Special Issue "Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims"

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Quality and Patient Safety".

Deadline for manuscript submissions: 29 February 2024 | Viewed by 4069

Special Issue Editors

Department of Neuoscience, University of Padua, 35121 Padua, Italy
Interests: public health education; legal medicine; medico-legal autospy; clinical risk management; damage; legal liability; medicolegal implications; ethics; patient blood management; health organization
Special Issues, Collections and Topics in MDPI journals
Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, TS, Italy
Interests: public health education; legal medicine; medico-legal autospy; clinical risk management; damage; legal liability; medicolegal implications; ethics; patient health organization
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Billions of medical and surgical procedures are performed every day in hospitals around the world. In recent years, and especially after the COVID-19 pandemic, the need for a hospital organization capable of welcoming and managing the needs of the population is increasingly felt and necessary. The World Health Organization (WHO) has urged member countries to implement reforms and promote new evidence-based practices.

In many ways, improvements and updates in clinical practice and organization are needed for the benefit of patients, their safety and health care workers. The hospital organization must consider the new general conditions in which it operates in which, in addition to the needs due to the assistance of COVID patients, it must keep ordinary activities safe and this represents a challenge.

Western countries are experiencing what is called the "silver tsunami", a significant increase in the average age of the population with the consequent need to better calibrate the organization and available resources. There are situations of lack of technologies and drugs such as plasma derivatives and it is therefore increasingly important to develop a strategy for the management of these new emerging aspects.

In Europe, investment programs are being developed aimed at increasing the resilience of national systems also in the health sector. These programs provide for investment in technologies that can lead to technological and scientific innovation in order to maintain clinical activities and enable the development of scientific research innovation.

Clinical risk management is an increasingly necessary and important activity in this particular context that must be integrated in order to increase the safety of patients and healthcare professionals. A particular area of ​​this topic is represented by nosocomial infections which represent adverse events to be prevented and often managed in the medical-legal field in terms of health responsibility and in the field of the autopsy.

Many publications on these topics can be collected internationally. This Special Issue aims to collect original research, case studies, literature evidence, case reports, studies that show examples of healthcare organization, peculiar cases in the organizational, medical examiner, patient safety and safety at work, scientific innovation and research.

In this Special Issue, we invite researchers to submit research covering, but not limited to, the following potential topics: 

  • Health organization
  • Tecnology Innovation
  • National rules and laws in medical liability and clinical risk management
  • Patient safety
  • Ethics in medicine
  • Adverse events
  • Violence against health workers
  • Suicide risk prevention
  • Infectious diseases
  • Adverse drug reactions
  • Patient Blood Management
  • Environmental risks for healthcare personnel
  • Healthcare-associated infections
  • Death
  • Autopsy
  • Scientific research in medicine
  • Postmortem investigation
  • Vaccines

Dr. Matteo Bolcato
Dr. Stefano D'Errico
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • clinical risk management
  • autopsy
  • medical liability
  • nosocomial infections
  • safety
  • technology
  • infectious diseases
  • diagnosis

Published Papers (6 papers)

