Tracking the patient journey by combining multiple hospital database systems

With new national targets for patient flow in public hospitals designed to increase efficiencies in patient care and resource use, better knowledge of events affecting length of stay will support improved bed management and scheduling of procedures. This paper presents a case study involving the integration of material from each of three databases in operation at one tertiary hospital and demonstrates it is possible to follow patient journeys from admission to discharge. What is known about this topic? At present, patient data at one Queensland tertiary hospital are assembled in three information systems: (1) the Hospital Based Corporate Information System (HBCIS), which tracks patients from in-patient admission to discharge; (2) the Emergency Department Information System (EDIS) containing patient data from presentation to departure from the emergency department; and (3) Operation Room Management Information System (ORMIS), which records surgical operations. What does this paper add? This paper describes how a new enquiry tool may be used to link the three hospital information systems for studying the hospital journey through different wards and/or operating theatres for both individual and groups of patients. What are the implications for practitioners? An understanding of the patients’ journeys provides better insight into patient flow and provides the tool for research relating to access block, as well as optimising the use of physical and human resources.

Alternate structural system of incorporating flat bed rail wagons as low volume road bridge decks

The stimulus for this project rose from the need to find an alternative solution to aging superstructures of road-bridge in low volume roads (LVR). The solution investigated, designed and consequently plans to construct, involved replacing an aging super-structure of a 10m span bridge with Flat-Bed Rail Wagon (FBRW). The main focus of this paper is to present alternate structural system for the design of the FBRW as road bridge deck conforming to AS5100. The structural adequacy of the primary members of the FBRW was first validated using full scale experimental investigation to AS5100 serviceability and ultimate limit state loading. The bare FBRW was further developed to include a running surface. Two options were evaluated during the design phase, namely timber and reinforced concrete. First option, which is presented here, involved strengthening of the FBRW using numerous steel sections and overlaying the bridge deck with timber planks. The idea of this approach was to use all the primary and secondary members of the FBRW in load sharing and to provide additional members where weaknesses in the original members arose. The second option, which was the preferred option for construction, involved use of primary members only with an overlaying reinforced concrete slab deck. This option minimised the risk associated with any uncertainty of secondary members to its structural adequacy. The paper will report selected results of the experiment as well as the design phases of option one with conclusions highlighting the viability of option 1 and its limitations.

Nursing resource implications of the unoccupied bed

Objective: To explore the specific factors that impact on nursing resources in relation to the ‘unoccupied bed’. Design: Descriptive observational Setting: Multiple wards in single site, tertiary referral hospital Main outcome measure: Identification and classification of tasks related to the unoccupied bed. Results: Our study identified three main areas of nursing work, which centre on the ‘unoccupied bed’: 1) bed preparation for admission; 2) temporary transfer; 3) bed preparation post patient discharge. Conclusion: The unoccupied bed is not resource neutral and may involve considerable nursing time. The time associated with each of the reasons for the bed being unoccupied remains to be quantified.

Smart Grid Test Bed Design and Implementation

Given there is currently a migration trend from traditional electrical supervisory control and data acquisition (SCADA) systems towards a smart grid based approach to critical infrastructure management. This project provides an evaluation of existing and proposed implementations for both traditional electrical SCADA and smart grid based architectures, and proposals a set of reference requirements which test bed implementations should implement. A high-level design for smart grid test beds is proposed and initial implementation performed, based on the proposed design, using open source and freely available software tools. The project examines the move towards smart grid based critical infrastructure management and illustrates the increased security requirements. The implemented test bed provides a basic framework for testing network requirements in a smart grid environment, as well as a platform for further research and development. Particularly to develop, implement and test network security related disturbances such as intrusion detection and network forensics. The project undertaken proposes and develops an architecture of the emulation of some smart grid functionality. The Common Open Research Emulator (CORE) platform was used to emulate the communication network of the smart grid. Specifically CORE was used to virtualise and emulate the TCP/IP networking stack. This is intended to be used for further evaluation and analysis, for example the analysis of application protocol messages, etc. As a proof of concept, software libraries were designed, developed and documented to enable and support the design and development of further smart grid emulated components, such as reclosers, switches, smart meters, etc. As part of the testing and evaluation a Modbus based smart meter emulator was developed to provide basic functionality of a smart meter. Further code was developed to send Modbus request messages to the emulated smart meter and receive Modbus responses from it. Although the functionality of the emulated components were limited, it does provide a starting point for further research and development. The design is extensible to enable the design and implementation of additional SCADA protocols. The project also defines an evaluation criteria for the evaluation of the implemented test bed, and experiments are designed to evaluate the test bed according to the defined criteria. The results of the experiments are collated and presented, and conclusions drawn from the results to facilitate discussion on the test bed implementation. The discussion undertaken also present possible future work.

