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15 records – page 1 of 2.

[Creation and use of the complex of automated programs of diagnosis and prognosis of ischemic heart disease. 2. Main diagnostic programs and the results of their use].

https://arctichealth.org/en/permalink/ahliterature249254
Source
Ter Arkh. 1978;50(8):8-11
Publication Type
Article
Date
1978

The effect of arctic isolation on human performance

https://arctichealth.org/en/permalink/ahliterature300585
Source
Review of research on military problems in cold regions
Publication Type
Report
Date
December 1964
  1 website  
Author
R.G. Possenti
Author Affiliation
Arctic Aeromedical Laboratory
Source
Review of research on military problems in cold regions
Date
December 1964
Language
English
Publication Type
Report
Keywords
Military operations research - Cold weather operation
Abstract
Examples of failure to prepare adequately for military operations in cold regions can be found in history from the time of Hannibal to the Korean conflict. Cold, darkness, wind, snow, ice, muskeg, glaciers, vast unpopulated areas, insects, ice fog, and whiteouts are well-known examples of factors which characterize the harsh unyielding arctic environment. The papers presented in this symposium will hopefully assist in serving as a stimulus for a more concentrated effort toward resolving the problems of operating in cold regions.
Online Resources
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Logics and logistics of community intervention against osteoporosis: an evidence basis.

https://arctichealth.org/en/permalink/ahliterature72769
Source
J Med Syst. 1997 Feb;21(1):33-47
Publication Type
Article
Date
Feb-1997
Author
J. Waller
M. Angbratt
C. Blomberg
A C Kronhed
L. Larsson
O. Löfman
M. Möller
G. Toss
M. Foldevi
E. Trell
Author Affiliation
Vadstena Primary Health Care Center, Sweden.
Source
J Med Syst. 1997 Feb;21(1):33-47
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Adult
Aged
Consumer Participation
Evidence-Based Medicine
Female
Guidelines
Health Education - organization & administration
Health Knowledge, Attitudes, Practice
Health Promotion - organization & administration
Health Services Research
Humans
Male
Middle Aged
Operations Research
Osteoporosis - prevention & control
Program Development
Sweden
Abstract
Under designations like small areas action research and intervention, directed 'ground-up' health promotion and prevention in the population form an important part of the ongoing medical systems development. There is recent evidence of the success of community intervention against cardiovascular disease. In osteoporosis, however, there is still a lack of conclusive data on both the logics and logistics of such an approach. Since 1988, a county health policy program has been formulated and implemented in Ostergötland, Sweden, following the principles and guidelines of the WHO HFA 2000 declaration. Vadstena (n approximately 7,600) was chosen for a local and generalizable osteoporosis prevention project mediated by the primary care organization by means of health promotion and education in the community. In the present report we emphasize that community intervention is an important new advancement of the medical systems, where the basic research questions include operational and management aspects as equally vital and measurable requisites and results as other performance and outcome variables. We found that a community intervention trial against osteoporosis is both motivated and feasible and in this report wish to provide evidence on these crucial issues of logics and logistics.
PubMed ID
9172068 View in PubMed
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Markers of overcrowding in a pediatric emergency department.

https://arctichealth.org/en/permalink/ahliterature144415
Source
Acad Emerg Med. 2010 Feb;17(2):151-6
Publication Type
Article
Date
Feb-2010
Author
Antonia S Stang
David McGillivray
Maala Bhatt
Antoinette Colacone
Nathalie Soucy
Ruth Léger
Marc Afilalo
Author Affiliation
Pediatric Emergency Department, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. antonia.stang@albertahealthservices.ca
Source
Acad Emerg Med. 2010 Feb;17(2):151-6
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Canada
Cross-Sectional Studies
Emergency Service, Hospital - utilization
Factor Analysis, Statistical
Humans
Operations Research
Patient Transfer - statistics & numerical data
Patients - statistics & numerical data
Pediatrics - organization & administration
Process Assessment (Health Care)
Triage - statistics & numerical data
Abstract
The objective of this study was to identify markers of overcrowding in pediatric emergency departments (PEDs) according to expert opinion and then to use statistical methods to further explore the underlying construct of overcrowding.
A cross-sectional survey of all PED directors (n = 12) and pediatric emergency medicine fellowship program directors (n = 10) across Canada was conducted to elicit expert opinion on relevant markers of emergency department (ED) crowding. The list of markers was reduced to those specific to the ED for which data could be extracted from one tertiary care PED from an existing computerized patient tracking system. Data representing 2,190 consecutive shifts and 138,361 patient visits were collected between April 2005 and March 2007. Common factor analysis (CFA) was used to determine the underlying factors that best represented overcrowding as determined by markers identified by experts in pediatric emergency medicine
The main markers of overcrowding identified by the survey included measures of patient volume (25%), ED operational processes (55%), and delays in transferring patients to inpatient beds (13%). Data collected on 41 markers were retained for the CFA. The results of the CFA indicated that the largest portion of variation in the data (48%) was accounted for by markers describing patient volumes and flow through the ED. Measures of admission delays accounted for a smaller proportion of variability (9%).
The results suggest that for this tertiary PED, markers of ED operational processes and patient volume may be more relevant for determination of overcrowding than markers reflecting delays in transferring patients to inpatient beds. This study provides a foundation for further research on markers of overcrowding specific to the pediatric setting.
Notes
Comment In: Acad Emerg Med. 2010 Feb;17(2):202-320370750
PubMed ID
20370744 View in PubMed
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Model simulation of the patient flow through a screening centre for diabetic retinopathy.

