A Posterior Predictive Model-Based Control Chart for Monitoring Healthcare

Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Determinants of Knowledge-Based Improving Workflow and Communication within Surgical Team

Surgical team consists of variety types of medical specialists possessing different kind of knowledge, motivations, personalities or abilities. This together with poor knowledge transfer, lack of information and communication technologies (ICT) implementations in hospitals can cause protraction of patient care processes and even jeopardize patient safety. There is presented in the article the outcomes of studies on communication and workflow in surgical team in the background of different collaboration levels in healthcare system. As a result the five determinants of improving workflow and communication within surgical team were indicated as well as knowledge-based tools and supporting information technology were proposed.

Evaluating the Standards of Hospital Pharmacies in Therapeutic Centers Affiliated with Kermanshah University of Medical Sciences, Iran

Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.

Dynamic Performance Indicators for Aged-Care Construction Projects

Key performance indicators (KPIs) are used for post result evaluation in the construction industry, and they normally do not have provisions for changes. This paper proposes a set of dynamic key performance indicators (d-KPIs) which predicts the future performance of the activity being measured and presents the opportunity to change practice accordingly. Critical to the predictability of a construction project is the ability to achieve automated data collection. This paper proposes an effective way to collect the process and engineering management data from an integrated construction management system. The d-KPI matrix, consisting of various indicators under seven categories, developed from this study can be applied to close monitoring of the development projects of aged-care facilities. The d-KPI matrix also enables performance measurement and comparison at both project and organization levels.

Dynamic Features Selection for Heart Disease Classification

The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts- knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.