Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims: 2nd Edition

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

Deadline for manuscript submissions: 31 January 2025 | Viewed by 4975

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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
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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 hospital organization capable of welcoming and managing the needs of the population is increasingly 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. Hospital organization must consider the new general conditions in which it operates and in addition to the needs of COVID-19 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 of hospitals and available resources. There is an evident 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 that aim to increase the resilience of national systems in the health sector. These programs provide 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 interest is nosocomial infections, which represent adverse events that must 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 found across the globe. 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 staff, patient safety and safety at work and 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;
  • Technology 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

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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 (5 papers)

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Research

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11 pages, 3442 KiB  
Article
Machine Learning-Based Prediction of Readmission Risk in Cardiovascular and Cerebrovascular Conditions Using Patient EMR Data
by Prasad V. R. Panchangam, Tejas A, Thejas B U and Michael J. Maniaci
Healthcare 2024, 12(15), 1497; https://doi.org/10.3390/healthcare12151497 - 28 Jul 2024
Viewed by 968
Abstract
The primary objective of this study was to develop a risk-based readmission prediction model using the EMR data available at discharge. This model was then validated with the LACE plus score. The study cohort consisted of about 310,000 hospital admissions of patients with [...] Read more.
The primary objective of this study was to develop a risk-based readmission prediction model using the EMR data available at discharge. This model was then validated with the LACE plus score. The study cohort consisted of about 310,000 hospital admissions of patients with cardiovascular and cerebrovascular conditions. The EMR data of the patients consisted of lab results, vitals, medications, comorbidities, and admit/discharge settings. These data served as the input to an XGBoost model v1.7.6, which was then used to predict the number of days until the next readmission. Our model achieved remarkable results, with a precision score of 0.74 (±0.03), a recall score of 0.75 (±0.02), and an overall accuracy of approximately 82% (±5%). Notably, the model demonstrated a high accuracy rate of 78.39% in identifying the patients readmitted within 30 days and 80.81% accuracy for those with readmissions exceeding six months. The model was able to outperform the LACE plus score; of the people who were readmitted within 30 days, only 47.70 percent had a LACE plus score greater than 70, and, for people with greater than 6 months, only 10.09 percent had a LACE plus score less than 30. Furthermore, our analysis revealed that the patients with a higher comorbidity burden and lower-than-normal hemoglobin levels were associated with increased readmission rates. This study opens new doors to the world of differential patient care, helping both clinical decision makers and healthcare providers make more informed and effective decisions. This model is comparatively more robust and can potentially substitute the LACE plus score in cardiovascular and cerebrovascular settings for predicting the readmission risk. Full article
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26 pages, 1741 KiB  
Article
Evaluation of Community Involvement and Development in an Orthopedic Hospital
by Flaviu Moldovan and Liviu Moldovan
Healthcare 2024, 12(13), 1286; https://doi.org/10.3390/healthcare12131286 - 27 Jun 2024
Viewed by 790
Abstract
Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the [...] Read more.
Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the sustainability of healthcare organizations, which includes the area of community involvement and expansion. It is made up of nine indicators. These were designed using the most representative activities reported by hospitals around the world. Their testing was conducted in an orthopedic emergency hospital. The designed indicators are community engagement actions; the interventions’ content adapted to the community; partnership and networking; the involvement of volunteers and training networks; the involvement and participation of professional associations; community-involved local opinion leaders; satisfaction with partnerships; initiatives together with the community; and educational visits. The testing and validation of health practices of the indicators highlighted their adequacy with the proposed purpose of the research and the promotion of sustainable development. We have also verified their compatibility with the requirements of national hospital accreditation legislation and the European framework for quality assurance in hospitals. Full article
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24 pages, 2040 KiB  
Article
An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System
by Flaviu Moldovan and Liviu Moldovan
