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PubMed1979

[Rapid and automatic acquisition and transmission of acid-base equilibrium parameters in a clinical biology laboratory (author's transl)].

The "pH-blood gas" department of our clinical biology laboratory was organized to meet rapidly and in the most reliable conditions possible the numerous and urgent analytical demands that had been confronting us. The structure was set up, therefore, in order to accelerate the speed at which blood samples could be transferred and make it possible to quickly and reliably obtain and transmit the results of the analyses. These necessities were satisfied thanks to the installation of a pneumatic tube allowing the rapid transfer of syringes, the utilization of automatic analysers, and the installation of a data processing system.

Acid-Base Equilibrium↗
PubMed1995

[How to solve hospital operating problems based on the experience of the Hanshin earthquake?].

Immediately after the Hanshin (Kobe-Osaka) earthquake, electricity, water and gas supplies were discontinued at Kobe General Hospital, causing difficulties with many important hospital functions including the water cooled independent electric power plant, respirators, and sterilizers. A large water storage facility is needed to keep the water cooled type independent power plant operating. Alternative plans including the introduction of an air cooled independent power plant and a sea water to fresh water exchange system should be considered. Portable compressors are needed to retain the function of respirators in the absence of a water supply. The emergency use of propane gas should also be considered for sterilization and cooking facilities. There were very great problems in communication after the earthquake. The only method was the use of public phones, which have priority over private lines. Therefore, each hospital should have phones with similar priority. In addition, the use of personal computers and/or computer network methods should be considered to preserve a high level of communication after an earthquake. Otherwise, a hospital should be equipped with wireless phones. Immediately after the earthquake, the care of critically ill patients could not be achieved. Therefore, 20 cardiac patients requiring intensive care had to be transferred to other heart centers. The best method for the transfer is by helicopter. Kobe City suffered a transport crisis which occurred immediately after the earthquake and continued up to the end of March. A big helicopter or a special bus guided by a police car should be considered for hospital staff transport.(ABSTRACT TRUNCATED AT 250 WORDS)

Disasters↗
PubMed1999

Differences in the response times of pages originating from the ICU.

STUDY OBJECTIVES: To determine whether the type of paging system causes significant differences in the response time by physicians to their pages in an ICU setting. DESIGN AND SETTING: Prospective cohort study performed in the ICU of two university-affiliated hospitals. All pages were classified by several different variables, including the type of paging system: direct paging if a nurse or hospital operator could directly place the page, or indirect paging if a nurse or hospital operator was required to contact the physician's office or a private answering service who would then independently contact the physician. The main outcome measure was physicians' response time, in minutes, to pages originating from the ICU. RESULTS: During a 100-day period, 402 pages were sent and answered by 166 different physicians (87 attending physicians and 79 housestaff/physician assistants). The median response time for all pages was 3 min with a 25 to 75% quartile of 1 to 8 min. Twenty-five percent of the pages placed through an indirect system were associated with a response time of >/= 29 min. In a multivariate model with the response time dichotomized at >/= 15 min ("slow") or < 15 min ("adequate"), pages placed through an indirect system were answered significantly more slowly than pages placed through a direct system (p < 0.001; odds ratio, 4.36; 95% confidence interval, 2.05 to 9.29). Pages answered in an adequate amount of time were also associated with a significantly higher degree of overall nursing satisfaction with the care delivered by the physician in response to the specific page when compared with pages answered in a "slow" manner (p < 0.001). CONCLUSIONS: Physicians who use an indirect paging system are significantly slower in their response to ICU pages when compared with physicians who utilize a direct paging system. These results may lead to improvements in paging systems used by physicians who care for patients in an ICU setting.

Cohort Studies↗
PubMed2002

Systems' design must allow for change.

Having moved on from traditional nurse call systems, modern healthcare communications are no longer the province of a single user-group within the healthcare arena. To accommodate this change the traditional approach by suppliers is moving from a specific focus on technology to a broader interest in systems application. In this article, Phil Wade, sales director of Static Systems Group, explains the key factors that have affected this transition and how they are now paving the way for further improvements in patient care. The article is based on the views contained in his recent presentation to the IHEEM Engineering for Healthcare seminar that is to be repeated at Pinderfield Hospital, Wakefield, in October and The Royal Free Hospital, London, in December.

