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1 – 10 of 45Somkiat Tangjitsitcharoen and Haruetai Lohasiriwat
After knee replacement surgery, rehabilitation is needed to recover to normal levels of mobility. A continuous passive motion (CPM) machine is usually introduced at this stage to…
Abstract
Purpose
After knee replacement surgery, rehabilitation is needed to recover to normal levels of mobility. A continuous passive motion (CPM) machine is usually introduced at this stage to aid rehabilitation. However, the redundant structure and complex mechanism of the existing machine has resulted in irregular use. The purpose of this paper is to redesign the current machine.
Design/methodology/approach
The mechanical and electrical systems of the current machine were studied alongside interviews with stakeholders. Problems with the existing machine were identified. Related information was gathered in both the engineering and medical aspects. The redesign concept of the equipment was specified following engineering analyses to develop the final model. Finite element analysis was performed to ensure the appropriate size and dimension of the equipment. The prototype of the redesigned CPM was manufactured in-house. Product testing was conducted with 40 volunteers including experienced therapists, nurses, university students and working-age people.
Findings
Compared to the previous machine, the newly designed model was improved in both functioning and manufacturing costs. The redesigned machine is more durable and consists of a less complex structure.
Originality/value
The redesigned machine introduces some new features and removes unnecessary functions. As a result, the model costs less and hence, is considered beneficial to the general public. More utilization is expected which could eventually reduce the therapists’ workload at the hospital. This research provides well-defined processes of the product development starting from the users’ requirement analysis to the prototype testing stage.
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Pamela David, Intan S. Zulkafli, Rasheeda Mohd Zamin, Snehlata Samberkar, Kah Hui Wong, Murali Naidu and Srijit Das
The teaching and learning of anatomy has experienced a significant paradigm shift. The present study assessed the level of knowledge in anatomy in medical postgraduate students…
Abstract
Purpose
The teaching and learning of anatomy has experienced a significant paradigm shift. The present study assessed the level of knowledge in anatomy in medical postgraduate students and explored the impact of interventions in the form of anatomical videos on knowledge obtained. An awareness of the importance of human anatomy for clinical skills was created to ensure a certain level of competence be achieved by the end of the anatomy course.
Design/methodology/approach
Postgraduate medical students were recruited from various specialties on voluntary basis. The first step was to conduct a preliminary screening exam to determine the level of anatomical knowledge. The students were then divided into two groups at random, one of which received no intervention (the control group), and the other of which watched the videos with content that was pertinent to the practical demonstrations (intervention). To assess the effects of the video intervention, a post-test was administered to all students.
Findings
Both spot tests (SPOTs) and short answer question (SAQ) components for scores of all the regions from the intervention groups were comparable to the scores obtained by the post-test control group, although the findings were not significant (p > 0.05). However, the intervention group from the abdomen (ABD) region did perform significantly better (p < 0.05) than the screening test score.
Originality/value
The results of the research study imply that interventions like anatomical videos can bridge the postgraduate trainee’s anatomy knowledge gap in a practical method which will immensely help in increasing their knowledge.
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Annelies van der Ham, Arno van Raak, Dirk Ruwaard and Frits van Merode
Integration, that is, the coordination and alignment of tasks, is widely promoted as a means to improve hospital performance. A previous study examined integration and…
Abstract
Purpose
Integration, that is, the coordination and alignment of tasks, is widely promoted as a means to improve hospital performance. A previous study examined integration and differentiation, that is, the extent to which tasks are segmented into subsystems, in a hospital's social network. The current study carries this research further, aiming to explain integration and differentiation by studying the rules and coordination mechanisms that agents in a hospital network use.
Design/methodology/approach
The current case study deepens the analysis of the social network in a hospital. All planning tasks and tasks for surgery performance were studied, using a naturalistic inquiry approach and a mixed method.
Findings
Of the 314 rules found, 85% predominantly exist in people's minds, 31% are in documents and 7% are in the information system. In the early planning stages for a surgery procedure, mutual adjustment based on hospital-wide rules is dominant. Closer to the day of surgery, local rules are used and open loops are closed through mutual adjustment, thus achieving integration. On the day of surgery, there is mainly standardization of work and output, based on hospital-wide rules. The authors propose topics for future research, focusing on increasing the hospital's robustness and stability.
Originality/value
This exploratory case study provides an overview of the rules and coordination mechanisms that are used for organizing hospital-wide logistics for surgery patients. The findings are important for future research on how integration and differentiation are effectively achieved in hospitals.
