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Innovation in Hospital Management: Strategies and Efforts for Patient and...
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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: closed (29 February 2024) | Viewed by 48431

Special Issue Editors

Dr. Matteo Bolcato

E-Mail Website
Guest Editor
Department of Neuroscience, University of Padua, 35121 Padua, Italy
Interests: transfusion medicine; patient blood management; legal medicine; medico-legal autopsy; clinical risk management; damage; legal liability; medicolegal; implications
Special Issues, Collections and Topics in MDPI journals
Dr. Stefano D'Errico

E-Mail Website
Guest Editor
Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, TS, Italy
Interests: public health education; legal medicine; medico-legal autopsy; 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 2700 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

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Related Special Issue

Published Papers (13 papers)

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Research

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12 pages, 1744 KiB  
Article
Health in a Virtual Environment (HIVE): A Novel Continuous Remote Monitoring Service for Inpatient Management
by Tim Bowles, Kevin M. Trentino, Adam Lloyd, Laura Trentino, Kevin Murray, Aleesha Thompson, Frank M. Sanfilippo and Grant Waterer
Healthcare 2024, 12(13), 1265; https://doi.org/10.3390/healthcare12131265 - 26 Jun 2024
Cited by 2 | Viewed by 3161
Abstract
The aim of this study was to describe the implementation of a novel 50-bed continuous remote monitoring service for high-risk acute inpatients treated in non-critical wards, known as Health in a Virtual Environment (HIVE). We report the initial results, presenting the number and [...] Read more.
The aim of this study was to describe the implementation of a novel 50-bed continuous remote monitoring service for high-risk acute inpatients treated in non-critical wards, known as Health in a Virtual Environment (HIVE). We report the initial results, presenting the number and type of patients connected to the service, and assess key outcomes from this cohort. This was a prospective, observational study of characteristics and outcomes of patients connected to the HIVE continuous monitoring service at a major tertiary hospital and a smaller public hospital in Western Australia between January 2021 and June 2023. In the first two and a half years following implementation, 7541 patients were connected to HIVE for a total of 331,118 h. Overall, these patients had a median length of stay of 5 days (IQR 2, 10), 11.0% (n = 833) had an intensive care unit admission, 22.4% (n = 1691) had an all-cause emergency readmission within 28 days from hospital discharge, and 2.2% (n = 167) died in hospital. Conclusions: Our initial results show promise, demonstrating that this innovative approach to inpatient care can be successfully implemented to monitor high-risk patients in medical and surgical wards. Future studies will investigate the effectiveness of the program by comparing patients receiving HIVE supported care to comparable patients receiving routine care. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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15 pages, 813 KiB  
Article
Development of an Implementation Strategy Tailored to Deliver Evidence-Based and Person-Centred Nursing Care for Patients with Community-Acquired Pneumonia: An Intervention Mapping Approach
by Signe Eekholm, Karin Samuelson, Gerd Ahlström and Tove Lindhardt
Healthcare 2024, 12(1), 32; https://doi.org/10.3390/healthcare12010032 - 22 Dec 2023
Cited by 1 | Viewed by 3843
Abstract
Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a [...] Read more.
Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a tailored theory- and research-based implementation strategy that supports registered nurses (RNs) in delivering evidence-based and person-centred care for this patient population in a hospital setting. The implementation strategy was developed by completing the six steps of the Intervention Mapping framework: (1) developing a logic model of the problem and (2) a logic model of change by defining performance and change objectives, (3) designing implementation strategy interventions by selecting theory-based change methods, (4) planning the interventions and producing materials through a co-design approach, (5) developing a structured plan for adoption, maintenance and implementation and (6) developing an evaluation plan. This method can serve as a guide to (1) target behavioural and environmental barriers hindering the delivery of nursing care in local clinical practice, (2) support evidence uptake, (3) support RNs in the delivery of nursing care according to individual patient needs and thereby (4) optimise health-related patient outcomes. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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11 pages, 485 KiB  
Article
Liability and Medico-Legal Implications in Estimating the Likelihood of Having Attained 14 Years of Age in Pediatric Clinical Practice: A Pilot Study
by Roberto Scendoni, Dora Mirtella, Roberto Cameriere, Luca Tomassini, Francesco De Micco, Francesca Baralla and Mariano Cingolani
Healthcare 2023, 11(23), 3047; https://doi.org/10.3390/healthcare11233047 - 26 Nov 2023
Viewed by 1366
Abstract
Accurate methods of age estimation are more essential than ever due to the rise in undocumented individuals without proper identification, often linked to illegal immigration and criminal activities. This absence of reliable records presents challenges within the legal systems, where age thresholds in [...] Read more.
Accurate methods of age estimation are more essential than ever due to the rise in undocumented individuals without proper identification, often linked to illegal immigration and criminal activities. This absence of reliable records presents challenges within the legal systems, where age thresholds in the context of children’s rights vary across countries. Age 14 has global significance, as established by the UN Convention on the Rights of the Child and the EU for administrative purposes. Accurate age estimation is crucial in medical decisions, reproductive health, and forensics. This study focuses on age estimation via dental radiographs, proposing a method for estimating the likelihood of having attained the age of 14. Orthopantomograms were analyzed from two samples, 191 Italian children (aged 5–15) and 822 Chilean subjects (aged 11–22), using dental maturity indices. These indices evaluated open tooth apices and complete root development. Statistical analysis confirmed the method’s reliability in identifying individuals aged 14 or older, with sex-specific cut-offs. The proposed method particularly advocates an approach based on dental mineralization, which could surpass those relying on bone growth. The collaboration between medical experts, including pediatricians and diagnostic imaging specialists, is vital for standardized age estimation strategies. Ethical concerns regarding radiation exposure and accountability are recognized, although the method’s low radiation doses are deemed acceptable. The proposed method will help health professionals to accurately predict whether or not the 14-year threshold has been reached, opening up new avenues of medico-legal interest and laying the foundations for a legal framework that would allow the pediatrician, when involved, to use a valid and recognized diagnostic approach. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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9 pages, 234 KiB  