https://arctichealth.org/en/permalink/ahliterature46944
Source
Acta Ophthalmol Scand. 2005 Dec;83(6):678-86
Publication Type
Article
Date
Dec-2005
Author
Anja B Hansen
René Normann Hansen
Morten Colding-Jørgensen
Knut Borch-Johnsen
Henrik Lund-Andersen
Author Affiliation
Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. anbha@herlevhosp.kbhamt.dk
Source
Acta Ophthalmol Scand. 2005 Dec;83(6):678-86
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Algorithms
Computer simulation
Denmark
Diabetic Retinopathy - diagnosis
Health Facilities - organization & administration
Humans
Models, Theoretical
Operations Research
Photography
Research Support, Non-U.S. Gov't
Vision Screening - organization & administration
Abstract
PURPOSE: To construct a quantitative, flexible and simplified mathematical model of the patient flow through the Eye Clinic at the Steno Diabetes Centre (SDC) in order to enable rational dimensioning and assess the effects of modifications. METHODS: Patient data were drawn from the Eye Care database at the SDC. A simple patient flow model was constructed, allowing simultaneous adjustments of all variables, and the model was tested. Two scenarios were simulated: (1) adjusting the algorithm that assigns the follow-up intervals, and (2) increasing the population size to include all patients with diabetes in Copenhagen County. RESULTS: The model can describe the patient flow under steady state conditions, but is less precise in predicting transient changes with the present set-up. Accordingly all simulations were run for a substantial number of iterations. The two scenarios illustrate the usefulness of the model by calculating the required photographic examination capacity for the specific population, thereby allowing better estimations of future dimensioning of the organization. CONCLUSION: The study presents a patient flow model that can be used to illustrate the effects of proposed changes prior to their implementation, specifically with respect to the capacity of the system.
PubMed ID
16396644 View in PubMed
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No paper, but the same routines: a qualitative exploration of experiences in two Norwegian hospitals deprived of the paper based medical record.

https://arctichealth.org/en/permalink/ahliterature93767
Source
BMC Med Inform Decis Mak. 2008;8:2
Publication Type
Article
Date
2008
Author
Lium Jan-Tore
Tjora Aksel
Faxvaag Arild
Author Affiliation
Department of Industrial Economics and Technology Management, and Norwegian Research Centre for Electronic Patient Records, Norwegian University of Science and Technology (NTNU), Norway. jantore@lium.no
Source
BMC Med Inform Decis Mak. 2008;8:2
Date
2008
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Attitude to Computers
Consumer Satisfaction
Cross-Sectional Studies
Hospital Information Systems
Humans
Institutional Practice
Interviews as Topic
Medical Records Systems, Computerized - utilization
Medical Staff, Hospital - psychology
Norway
Operations Research
Qualitative Research
Questionnaires
User-Computer Interface
Workplace
Abstract
BACKGROUND: It has been shown that implementation of electronic medical records (EMR) and withdrawal of the paper-based medical record is feasible, but represents a drastic change in the information environment of hospital physicians. Previous investigations have revealed considerable inter-hospital variations in EMR system use and user satisfaction. The aim of this study was to further explore changes of clinicians' work after the EMR system implementation process and how they experienced working in a paper-deprived information environment. METHODS: Qualitative study based on 18 semi-structured interviews with physicians in two Norwegian hospitals. RESULTS: Ten different but related characteristics of work within the EMR-based practice were identified; (1) there was closer clinical and administrative cooperation during the implementation processes; (2) there were greater benefits when everybody used the system; (3) systems supported freshmen better than experienced physicians; (4) the EMR was useful in regard to professional learning; (5) new users were given an introduction to the system by experienced; (6) younger clinicians reported different attitudes than senior clinicians, but this might be related to more than age and previous experience with computers; (7) the EMR made it easier to generate free-text notes, but this also created a potential for information overflow; (8) there is little or no support for mobile work; (9) instances of downtime are still experienced, and this influenced the attitude towards the system and (10) clinicians preferred EMR-only compared to combined paper and electronic systems. CONCLUSION: Despite the removal of paper-based records from clinical workflow (a change that hospital clinicians perceived as highly useful), many of the old routines remained unchanged, limiting the potential of the EMR system. Thus, there is a need to not only remove paper in the physical sense, but also to established routines to fully achieve the benefits of an EMR system.
PubMed ID
18186935 View in PubMed
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Operations research methods improve chemotherapy patient appointment scheduling.