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Ahmed A. Khalifa and Mariam A. Ibrahim
The study aims to evaluate PubMed publications on ChatGPT or artificial intelligence (AI) involvement in scientific or medical writing and investigate whether ChatGPT or AI was…
Abstract
Purpose
The study aims to evaluate PubMed publications on ChatGPT or artificial intelligence (AI) involvement in scientific or medical writing and investigate whether ChatGPT or AI was used to create these articles or listed as authors.
Design/methodology/approach
This scoping review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A PubMed database search was performed for articles published between January 1 and November 29, 2023, using appropriate search terms; both authors performed screening and selection independently.
Findings
From the initial search results of 127 articles, 41 were eligible for final analysis. Articles were published in 34 journals. Editorials were the most common article type, with 15 (36.6%) articles. Authors originated from 27 countries, and authors from the USA contributed the most, with 14 (34.1%) articles. The most discussed topic was AI tools and writing capabilities in 19 (46.3%) articles. AI or ChatGPT was involved in manuscript preparation in 31 (75.6%) articles. None of the articles listed AI or ChatGPT as an author, and in 19 (46.3%) articles, the authors acknowledged utilizing AI or ChatGPT.
Practical implications
Researchers worldwide are concerned with AI or ChatGPT involvement in scientific research, specifically the writing process. The authors believe that precise and mature regulations will be developed soon by journals, publishers and editors, which will pave the way for the best usage of these tools.
Originality/value
This scoping review expressed data published on using AI or ChatGPT in various scientific research and writing aspects, besides alluding to the advantages, disadvantages and implications of their usage.
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Imma Latessa, Antonella Fiorillo, Ilaria Picone, Giovanni Balato, Teresa Angela Trunfio, Arianna Scala and Maria Triassi
One of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in…
Abstract
Purpose
One of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in expenditure due to the aging of the population. In fact, hip and knee arthroplasty surgery are mainly due to primary osteoarthritis that affects the elderly population. This study was carried out with the aim of analysing the introduction of the fast track surgery protocol, through the lean Six Sigma, on patients undergoing knee and hip prosthetic replacement surgery. The goal was to improve the arthroplasty surgery process by reducing the average length of stay (LOA) and hospital costs
Design/methodology/approach
Lean Six Sigma was applied to evaluate the arthroplasty surgery process through the DMAIC cycle (define, measure, analyse, improve and control) and the lean tools (value stream map), adopted to analyse the new protocol and improve process performance. The dataset consisted of two samples of patients: 54 patients before the introduction of the protocol and 111 patients after the improvement. Clinical and demographic variables were collected for each patient (gender, age, allergies, diabetes, cardiovascular diseases and American Society of Anaesthesiologists (ASA) score).
Findings
The results showed a 12.70% statistically significant decrease in LOS from an overall average of 8.72 to 7.61 days. Women patients without allergies, with a low ASA score not suffering from diabetes and cardiovascular disease showed a significant a reduction in hospital days with the implementation of the FTS protocol. Only the age variable was not statistically significant.
Originality/value
The introduction of the FTS in the orthopaedic field, analysed through the LSS, demonstrated to reduce LOS and, consequently, costs. For each individual patient, there was an economic saving of € 445.85. Since our study takes into consideration a dataset of 111 patients post-FTS, the overall economic saving brought by this study amounts to €49,489.35.
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Alessandra Da Ros, Francesca Pennucci and Sabina De Rosis
The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management…
Abstract
Purpose
The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.
Design/methodology/approach
A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.
Findings
Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.
Practical implications
Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.
Originality/value
The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.
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Sara Candidori, Serena Graziosi, Paola Russo, Kasra Osouli, Francesco De Gaetano, Alberto Antonio Zanini and Maria Laura Costantino
The purpose of this study is to describe the design and validation of a three-dimensional (3D)-printed phantom of a uterus to support the development of uterine balloon tamponade…
Abstract
Purpose
The purpose of this study is to describe the design and validation of a three-dimensional (3D)-printed phantom of a uterus to support the development of uterine balloon tamponade devices conceived to stop post-partum haemorrhages (PPHs).
Design/methodology/approach
The phantom 3D model is generated by analysing the main requirements for validating uterine balloon tamponade devices. A modular approach is implemented to guarantee that the phantom allows testing these devices under multiple working conditions. Once finalised the design, the phantom effectiveness is validated experimentally.
Findings
The modular phantom allows performing the required measurements for testing the performance of devices designed to stop PPH.
Social implications
PPH is the leading obstetric cause of maternal death worldwide, mainly in low- and middle-income countries. The proposed phantom could speed up and optimise the design and validation of devices for PPH treatment, reducing the maternal mortality ratio.