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Research

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Article
Cardiovascular Disease-Related Health Promotion and Prevention Services by Pharmacists in Saudi Arabia: How Well Are They Prepared?
Healthcare 2023, 11(11), 1614; https://doi.org/10.3390/healthcare11111614 - 31 May 2023
Viewed by 233
Abstract
Background: Cardiovascular diseases (CVDs) have been identified as the leading reason for morbidity and mortality in Saudi Arabia. Pharmacists play a major role in CVD prevention and health promotion. We aimed to assess the knowledge, attitudes, and involvement of pharmacists in CVD prevention [...] Read more.
Background: Cardiovascular diseases (CVDs) have been identified as the leading reason for morbidity and mortality in Saudi Arabia. Pharmacists play a major role in CVD prevention and health promotion. We aimed to assess the knowledge, attitudes, and involvement of pharmacists in CVD prevention and evaluate the influence of continuing medical education in CVD-prevention services in Saudi Arabia. Method: A cross-sectional study was conducted to evaluate the involvement of pharmacists in CVD-related prevention services along with their knowledge and attitudes. A 34-item questionnaire was developed and distributed among the participants. Results: A total of 324 responses were included in the study. More than 60% of pharmacists had provided counseling regarding the importance of healthy lifestyles and self-monitoring CVD risk factors. About half of the participants (49.1%) had never received any CVD-related continuing medical education. Overall, more than 60% of the participants reported positively towards their role in CVD prevention. Lack of time (66%) and lack of educational materials and tools (41%) were the top perceived barriers for providing CVD-prevention and health-promotion activities, followed by lack of skills in using tools (36%) and lack of privacy/space (33%). Conclusions: The involvement of pharmacists in the prevention of CVD is limited in this study. Further education and capacity building are required to strengthen pharmacists’ involvement in CVD-prevention and health-promotion activities. Full article
Article
The Effect of Service Quality on Patient Citizenship Behaviors: Evidence from the Health Sector
Healthcare 2023, 11(3), 370; https://doi.org/10.3390/healthcare11030370 - 28 Jan 2023
Viewed by 585
Abstract
Background: Nowadays, health organizations seek to bring innovations to their services to stand out in competition with their rivals by improving service quality (SQ), encouraging patients to always make the same organizational choices, and enhance the behavior of patient citizenship. Objective: This study [...] Read more.
Background: Nowadays, health organizations seek to bring innovations to their services to stand out in competition with their rivals by improving service quality (SQ), encouraging patients to always make the same organizational choices, and enhance the behavior of patient citizenship. Objective: This study aims to determine the mediating role of patient satisfaction (PS), patient loyalty (PL), and employee responsiveness (ER) between the service quality and patient citizenship behaviors (PCB). Methods: In order to test the proposed hypotheses, quantitative research methods were utilized; cross-sectional data was collected using scales between December 2021 and March 2022. Results were obtained from 422 participants. The data were analyzed using descriptive statistics, correlation, confirmatory factor analysis, and structural equation modeling methods, using AMOS 21. Results: SQ was found to have a significant and positive effect on PL, PS, and ER. PL, PS, and ER were found to have a significant and positive effect on PCB. The indirect effect of SQ on PCB was found to be positive. Discussion: The findings demonstrate that SQ does not directly affect or create PCB, but it is affected by the mediators in order to create PCB via satisfaction, loyalty, and employee responsiveness. Full article
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Article
Development and Implementation of a Professional Practices Evaluation during Radiopharmaceuticals Administration
Healthcare 2022, 10(11), 2247; https://doi.org/10.3390/healthcare10112247 - 10 Nov 2022
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Abstract
Securing both the patient and radiopharmaceuticals (RPs) circuit is an essential concern in nuclear medicine (NM). These circuits converge at the RP administration phase, a key step in patient management in NM. In a continuous quality improvement approach, we developed and implemented an [...] Read more.
Securing both the patient and radiopharmaceuticals (RPs) circuit is an essential concern in nuclear medicine (NM). These circuits converge at the RP administration phase, a key step in patient management in NM. In a continuous quality improvement approach, we developed and implemented an evaluation of professional practices (EPPs) methodology focused on RPs injection to identify and correct deviations from good practices. The nuclear medicine technologists (NMTs) of a single center were evaluated. A specific audit grid was designed for this purpose, covering 4 main themes. Following the audit campaign, an improvement action plan was set up to address the non-conformities observed. Nine NMTs were audited on 4 RPs injections each. The mean total score was 93.36% with, on average, 7.01% and 3.00% of unmet and partially met criteria, respectively. In view of the non-compliance rates of hygiene and radiation protection items, theoretical reviews of these themes were included in the improvement action plan. As a part of the quality assurance system of a healthcare unit, EPPs are useful for identifying and correcting practice deviations at an early stage. They should be regularly repeated and combined with rigorous training and qualification of operators involved in RPs injection. Full article
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Article
The Implementation of a Geriatrics Co-Management Model of Care Reduces Hospital Length of Stay
Healthcare 2022, 10(11), 2160; https://doi.org/10.3390/healthcare10112160 - 29 Oct 2022
Viewed by 710
Abstract
(1) Background: Older adults comprise a large proportion of hospitalized patients. Many are frail and require complex care. Geriatrics has developed models of care specific to this inpatient population. Our objective was to demonstrate the effect of a geriatric co-management team on clinical [...] Read more.
(1) Background: Older adults comprise a large proportion of hospitalized patients. Many are frail and require complex care. Geriatrics has developed models of care specific to this inpatient population. Our objective was to demonstrate the effect of a geriatric co-management team on clinical administrative indicators of care in Clinical Teaching Units (CTUs) that have adopted the Age-friendly Hospital (AFH) principles in Brazilian hospitals. (2) Methods: Following 3 months of implementation of the AFH principles in CTUs, two periods of the same 6 months of two consecutive years were compared. (3) Results: The total number of participants in the study was 641 and 743 in 2015 and 2016, respectively. Average length of patient-stay (length of stay: 8.7 ± 2.7 vs. 5.4 ± 1.7 days) and number of monthly complaints (44.2 ± 6.5 vs. 13.5 ± 2.2) were significantly lower with the co-management model. Number of homecare service referrals/month was also significantly higher (2.5 ± 1 vs. 38.3 ± 6.3). The 30-day readmission rates and total hospital costs per patient remained unchanged. (4) Conclusion: The presence of a geriatric co-management team in CTUs is of added benefit to increase the efficiency of the AFH for vulnerable older inpatients with reduced LOS and increased referrals to homecare services without increasing hospital costs. Full article
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Article
Advanced Practice Providers as Leaders of a Rapid Response Team: A Prospective Cohort Study
Healthcare 2022, 10(11), 2122; https://doi.org/10.3390/healthcare10112122 - 25 Oct 2022
Viewed by 606
Abstract
In view of the shortage of medical staff, the quality and continuity of care may be improved by employing advanced practice providers (APPs). This study aims to assess the quality of these APPs in critical care. In a large teaching hospital, rapid response [...] Read more.
In view of the shortage of medical staff, the quality and continuity of care may be improved by employing advanced practice providers (APPs). This study aims to assess the quality of these APPs in critical care. In a large teaching hospital, rapid response team (RRT) interventions led by APPs were assessed by independent observers and intensivists and compared to those led by medical residents MRs. In addition to mortality, the MAELOR tool (assessment of RRT intervention), time from RRT call until arrival at the scene and time until completion of clinical investigations were assessed. Process outcomes were assessed with the crisis management skills checklist, the Ottawa global rating scale and the Mayo high-performance teamwork scale. The intensivists assessed performance with the handoff CEX recipient scale. Mortality, MAELOR tool, time until arrival and clinical investigation in both groups were the same. Process outcomes and performance observer scores were also equal. The CEX recipient scores, however, showed differences between MRs and APPs that increased with experience. Experienced APPs had significantly better situational awareness, better organization, better evaluations and better judgment than MRs with equal experience (p < 0.05). This study shows that APPs perform well in leading an RRT and may provide added quality over a resident. RRTs should seriously consider the deployment of APPs instead of junior clinicians. Full article
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Review

