PURPOSE – The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. DESIGN/METHODOLOGY/APPROACH – This paper is a viewpoint. FINDINGS – One’s...

In about 30-40 % of ischemic strokes, even after an extensive clinical investigation, it is not possible to determine any one etiology. It is possible that a fraction of these strokes, named cryptogenic, happen after an episode of paroxystic atrial fibrillation (AF) that was not registered. Strokes due to atrial...

Timely and accurate diagnosis of sepsis is of great importance for the choice of treatment, level of monitoring and prognosis. For this biomarkers could be a significant aid, and thus the search for and application of sepsis biomarkers are of great importance.  Current evidence suggests that C-reactive protein and...

Applications of point-of-care testing (POCT) for diagnostic biomarker measurement in healthcare have increased significantly in recent years in a wide range of clinical scenarios. These include infectious disease, critical care, cardiology and other areas of emergency medicine. Traditionally, routine clinical...

Introduction of point–of-care testing (POCT) in hospitals requires the use of principles of change management. Manufacturers can support this process. E-learning programs adapted to the local situation with regular updates, a centralized accreditation and user-registration system and service level agreements are...

Part 2: Red flags The transition from fetus to newborn is a process of rapid physiological adaptation that is sometimes delayed by complications. Most newborns complete the process of transition with little or no delay.  These infants may demonstrate normal transitional findings, including tachypnea and tachycardia, ...

Part 1: The physiology of transition The transition from fetus to neonate is a critical time of physiological adaptation. While the majority of term infants complete this process in a smooth and organized fashion, some infants experience a delay in transition or exhibit symptoms of underlying disease. Careful...

Ever since the landmark document “To err is human” [1] was released, patient safety has been the paramount objective in US hospitals. “Patient safety” became the catch phrase and focus for all activities; a trend that was rapidly taken up by the rest of the world’s hospitals. Suddenly a new catch phrase – “lean” – ...

Reprinted with permission from British Journal of Nursing, 2004, Vol 13, No 9.  Arterial puncture is the most common method used to obtain a sample for the measurement of arterial blood gases (ABGs) and is essential to guide the prescription of long-term oxygen therapy (LTOT) in patients with chronic hypoxic lung...

The National Kidney Disease Education Program (NKDEP) Laboratory Working Group reviewed problems related to serum creatinine measurement for estimating glomerular filtration rate (GFR) and prepared recommendations to standardize and improve creatinine measurement. The NKDEP recommends using the estimating equation...