Healthcare 2024, 12(11), 1080; https://doi.org/10.3390/healthcare12111080 - 24 May 2024
Cited by 1 | Viewed by 881
Abstract
Background and Objectives: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component [...] Read more.
Background and Objectives: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability. Materials and Methods: We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world. Results: We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement–importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram. Conclusions: Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability. Full article
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16 pages, 4739 KiB  
Communication
South Tyrol Healthcare Company: A Look at a Peculiar Model of Claims Management in Italy and Analysis of Its Last 11 Years
by Martina Zanon, Francesco Randazzo, Valter Equisetto, Paolo Martini, Silvia Winkler, Christian Leuprecht, Stephan Vale, Antonia Tessadri, Monica Concato and Stefano D’Errico
Healthcare 2024, 12(11), 1070; https://doi.org/10.3390/healthcare12111070 - 24 May 2024
Viewed by 662
Abstract
Background: Alternative Disputes Resolution (ADR) systems are becoming increasingly important tools in recent years for the management and resolution of health responsibility cases, but their dissemination and efficiency are still poorly described. The purpose of this paper is to present an ADR system [...] Read more.
Background: Alternative Disputes Resolution (ADR) systems are becoming increasingly important tools in recent years for the management and resolution of health responsibility cases, but their dissemination and efficiency are still poorly described. The purpose of this paper is to present an ADR system in the autonomous province of Bolzano: the Conciliation Commission. Methods: systematic collection of all claims of the South Tyrol Sanitary Service that were dealt with in the Conciliation Commission from 1 January 2012 to 31 December 2022. Results: closing times of the applications received turn out to be less than a year in 63.8% of the cases, with a number of cases managed rather stably in the time, even if minimal if compared to the number of complaints received to the South Tirol Health Service. Only 5.3% of the application continued the legal process before a civil court. Conclusions: the Conciliation Commission of South Tirol appears to be an excellent instrument for the resolution of disputes in the healthcare field, with rapid resolution times and little to zero costs for the healthcare company, a public health institution. Despite its effectiveness, it seems to be a tool that is still little-known in South Tyrol. Full article
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19 pages, 760 KiB  
Systematic Review
The State-of-the-Art of Mycobacterium chimaera Infections and the Causal Link with Health Settings: A Systematic Review
by Vittorio Bolcato, Matteo Bassetti, Giuseppe Basile, Luca Bianco Prevot, Giuseppe Speziale, Elena Tremoli, Francesco Maffessanti and Livio Pietro Tronconi
Healthcare 2024, 12(17), 1788; https://doi.org/10.3390/healthcare12171788 - 6 Sep 2024
Viewed by 1203
Abstract
(1) Background. A definition of healthcare-associated infections is essential also for the attribution of the restorative burden to healthcare facilities in case of harm and for clinical risk management strategies. Regarding M. chimaera infections, there remains several issues on the ecosystem and pathogenesis. [...] Read more.
(1) Background. A definition of healthcare-associated infections is essential also for the attribution of the restorative burden to healthcare facilities in case of harm and for clinical risk management strategies. Regarding M. chimaera infections, there remains several issues on the ecosystem and pathogenesis. We aim to review the scientific evidence on M. chimaera beyond cardiac surgery, and thus discuss its relationship with healthcare facilities. (2) Methods. A systematic review was conducted on PubMed and Web of Science on 7 May 2024 according to PRISMA 2020 guidelines for reporting systematic reviews, including databases searches with the keyword “Mycobacterium chimaera”. Article screening was conducted by tree authors independently. The criterion for inclusion was cases that were not, or were improperly, consistent with the in-situ deposition of aerosolised M. chimaera. (3) Results. The search yielded 290 eligible articles. After screening, 34 articles (377 patients) were included. In five articles, patients had undergone cardiac surgery and showed musculoskeletal involvement or disseminated infection without cardiac manifestations. In 11 articles, respiratory specimen reanalyses showed M. chimaera. Moreover, 10 articles reported lung involvement, 1 reported meninges involvement, 1 reported skin involvement, 1 reported kidney involvement after transplantation, 1 reported tendon involvement, and 1 reported the involvement of a central venous catheter; 3 articles reported disseminated cases with one concomitant spinal osteomyelitis. (4) Conclusions. The scarce data on environmental prevalence, the recent studies on M. chimaera ecology, and the medicalised sample selection bias, as well as the infrequent use of robust ascertainment of sub-species, need to be weighed up. The in-house aerosolization, inhalation, and haematogenous spread deserve experimental study, as M. chimaera cardiac localisation could depend to transient bacteraemia. Each case deserves specific ascertainment before tracing back to the facility, even if M. chimaera represents a core area for healthcare facilities within a framework of infection prevention and control policies. Full article
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