539/gjhs.v9n12p56.
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BACKGROUND: The legislation of Swedish forensic psychiatric care states that the risk of further violence must be assessed before a patient is granted release from a forensic psychiatric hospital. The aim of the study was to describe the experiences of forensic nurses with in-patient risk assessment processes, and their implication for daily clinical forensic praxis.METHOD: Semi-structured interviews with staff who were involved in the patients risk assessment process. The interview texts were analyzed using qualitative latent content analysis.DISCUSSION: The forensic nursing staff has to deal with many contradictory realities. The description was about being able to balance between supporting their work with an EBP approach of risk assessment while trying to establish interpersonal relationships and to allow for positive meetings with the patient. The study indicated that staff used a multiple sources of knowledge in order to make credible and accurate risk assessments.CONCLUSIONS: If the risk assessment process are to be used in a legally secure manner, the staff must receive regular support from team leadership that can provide both guidance and training. Based on a holistic approach, the link between the instinct of staff and their work with structured risk assessment must be founded on routines and solid platforms.
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Lesho, Emil P., Edward E. Walsh, Jennifer Gutowski, Lisa Reno, Donna Newhart, Stephanie Yu, Jonathan Bress, and Melissa Bronstein. "489. A Case-Control Approach to an Outbreak of SARS-CoV-2 on an Acute Stroke Unit in the U.S." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S310—S311. http://dx.doi.org/10.1093/ofid/ofaa439.682.
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Abstract Background Detailed descriptions of hospital-acquired SARS-CoV-2 infections and transmission chains in healthcare settings are crucial to controlling outbreaks and improving patient safety. However, such reports are scarce. We sought to determine origins and factors associated with nosocomial transmission of SARS-CoV-2 in a 528-bed teaching hospital in Western New York. Methods The index patient, who had mental illness, wandered throughout the ward, would not wear a facemask, and was often kept seated at the nursing station, developed COVID-19 on day- 22 of hospitalization. A case-control approach was used, wherein all patients, staff, and 128 randomly selected environmental surfaces on the outbreak unit (case), and randomly selected patients, staff, and environmental surfaces on designated COVID-19 and non-COVID-19 units (control), were tested for SARS-COV-2 by RT-PCR and IgG SARS-COV-2 antibodies (SAR-Ab). Compliance with hand hygiene (HH) and COVID-specific personal protective equipment (PPE) was assessed. Results 145 staff and 26 patients were potentially exposed resulting in 25 secondary cases (14 staff and 11 patients). 4/14 (29%) of the staff and 7/11 (64%) of the patients who tested positive, and later became ill, were asymptomatic at the time of testing (Figures 1–2). There was no difference in mean cycle threshold for SARS-COV-2 gene targets between asymptomatic and symptomatic individuals. 0/32 randomly selected staff from the positive and negative control wards tested positive. PPE compliance based on 354 observations was not significantly different between wards. Environmental surface contamination with SARS-COV-2 RNA was not different between outbreak and control wards. Mean monthly HH compliance, based on 20,146 observations, was lower on the outbreak ward (p < 0.006) (Figure 3). 142 staff volunteered for serologic testing. The proportion staff with detectable SAR-Ab was higher on the outbreak ward (OR 3.78: CI 1.01–14.25). Figure 1 Figure 2 Figure 3 Conclusion The risk of staff exposure was higher in an outbreak setting than on a dedicated COVID-19 unit (Figure 4). Noncompliant patient behavior, decreased hand hygiene, and pre-symptomatic transmission can contribute to nosocomial spread and are important considerations for ongoing infection control efforts. Figure 4 Disclosures All Authors: No reported disclosures
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Trong Tuan, Luu. "Clinical governance, corporate social responsibility, health service quality, and brand equity." Clinical Governance: An International Journal 19, no. 3 (July 1, 2014): 215–34. http://dx.doi.org/10.1108/cgij-02-2014-0007.
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Purpose – Brand equity of hospitals is built on patient care service quality. Through the testing of the hypotheses on the relationships between brand equity and its precursors, the purpose of this paper is to examine if clinical governance effectiveness is driven by corporate social responsibility (CSR), and if clinical governance effectiveness influences patient care service quality which in turn influences brand equity. Design/methodology/approach – In total, 417 responses in completed form returned from self-administered structured questionnaires relayed to 835 clinical staff members underwent the structural equation modeling-based analysis. Findings – CSR, as the data divulges, is a strong predictor of clinical governance effectiveness which yields high patient care quality and brand equity of the hospital. Originality/value – The expedition to test research hypotheses constructed layer by layer of CSR-based model of hospital brand equity in which high levels of CSR among clinical members in the hospital activates clinical governance mechanism, without which, initiatives to improve patient care service quality may not be successfully implemented to augment brand equity of Vietnam-based hospitals.
