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Adverse events in health care became more evident at the beginning of the 21st century, being an emerging problem worldwide and impacting the lives of people receiving health care, contributing to preventable injuries and deaths. This evidence has motivated the development of specific training in the area of patient safety with a strong focus on the education and training of health professionals, and, more recently, it also aimed at patient, informal caregiver and all citizens. In this sense, the use of digital technology for patient safety training has been an important challenge and proves to be a good solution for training and continuous learning, both for professionals and people in general. The use of multimedia, videos, games, simulators, among others, are effectively essential resources to improve people’s health literacy and safety of care.

This chapter presents a narrative review on patient safety training and the contributions of digital technology. The experience report will also be used, presenting some examples of quality improvement projects developed by Portuguese and Brazilian entities, in training contexts, highlighting the importance of investing in the health literacy of professionals, patients/informal caregivers and civil society, through applying specific techniques and using digital technology.

This study aims to enhance storage and distribution operations at a pharmaceutical supply center (PSC) in primary health care (PH) using lean health care (LH) tools. Supply centers for health products, medications and supplies have unique characteristics compared to centers for other goods due to complex processes, specific services, diverse stakeholders and multiple interactions. The authors adapt LH tools to address these complexities and meet industry-specific needs.

The investigation unit is a PSC in a large southern Brazilian city, and the processes analyzed are the storage and distribution of medications. The authors performed action research from June 2019 to February 2020. Data collection and problem diagnosis involved the development of a value stream mapping.

The authors adapted the overall equipment effectiveness calculation, efficiency analysis, and loss classification for PSC operations. Eighteen core issues were found: waiting, movement, transport, stock, inadequate processing, defects and human potential losses. The authors proposed waste reduction tools and practices. Inadequate storage conditions may compromise medicine quality, efficacy and safety. This can result from lacking physical structures or noncompliance with procedures. Next, the authors recommend simulating scenarios for validation before implementation.

The study explored ways to enhance layout and medicine distribution at the PSC, focusing on reducing loss and cost impact.

Originality lies in LH application in a PSC of PH, often applied in secondary or tertiary health levels like hospitals. The novelty necessitated adaptations of tools for future PSC applications.

Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

This study aims to analyze a conspicuous corpus of literature related to the field of technology-based intensive care research and to develop an architecture model of the future smart intensive care unit (ICU).

Papers related to the topics of electronic health record (EHR), big data, data flow and clinical decision support in ICUs were investigated. These concepts have been analyzed in combination with secondary use of data, prediction models, data standardization and interoperability challenges. Based on the findings, an architecture model evaluated using MIMIC III is proposed.

Research identified issues regarding implementation of systems, data sources, interoperability, management of big data and free text produced in ICUs and lack of accuracy of prediction models. ICU should be treated as part of a greater system, able to intercommunicate with other entities.

The research examines the current needs of ICUs in interoperability and data management. As environment changes dynamically, continuous assessment and evaluation of the model with other ICU databases is required.

The proposed model improves ICUs interoperability in national health system, ICU staff intercommunication, remote access and decision support. Its modular approach ensures that ICUs can have their own particularities and specialisms while ICU functions provide ongoing expertise and training to upgrade its staff.

Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.

Wearable health devices (WHDs) have demonstrated significant potential in assisting elderly adults with proactive health management by utilizing sensors to record and monitor various aspects of their health, including physical activity, heart rate, etc. However, limited research has systematically explored older adults’ continued usage intention toward WHD. By utilizing the extended unified theory of acceptance and use of technology (UTAUT2), this paper aims to probe the precursors of elderly adults’ continuance intention to use WHD from an enabler–inhibitor perspective.

The research model was developed based on UTAUT2 and examined utilizing the partial least squares technique (PLS). The research data were collected through in-person meetings with older people (n = 272) in four cities in China.

Results reveal that performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic values and perceived complexity are the positive predictors of elderly adults’ continuance intention to use WHDs. Technology-related anxiety and usage cost negatively influence the formation of older people’s continuance intention.

This work is an original empirical investigation that draws on several theories as guiding frameworks. It adds to the existing literature on the usage of wearable technologies and offers insights into how the elderly’s intentions to continue using WHDs can be developed. This study broadens the scope of the UTAUT2 application and presents an alternative theoretical framework that can be utilized in future research on the usage behavior of wearable devices by individuals.

