bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Social Media cause Needed Health Care Transformation to Occur? The STRONGERR Project
Authors: Mazurik Laurel 
Published: June 2023

Introduction:The key cripplers of health care are:1. Fragmented Patient chartPossible solutions:
single cloud-based chart that is owned by the patient protected by the governmentinformation uploaded by a certified care provider (or they don't get paid)Maintained by a patient navigator who organizes informationlinked to self-care directions andtele-support clinicians2. Disparate and rapidly changing medical treatments of variable support with evidenceWhy can't we integrate all guidance into one set of current recommendations so that when you put your information into the patient's EMR, guidance pops up and you follow that.Not only will that lead to consistency, you are essentially entering a patient into a clinical trial of sorts as this data can be reviewed later.3. CME
Fragmented, disparate, inconsistent.Make it a paid part of our salary making it mandatory, and consistent4. TelemedicineCreate a Provincial or State or Regional Virtual hospital that Offers 24/7, Full hospital e-consultant services.a. Tier one, e-Consultants support acute care issues.They help you decide regardless of where you are working the management and connect with a regional hospital bed registry so you can move your patient from your ED to a hospital with beds.b. Tier two, e-Consultants who support in-patient rounds virtually in rural/remote settings with hospitalists. For example, an Internist could support and monitor a regional virtual ward and do rounds with in-house hospitalists on patients across the region.C. Tier three would be the equivalent of an outpatient clinic, done virtually.Method:A STRONGERR website using Social Media tools will be created to determine if social media can be used to accelerate health care transformation to create a unified delivery system.Results:Website will be up by Dec 2022. Results April 2023.Conclusion:To be determined.
Using a Multi-Agency Response Framework During COVID19 by Emergency Managers in a Healthcare Organization
Authors: Fitzgerald Mary Rose , O'Sullivan David , O'Brien Cian 
Published: June 2023

Introduction:The paper provides the perspective of emergency managers within a healthcare service, using a multi-agency framework to coordinate a regional response to COVID 19. While health services play a role in the planning, response and recovery to major emergencies they are rarely the lead in coordinating the response. The exploration of existing research through Pauchant and Mitroff Onion Theory is combined with the challenges and experiences faced by emergency managers during the COVID 19 response in Ireland. The research mirrors the experience of emergency managers that preparedness and relationship building are key to quickly establishing a response. However the experience of emergency managers was that although shared situational awareness is critical a flexible system framework is required, particularly in a prolonged pandemic situation. A hierarchical command and control system can negatively impact on strong local relationships and problem solving capability. The experience of emergency mangers concurs with research that the development of a learning organization is pivotal in information preparedness before and during the response and recovery phase. The challenges of implementing lessons learned across a national health service can be challenging especially during an extended response phase.Method:A deductive manifest analysis approach was adopted to carry out a qualitative thematic content analysis of exercise reports and emergency debrief reports.Results:Research QuestionsLessons learned in the five years prior to COVID 19 enhanced the response to the pandemic emergency–yes there are several examples of how lessons learned can improve response to seemingly unrelated emergencies.The principals of the MEM Framework in Ireland are applicable to a pandemic emergency–yes but this is dependent on local arrangements and relationships to allow flexibility in the implementation of the framework.Conclusion:Regular training and exercising as well as a debriefing of exercises and real emergencies enhances preparedness for emergencies.
The Surge Capacity Applied to Migration Crises: "The Need for a Conceptual Framework for Emergency Medical Teams”
Authors: Echeverri Lina , Campoggiani Laura , Salio Flavio , Ragazzoni Luca 
Published: June 2023