Article
Nurses’ Experience Implementing an Automated Video Monitoring System to Decrease the Risk of Patient Falls during a Global Pandemic
by Joseph A. Allen, Roni Reiter-Palmon, Katherine J. Jones, Lucas Sabalka, Kelsey Ciagala and Andrea Meens
Healthcare 2023, 11(18), 2556; https://doi.org/10.3390/healthcare11182556 - 15 Sep 2023
Cited by 1 | Viewed by 2185
Abstract
Healthcare is a complex sociotechnical system where information systems (IS) and information technology (IT) intersect to solve problems experienced by patients and providers alike. One example of IS/IT in hospitals is the Ocuvera automated video monitoring system (AVMS), which has been implemented in [...] Read more.
Healthcare is a complex sociotechnical system where information systems (IS) and information technology (IT) intersect to solve problems experienced by patients and providers alike. One example of IS/IT in hospitals is the Ocuvera automated video monitoring system (AVMS), which has been implemented in more than 30 hospitals. The purpose of this study was to evaluate nurses’ attitudes toward AVMS implementation over time as they received the training program developed for this intervention. Consistent with the job demands–resources (JDR) model, we found that perceptions of AVMS usefulness increased over time and were positively associated with perceptions of social influence and behavioral control. These results were consistent with our finding that there was a significant decrease in the risk of unassisted falls from the bed from baseline to intervention. Leaders in hospital systems and healthcare organizations may want to consider implementing an AVMS as researchers continue to test, verify, and demonstrate the effectiveness of these interventions for improving patient well-being. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
13 pages, 267 KiB  
Article
Provision of Safe Anesthesia in Magnetic Resonance Environments: Degree of Compliance with International Guidelines in Saudi Arabia
by Mohammed S. Alshuhri, Bader A. Alkhateeb, Othman I. Alomair, Sami A. Alghamdi, Yahia A. Madkhali, Abdulrahman M. Altamimi, Yazeed I. Alashban and Meshal M. Alotaibi
Healthcare 2023, 11(18), 2508; https://doi.org/10.3390/healthcare11182508 - 10 Sep 2023
Cited by 2 | Viewed by 1671
Abstract
Background: The lack of local guidelines and regulations for the administration of anesthesia in magnetic resonance imaging (MRI) units presents a potential risk to patient safety in Saudi Arabia. Hence, this study aimed to evaluate the extent to which hospitals in Saudi Arabia [...] Read more.
Background: The lack of local guidelines and regulations for the administration of anesthesia in magnetic resonance imaging (MRI) units presents a potential risk to patient safety in Saudi Arabia. Hence, this study aimed to evaluate the extent to which hospitals in Saudi Arabia follow international guidelines and recommendations for the safe and effective administration of anesthesia in an MRI environment. Methods: This study used a questionnaire that was distributed to 31 medical facilities in Saudi Arabia that provided anesthesia in MRI units. Results: The findings of the study revealed that the mean compliance with the 17 guidelines across the 31 sites was 77%; 5 of the 31 sites (16.1%) had a compliance rate of less than 50% with the recommended guidelines. Only 19.4% of the institutes provided general safety education. Communication breakdowns between anesthesia providers and MRI teams were reported. Conclusions: To conclude, this survey highlights the status of anesthesia standards in Saudi Arabian MRI units and emphasizes areas that require better adherence to international guidelines. The results call for targeted interventions, including the formulation of specific national anesthesia guidelines for MRI settings. Communication breakdowns between anesthesia providers and MRI teams were reported at a rate of 83.9% during the administration of a gadolinium contrast agent. There were additional breakdowns, particularly for high-risk patients with implants, such as impaired respirators (74.2%), thus requiring further investigation due to potential safety incidents during MRI procedures. While considering the limitations of this study, such as potential biases and the low response rate, it provides a valuable foundation for refining protocols and promoting standardized practices in Saudi Arabian healthcare. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
12 pages, 261 KiB  
Article
Cardiovascular Disease-Related Health Promotion and Prevention Services by Pharmacists in Saudi Arabia: How Well Are They Prepared?
by Sirajudeen Shaik Alavudeen, Vigneshwaran Easwaran, Noohu Abdulla Khan, Krishnaraju Venkatesan, Premalatha Paulsamy, Abubakr Taha Mohammed Hussein, Mohammad Tarique Imam, Ziyad Saeed Almalki and Md Sayeed Akhtar
Healthcare 2023, 11(11), 1614; https://doi.org/10.3390/healthcare11111614 - 31 May 2023
Cited by 4 | Viewed by 2408
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
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
14 pages, 1103 KiB  
Article
The Effect of Service Quality on Patient Citizenship Behaviors: Evidence from the Health Sector
by Saime Ulucayli, Kemal Cek and Adile Oniz
Healthcare 2023, 11(3), 370; https://doi.org/10.3390/healthcare11030370 - 28 Jan 2023
Cited by 3 | Viewed by 2236
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
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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9 pages, 501 KiB  
Article
Development and Implementation of a Professional Practices Evaluation during Radiopharmaceuticals Administration
by Charlotte Donzé, Léa Rubira, Lore Santoro, Pierre Olivier Kotzki, Emmanuel Deshayes and Cyril Fersing
Healthcare 2022, 10(11), 2247; https://doi.org/10.3390/healthcare10112247 - 10 Nov 2022
Cited by 1 | Viewed by 1697
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
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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8 pages, 796 KiB  
Article
The Implementation of a Geriatrics Co-Management Model of Care Reduces Hospital Length of Stay
by Homero Teixeira Leite, Alex C. Manhães, Luisa A. Antunes, Tevy Chan, Guy Hajj-Boutros and José A. Morais
Healthcare 2022, 10(11), 2160; https://doi.org/10.3390/healthcare10112160 - 29 Oct 2022
Cited by 2 | Viewed by 1805
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
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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10 pages, 3738 KiB  
Article
Advanced Practice Providers as Leaders of a Rapid Response Team: A Prospective Cohort Study
by Herman G. Kreeftenberg, Ashley J. R. de Bie, Jeroen T. Aarts, Alexander J. G. H. Bindels, Nardo J. M. van der Meer and Peter H. J. van der Voort
Healthcare 2022, 10(11), 2122; https://doi.org/10.3390/healthcare10112122 - 25 Oct 2022
Viewed by 1917
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
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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Review

