Hospitals, Volume 2, Issue 1 (March 2025) – 8 articles

Background: With so much emphasis currently on Social Determinants of Health (SDOH), we examined the characteristics of U.S. hospitals making commitments to SDOH and engagement with community social determinant programs and activities (CSDPAs). Methods: This cross-sectional study used the 2021 American Hospital Association (AHA) Annual Survey with a total of 5992 hospitals included. The dependent variables were the community social determinants composite score, community partnership composite score, and the use of CSPDAs to assess outcomes. Results: Hospitals most influenced by payment policies and regulations were most likely to engage in CSDPAs. Hospitals with ACOs implement 3.38 more CSPDAs and hospitals participating in bundled payments are 41% more likely to address SDOH (OR = 1.41, 95% CI = [1.14, 1.75]). Hospitals in competitive markets and hospitals with ≥400 beds are positively associated with both SDOH activities and partnerships. Teaching hospitals, not-for-profit hospitals, Medicare mix, and rural hospitals, as well as market competition, were positively associated with higher levels of CSDPAs. Conclusion: Reimbursement requirements, organizational size and resources, and external pressures were shown as drivers for hospitals to implement CSDPAs. Full article

Introduction: Chronic neck pain is a prevalent condition that challenges physical therapists (PTs) due to its multifactorial etiology. Differential diagnosis is crucial for identifying the underlying causes and providing appropriate interventions. However, the extent to which PTs apply and understand differential diagnostic criteria remains unclear. This study aimed to evaluate the knowledge, attitudes, and behaviors of PTs in France regarding the differential diagnosis of chronic neck pain. Materials and Methods: An online questionnaire was designed to assess PTs’ beliefs, attitudes, knowledge, and clinical application of differential diagnostic criteria in chronic neck pain. The survey was distributed nationwide and included questions regarding demographic data, theoretical knowledge, practical application, and perceived barriers. A total of 80 responses were collected and analyzed using descriptive and inferential statistics. Results: The results revealed moderate levels of theoretical knowledge among participants, with 62% correctly identifying key criteria for differential diagnosis. However, only 45% reported consistently applying these criteria in clinical practice. Common barriers included time constraints (70%), lack of access to advanced diagnostic tools (55%), and insufficient training (40%). Attitudes towards the importance of differential diagnosis were predominantly positive, with 85% recognizing its relevance for improving patient outcomes. Conclusions: This study highlights a gap between PTs’ knowledge and the practical application of differential diagnosis criteria in chronic neck pain. Addressing barriers such as training and resource availability could enhance clinical practices. Future efforts should focus on integrating these competencies into professional development programs to improve diagnostic accuracy and patient care. Full article

Objective: This study investigates alarm fatigue among ICU nurses in China and its influencing factors to optimize alarm management. Methods: This study was conducted using a cross-sectional design. In May 2022, electronic questionnaires were distributed to ICU nurses in Beijing tertiary hospitals, using the Chinese version of the alarm fatigue scale and equipment alarm records. Data were analyzed using SPSS 26. Results: Results showed an average alarm fatigue score of 20.70 ± 6.54 (out of 52), indicating a moderate-to-low level. Nurses’ self-assessed health, work attitude, alarm accuracy, and frequency of simultaneous alarms significantly influenced fatigue levels (p < 0.05). Principal component analysis identified five factors, with work intensity, mental health, false alarm rate, and job responsibility being significant predictors (95% CI excluded zero). Alarm records revealed an average of 621 daily alarms in ICUs, 93.93% from monitors, with a false alarm rate of 56.36%, and only 43.64% being valid. Conclusions: This study highlights the multi-factorial nature of alarm fatigue and the need to improve alarm systems and nurse support. Full article

IV line connectors often become contaminated between infusions, which leads to line infections. A flexible shield was developed to prevent this by means of passive protection. It was tested in a simulated bedside environment and protected from touch contamination as well as airborne transmission of skin bacteria to the connector hub. This flexible shield can compensate for the unavoidable human factor infection control lapses that occur during IV line handling by healthcare workers. Full article