Introduction:Migration and forced displacement are reshaping the globe today. More people are being displaced by conflicts and natural disasters than ever before, and climate change is playing a pivotal role as a contributing factor for migration and conflict.While there is a growing literature regarding provision of care for migrants in hosting countries there is no evidence on the use of the surge capacity model to support preparedness, readiness, and response to migration crisis by local health services, or medical teams.Method:A scoping review with a narrative summary relevant to disaster medicine, looking at two major migration routes (Central/Eastern Mediterranean and South/Central America) was performed to determine if the surge capacity model has been applied by medical teams responding to migration crises, and how this has affected the adaptation of health services.Results:Preliminary analysis demonstrates variations on the use of the term “surge capacity”, and the imperative need to better define its application when preparing to or responding to any type of disaster, here specifically migration crisis. Thus far, there is no evidence on the use of the surge capacity model for the conformation of national/international medical teams when responding to this type of crises, and its relation to the adaptation of health services. This is particularly relevant, as the surge capacity model can support building and/or strengthening the capacity and capability of national and international medical teams.Conclusion:There is an imperative need to design a conceptual framework based on the surge capacity model for the conformation of fit-for-purpose medical teams, that ensures preparedness, readiness, and appropriate response to migration crises guaranteeing adaptation of health services depending on context needs, and that defines skills and competencies of the responders. Additionally, this provides a conducive platform for operational research activities to foster evidence coming from the field.
Evaluation of Inconclusive Results on the Cepheid X-Pert Xpress Platform (GXP) for the Diagnosis of Severe Acute Respiratory Syndrome-2: A Narrative Literature Review
Authors: van der Vegte Andrea , Conradie Maria , Orsmond Brendan , Smit Marco , Kleinhans Rochelle , Abraham Ria , Dowle Ashleigh , Jordaan Philip , Kennedy Keith , Molloy Michael 
Published: June 2023

Introduction:Molecular assay for diagnosing and detecting SARS-COV-2 is an essential tool in pandemic management, allowing for early informed decision-making. Worldwide, the gold standard for testing SARS-COV-2 includes real-time reverse transcription-polymerase chain reaction assay (RT-PCR). The Cepheid Xpert-Xpress was authorized for emergency diagnosis of SARS-COV-2. This platform demonstrated various advantages, including faster results, due to a decreased turnaround time, and decreased contamination risk. However, inconclusive results often leave clinicians uncertain regarding individual patient management decisions. Often leading to more confusion than answers.The aim of this literature review includes the following:
identify the frequency and clinical implications of inconclusive results for SARS-COV-2 diagnosis utilizing GeneXpert assaywhether inconclusive results should be interpreted as negativeassessing the reliability of the GeneXpert platform to diagnose SARS-COV-2Method:A narrative literature review was conducted with eight critically appraised articles which met the inclusion criteria.After the initial data collection, the SANRA Framework was implemented to aid in the sorting and filtering of data. The analysis of data was conducted with a critical appraisal tool.Results:The GeneXpert SARS-COV-2 assay demonstrated high sensitivity and specificity. Studies indicated that inconclusive results associated with a high cycle-threshold value (CT-value) of more than thirty-five on the Cepheid Xpert Xpress were associated with a decreased viral load and, thus, decreased infectivity. However, numerous factors influence the CT-value, such as specimen integrity. Thus, results must not be interpreted in isolation.Conclusion:This narrative literature review demonstrated the need for institutions to assist clinicians with decision-making regarding inconclusive results. A flow diagram grading a patient’s risk of having SARS-COV-2 with an inconclusive result could be of immense value. The flow diagram should incorporate the current epidemiology in the area, patient symptomology and risk and duration of exposure.
“This is a T.E.S.T.” (Tabletop Exercise Simulation Tool): Using Gamification to Train Public Health Staff in Community Reception Centers for a Nuclear or Radiological Incident
Authors: Schnall Amy , Finklea Lauren 
Published: June 2023

Introduction:After a nuclear or radiological (nuc/rad) incident, there is a need to screen, potentially decontaminate, and monitor the affected population. A Community Reception Center (CRC) is a site that provides these services, plus more, to those displaced by a large-scale incident. By using CRCs, federal agencies and state, tribal, local, and territorial (STLT) health departments can monitor the affected population, help prevent hospitals from becoming overburdened with persons not critically injured, compliment shelter operations, and obtain a basis for a long-term registry. However, public health staff often are not fully trained in their CRC role and the decision-making factors.Method:The Centers for Disease Control and Prevention (CDC) developed a unique training board game, “This is a T.E.S.T.” (Tabletop Exercise Simulation Tool), for public health staff about their CRC role and decision-making factors. We play-tested the game with several CDC and STLT staff in 2022 and received informal feedback.Results:Players found the game facilitated discussion and identified gaps in CRC plans, safety hazards, population needs, and staffing requirements. They also said the game improved collaboration and communication. Over 90% of players strongly agreed the game accurately simulated both bottlenecks and resource needs, individual needs and anxiety, and allowed a greater understanding of CRC operations.Conclusion:Games have been used for emergency response using different platforms such as virtual reality and video games. This is a T.E.S.T. facilitates collaboration by tasking players with managing resources, staff fatigue, public anxiety, and hazards. Players provided valuable feedback on its usability while learning more about CRCs. “This is a T.E.S.T” provides a unique, innovative training experience that incorporates components from typical tabletop and full-scale exercises, CRC capacity estimates through CDC’s CRC SimPLER (Simulation Program for Leveraging and Evaluating Resources), and key principles of adult learning.
Outcomes of Hemorrhage Control Training for Community Organizations in Rwanda
Authors: Longerstaey Oriane , Denison Kyle , Lee Noelle , Nzeyimana Innocent , Rutagumba Dieudonne , Hughes Ashley , Lacasse Chelsea , Krebs Elizabeth 
Published: June 2023