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20 pages, 3786 KiB  
Review
Design a Clinical Research Protocol: Influence of Real-World Setting
by Jonathan Cimino and Claude Braun
Healthcare 2023, 11(16), 2254; https://doi.org/10.3390/healthcare11162254 - 10 Aug 2023
Cited by 7 | Viewed by 5030
Abstract
The design of a clinical research protocol to evaluate new therapies, devices, patient quality of life, and medical practices from scratch is probably one of the greatest challenges for the majority of novice researchers. This is especially true since a high-quality methodology is [...] Read more.
The design of a clinical research protocol to evaluate new therapies, devices, patient quality of life, and medical practices from scratch is probably one of the greatest challenges for the majority of novice researchers. This is especially true since a high-quality methodology is required to achieve success and effectiveness in academic and hospital research centers. This review discusses the concrete steps and necessary guidelines needed to create and structure a research protocol. Along with the methodology, some administrative challenges (ethics, regulatory and people-management barriers) and possible time-saving recommendations (standardized procedures, collaborative training, and centralization) are discussed. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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19 pages, 333 KiB  
Review
Assisted Suicide and Euthanasia in Mental Disorders: Ethical Positions in the Debate between Proportionality, Dignity, and the Right to Die
by Matteo Scopetti, Donato Morena, Martina Padovano, Federico Manetti, Nicola Di Fazio, Giuseppe Delogu, Stefano Ferracuti, Paola Frati and Vittorio Fineschi
Healthcare 2023, 11(10), 1470; https://doi.org/10.3390/healthcare11101470 - 18 May 2023
Cited by 17 | Viewed by 17069
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
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)

