INTRODUCTION: The number of injuries and expenses from unsafe delivery of health care has heeded the call for a greater patient safety advocacy. The development of an effective reporting system contributes towards this cause. The study aimed to explore the perceptions of nurses regarding critical incidents and investigate the factors affecting their decision to report a certain event. METHODS: Focus group discussions including 28 nurses working in the service wards of a tertiary hospital, and the data gathered were analyzed using descriptive qualitative approach. RESULTS: Three key themes emerged from the discussions: (1) perceptions of an incident, (2) attitudes, norms, and culture of incident reporting in the workplace, and (3) perceptions and suggestions for management actions and improving the reporting system. The study showed that various factors tend to interplay in the identification of an incident as well as the consideration to perform the behavior. DISCUSSION The primary practice and education implications focus on changing the workplace culture and proper orientation of the staff, while further research regarding the role of reporting, and appropriate analysis of error reporting among other health care professionals would be recommended.
hospital communication systems ; nursing education ; critical incidents ; patient safety

OBJECTIVES: Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. METHODS: Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. RESULTS: During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. CONCLUSIONS: From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital.
Commerce ; Computer Communication Networks ; Delivery of Health Care ; Health Services ; Health Services Research* ; Hospital Communication Systems ; Hospitals, General ; Humans ; Internet* ; Learning ; Patient Care ; Precision Medicine ; Telemedicine ; Wireless Technology

PURPOSE: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. METHODS: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. RESULTS: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. CONCLUSION: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.
Centralized Hospital Services ; Delivery of Health Care ; Disulfiram ; Emergencies ; Emergency Medical Service Communication Systems ; Female ; Hand Strength ; Humans ; Infant, Newborn ; Information Centers ; Intensive Care Units, Neonatal ; Medical Staff ; Obstetric Labor, Premature ; Porphyrins ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Transportation of Patients

OBJECTIVES: The purpose of this study was to develop a prototype wireless local area network (LAN)-based tracking system and evaluate its efficacy. METHODS: A wireless LAN-based tracking system was developed with a personal digital assistant (PDA) having a simple text messaging function and a prototype stand-alone tracking device. Evaluation of the effectiveness of the tracking system was performed in two ways. Twenty-five messages were sent to nurses by direct communication and 46 messages were sent by the wireless system. Thirty cases by nurses and 30 cases by the wireless system to locate hospital equipment were performed. The time required to transfer messages and to locate equipment was measured and analyzed with a Mann-Whitney test and a paired t-test, respectively. RESULTS: The mean time required to transfer messages by direct communication and by the wireless system were 37.92 +/- 19.19 seconds and 30.65 +/- 9.80 seconds, respectively which were not statistically different (p = 0.108). The mean time required to locate equipment by the nurses and by the wireless system was 234.00 +/- 59.99 and 23.97 +/- 6.17 seconds, respectively which was statistically different (p < 0.001). CONCLUSIONS: The wireless LAN-based tracking system can save time for nurses to communicate and to check for the location of equipment in wards which allows nurses to spend more time and attention to patient care and safety.
Computers, Handheld ; Equipment and Supplies, Hospital ; Hospital Communication Systems ; Local Area Networks ; Patient Care ; Text Messaging ; Track and Field

This paper introduces the purpose, integration profile of workflow, integration profile of content of IHE Laboratory Technical Framework and the dependency on IT Infrastructure Technical Framework. And the domestic situation of LIS and HIS integration is analyzed briefly too.
Computer Communication Networks ; Hospital Information Systems ; Humans ; Laboratories, Hospital ; organization & administration ; Software ; Systems Integration ; User-Computer Interface

BACKGROUNDPrimary percutaneous coronary intervention (PCI) has been identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The strategy of transferring patient to a PCI center was recently recommended for those with acute STEMI who were present to PCI incapable hospitals, which include lack of facilities or experienced operators. In China, some local hospitals have been equipped with PCI facilities, but they have no interventional physicians qualified for performing primary PCI. This study was conducted to assess the feasibility, safety and efficacy of the strategy of transferring physician to a PCI-equipped hospital to perform primary PCI for patients with acute STEMI.

