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In March 2020, the worldwide outbreak of COVID-19 led to the declaration of a global pandemic by the World Health Organization. As a result of the rapid spread and severity of the disease, health services experienced unprecedented pressure on acute hospital systems. Many strategies were implemented to both curb the spread of the disease and manage its impact on health services. Field hospitals were one such measure, deployed as surge capacity facilities to provide solutions to patient flow challenges due to spikes in hospital admissions associated with COVID-19. In Ireland, a temporary Intermediate Care Facility (ICF) was established on the grounds of a university campus in response to the pandemic. Designed as a step-down interprofessional care facility for local acute hospitals, this service had capacity for 84 patients and was operational for 4 months. A qualitative study was conducted to explore patient’s experience of receiving care in the ICF. Thirteen patients participated in semi-structured interviews post-discharge. Following inductive thematic analysis, 3 main themes emerged: the ICF as a (1) Novel healthcare setting, (2) Person-centered care and (3) Psycho-social climate. This study describes patients’ experience of care in the ICF during the COVID-19 pandemic which may inform future policies and practice initiatives targeting patient care and patient outcomes, as well as pandemic preparedness and response plans.

Malaria is most common health problem in tropical areas that can lead to fatal complications including acute kidney injury. Plasmodium falciparum infection is one of leading cause of complicated malaria leading to death. Although the pathogenesis of acute kidney injury is not fully understood, however, blockage of renal microcirculation due to sequestration of red blood cells, immune mediated glomerular injury, and hypovolemia, play a pivotal role in causing acute of kidney dysfunction. Acute tubular necrosis is most found on histological examination. Acute kidney dysfunction induced by malaria infection can cause irreversible damage if not managed properly. Therefore, early diagnosis and management with dialysis, plays important role in saving life.

Doctors at Waris a candid account of a trauma surgical team based, for a tour of duty, at a field hospital in Helmand, Afghanistan. Mark de Rond tells of the highs and lows of surgical life in hard-hitting detail, bringing to life a morally ambiguous world in which good people face impossible choices and in which routines designed to normalize experience have the unintended effect of highlighting war's absurdity. With stories that are at once comical and tragic, de Rond captures the surreal experience of being a doctor at war. He lifts the cover on a world rarely ever seen, let alone written about, and provides a poignant counterpoint to the archetypical, adrenaline-packed, macho tale of what it is like to go to war. Here the crude and visceral coexist with the tender and affectionate. The author tells of well-meaning soldiers at hospital reception, there to deliver a pair of legs in the belief that these can be reattached to their comrade, now in mid-surgery; of midsummer Christmas parties and pancake breakfasts and late-night sauna sessions; of interpersonal rivalries and banter; of caring too little or too much; of tenderness and compassion fatigue; of hell and redemption; of heroism and of playing God. While many good firsthand accounts of war by frontline soldiers exist, this is one of the first books ever to bring to life the experience of the surgical teams tasked with mending what war destroys.

Confronted with the coronavirus disease 2019 (COVID-19) pandemic, New York City Health + Hospitals, the city's public health care system, rapidly expanded capacity across its eleven acute care hospitals and three new field hospitals. To meet the unprecedented demand for patient care, NYC Health + Hospitals redeployed staff to the areas of greatest need and redesigned recruiting, onboarding, and training processes. The hospital system engaged private staffing agencies, partnered with the Department of Defense, and recruited volunteers throughout the country. A centralized onboarding team created a single-source portal for medical care providers requiring credentialing and established new staff positions to increase efficiency. Using new educational tools focused on COVID-19 content, the hospital system trained twenty thousand staff members, including nearly nine thousand nurses, within a two-month period. Creation of multidisciplinary teams, frequent enterprisewide communication, willingness to shift direction in response to changing needs, and innovative use of technology were the key factors that enabled the hospital system to meet its goals.

In the Nordic countries as well as globally, ageing populations and more people with chronic diseases leads to more middle-aged and older people becoming informal caregivers. Informal caregivers may face health consequences due to stress associated with taking care of a relative. Some groups may be more prone to negative health consequences, e.g. those with low income and short educational attainment, women and ageing people. However, less attention has been given to what drives these differences and how they may be mitigated. In this study including men and women with different socioeconomic position aged 50 and above caring for an adult with chronic disease, we will investigate how they experience their role as caregivers and what they perceive as driving and mitigating factors of health consequences. Qualitative methods will be applied, including semi-structured interviews with informal caregivers. Participants will be recruited from two hospitals located in a socioeconomically divers region of Denmark. In both hospitals field observations will be conducted to observe the interaction between patient, caregiver and health professionals. Results from this investigation will highlight possible ways to mitigate inequality and may lay the foundation for future interventions aimed at vulnerable informal caregivers. Knowledge of factors associated with inequality in health consequences among informal caregivers and mitigating factors are relevant for healthcare personnel as well as stakeholders working with informal caregivers. At the conference preliminary themes from field observations and pilot interviews will be presented, and further experiences with difficulties and opportunities engaging in this field will be discussed.

