Stressors contributing to burnout among acute care and trauma surgery care teams: a systems-analysis approach.

Background: Burnout negatively impacts healthcare professionals' well-being, leading to an increased risk of human errors and patient harm. There are limited assessments of burnout and associated stressors among acute care and trauma surgery teams.

Methods: Acute care and trauma surgery team members at a US academic medical center were administered a survey that included a 2-item Maslach Burnout Inventory and 21 workplace stressors based on the National Academy of Medicine's systems model of clinician burnout and professional well-being.

Longitudinal analysis of culture of patient safety survey results in surgical departments.

Background: There is a need for improved methodologies on how to longitudinally analyze, interpret and learn from the Surveys on Patient Safety Culture™ (SOPS), developed by the Agency for Healthcare Research and Quality (AHRQ). Typically, SOPS quantify results by the percentage of positive responses, but this approach may miss insights from neutral or negative feedback.

Study Design: The SOPS were distributed every two years from 2011 to 2022 to all hospital staff at one academic institution from perioperative services.

Design Approaches for Developing Quality Checklists in Healthcare Organizations: A Scoping Review.

Quality checklists have demonstrated benefits in healthcare and other high-reliability organizations, but there remains a gap in the understanding of design approaches and levels of stakeholder engagement in the development of these quality checklists. This scoping review aims to synthesize the current knowledge base regarding the use of various design approaches for developing quality checklists in healthcare. Secondary objectives are to explore theoretical frameworks, design principles, stakeholder involvement and engagement, and characteristics of the design methods used for developing quality checklists.

Operating Room Teams Display Acceptable Levels of Patient Safety Behaviors During Surgical Cases.

Introduction: Cornerstones of patient safety include reliable safety behaviors proposed by Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) practices. A better quantification of these behaviors is needed to establish a baseline for future improvement efforts.

Methods: At one large academic medical center, OR Teams were prospectively assigned to be observed during surgical cases, and patient safety behaviors were quantified using the Teamwork Evaluation of Non-Technical Skills (TENTS) instrument.

Analysis of patient safety event report categories at one large academic hospital.

Given the persistent safety incidents in operating rooms (ORs) nationwide (approx. 4,000 preventable harmful surgical errors per year), there is a need to better analyze and understand reported patient safety events. This study describes the results of applying the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) supported by the Teamwork Evaluation of Non-Technical Skills (TENTS) instrument to analyze patient safety event reports at one large academic medical center.

Temperature drift during environmental radiation monitoring and its unfolding.

The aim of the presented paper is to examine the temperature drift and its unfolding for an environmental monitor equipped with a LaBr(Ce) detector. It is known that temperature could influence energy, shape, and efficiency calibration. Consequently, when ambient temperature changes, the full energy absorption peak moves in the resulting spectrum.

Augmenting Quality Assurance Measures in Treatment Review with Machine Learning in Radiation Oncology.

Purpose: Pretreatment quality assurance (QA) of treatment plans often requires a high cognitive workload and considerable time expenditure. This study explores the use of machine learning to classify pretreatment chart check QA for a given radiation plan as difficult or less difficult, thereby alerting the physicists to increase scrutiny on difficult plans.

Methods And Materials: Pretreatment QA data were collected for 973 cases between July 2018 and October 2020.

Urban Agriculture as an Alternative Source of Food and Water Security in Today's Sustainable Cities.

The concept of a regenerative city goes far beyond a sustainable one. The regenerative approach is to think of urban green space as a productive landscape, a source of food, and a support for biodiversity. In this approach, the so-called urban wastelands have a positive significance.

The Effect of a System-Level Tiered Huddle System on Reporting Patient Safety Events: An Interrupted Time Series Analysis.

Background: The objective of this research was to evaluate the effect of implementing a system-level tiered huddle system (THS) on the reporting of patient safety events into the official event reporting system.

Methods: A quasi-experimental study using interrupted time series was conducted to assess the impact and changes to trends in the reporting of patient safety events pre- (February-July 2020; six months) and post- (September 2020-February 2021; six months) THS implementation within one health care system (238 clinics and 4 hospitals). The severity of harm was analyzed in July 2021 using a modified Agency for Healthcare Research and Quality (AHRQ) harm score classification.

Effect of Notes' Access and Complexity on OpenNotes' Utility.

Background: Health care providers are now required to provide their patients access to their consultation and progress notes. Early research of this concept, known as "OpenNotes," showed promising results in terms of provider acceptability and patient adoption, yet objective evaluations relating to patients' interactions with the notes are limited.

Objectives: To assess the effect of the complexity level of notes and number of accesses (initial read vs.

Towards better understanding of workplace factors contributing to hospitalist burden and burnout prior to COVID-19 pandemic.

Background: Hospitalists are physicians trained in internal medicine and play a critical role in delivering care in in-patient settings. They work across and interact with a variety of sub-systems of the hospital, collaborate with various specialties, and spend their time exclusively in hospitals. Research shows that hospitalists report burnout rates above the national average for physicians and thus, it is important to understand the key factors contributing to hospitalists' burnout and identify key priorities for improving hospitalists' workplace.

A Novel Theory-Based Virtual Reality Training to Improve Patient Safety Culture in the Department of Surgery of a Large Academic Medical Center: Protocol for a Mixed Methods Study.