Other

Jump to: Research, Review

10 pages, 441 KiB  
Case Report
Continuing Education through the Campus Game: A Sustainable Gamification Project to Improve Doctors’ and Nurses’ Knowledge of Quality and Clinical Risk Management
by Claudio Pensieri, Anna De Benedictis, Francesco De Micco, Sabrina Saccoccia, Dhurata Ivziku, Marzia Lommi and Rossana Alloni
Healthcare 2023, 11(16), 2236; https://doi.org/10.3390/healthcare11162236 - 9 Aug 2023
Cited by 4 | Viewed by 2177
Abstract
The COVID-19 disease has dramatically changed lives worldwide, including education. This is a challenge for traditional learning. In fact, the European Higher Education Area poses the challenge of boosting the quality of teaching through active methodologies supported by digital pedagogy. Gamification is one [...] Read more.
The COVID-19 disease has dramatically changed lives worldwide, including education. This is a challenge for traditional learning. In fact, the European Higher Education Area poses the challenge of boosting the quality of teaching through active methodologies supported by digital pedagogy. Gamification is one of these tools and it has considerable attention in the healthcare literature. We aimed to create a game in the Campus Bio-Medico University Hospital Foundation in order to offer continuing education on Quality and Clinical Risk procedures to our staff. The 2021 “Campus Game” (178 players) introduced the “Badge Challenge” (Team Building, Procedures, and Security) and 73 questions. The leaderboard of every single match was posted in some of the hospital’s strategic areas and also published online on the company intranet to ensure engagement and competitiveness. Gamification has spontaneously promoted teamworking and a virtuous process of multiprofessional education. We found that, during the Campus Game, there was a 4.9% increase in access to the intranet page containing information on Quality and Patient Safety and an 8% increase in access to the Hospital Policies and Procedures. In the near future, we wish to expand this game, involving hospitals with similar types of activity and levels of attention to quality and safety issues, and also to enhance the network of partners and the principles of Q&S management itself. Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)
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