International journal of medical informatics
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Multicenter Study
Machine learning predicts mortality in septic patients using only routinely available ABG variables: a multi-centre evaluation.
To evaluate the application of machine learning methods, specifically Deep Neural Networks (DNN) models for intensive care (ICU) mortality prediction. The aim was to predict mortality within 96 hours after admission to mirror the clinical situation of patient evaluation after an ICU trial, which consists of 24-48 hours of ICU treatment and then "re-triage". The input variables were deliberately restricted to ABG values to maximise real-world practicability. ⋯ An LSTM-based model could help physicians with the "re-triage" and the decision to restrict treatment in patients with a poor prognosis.
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Shift handover is seen as a key tool in ensuring continuity of care yet a number of studies have highlighted the role of shift handovers in adverse events. This, combined with the increased frequency of shift handovers, has led to interest in providing technological support for handover to enhance safety. The aim of this paper is to describe current practices for the conduct of shift handovers and to use this as a basis for considering the role that technology could play in supporting handover. ⋯ The benefits provided by a face to face handover suggest that technology should focus on supporting rather than replacing the verbal shift handover report, providing a flexible solution that allows handover participants to gather more information as it is required.
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Multicenter Study Comparative Study
Leadership structures in emergency care settings: a study of two trauma centers.
Trauma resuscitation involves multidisciplinary teams under surgical leadership in most US trauma centers. Because many trauma centers have also incorporated emergency department (ED) physicians, shared and cross-disciplinary leadership structures often occur. Our study identifies leadership structures and examines the effects of cross-disciplinary leadership on trauma teamwork. ⋯ Most important weaknesses of different leadership structures are manifested in inefficient teamwork or inappropriate patient care. These inefficiencies are particularly problematic when leadership is shared between physicians from different disciplines with different levels of experience, which often leads to conflict, reduces teamwork efficiency and lowers the quality of care. We discuss practical implications for technology design.