We explore attention to Clinton's health care reform proposal, ongoing debates, and its political demise to develop theory that explains how events create opportunities for cognitive realignment and transformation in institutional logics. Our case analysis illustrates how a bottom-up process of environmental sensemaking led to the emergence and adoption of a logic of managed care, which provided new organizing principles in the hospitals' organizational field. In addition to theorization, highlighted by prior research, we propose a second mechanism of environmental sensemaking: representation of change through exemplars and environmental features. The interplay between theorization, representation, and ongoing event attention can lead to change in institutional logics over an event's life course. We found that the managed care logic did not emerge in a fully formed fashion, but that actors theorized individual dimensions of the logic consistent with changing representations of hospitals' relationships with other actors in the field. As the event unfolded, the individual dimensions came to be theorized as part of an overall managed care logic. The label \"managed care,\" previously understood as a specific organizational form, took on a new meaning to symbolize the organizing principles for hospitals' relationships with a variety of institutional actors as alternative models not congruent with the changing organizational field were abandoned.

Louis, Chicago, and Tulsa between 1917 and 1921; help for African American and white Southerners after the Mississippi flood of 1927; relief projects during the Dust Bowl and after the New DealAn epilogue relates the history of the American Red Cross since the beginning of World War II and illuminates the organization's current practices as well as its international reputation.

The outbreak of the First World War in August 1914 was met with much jingoistic enthusiasm by the Australian population. Men volunteered in their hundreds for service for God, King, and Country; to defend the Empire; for adventure; and to see the world. Women on the homefront formed up Red Cross branches across the country in small country towns and city suburbs to serve ‘their boys’. Unfortunately for the men who enlisted their desire to serve the Empire was not met with a similar level of organisational efficiency by authorities in Australia. The military were completely overwhelmed by the progress of the war, especially the level of casualties that resulted from the Gallipoli campaign.

Purpose Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of patients within tertiary hospitals is one of the strategies, which has been used in the last decades to ensure health care systems’ sustainability. Furthermore, LOS is one of the key performance indicators, which is widely used to assess hospital efficiency. Hence, it is crucial that policy makers use evidence-based practices in health care to aim for optimal LOS. The purpose of this paper is to identify and summarize empirical research that brings together studies on the various variables that directly or indirectly impact on LOS within tertiary hospitals so as to develop a LOS causal systems model. Design/methodology/approach This scoping review was guided by the following research question: “What is affecting the LOS of patients within tertiary-level health care?” and by the guidelines specified by Arksey and O’Malley (2005), and by Armstrong et al. (2011). Relevant current literature was retrieved by searching various electronic databases. The PRISMA model provided the process guidelines to identify and select eligible studies. Findings An extensive literature search yielded a total of 30,350 references of which 46 were included in the final analysis. These articles yielded variables, which directly/indirectly are linked to LOS. These were then organized according to the Donabedian model – structure, processes and outcomes. The resultant LOS causal model reflects its complexity and confirms the consideration by scholars in the field that hospitals are complex adaptive systems, and that hospital managers must respond to LOS challenges holistically. Originality/value This paper illustrates a complex LOS causal model that emerged from the scoping review and may be of value for future research. It also highlighted the complexity of the construct under study.

Background. We investigated an outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus complex infection among US service members injured in Iraq. Methods. The investigation was conducted in Iraq and Kuwait, in the 2 military hospitals where the majority of injured service members were initially treated. After initially characterizing the outbreak, we evaluated 3 potential sources of infection for the period March 2003 to December 2004. The evaluation included screening samples that were obtained from the skin of patients for the presence of colonization and assessing the soil and health care environments for the presence of A. baumanii-calcoaceticus complex organisms. Isolates obtained from samples from patients in US Military treatment facilities, as well as environmental isolates, were genotypically characterized and compared using pulsed-field gel electrophoresis. Results. A. baumanii-calcoaceticus complex organisms were present on the skin in only 1 (0.6%) of 160 patients who were screened and in 1 (2%) of 49 soil samples. A. baumanii-calcoaceticus complex isolates were recovered from treatment areas in 7 of the 7 field hospitals sampled. Using pulsed-field gel electrophoresis, we identified 5 cluster groups in which isolates from patients were related to environmental isolates. One cluster included hospitalized patients who had not been deployed to Iraq. Among the clinical isolates, only imipenem, polymyxin B, and colistin demonstrated reliable in vitro antimicrobial activity. Generally, the environmental isolates were more drug susceptible than were the clinical isolates. Conclusions. Our findings suggest that environmental contamination of field hospitals and infection transmission within health care facilities played a major role in this outbreak. On the basis of these findings, maintaining infection control throughout the military health care system is essential. Novel strategies may be required to prevent the transmission of pathogens in combat field hospitals.