Background: Preventable surgical errors of varying degrees of physical, emotional, and financial harm account for a significant number of adverse events. These errors are frequently tied to systemic problems within a health care system, including the absence of necessary policies/procedures, obstructive cultural hierarchy, and communication breakdown between staff. We developed an innovative, theory-based virtual reality (VR) training to promote understanding and sensemaking toward the holistic view of the culture of patient safety and high reliability.

Multi-Institutional Stereotactic Body Radiation Therapy Incident Learning: Evaluation of Safety Barriers Using a Human Factors Analysis and Classification System.

Objectives: Stereotactic body radiation therapy (SBRT) can improve therapeutic ratios and patient convenience, but delivering higher doses per fraction increases the potential for patient harm. Incident learning systems (ILSs) are being increasingly adopted in radiation oncology to analyze reported events. This study used an ILS coupled with a Human Factor Analysis and Classification System (HFACS) and barriers management to investigate the origin and detection of SBRT events and to elucidate how safeguards can fail allowing errors to propagate through the treatment process.

State of the evidence on simulation-based electronic health records training: A scoping review.

This study synthesized the available evidence of simulation-based electronic health records (EHRs) training in educational and clinical environments for healthcare providers in the literature. The Arksey and O'Malley methodological framework was employed. A systematic search was carried out in relevant databases from inception to January 2020, identifying 24 studies for inclusion.

Codesign approaches involving older adults in the development of electronic healthcare tools: a systematic review.

Objective: The primary aim was to review and synthesise the current evidence of how older adults are involved in codesign approaches to develop electronic healthcare tools (EHTs). The secondary aim was to identify how the codesign approaches used mutual learning techniques to benefit older adult participants.

Design: Systematic review following the Preferred Reporting Items for Systematic Reviews 2020 checklist.

Development of a Patient-Centered Preference Tool for Patients With Hematologic Malignancies: Protocol for a Mixed Methods Study.

Background: The approval of novel therapies for patients diagnosed with hematologic malignancies have improved survival outcomes but increased the challenge of aligning chemotherapy choices with patient preferences. We previously developed paper versions of a discrete choice experiment (DCE) and a best-worst scaling (BWS) instrument to quantify the treatment outcome preferences of patients with hematologic malignancies to inform shared decision making.

Objective: We aim to develop an electronic health care tool (EHT) to guide clinical decision making that uses either a BWS or DCE instrument to capture patient preferences.

Co-Design Approaches Involving Older Adults in the Development of Electronic Healthcare Tools: A Systematic Review.

We present evidence on the current state of utilizing co-design approaches involving older adults in developing electronic healthcare tools (EHTs). Research gaps were identified in defining the stages, involvement processes, and levels of participation using existing theoretical frameworks. Future studies should explore both involvement processes and levels of participation to optimally empower and collaborate with older adults in developing EHTs.

Predicting Objective Performance Using Perceived Cognitive Workload Data in Healthcare Professionals: A Machine Learning Study.

Cognitive Workload (CWL) is a fundamental concept in predicting healthcare professionals' (HCPs) objective performance. The study aims to compare the accuracy of the classical model (utilizes all six dimensions of the National Aeronautics and Space Administration Task Load Index (NASA-TLX)) and novel models (utilize four or five dimensions of NASA-TLX) in predicting HCPs' objective performance. We use a dataset from our previous human factors research studies and apply a broad selection of supervised machine learning classification techniques to develop data-driven computational models and predict objective performance.

Feature Engineering for Interpretable Machine Learning for Quality Assurance in Radiation Oncology.

Chart checking is a time intensive process with high cognitive workload for physicists. Previous studies have partially automated and standardized chart checking, but limited studies implement data-driven approaches to reduce cognitive workload for quality assurance processes. This study aims to evaluate feature selection methods to improve the interpretability and transparency of machine learning models in predicting the degree of difficulty for a pretreatment physics chart check.

Electronic Reporting of Workplace Violence Incidents: Improving the Usability, and Optimizing Healthcare Workers' Cognitive Workload, and Performance.

A majority of healthcare workers (HCWs) experience workplace violence (WPV) but most WPV events go unreported. Underreporting of WPV is well documented in the literature as a barrier to identifying underlying causes and to evaluating the effectiveness of WPV interventions. Previous studies suggest that WPV reporting data is fragmentary, unreliable, and inconsistent.

Using Explainable Supervised Machine Learning to Predict Burnout in Healthcare Professionals.

Burnout in healthcare professionals (HCPs) is a multi-factorial problem. There are limited studies utilizing machine learning approaches to predict HCPs' burnout during the COVID-19 pandemic. A survey consisting of demographic characteristics and work system factors was administered to 450 HCPs during the pandemic (participation rate: 59.

The Sociotechnical Factors Associated With Burnout in Residents in Surgical Specialties: A Qualitative Systematic Review.

Objective: The consequences of burnout remain prevalent within general surgery training programs, yet there is no comprehensive description of the factors associated with burnout. Using sociotechnical systems theory, this review aims to qualitatively evaluate the factors associated with burnout in surgical residents.

Design: A systematic review of the literature was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Dependence of photon registration efficiency on LaBr(Ce) detector orientation for in situ radionuclide monitoring.

Knowledge of a radiation detector's numerical characteristics allows its energy efficiency to be calibrated theoretically for any measurement geometry. Here, energy efficiency calibration is discussed for oriented LaBr(Ce) detectors used for in situ radiation monitoring. Vertical and horizontal detector orientations relative to the ground surface are compared using efficiency calibrations based on the detector's numerical characteristics and are equally effective.