Introduction:Traumatic injury from road traffic accidents is a major cause of morbidity and mortality in Rwanda. Basic first aid training can help bystanders to provide prehospital care. The objective of this study was to determine the impact of Stop the Bleed (STB) hemorrhage control training on participant knowledge, attitudes, and practices regarding bleeding control.Method:A total of 64 participants from two community organizations (Healthy People Rwanda and the Rwandan Emergency Care Association) were provided with training in STB. The course included a didactic presentation and skills session where participants could practice skills. A KAP (Knowledge, Attitudes, Practices) survey was provided to participants before training, immediately after training, three months, and six months post-training.Results:Immediately after training, participant knowledge of bleeding control techniques improved across 5 of 7 questions, including correct tourniquet placement (98% vs 85%) and the correct order of steps to take when treating bleeding (63% vs 9%). There was also a significant increase in confidence across six measures: identifying life-threatening bleeding, applying a tourniquet, applying direct pressure, wound packing, treating severe active bleeding, and teaching bleeding control techniques to others (p<0.001). After three months, 100% (n = 21) of participants reported using at least one skill from the course, and 95.24% (n = 20) reported using at least one piece of equipment provided during the course. After six months, 93.33% (28 of 30) of participants reported using at least one skill from the course, and 86.67% (26 of 30) reported using at least one piece of equipment provided during the course. Notably, 17 participants reported using the tourniquet they had received by six months post-training.Conclusion:This study found that STB training increased participant knowledge of bleeding control techniques and confidence in performing techniques for bleeding control. All participants reported using skills learned from the course.
Reinventing Medical Hazardous Materials Response for Radiological Emergencies: Building Resiliency in Emergency Medical Response Systems Through a Novel Approach to Education and Training
Authors: Hwang Esther , Mize Benjamin , Glassman Erik 
Published: June 2023

Introduction:The past three years have included multiple Public Health Emergencies of International Concern (PHEIC) and dramatically impacted all facets of Emergency Medical Response. During this time, simultaneous crises have demonstrated the value of the non-traditional responder in mitigating complex incidents. Current geopolitical climate has proliferated nuclear power and increases the necessity for readiness and awareness for radiological incidents. These are complex incidents a responder may face and requires even the lowest skilled practitioner to be fully engaged before special operations intervention.Limited research exists to determine whether current emergency medical services (EMS) training supplies the competency necessary to ensure safety of the prehospital provider during a radiological incident. Forthcoming research will investigate the effectiveness of this current training within the United States.Method:Survey data will be collected from multiple providers across the United States to evaluate their confidence level on two primary objectives during a radiological incident: competency of personal protective equipment donning and doffing, and management of contaminated patients.Data analyses of survey responses help drive future proposed educational activities that will be compliant with best practices set forth by organizations such as the United States Department of Health and Human Services Radiation Emergency Medical Management (REMM), the National Fire Protection Agency (NFPA), and Radiation Emergency Assistance Center/ Training Site (REAC/TS).Results:Data will be collected by survey responses to evaluate a diverse range of EMS services. Details such as skill level, type of EMS service, catchment of communities served, and their impressions upon the training will be analyzed.Conclusion:This is an ongoing project that will embrace the perspectives of the diverse group of delegates of WADEM throughout and become enriched through the organization's wealth of knowledge. Gaps highlighted during roll-out of this research can also be used to address logistics, doctrine, and policy shortfalls.
The National Israeli Field Hospital in Ukraine - Innovative Adaptation to a Unique Scenario
Authors: Bar-On Elhanan , Vivante Asaf , Kreiss Yitshak 
Published: June 2023

