Hospitalist System under the Covid-19 Pandemic: The Perspective of Value Co-creation

Abstract Background The core spirit of the Hospitalist system aims to set up dedicated wards, integrate physician manpower, focus on whole-person care, in order to cope with the aging population and Covid-19 pandemic, and to ensure that both parties, the medical personnel and patients, can provide or receive complete medical care. As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients. Methods Hospitalists from 12 hospitals across Taiwan completed a cross-sectional survey. The target population was identified through Taiwan Doctors and Nurses. Survey questionnaire was accessed by 342, incomplete response (18) were excluded and 324 completed responses were analysed. Results That the higher the cognition of medical staff on whole-person care, the higher the motivation to participate in cross-team cooperation (F = 35.914, p < 0.001); when the motivation to participate in cross-team cooperation was higher, the behavior of participating in whole-person care also increased. Will be higher (F = 36.483, p < 0.001); whole-person care behavior participation behavior has a significant impact on value creation (F = 21.068, p < 0.001) Conclusions As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients. This change will make possible the improvement of patient safety and quality medical care. The research results can be provided for reference in European and American countries. Key messages • A hospitalist support system is essential for establishing an efficient medical environment and reducing administrative work, which can help hospitals introduce a hospitalist system. • To build a more stable and sustainable system, it is necessary to create a systemic operational foundation for proceeding with this new hospitalist system.


Background:
Function, coping and health are central factors in rehabilitation after injury or sickness.To investigate how these factors are associated with sick leave during 12 months after rehabilitation is the aim of this study.

Methods:
A sample of 412 rehabilitation patients 67years were included.They were all employed, and referred to interprofessional rehabilitation in western Norway.Rehabilitation consisted of physical activity/exercise, cognitive approaches and pain management.In two surveys patients reported mental (MCS) and physical (PCS) function (SF-36), selfperceived health (EQ-VAS) and coping .Register data on sick leave during 12 months in the calendar year after rehabilitation was retrieved from Statistics Norway and categorised to; non, (n = 168), 364 days (n = 152) and 365 days (n = 92).Ordinal regression was used to analyse association between sick leave and MCS, PCS, EQ-VAS and SOC-13, adjusted for age, sex and diagnoses.

Conclusions:
Patients ´self-reported mental and physical function were associated with sick leave 12 months after inter-professional rehabilitation.Higher level of function was associated with no sick leave.In our study, patient's self-reported health and coping were not associated with sick leave.This suggest that interventions for functional improvement are beneficial in health care strategies to help patients return to work after injury or sickness.

Key messages:
Achieved higher physical and mental function after rehabilitation seems to contribute to reduced sick leave after injury or sickness.
Improving function should remain a central factor in rehabilitation.
Abstract Globally, the reforms of healthcare systems aim to bring back the patient at the centre of these organisations after the issues related to the COVID-19 outbreak.The patient returns to be fully considered, as an individual whose must be protected physical and psychological health as well as social well-being.Humanization of care is returning to the foreground.For centuries, art has been used throughout Europe in the health context for its power to support patients in their disease.Today, this approach can be rediscovered in historical hospitals, where tradition, art and assistance coexist.This study aims to investigate the interest for the development of projects for the humanization of care exploiting the artistic heritage of the historical hospitals owned by Health Authorities.The cross-case analysis was chosen as study design.The case studies are the historical hospitals in the city centre of Venice, Florence, and Rome.The evaluation of the proposal was carried out through semi-structured interviews with the general managers of the Health Authorities, the medical directors of the selected hospitals and the delegates for the protection and promotion of cultural heritage.The results were analysed using a qualitative model (coding).All respondents welcomed the proposal to launch projects for the humanization of care that foresee the use of the artistic heritage of the historical hospitals to involve patients in the field of health care.Interviewees expressed the desire to invest human and structural resources in the development of these projects.Moreover, directors suggest choosing a specific target with which to start the experimentation and to dispense a specific training to future engaged social and health personnel.The implementation of projects for the humanization of care using the artistic heritage of historical hospitals can be replicated worldwide where healthcare institutions have a cultural wealth to be handed down, shared and valued.

Key messages:
In the post COVID-19 era, it is strategic to exploit artistic heritage owned by the Health Authority for the positive impact in the patient's experience.Artistic heritage claims its role as a health service for supporting patients, caregivers and also health workforce.