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Dowden, Stephanie, Maria McCarthy, and George Chalkiadis. "Achieving Organizational Change in Pediatric Pain Management." Pain Research and Management 13, no. 4 (2008): 321–26. http://dx.doi.org/10.1155/2008/146749.
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BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices.OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital.DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party.RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described.CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement.
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Wensley, Sean, Vicki Betton, Nicola Martin, and Emma Tipton. "Advancing animal welfare and ethics in veterinary practice through a national pet wellbeing task force, practice-based champions and clinical audit." Veterinary Record 187, no. 8 (June 12, 2020): 316. http://dx.doi.org/10.1136/vr.105484.
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BackgroundVeterinary animal welfare advocacy can be undertaken at individual, community, national and international levels. The People’s Dispensary for Sick Animals (PDSA), a veterinary charity with 48 Pet Hospitals UK-wide, created a consultative staff network to put an explicit organisational focus on animal welfare–focused veterinary practice.MethodsPDSA created a national internal committee—a Pet Wellbeing Task Force—composed of veterinary staff representatives. Together with recruited hospital-based Champions who serve as a focus for animal welfare and ethics within their clinical teams, the resulting staff network has described a vision of animal welfare and ethics within companion animal veterinary practice, with accompanying practice-level actions. These actions have formed the basis for national clinical audit, repeated three times since 2013.ResultsThe audit, alongside targeted interventions, has driven organisational change (eg, new policies), led to measurable improvements in pet wellbeing (eg, improved pain assessment and management) and stimulated collaborative practice-based research with universities.ConclusionA dedicated staff network has facilitated organisation-wide communication on animal welfare and ethics; offered a safe space to raise and discuss animal welfare and ethical issues; and fostered leadership, by working towards model veterinary practice with respect to animal welfare and ethics, with benefits for pet patients, staff and the wider veterinary and veterinary nursing professions.
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Stuart, Duncan. "Invited Comment." Australian Medical Record Journal 19, no. 3 (September 1989): 97–99. http://dx.doi.org/10.1177/183335838901900302.
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The Medical Management Analysis (MMA) system of quality assurance by screening medical records for “occurrences” was trialled at the Royal North Shore Hospital, a major 780 bed teaching hospital in Sydney, in 1988. This Californian approach has now evolved into a more focused hospital-based peer review system (called QARNS) which is operating effectively and efficiently at the hospital. Whilst still based on the 23 MMA criteria, QARNS has achieved greater acceptance and action from the clinical staff. Implementation of QARNS at the other four acute general hospitals within the adjacent Area Health Service is now under active consideration.
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Worthington, Nicole, and Shannon Bristow. "Enhancing a culture of patient safety in an oncologic hospital setting." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 135. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.135.
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135 Background: Patient safety is a priority for all hospitals and staff members. With approx. 1:10 hospitalized patients experiencing an adverse event1, healthcare lags behind other industries with regards to safety. Oncology patients have an increased risk of adverse events due to an immunocompromised status, coupled with complex treatments. Cancer Treatment Centers of America at Eastern Regional Medical Center (ERMC) recognized the need to heighten patient safety while maintaining a positive patient experience. Methods: ERMC participates in the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture to assess employee’s perception of the organization’s patient safety, conducted every 18-24 months. The most recent survey was conducted between May 11 - June 1, 2015. Interventions to enhance safety culture from 2013 to 2015 survey results included: daily safety check-ins for all hospital departments for both day and night shifts; sharing safety stories before routine meetings; leadership rounding; and enhanced transparency of safety events that occurred throughout the hospital. Routine in-servicing was also completed to educate staff members on reportable safety events for Pennsylvania and foster ongoing discussions about patient safety. Results: Survey response rate experienced a 236% increase from 2013 to 2015 (218 to 628 responses respectively). Of the 12 patient safety composites, 11 showed an increase in scores from 2013 to 2015, the outlier being “overall perceptions of patient safety” composite score which dropped by two percentage points. Furthermore, ERMC was above the national benchmark in all 12 patient safety composite categories for the 2015 survey. Conclusions: The ERMC staff considers safety a priority, as evidenced by the increase in AHRQ survey scores from 2013 to 2015. Perceptions of safety throughout the system have increased with the initiation of several safety projects. Based on raw comments from the AHRQ culture of safety survey, more work is needed to involve non-clinical staff in hospital safety. Moving forward, ERMC will investigate innovative solutions to involve all staff, clinical and non-clinical alike, to be engaged in patient safety.