Introduction:Following the outbreak of hostilities in Ukraine and the resultant humanitarian crisis, the State of Israel deployed a field hospital inside Ukraine. Challenges included a large refugee population, disruption of routine medical services to the local population, first-time deployment of a civilian field hospital, and deployment to a country at war.Method:The activity of the field hospital during a deployment in Ukraine is described along with lessons learned for future deployments.Results:A Rapid Assessment Team (RAT) performed needs assessment and coordination with local authorities. The main necessity encountered was delivery of primary care to both the refugee and local population. During the 6 weeks of deployment, 6,161 patients were treated in the hospital. 65 patients were hospitalized and 59 underwent surgery. The hospital was completely digitalized. 103 remote consultations were performed using telemedicine techniques. Capacity building of local teams was given high priority and 796 Ukrainian health professionals underwent training.Conclusion:Deployment of a national civilian field hospital in a country of war is possible through coordination with local authorities while undertaking the necessary security measures.The change in caseload from expected war trauma to predominantly primary care necessitated agility in planning and operation with subsequent adaptation of hospital and staff structure.The use of telemedicine enhanced capabilities, allowing access to consultation with the most experienced specialists in Israel.Capacity building of local teams should be given a high priority. This was implemented by combining clinical training and the inclusion of a medical simulation unit in the hospital.Dispatching a team delivering medical care and extending a helping hand in time of need, especially when done by a national entity, contributes greatly to building the people's faith, hope, and resilience during the crisis, and has a critical role in the recovery effort.
No One Should Die Alone: Preparing for the Next Pandemic
Authors: Cliff Barbara 
Published: June 2023

Introduction:As health care professionals and family members, we know that many patients died alone in healthcare settings during the first six months of the COVID-19 pandemic. An extensive literature review confirms this as well, and concludes that visiting restrictions during the pandemic had negative impacts on patients and their loved ones.There is a right to not die alone contained in the Dying Patient’s Bill of Rights; however, it happened time and time again during the early months of this pandemic when countless people in long-term care settings and hospitals were reported to be isolated during their final hours of life. No one should die alone! What can we learn from this experience to try to minimize this from happening during the next pandemic?Method:This study will explore the state of the literature on the status and impact of visitor restrictions during the COVID-19 pandemic, in conjunction with a survey of a defined sample of practicing registered nurses in the United States. This study seeks to respond to the primary research question of how patients’/family members’ end-of-life needs can be met in a pandemic when hospital visitation is severely limited or non-existent? There are for (4) related sub-questions concerning effective direct and indirect methods of family presence.Results:The literature concludes that countless people were isolated without family presence during their final hours of life during the first six months of COVID-19. The initial survey process is currently underway, with the identification and analysis of recommendations for improvement in early 2023.Conclusion:The goal of this study is to develop best practices for meeting the end-of-life needs of hospitalized patients and their loved ones during a pandemic, so that to the extent possible, no one dies alone.
Review of Psychiatric Patient Transfer Times in an Emergency Department with Limited Psychiatric Services
Authors: Conradie Maria , Orsmond Brendan , Andrews Robin , Bilal Muhammad , van der Vegte Andrea , Abraham Ria , van Rensburg Rochelle Janse , Taqvi Syed , Jordaan Phillip , Smit Marco , Dowle Ashleigh , Vythilingam Darshini , Wickham Bryce , Kennedy Keith , Kelly Thomas , Molloy Michael 
Published: June 2023

Introduction:The National Ambulance Service (NAS) must transport patients with acute psychiatric needs to their nearest emergency department for assessment. Wexford General Hospital (WGH) does not have on-site medical psychiatric services after hours, in-patient psychiatric beds, or dedicated psychiatric doctors. Patients requiring formal acute psychiatric assessment and/or admission after ED review need to be transferred 60-80 km to other healthcare facilities.Aimed to assess average ED stays of psychiatric patients and determine what degree transfer time contributed to their total time would help to determine what delay there was to providing acute psychiatric care due to the lack of after hours/on-site services.Method:Data was collected from the iPMS system. A total of 125 patients presented with primary psychiatric complaints between January 1, 2021 and December 31, 2021 and required onward transfer for acute psychiatric assessment or admission. Patients were excluded if less than 18 years or had been admitted to another WGH service before transfer. There are no existing guidelines in the National Clinical Program for Psychiatry or NICE guidelines for acute psychiatric patient transfer times or ED stays.Results:The average WGH ED attendance time was 15h 27min (range 0h08min and 19h22min). The longest interval contributing to overall time was Transfer Booked to Transfer Time (average 3h 27min). The time from Psychiatric Referral to Transfer accounted for 30% (on average) of patients’ attendance time.Conclusion:There are significant delays in accessing acute psychiatric care due to the absence of Ambulance Service Bypass Protocols to transport patients to the most appropriate rather than the nearest ED. Proposed Trauma bypass system changes offer unique opportunities to review such inequity of access to acute psychiatric services.