Background:
The core spirit of the Hospitalist system aims to set up dedicated wards, integrate physician manpower, focus on whole-person care, in order to cope with the aging population and Covid-19 pandemic, and to ensure that both parties, the medical personnel and patients, can provide or receive complete medical care.As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients.

Methods:
Hospitalists from 12 hospitals across Taiwan completed a cross-sectional survey.The target population was identified through Taiwan Doctors and Nurses.Survey questionnaire was accessed by 342, incomplete response (18) were excluded and 324 completed responses were analysed.

Results:
That the higher the cognition of medical staff on whole-person care, the higher the motivation to participate in cross-team cooperation (F = 35.914,p < 0.001); when the motivation to participate in cross-team cooperation was higher, the behavior of participating in whole-person care also increased.Will be higher (F = 36.483,p < 0.001); whole-person care behavior participation behavior has a significant impact on value creation (F = 21.068,p < 0.001) Conclusions: As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients.This change will make possible the improvement of patient safety and quality medical care.The research results can be provided for reference in European and American countries.

Key messages:
A hospitalist support system is essential for establishing an efficient medical environment and reducing administrative work, which can help hospitals introduce a hospitalist system.
To build a more stable and sustainable system, it is necessary to create a systemic operational foundation for proceeding with this new hospitalist system.

Background:
Gestational diabetes mellitus (GDM) is a significant, global public health problem.Subsequent strain on healthcare systems is widespread and multidisciplinary care may be inadequate.We assessed current nutrition management of GDM in a large, metropolitan maternity hospital in Melbourne, Australia and associations between the model of dietetic care and maternal and neonatal health outcomes.

Methods:
Hospital medical record data from The Women's Hospital, Melbourne for women with GDM (n = 1,185) (July 2105-May 2017) was retrospectively analysed.Adjusted linear and logistic regression were used to assess associations between the number of dietitian consultations and maternal and neonatal health outcomes.

Conclusions:
The optimal schedule of dietitian consultations for women with GDM in Australia is unclear.Alternative delivery of nutrition education for women with GDM such as telehealth and utilisation of technology may assist in relieving public health and healthcare system pressures and ensure optimal pregnancy outcomes.

Key messages:
Delivering medical nutrition therapy through individual consultations does not deliver a linear benefit to women with GDM and their offspring.
Alternative delivery modes are needed to optimise outcomes for healthcare services and their patients.Sufficient information is the foundation for efficient and highquality health care services.In the field of extramural health care, this challenge is particularly evident: missing or insufficient information can lead to underuse, overuse, or misuse of health care, e.g.due to the necessity of multiple assessments or lack of relevant information.The noticeable shortage of health care professionals further underscores the urgent need for efficient and quality-assured health care services.The aim of the project LICA -linked care -is to provide a platform for better coordination and information exchange between health professionals involved in home care, with a focus on ICT in nursing in Austria.The project is funded by the Austrian Research Promotion agency (FFG) as part of the ''benefit -demografischer Wandel als Chance '' program (April 2020-March 2025).The requirement analysis was conducted from April to December 2021.In light of the user-centered approach a mix of methods was chosen, consisting of: literature analysis, 5 guideline-based focus group interviews, guideline-based expert interviews n = 44 (people in need of care n = 23, health professionals n = 21), documentation-analysis (4 care documentation systems -from participating project partners) and working diaries: n = 5 on 5 consecutive working days ( = 25 diaries).Therefore, three main target groups were identified: i) people in need of care, ii) healthcare professionals and iii) healthcare providers.The data were analyzed using a qualitative content analysis based on Kuckartz.The main results regarding the status quo are: i) different documentation systems are utilized, ii) lack of digitized documents, iii) currently no standardized documentation system is in use.Thus, following requirements could be identified: i) interoperability with existing systems, ii) setting comprehensive function, iii) usability, iv) interdisciplinary readability, v) error-management, and vi) proper data protection measures.

Key messages:
Healthcare systems are under great pressure worldwide.
Innovative solutions can help maintain and improve the quality and efficacy of healthcare services.Gapless and efficient information provision is a key essential to high quality healthcare.The project offers a user-centric approach to develop a platform for connectivity of existing systems.
15th European Public Health Conference 2022