Predicting patient acuity from electronic patient records.

Background: The ability to predict acuity (patients' care needs), would provide a powerful tool for health care managers to allocate resources. Such estimations and predictions for the care process can be produced from the vast amounts of healthcare data using information technology and computational intelligence techniques. Tactical decision-making and resource allocation may also be supported with different mathematical optimization models.

The impact of an empowering Internet-based Breast Cancer Patient Pathway program on breast cancer patients' clinical outcomes: a randomised controlled trial.

Aims And Objectives: To evaluate the effect of the Breast Cancer Patient Pathway program on breast cancer patient's empowerment process.

Background: The results of earlier studies indicate that the use of tailored Internet-based patient education programs increased patient's knowledge level; however, other outcome measures differed.

Design: This randomised control trial studied the effect of the Internet-based patient educational program on breast cancer patients' empowerment.

National survey focusing on the crucial information needs of intensive care charge nurses and intensivists: same goal, different demands.

Background: Although information technology adequately supports clinical care in many intensive care units (ICUs), it provides much poorer support for the managerial information needed to coordinate multi-professional care. To gain a general view of the most crucial multi-professional information needs of ICU shift leaders a national survey was conducted, focusing on the information needs of charge nurses and intensivists.

Methods: Based on our previous observation study an online survey was developed, containing 122 information need statements related to the decision-making of ICU shift leaders.

Information utilization in tactical decision making of middle management health managers.

Healthcare is an information-intensive field, as information is needed to make strategic, tactical, and operational decisions. The purpose of this study was to identify the tactical decisions that middle management healthcare managers make, the information that is available, and the necessary information that is missing using the cardiac care process as an example. Data were collected through focused interviews of nurses and physicians who work in middle management in a secondary healthcare field.

The impact of an empowering Internet-based Breast Cancer Patient Pathway programme on breast cancer patients' knowledge: a randomised control trial.

Objective: The aim of this study was to analyse the effect of Breast Cancer Patient Pathway program.

Methods: In one Finnish university hospital during 2008-10 newly diagnosed breast cancer patients were randomised to the intervention (n = 50) and the control groups (n = 48). The breast cancer patient's knowledge expectations and perception of received knowledge, knowledge, the source of information and satisfaction in received patient education were measured.

Internet based patient pathway as an educational tool for breast cancer patients.

Objective: The aim of this paper was to describe the process of developing an Internet-based empowering patient education program for breast cancer patients and to evaluate the quality of the program from the perspective of patients. In this program, the patient pathway was used as an educational tool.

Methods: The Breast Cancer Patient Pathway (BCPP) was developed and tested at one Finnish university hospital in 2005-2007.

Managing daily intensive care activities: an observational study concerning ad hoc decision making of charge nurses and intensivists.

Introduction: Management of daily activities in ICUs is challenging. ICU shift leaders, charge nurses and intensivists have to make several immediate ad hoc decisions to enable the fluent flow of ICU activities. Even though the management of ICU activities is quite well delineated by international consensus guidelines, we know only a little about the content of the real clinical decision making of ICU shift leaders.

PERFECT preterm infant study.

Introduction: This article summarizes the main findings of the preterm infant sub-study of the Performance, Effectiveness and Costs of Treatment episodes (PERFECT) study. We studied effects of birth hospital level and time of birth on mortality and morbidity and cost-effectiveness of care of very low gestational age (VLGA)/very low birth weight (VLBW) infants.

Material And Methods: The study included all infants born below 32 weeks or 1501 g in Finland in 2000-2007.

Critical incidents and important information in the care processes of patients with cardiac symptoms.

Aim: To describe important information in the care processes of patients with cardiac symptoms.

Background: Process-based work-flow models are increasingly being used in healthcare. At the same time, developments in information systems offer the possibility of supporting improvements in process and information management in healthcare.

Development and behaviour of 5-year-old very low birthweight infants.

The place and time of birth influence the mortality of premature infants. We studied the effect of prematurity, time of birth, birth hospital level and district on the development and behaviour in a national cohort of 5-year-old Finnish very low birthweight infants (VLBWI). All surviving VLBWI (gestational age <32 weeks or birthweight View Article and Find Full Text PDF

The effects of Internet or interactive computer-based patient education in the field of breast cancer: a systematic literature review.

Objective: The aim of this systematic review was to analyze what kind of Internet or interactive computer-based patient education programs have been developed and to analyze the effectiveness of these programs in the field of breast cancer patient education. Patient education for breast cancer patients is an important intervention to empower the patient. However, we know very little about the effects and potential of Internet-based patient education in the empowerment of breast cancer patients.

Key elements of successful care process of patients with heart symptoms in an emergency care - could an ERP system help?

The aim of the study was to identify key elements of successful care process of patients with heart symptoms from the nursing management viewpoint in an emergency care. Through these descriptions, we aimed at identifying possibilities for using enterprise resource planning (ERP) systems to support decision making in emergency care. Hospitals are increasingly moving to process-based workings and at the same time new information system in healthcare are developed and therefore it is essential to understand the strengths and weaknesses of current processes better.

Health-related quality of life in 5-year-old very low birth weight infants.

Objective: To investigate the effect of preterm birth, the time of birth, and birth hospital level and district on health-related quality of life (HRQoL) and quality-adjusted life years (QALYs).

Study Design: This national study included all very low birth weight infants (VLBWIs; birth weight View Article and Find Full Text PDF

Differences in the length of initial hospital stay in very preterm infants.

Aim: To investigate the effect of maternal, infant and birth hospital district related factors on the length of initial hospital stay in very preterm infants. In addition, rehospitalization rate within the first year from the initial discharge was studied.

Methods: A register study covering all very preterm infants (gestational age < 32 weeks or birthweight < 1501 g) born alive in Finland between years 2000 and 2003 (N = 2148).

Production flow analysis: a tool for designing a lean hospital.

Production flow analysis (PFA) was used in the planning process for a new acute care hospital. The PFA demonstrated that functional organisation--for example, with centralised medical imaging-- generates a lot of back and forth patient transfers between functional units. This to-and-fro patient flow increases lead times of care processes and also exposes the patients to unnecessary complications.

The effect of birth in secondary- or tertiary-level hospitals in Finland on mortality in very preterm infants: a birth-register study.

Objective: Our goal was to test the hypothesis that the level of the delivery hospital affects 1-year mortality of very preterm infants in Finland.

Patients And Methods: This retrospective national medical birth-register study included 2291 very preterm infants (gestational age of < 32 weeks at birth or birth weight of < or = 1500 g) born in 14 level II (central) and 5 level III (university) hospitals in 2000-2003. The main outcome measures were adjusted total mortality (including stillbirths) and mortality of live-born infants until the age of 1 year.

Interactive skills of infants with their high-risk mothers.

In this pilot study, the interactive skills of infants with their high-risk, substance-dependent mothers were explored in residential treatment from pregnancy until the infant was 6 months of age. Fourteen mother-infant pairs were videotaped in feeding and free play situations at 6 months after birth. A comparison, low-risk group consisted of 12 ordinary Finnish mother-infant pairs with minimal clinical risks.

Low plasma cholecystokinin levels in colicky infants.

Objectives: Cholecystokinin (CCK) plays an important role in postprandial gallbladder contraction and may also have pacifying behavioral effects, such as inducing satiety and calming in infants. The authors hypothesized that colicky infants have impaired CCK secretion, which contributes to their gallbladder hypocontractility (reported earlier) and excessive crying.

Methods: Cholecystokinin levels of 40 colicky and 37 control infants were evaluated at a mean of age 5 weeks.