Thin bed masonry system: review and future prospects

Masonry is one of the most ancient construction materials in the World. When compared to other civil engineering practices, masonry construction is highly labour intensive, which can affect the quality and productivity adversely. With a view to improving quality and in light of the limited skilled labour in the recent times several innovative masonry construction methods such as the dry stack and the thin bed masonry have been developed. This paper focuses on the thin bed masonry system, which is used in many parts of Europe. Thin bed masonry system utilises thin layer of polymer modified mortars connecting the accurately dimensioned and/or interlockable units. This assembly process has the potential for automated panelised construction system in the industry setting or being adopted in the site using less skilled labour, without sacrificing the quality. This is because unlike the conventional masonry construction, the thin bed technology uses thinner mortar (or glue) layer which can be controlled easily through some novel methods described in this paper. Structurally, reduction in the thickness of the mortar joint has beneficial effects; for example it increases the compressive strength of masonry; in addition polymer added glue mortar enhances lateral load capacity relative to conventional masonry. This paper reviews the details of the recent research outcomes on the structural characteristics and construction practices of thin bed masonry. Finally the suitability of thin bed masonry in developing countries where masonry remains as the most common material for residential building construction is discussed.

Assessing ease of use of the Staminalift bed mover

Battery powered bed movers are increasingly being used within the hospital setting. These energy augmenting devices facilitate the safe movement of beds and patients by healthcare workers. The use of powered bed movers is believed to result in reduced physical efforts on the behalf of staff members, which may be associated with a decreased risk of occupational related injuries. A provisional study was performed in a hospital environment to assess the muscular efforts associated with moving hospital beds both manually and with the aid of a bed mover. The results enable the effects of using bed movers to be quantified.

Research outcomes for improved management of insulated rail joints

Insulated Rail Joints (IRJs) are safety critical component of the automatic block signalling and broken rail detection systems. IRJs exhibit several failure modes due to complex interaction between the railhead ends and the wheel tread near the gap. These localised zones could not be monitored using automatic sensing devices and hence are resorted to visual inspection only, which is error prone and expensive. In Australia alone currently there are 50,000 IRJs across 80,000 km of rail track. The significance of the problem around the world could thus be realised as there exists one IRJ for each 1.6 km track length. IRJs exhibit extremely low and variable service life; further the track substructure underneath IRJs degrade faster. Thus presence of the IRJs incur significant costs to track maintenance. IRJ failures have also contributed to some train derailments and various traffic disruptions in rail lines. This paper reports a systematic research carried out over seven years on the mechanical behaviour of IRJs for practically relevant outcomes. The research has scientifically established that stiffening the track bed for reduction in impact force is an ill-conceived concept and the most effective method is to reduce the gap size. Further it is established that hardening the railhead ends through laser coating (or other) cannot adequately address the metal flow problem in the long run; modification of the railhead profile is the only appropriate technique to completely eliminate the problem. Part of these outcomes has been adopted by the rail infrastructure owners in Australia.

Health information management : What business are we in?

Developments in information technology will drive the change in records management; however, it should be the health information managers who drive the information management change. The role of health information management will be challenged to use information technology to broker a range of requests for information from a variety of users, including he alth consumers. The purposes of this paper are to conceptualise the role of health information management in the context of a technologically driven and managed health care environment, and to demonstrat e how this framework has been used to review and develop the undergraduate program in health information management at the Queensland University of Technology.