The implementation of evidence-based practice (EBP) is crucial for improving patient outcomes and healthcare delivery, yet it faces significant challenges in acute care settings due to organisational barriers, resource limitations, and leadership complexities. This study explores how ward managers (WMs) facilitate knowledge utilisation (KU) and promote EBP adoption in these environments. A longitudinal qualitative case study was conducted over eight months in two acute care hospitals in the East Midlands, England. Data were collected through semi-structured interviews with 23 WMs, nonparticipant observations, and document analysis. Thematic analysis was used to identify key findings. Six themes emerged: navigating leadership challenges, overcoming organisational and resource barriers, sustaining EBP through learning networks, integrating technology, tailoring EBP to patient-centred care, and providing emotional support for staff. Hybrid leadership strategies, combining directive and collaborative approaches, were critical in addressing barriers, fostering engagement, and embedding EBP into workflows. Mentorship and resource management also played pivotal roles. The study highlights the need for tailored leadership strategies, innovative resource utilisation, and sustainable learning networks to overcome systemic challenges and promote EBP. These findings provide actionable insights for fostering evidence-informed care environments in resource-constrained acute care settings. Full article

Slips and fall-related accidents cause a significant number of injuries in hospitals. Due to constant movement of doctors and nurses across different departments in hospitals such as OPD, trauma centres, and ICUs, there are possible interactions of their footwear with slippery floorings (e.g., wet or with soap suds), which may cause unexpected slips. To date, there is a lack of understanding on the traction of different footwear worn by hospital staff. This impedes the selection of appropriate floorings and footwear for preventing slips and falls in hospitals. In this work, the traction performances of twelve common footwear designs, worn by hospital staff, were tested on three different floorings at important locations, i.e., an outpatient department, trauma centre, and ICU entrance, at a busy public hospital. Oblique tread patterns are recommended for moderately rough floors under dry and Lizol conditions. Horizontally oriented patterns are better for smoother floors in dry conditions, while vertically oriented patterns are ideal for areas with frequent contaminant exposure. No specific recommendation can be made for soap-contaminated floors due to the contaminant’s high viscosity. The results also indicated the strong influence of flooring roughness on the measured traction, over footwear tread parameters. Also, liquid soaps were observed to significantly reduce footwear–floor traction. The findings are anticipated to be valuable to hospital management for the selection of appropriate high-traction floorings, and provide important guidelines for footwear selection, for the mitigation of slips and falls in hospitals. Full article

Hospital and health system bankruptcies and closures continue to rise in the United States. They are troubling news not only for patients and communities but also for insurance companies. Hospital closures often lead to higher costs for insurers due to increased claim denials, delayed payments, reduced provider network and access to care, higher out-of-network costs, and a disruption of our healthcare system. These factors ultimately impact the health insurance companies’ bottom lines as well as their ability to manage patient care effectively with the risk of causing customer/patient dissatisfaction. Insurance companies can help prevent hospital closures, especially in rural areas, by implementing some of the following mechanisms: timely and adequate payments; improved patient-centric payment systems; and standby capacity payments to cover minimum fixed costs. Such early strategic investments have the potential to offset the higher costs for insurance companies associated with hospital closures and improve the sustainability of the U.S. healthcare system. Full article

The role of clinical trials cannot be ignored due to its contribution to innovative treatment, therapies, and drug development in promoting quality service delivery. We investigated and explored the management aspect of clinical trials and its impact on healthcare service delivery within the NHS. A qualitative methodology with an interpretivism approach was adopted to collect data from nine participants using a purposive sampling method in the management of clinical trials at the NHS. A semi-structured interview with open-ended questions and probing techniques conducted via Microsoft Teams was used as a data collection tool. The collected data were thematically analysed with the support of NVivo 14 software. The staffs’ perceptions were somewhat effective and highlights required improvement for better performance regarding clinical trial management at the NHS setting. The findings represent improved patient outcomes, increasing evidence-based decision making, and the development of innovative therapies and research infrastructure could be some positive impacts of the effective management of clinical trials. However, the findings show that improvement in stakeholder collaboration and communication is vital to combat the existing challenges such as regulatory hurdles and issues in participant recruitment, retention, and communication. The findings provide practical values and insight into the staff working in the management of clinical trial processes and the audiences relevant to this field. A comprehensive understanding of the proactive measures and factors that are essential for the improvement of clinical trial management has been interpreted. In the hospital’s settings, supervision and improvement of clinical trials are necessary to promote innovative therapies, research infrastructure, and quality patient care and service delivery. Full article