The authors propose a blockchain platform for managing clinical trial data to enhance data validity, integrity, trust and transparency in the pharmaceutical research process. The authors also provide an extensive review of how blockchain technology supports the business processes of clinical trials.

A systematic literature review was conducted to identify the existing applications of blockchain in pharmaceutical process management. A conceptual design for a blockchain infrastructure to address clinical trial challenges is developed by outlining the entire clinical trial value chain and identifying the coordination and communication among its stakeholders. A stakeholder analysis is conducted to ensure that the clinical trial processes satisfy the requirements and preferences of each stakeholder.

The proposed blockchain platform offers a promising solution for enhancing integrity, trust and transparency in the clinical trial process. Additionally, blockchain can help streamline communication and collaboration between stakeholders by enabling multiple parties to access and share data in real time, lowering the possibility of delays or errors in data analysis and reporting.

The proposed blockchain platform can benefit patients by empowering them to have better-controlled access to their data and by allowing researchers to maintain adherence to reporting requirements. Additionally, the platform can benefit granting agencies, researchers and decision-makers by ensuring the integrity of clinical trial data and streamlining communication and collaboration between stakeholders.

This study builds on existing blockchain applications in pharmaceutical process management by developing a blockchain framework that can address clinical trial concerns from an integrated perspective.

As the application of artificial intelligence (AI) becomes more prevalent, many high-tech firms have employed AI applications to deal with emerging societal, technological and environmental challenges. Big data analytical capability (BDAC) has become increasingly important in the AI application processes. Drawing upon the resource-based view and the theory of planned behavior, this study aims to investigate how BDAC and collaboration affect new product performance (NPP). Practically, a harmonic working team is particularly important for creating management synergies, this empirical analysis demonstrates the importance of BDAC and collaboration for NPP.

This paper focuses on the performance of firms that applied AI in their operations. This study collected data from firms in Greater China, including China and Taiwan, as Greater China is currently the leading manufacturer of semiconductor, electronic and electric products for AI applications in the manufacturing process. Confirmatory factor analysis and structural equation modeling is employed for statistical analysis.

The analytical results indicate that BDAC positively relates to collaboration capability (CC) in AI applications but not to team collaboration (TC). CC positively correlates with TC, and both CC and TC positively correlate with NPP. Further, the mediating effect was examined using the Sobel t-test, which reveals that CC is a significant mediator in the influence of BDAC on NPP.

The strategic implementation of BDAC and collaboration can allow an enterprise to improve its NPP when driven by the external environment to use AI, which further enhances NPP. These processes indicate that AI and BDAC are both crucial for the success of a company’s collaboration and for effective management to improve NPP in the face of global competition.

This study introduces the concept of BDAC to explain the relationship between CC and TC, as they pertain to NPP. This study presented a discussion of the theoretical and practical implications of the research findings and could provide a framework for managing BDAC.

This paper aims to explore and review the potential of robotic rehabilitation as a treatment approach for Alzheimer’s disease (AD) and its impact on the health and quality of life of AD patients.

The present discourse endeavors to provide a comprehensive overview of extant scholarly inquiries that have examined the salience of inhibitory mechanisms vis-à-vis robotic interventions and their impact on patients with AD. Specifically, this review aims to explicate the contemporary state of affairs in this realm by furnishing a detailed explication of ongoing research endeavors. With the objective of elucidating the significance of inhibitory processes in robotic therapies for individuals with AD, this analysis offers a critical appraisal of extant literature that probes the intersection of cognitive mechanisms and assistive technologies. Through a meticulous analysis of diverse scholarly contributions, this review advances a nuanced understanding of the intricate interplay between inhibitory processes and robotic interventions in the context of AD.

According to the review papers, it appears that implementing robot-assisted rehabilitation can serve as a pragmatic and effective solution for enhancing the well-being and overall quality of life of patients and families engaged with AD. Besides, this new feature in the robotic area is anticipated to have a critical role in the success of this innovative approach.

Due to the nascent nature of this cutting-edge technology and the constrained configuration of the mechanized entity in question, further protracted analysis is imperative to ascertain the advantages and drawbacks of robotic rehabilitation vis-à-vis individuals afflicted with Alzheimer’s ailment.

The potential for robots to serve as indispensable assets in the provision of care for individuals afflicted with AD is significant; however, their efficacy and appropriateness for utilization by caregivers of AD patients must be subjected to further rigorous scrutiny.

This paper reviews the current robotic method and compares the current state of the art for the AD patient.