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Review
Assisted Suicide and Euthanasia in Mental Disorders: Ethical Positions in the Debate between Proportionality, Dignity, and the Right to Die
Healthcare 2023, 11(10), 1470; https://doi.org/10.3390/healthcare11101470 - 18 May 2023
Viewed by 683
Abstract
The admission of people suffering from psychiatric and neurocognitive disorders to euthanasia and physician-assisted suicide (E/PAS) in some European and non-European countries represents a controversial issue. In some countries, the initial limitation of E/PAS to cases of severe physical illness with poor prognosis [...] Read more.
The admission of people suffering from psychiatric and neurocognitive disorders to euthanasia and physician-assisted suicide (E/PAS) in some European and non-European countries represents a controversial issue. In some countries, the initial limitation of E/PAS to cases of severe physical illness with poor prognosis in the short term has been overcome, as it was considered discriminatory; thus, E/PAS has also been made available to subjects suffering from mental disorders. This decision has raised significant ethical questions regarding the capacity and freedom of self-determination; the family, social, and economic contexts; the social consideration of the sense of dignity and the pressure on the judgment of one’s personal value; the contextual therapeutic possibilities; the identification of figures involved in the validation and application; as well as the epistemological definitions of the clinical conditions in question. To these issues must be added the situation of legislative vacuum peculiar to different countries and the widespread lack of effective evaluation and control systems. Nonetheless, pessimistic indicators on global health status, availability of care and assistance, aging demographics, and socioeconomic levels suggest that there may be further pressure toward the expansion of such requests. The present paper aims to trace an international overview with the aim of providing ethical support to the debate on the matter. Precisely, the goal is the delimitation of foundations for clinical practice in the complex field of psychiatry between the recognition of the irreversibility of the disease, assessment of the state of physical and mental suffering, as well as the possibility of adopting free and informed choices. Full article
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