Originality/value
To the best of the authors’ knowledge, the 3D-printed phantom represents the first example of a modular, flexible and transparent uterus model. It can be used to validate and perform usability tests of medical devices.
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Carlo Ricciardi, Giovanni Balato, Maria Romano, Ida Santalucia, Mario Cesarelli and Giovanni Improta
The reduction of costs has a more and more relevant role in the healthcare context, therefore, a large effort is done by health providers to this aim, for example, by reducing the…
Abstract
Purpose
The reduction of costs has a more and more relevant role in the healthcare context, therefore, a large effort is done by health providers to this aim, for example, by reducing the length of hospital stay (LOS) of patients undergoing surgery. Fast track surgery fits perfectly this issue and was applied to patients undergoing knee replacement surgery due to Osteoarthritis, one of the most common diseases of aged population. The paper aims to discuss these issues.
Design/methodology/approach
Lean six sigma was applied to analyze the implementation of fast track surgery through the define, measure, analyze, improve, control roadmap, used as a typical problem-solving approach. It is characterized by five operational phases, which make possible the achievement of fixed goals through a rigorous process of defining, measuring, analyzing, improving and controlling business problems.
Findings
The corrective action, consisting in the application of fast track surgery, improved both effectiveness and efficiency of the process of care. The average length of hospital stay (LOS) was reduced from 8.34 to 6.68 days (–19.9 percent) and its standard deviation from 2.41 to 1.99 days (–17.1 percent). The statistical significance of this decrease was verified by means of proper tests. Moreover, some variables influencing the LOS were identified.
Research limitations/implications
The follow up and the satisfaction of patients were not analyzed and could be a future development of this study.
Practical implications
Patients will experience a faster recovery while the hospital will benefit from a rise of available beds. The effect is a general improvement of hospital management.
Originality/value
The introduction of fast track surgery for patients undergoing knee replacement surgery made significantly reduce LOS and, consequently, costs’ with a money saving of more than 50,000 euro per year.
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Deirdre Harmon and Michelle Spirtos
Many treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective…
Abstract
Purpose
Many treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective approach. The purpose of this study was to investigate the methods of treatment of PIP joint fractures being used by trauma surgeons in the Republic of Ireland currently and the timing of referral to therapy.
Design/methodology/approach
A cross-sectional descriptive study methodology was used to survey trauma surgeons, occupational therapists and physiotherapists in Ireland. An online platform was used. A total of 21 surveys were returned by surgeons and 37 by therapists. Descriptive statistical analysis was used to present the results.
Findings
Buddy strapping was reported as the primary treatment method for stable PIP joint fractures. All levels of fracture severity were reported to be treated using traction constructs, which include static and dynamic fixation and orthoses. Unstable fractures were managed using open reduction with internal fixation by 50 per cent of surgeons. Early timing of referral to therapy is reported by more surgeons than therapists. The majority of therapists indicated that they did not have the resources to see patients at the optimal time.
Originality/value
To the authors’ knowledge, this study provides the first description of the management of PIP joint fractures across the Irish health service. The findings of this study suggest that additional therapy resources are required within the health service executive to facilitate the desired early referral to therapy and to enable service development for this category of hand fractures.
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Bassem T. ElHassan and Alya A. Arabi
The purpose of this paper is to illuminate the ethical concerns associated with the use of artificial intelligence (AI) in the medical sector and to provide solutions that allow…
Abstract
Purpose
The purpose of this paper is to illuminate the ethical concerns associated with the use of artificial intelligence (AI) in the medical sector and to provide solutions that allow deriving maximum benefits from this technology without compromising ethical principles.
Design/methodology/approach
This paper provides a comprehensive overview of AI in medicine, exploring its technical capabilities, practical applications, and ethical implications. Based on our expertise, we offer insights from both technical and practical perspectives.
Findings
The study identifies several advantages of AI in medicine, including its ability to improve diagnostic accuracy, enhance surgical outcomes, and optimize healthcare delivery. However, there are pending ethical issues such as algorithmic bias, lack of transparency, data privacy issues, and the potential for AI to deskill healthcare professionals and erode humanistic values in patient care. Therefore, it is important to address these issues as promptly as possible to make sure that we benefit from the AI’s implementation without causing any serious drawbacks.
Originality/value
This paper gains its value from the combined practical experience of Professor Elhassan gained through his practice at top hospitals worldwide, and the theoretical expertise of Dr. Arabi acquired from international institutes. The shared experiences of the authors provide valuable insights that are beneficial for raising awareness and guiding action in addressing the ethical concerns associated with the integration of artificial intelligence in medicine.
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