https://arctichealth.org/en/permalink/ahliterature118115
Source
Jt Comm J Qual Patient Saf. 2012 Dec;38(12):541-53
Publication Type
Article
Date
Dec-2012
Author
Pablo Santibáñez
Ruben Aristizabal
Martin L Puterman
Vincent S Chow
Wenhai Huang
Christian Kollmannsberger
Travis Nordin
Nancy Runzer
Scott Tyldesley
Author Affiliation
British Columbia Cancer Agency, Vancouver, Canada. psantibanez@bccancer.bc.ca
Source
Jt Comm J Qual Patient Saf. 2012 Dec;38(12):541-53
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Appointments and Schedules
British Columbia
Drug Administration Schedule
Humans
Neoplasms - drug therapy
Operations Research
Quality Improvement
Workload
Abstract
Clinical complexity, scheduling restrictions, and outdated manual booking processes resulted in frequent clerical rework, long waitlists for treatment, and late appointment notification for patients at a chemotherapy clinic in a large cancer center in British Columbia, Canada. A 17-month study was conducted to address booking, scheduling and workload issues and to develop, implement, and evaluate solutions.
A review of scheduling practices included process observation and mapping, analysis of historical appointment data, creation of a new performance metric (final appointment notification lead time), and a baseline patient satisfaction survey. Process improvement involved discrete event simulation to evaluate alternative booking practice scenarios, development of an optimization-based scheduling tool to improve scheduling efficiency, and change management for implementation of process changes. Results were evaluated through analysis of appointment data, a follow-up patient survey, and staff surveys.
Process review revealed a two-stage scheduling process. Long waitlists and late notification resulted from an inflexible first-stage process. The second-stage process was time consuming and tedious. After a revised, more flexible first-stage process and an automated second-stage process were implemented, the median percentage of appointments exceeding the final appointment notification lead time target of one week was reduced by 57% and median waitlist size decreased by 83%. Patient surveys confirmed increased satisfaction while staff feedback reported reduced stress levels.
Significant operational improvements can be achieved through process redesign combined with operations research methods.
PubMed ID
23240262 View in PubMed
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Preventing heart disease: is treating the high risk sufficient?

https://arctichealth.org/en/permalink/ahliterature234014
Source
J Clin Epidemiol. 1988;41(11):1083-93
Publication Type
Article
Date
1988
Author
T E Kottke
L C Gatewood
S C Wu
H A Park
Author Affiliation
Department of Medicine, Mayo Clinic, Rochester, MN 55905.
Source
J Clin Epidemiol. 1988;41(11):1083-93
Date
1988
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Coronary Disease - prevention & control
Finland
Humans
Hypercholesterolemia - complications - prevention & control
Hypertension - complications - prevention & control
Male
Middle Aged
Monte Carlo Method
Operations Research
Risk factors
Smoking - adverse effects - prevention & control
United States
Abstract
Monte Carlo simulation was used to assess the effects of several intervention strategies on coronary heart disease mortality rates in a Finnish and a North American cohort. Lowering total serum cholesterol by 4%, smoking by 15%, and diastolic blood pressure by 3% for the whole cohort would be expected to reduce the incidence of non-fatal myocardial infarction by at least 13% and coronary heart disease deaths by at least 18%. Lowering serum cholesterol by 34%, diastolic blood pressure to 90 mmHg, and reducing smoking by 20% in the subset of the population with all three risk factors in the highest quartile would result in a 6-8% reduction in non-fatal myocardial infarction and a 2-9% reduction in deaths from coronary heart disease in these cohorts. These data demonstrate that in populations with a relatively high incidence of heart disease, treating the entire population will produce larger effects than focusing only on high-risk populations.
PubMed ID
3204419 View in PubMed
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15 records – page 1 of 2.