Hospital Communication Systems↗
PubMed1989

Fetal heart rate transmission with the facsimile telecopier in rural areas.

Over a 30-month period, 24 portable facsimile telecopiers were placed in rural hospitals with delivery services, allowing 24-hour direct transmission of fetal heart rate tracings for consultation. An analysis of the first 209 intrapartum fetal heart rate strips is presented. Variable decelerations were the most frequent indication for consultation, but they were less commonly interpreted as indicating fetal distress. Such units have major advantages in terms of both cost and versatility over previously described systems and have proved extremely valuable to the rural practitioner of obstetrics.

Electrocardiography↗
PubMed2003

Wireless communications in acute health-care.

Before a particular form of wireless communication is implemented within a health-care institution, consideration should be given to the system's capacity for transmitting voice, data and video information, as well as its reliability and coverage. An important associated choice concerns the best combination of user devices that will enable secure and rapid transmission of data to clinical staff at the point of care. Several technologies are available. No new technology that is likely to become available over the next five years will address the two main concerns of health service organizations: the need for non-interference with sensitive equipment; and the need for immediate communication of urgent messages. We therefore believe that health industries with a mobile workforce will gain five to eight years of useful life from cordless telephone systems and that paging or other radio-based devices will remain an important mode of communication for at least the next five years, especially where emergency communication is concerned.

Hospital Communication Systems↗
PubMed1998

An organization-wide approach for an effective communication system, Part 1.

This two-part series provides a cogent discussion of designing and implementing an effective communication system, with a committee structure based on the Joint Commission on Accreditation of Health Care Organizations (JCAHO) functions. Part one includes the development and design using a systems approach. Part two, which will be published in the April 1998 issue of JONA, will address the evaluation of outcomes and implications of this communication system. The experiential learning gained from this process is illustrated by the analysis of themes that surfaced during the implementation.

Communication↗
PubMed1993

Assessing the effectiveness of communication in organisations: the communication audit approach.

Within the past decade there has been an enormous growth of interest in the field of organisational communication. Numerous books, book chapters and journal articles have been devoted to this topic. However, much of this output has been at the level of common sense exhortation, has tended to be anecdotal, or at best has been based upon the personal experience of the authors. Certainly within the UK there has been little hard empirical research into the nature, flow and functions of communication within organisations. This paper proposes the introduction of a much more systematic methodology for the study of such communication, based upon what is known as the 'communication audit' approach. This approach is fully explained and the main methods employed in communication audits outlined, together with their relative advantages and disadvantages. It is also pointed out that audits are now widely employed to measure performance in other spheres of the organisation, such as finance, and it is argued that the implementation of this system to measure communication performance is therefore long overdue. The benefits for organisations of carrying out audits are highlighted and suggestions are made about possible future directions for research in this area.

Communication↗
PubMed1979

Video intercom: O.R. consultation and frozen section with screen display of gross and microscopic findings.

Seldom does the pathologist at Saint Barnabas Medical Center, Livingston, NJ, enter the operating room to consult with the operating surgeon. Instead, consultation takes place via an audio-intercommunication system supplemented by video. In this article, the authors explain how and when the system is used, the equipment needed, and the benefits to be derived by pathology residents.

Education, Medical↗
PubMed2006

Alphanumeric paging in an academic hospital setting.

OBJECTIVE: To determine whether implementation of an alphanumeric-paging system would improve physician work environment. DESIGN: Surveys were distributed to all general surgery residents, faculty, and nurses before and after implementation of an alphanumeric-paging system. Housestaff also kept a detailed log of paging activity before and after the intervention. MEASUREMENTS: User satisfaction with the paging system was measured using a Likert format survey. Interruptions to patient care and pages requiring a call back were tracked using paging logs. RESULTS: Physician perceptions of the capability of text paging before the intervention were high and did not differ significantly postintervention. For nursing staff, postintervention perceptions of the text-paging system were significantly more positive than preintervention, especially with regard to perceived improvements in patient care (54.1% versus 81.6%, P < .05). Residents' paging logs reflected significantly decreased interruptions to patient care after the intervention (28.2% versus 46.9%, P < .05), with less pages requiring a call back (100% versus 73.6%, P < .05). CONCLUSIONS: Study participants rated the alphanumeric-paging system highly. Text-paging technology has the potential to reduce interruptions in patient care and improve physician work efficiency and satisfaction.

Chi-Square Distribution↗