Бібліотека Вінницького національного медичного університету ім. М.І.Пирогова

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Форма документа : Стаття із журналу
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Автор(и) : Khan I. D., Asima B., Khan S. A.
Назва : Operations throughput as a determinant of golden-hour in mass-gathering medicine
Місце публікування : International journal of medicine and medical research. - Ternopil, 2017. - Vol. 3, N 1. - С. 53-59 (Шифр МУ96/2017/3/1)
MeSH-головна: ХИРУРГИЧЕСКИЕ ОПЕРАЦИИ -- SURGICAL PROCEDURES, OPERATIVE
Анотація: Golden-hour, a time-tested concept for trauma-care, involves a systems approach encompassing healthcare, logistics, geographical, environmental and temporal variables. Golden-hour paradigm in massgathering-medicine such as the Hajj-pilgrimage entwines along healthcare availability, accessibility, efficiency and interoperability; expanding from the patient-centric to public-health centric approach. The realm of massgathering-medicine invokes an opportunity for incorporating operations-throughput as a determinant of golden-hour for overall capacity-building and interoperability. Methods. Golden-hour was evaluated during the Indian-Medical-Mission operations for Hajj-2016; which established, operated and coordinated a strategic network of round-the-clock medical operations. Throughput was evaluated as deliverables/time, against established Standard-Operating-Procedures for various clinical, investigation, drug-dispensing and patient-transfer algorithms. Patient encounter-time, waiting-time, turnaround-time were assessed throughout echeloned healthcare under a patient-centric healthcare-delivery model. Dynamic evaluation was carried out to cater for variation and heterogeneity. Results. Massive surge of 394 013 patients comprising 225 103 males (57.1%) and 168 910 females (42.9%) overwhelmed the throughput capacities of outpatient attendance, pharmacy, laboratory, imaging, ambulance, referrals and documentation. There was a delay in attendance, suspicion, diagnosis and isolation of patients with communicable infections. The situational-analysis of operations-throughput highlights wasted turnaround-time due to mobilization of medical-team, diverting critical healthcare resources away from emergency situations. Conclusions. Time being a crucial factor in the complexity of medical-care, operations-throughput remains an important determinant towards interoperability of bottlenecks, thereby being a determinant of golden-hour in mass-gathering-medicine. Early transportation of a patient to definitive-care reduces treatment initiation-time, notwithstanding logistics of communication, evacuation, terrain and weather being deterministic in outcome. Golden-hour needs to be emphasized under a population-based approach targeting the clientele towards administering first-aid and reaching out to hospital within the golden-hour
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