METHODSThree hundred and thirty-four consecutive STEMI patients with symptom presentation = 12 hours in five local hospitals from November 2005 to November 2007 were randomized to receive primary PCI by either physician transfer (physician transfer group, n=165) or patient transfer (patient transfer group, n=169) strategy. Door-to-balloon time, in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal re-infarction, and target vessel revascularization) were compared between the two groups.

RESULTSBaseline characteristics between the two groups were comparable. Thrombolysis in myocardial infarction (TIMI) 3 flow was revealed in more patients in the physician transfer group at initial angiography (17.6% vs 10.1%, P<0.05). The success rate of primary PCI (96.3% vs 95.4%, P>0.05) and length of hospital stay were similar between the two groups ((15+/-4) days vs (14+/-3) days, P>0.05). In the physician transfer group, door-to-balloon time was significantly shortened ((95+/-20) minutes vs (147+/-29) minutes, P<0.0001) and more patients received primary PCI with door-to-balloon time less than 90 minutes (21.2% vs 7.7%, P<0.001). During hospitalization, MACE occurred in 6.7% and 11.2% of patients in the physician and patient transfer groups, respectively (P=0.14). At 30-day clinical follow-up, the occurrence rates of death, non-fatal re-infarction, and target vessel revascularization (TVR) were 3.6% vs 5.9%, 4.2% vs 8.9%, and 1.2% vs 2.4% in the physician and patient transfer groups, respectively (all P>0.05). The cumulative composite of MACE was significantly reduced (8.9% vs 17.2%, P=0.03) and MACE free survival (91.0% vs 82.9%, P<0.05) was significantly improved in the physician transfer group at 30 days.

CONCLUSIONThe strategy of transferring physician to local hospital to perform primary PCI for patients with acute STEMI is feasible, safe and efficient in reducing the door-to-balloon time and 30-day MACE rate.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Female ; Hospital Communication Systems ; organization & administration ; Humans ; Interdisciplinary Communication ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Patient Care Team ; Patient Transfer ; Platelet Glycoprotein GPIIb-IIIa Complex ; antagonists & inhibitors ; Time Factors

Angioplasty, Balloon, Coronary ; Hospital Communication Systems ; organization & administration ; Humans ; Interdisciplinary Communication ; Myocardial Infarction ; therapy ; Patient Care Team ; Patient Transfer ; Time Factors

This article outlines the methods of building a safe environment for the hospital information system, and protecting data in three levels. Firstly it is recommended to build a highly efficient and redundant hot spare system for program applications and the database, secondly to make a copy of log file from the current database to the emergent server used for the whole hospital is suggested,finally another emergent server should be provided for the outpatient department. And thus, once there are some problems with the whole network, it would undertake the urgent services of the hospital as an outpatient network.
Computer Communication Networks ; Computer Security ; Computer Systems ; Hospital Information Systems

In the article,a plan of network construction which satisfies the demand of applications for a telemedical information sharing platform is proposed. We choice network access plans in view of user actual situation, through the analysis of the service demand and many kinds of network access technologies. Hospital servers that locate in LAN link sharing platform with node servers, should separate from the broadband network of sharing platform in order to ensure the security of the internal hospital network and the administration management. We use the VPN technology to realize the safe transmission of information in the platform network. Preliminary experiments have proved the plan is practicable.
Computer Communication Networks ; Computer Security ; standards ; Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Internet ; Radiology Information Systems ; Telemedicine ; methods ; standards ; User-Computer Interface

This article introduces the development of a middleware based on HL7, which solves the problem of data integration and sharing effectively and successfully, among the hospital internal subsystems and different hospitals' information systems.
Computer Communication Networks ; standards ; Computer Systems ; Hospital Information Systems ; standards ; Humans ; Information Services ; Information Systems ; Medical Records Systems, Computerized ; Software ; Systems Integration