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| 1 | Lean techniques for the improvement of patients' flow in emergency department显示文摘BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called 'lean' management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction. | HY Chan SM Lo LLY Lee WYL Lo WC Yu YF Wu ST Ho RSD Yeung JTS Chan | 2014 | World Journal of Emergency Medicine2014，5，1： | 6 |
| 2 | Membrane-bound mucins and mucin terminal glycans expression in idiopathic or Helicobacter pylori, NSAID associated peptic ulcers显示文摘AIM:To determine the expression of membrane-bound mucins and glycan side chain sialic acids in Helicobacter pylori(H.pylori)-associated,non-steroidal inflammatory drug(NSAID)-associated and idiopathic-gastric ulcers.METHODS:We studied a cohort of randomly selected patients with H.pylori(group 1,n=30),NSAID(group 2,n=18),combined H.pylori and NSAID associated gastric ulcers(group 3,n=24),and patients with idiopathic gastric ulcers(group 4,n=20).Immunohistochemistry for MUC1,MUC4,MUC17,and staining for Erythrina cristagalli agglutinin and Sambucus nigra agglutinin(SNA)lectins was performed on sections from the ulcer margins.RESULTS:Staining intensity of MUC17 was higher in H.pylori ulcers(group 1)than in idiopathic ulcers(group4),11.05±3.67 vs 6.93±4.00 for foveola cells,and10.29±4.67 vs 8.00±3.48 for gland cells,respectively(P<0.0001).In contrast,MUC1 expression was higher in group 4 compared group 1,9.89±4.17 vs 2.93±5.13 in foveola cells and 7.63±4.60 vs 2.57±4.50 for glands,respectively(P<0.0001).SNA lectin staining was increased in group 4,in parallel to elevated MUC1expression,indicating more abundantα2-6 sialylation in that group.CONCLUSION:Cytoplasmic MUC17 staining was sig-nificantly decreased in the cases with idiopathic ulcer.The opposite was observed for both MUC1 and SNA lectin.This observation may reflect important pathogenic mechanisms,since different mucins with altered sialylation patterns may differ in their protection efficiency against acid and pepsin. | Yaron Niv Doron Boltin Marisa Halpern Miriam Cohen Zohar Levi Alex Vilkin Sara Morgenstern Vahig Manugian Erica St Lawrence Pascal Gagneux Sukhwinder Kaur Poonam Sharma Surinder K Batra Samuel B Ho | 2014 | World Journal of Gastroenterology2014，20，40： | 5 |
| 3 | Flovnone and other constituents from Onychium siliculosum 显示文摘 | Kuoh CS Ho ST | 1981 | Phytochemistry1981，20，3： | 1 |
| 4 | Systemic high-sensitivity C-reactive protein levels in normal-tension glaucoma and primary open-angle glaucoma显示文摘 | Su WW Ho WJ Cheng ST | 2007 | J Glaucoma2007，16，3： | 1 |
| 5 | Dexame-thasone has a central antiemetic mechanism in decerebrated cats 显示文摘 | Ho CM Ho ST Wang JJ | 2004 | Anesth Analg2004，99，3： | 1 |
| 6 | Acquired Fanconi syndromeassociated with prolonged adefovir dipivoxil therapy in achronic hepatitis B patient显示文摘 | Law ST Li KK Ho YY | 2013 | Am J Ther2013，20，6： | 1 |
| 7 | Dexamethasone decreases epidural morphine related nausea and vomiting显示文摘 | Wang J j Ho ST Liu YH | 1999 | Anesth Analg1999，89，1： | 1 |
| 8 | Magnetic resonance imaging of the elbow显示文摘 | Potter HG Ho ST Altchek DW | | 0，，： | 1 |
| 9 | Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy显示文摘 | Wang JJ Ho ST Lee SC | 1999 | Br J Anaesth1999，83，： | 1 |
| 10 | The anagesic effect of PCA buprenorphine in Taiwan, s gynecologic patiens显示文摘 | Ho ST Wang JJ Liu HS | 1997 | Acta Anaesthesiol Sin1997，35，4： | 1 |
| 11 | The anti-inflammatory actions of LCY-2-CHO,a carbazole analogue,in vascular smooth muscle cells显示文摘 | Ho FM Kang HC Lee ST | 2007 | Biochem Pharmacol2007，74，2： | 1 |
| 12 | Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy 显示文摘 | WANG JJ HO ST LEE SC | 1999 | Br J Anaestha1999，83，： | 1 |
| 13 | Dexamethasone reduces nausea and Vomitingafter laparoscopic cholecystectomy显示文摘 | Wang JJ Ho ST Liu YH | 1999 | Br J Anaesthesia1999，83，： | 1 |
| 14 | A lethal pulmonary embolism during percutaneous vertebroplasty显示文摘 | Chen HL Wong CS Ho ST | 2002 | Anesth Analg2002，95，4： | 1 |
| 15 | Conpavison of intravenous malbuphine infusion versus naloxone in the prevention of epidural-related side effects显示文摘 | Wang JJ Ho ST | 1998 | Peg Anesth pain mde1998，23，3： | 1 |
| 16 | The prophylactic effect of tropisetron on epidural morphine-related nausea and vomiting:a comparison of dexamethasone with saline显示文摘 | Wang JJ Tzeng JI Ho ST | 2002 | Anesth Analg2002，94，3： | 1 |
| 17 | Dexamethasone reduces nausea and Vomiting after laparoscopic cholecystectomy显示文摘 | Wang JJ Ho ST Liu YH | 1999 | Br J Anaesth1999，83，5： | 1 |
| 18 | Dexamet hasone decreases epidural morphine related nausea and vomiting显示文摘 | Wang JJ Ho ST Liu YH | 1999 | Anesth Analg1999，89，1： | 1 |
| 19 | Validation of the brief pain inventory in a Taiwanese population显示文摘 | Ger LP Ho ST Sun WZ | 1999 | J Pain Symptom Manage1999，18，5： | 1 |
| 20 | Dexamethasone prevents postoperative nausea and vomiting:benefit versus risk显示文摘 | Ho CM Wu HL Ho ST | | 0，，3： | 1 |
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