1. Feasibility of a computerized clinical decision support system delivered via a socially assistive robot during grand rounds : a pilot studyValentino Šafran, Urška Smrke, Bojan Ilijevec, Samo Horvat, Vojko Flis, Nejc Plohl, Izidor Mlakar, 2025, izvirni znanstveni članek Opis: Aims and Objective: The aim of this study was to explore the feasibility, usability and acceptance of integrating Clinical Decision Support Systems with Socially Assistive Robots into hospital grand rounds. Background: Adopting Clinical Decision Support Systems in healthcare faces challenges such as complexity, poor integration with workflows, and concerns about data privacy and quality. Issues such as too many alerts, confusing errors, and difficulty using the technology in front of patients make adoption challenging and prevent it from fitting into daily workflows. Making Clinical Decision Support System simple, intuitive and user-friendly is essential to enable its use in daily practice to improve patient care and decision-making. Methods: This six-month pilot study had two participant groups, with total of 40 participants: a longitudinal intervention group (n =8) and a single-session evaluation group (n=32). Participants were medical doctors at the University Clinical Center Maribor. The intervention involved implementing a Clinical Decision Support System delivered via a Socially Assistive Robot during hospital grand rounds. We developed a system that employed the HL7 FHIR standard for integrating data from hospital monitors, electronic health records, and patient-reported outcomes into a single dashboard. A Pepper-based SAR provided patient specific recommendations through a voice and SAR tablet enabled interface. Key evaluation metrics were assessed using the System Usability Scale (SUS) and the Unified Theory of Acceptance, Use of Technology (UTAUT2) questionnaire, including Effort Expectancy, Performance Expectancy and open ended questions. The longitudinal group used the system for 6 months and completed the assessments twice, after one week and at the end of the study. The single-session group completed the assessment once, immediately after the experiment. Qualitative data were gathered through open-ended questions. Data analysis included descriptive statistics, paired t-tests, and thematic analysis. Results: System usability was rated highly across both groups, with the longitudinal group reporting consistently excellent scores (M =82.08 at final evaluation) compared to the acceptable scores of the single-session group (M =68.96). Extended exposure improved user engagement, reflected in significant increases in Effort Expectancy and Habit over time. Participants found the system enjoyable to use, and while no significant changes were seen in Performance Expectancy, feedback emphasized its efficiency in saving time and improving access to clinical data, supporting its feasibility and acceptability. Conclusions: This research supports the potential of robotic technologies to transform CDSS into more interactive, efficient, and user-friendly tools for healthcare professionals. The paper also suggests further research directions and technical improvements to maximize the impact of innovative technologies in healthcare.
Ključne besede: clinical decision support systems, clinical decision-making, hospital grand rounds, patient data integration, perceived quality of care, socially assistive robots, usability and familiarity, user experience questionnaire, workload reduction
Objavljeno v DKUM: 30.05.2025; Ogledov: 0; Prenosov: 2
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2. Dojemanje oskrbe, osredotočene na pacienta, v treh klinikah za zdravljenje neplodnosti : vpliv zdravljenja v domačem okolju ali tujini in povračila stroškovVeljko Vlaisavljević, Borut Kovačič, 2024, izvirni znanstveni članek Opis: Namen te študije je bil oceniti izkušnje bolnikov z oskrbo, osredotočeno na bolnika (PCC), na treh klinikah za zdravljenje neplodnosti glede na kritje stroškov zdravljenja in kraj, kjer so bili zdravljeni.
Ključne besede: assisted reproductive therapy, cross-border patients, patient treatment experience, patient centeredness, quality of care
Objavljeno v DKUM: 07.01.2025; Ogledov: 0; Prenosov: 22
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3. Long-term impact of community psychiatric care on quality of life amongst people living with schizophrenia : a systematic reviewJožica Černe Kolarič, Anja Plemenitaš Ilješ, Darja Kraner, Vida Gönc, Mateja Lorber, Nataša Mlinar Reljić, Zvonka Fekonja, Sergej Kmetec, 2024, pregledni znanstveni članek Opis: The review examines the long-term impact of community psychiatric care on improving the quality of life of people with schizophrenia. It addresses the global burden of this disorder and the need for effective community-based care strategies. A systematic literature search was conducted in databases such as CINAHL, Medline, Web of Science, Sage and ScienceDirect, with the search lasting until March 2024 and following the PRISMA guidelines. The inclusion criteria targeted studies that addressed the long-term effects of community mental health care for people aged 18 years and older with schizophrenia and included both quantitative and qualitative research designs. Studies unrelated to the research question or with significant methodological flaws were excluded. The risk of bias was assessed using GRADE and GRADECERqual, in addition to critical appraisal using the Joanna Briggs Institute (JBI) checklists. Independent screening and data extraction was performed, with results summarised by thematic analysis. In total, 11 studies met the inclusion criteria and included cross-sectional, cohort, qualitative and randomised controlled trial designs. The results showed that community psychiatric care significantly improves the quality of life, well-being and social integration of people with schizophrenia. Effective interventions identified include psychoeducation, cognitive behavioural therapy, social skills training and individualised care plans. However, challenges such as limited resources, labour shortages and social stigma, particularly in low-income neighbourhoods, were also identified. This study highlights the importance of continuous, personalised, multidisciplinary community-based care for sustainable mental health outcomes. Further research is recommended to investigate the long-term impact and strategies to overcome implementation challenges.
Ključne besede: schizophrenia, quality of life, community, psychiatric care, patient, systematic review
Objavljeno v DKUM: 22.11.2024; Ogledov: 0; Prenosov: 11
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4. Multilingual framework for risk assessment and symptom tracking (MRAST)Valentino Šafran, Simon Lin, Jama Nateqi, Alistair G. Martin, Urška Smrke, Umut Arioz, Nejc Plohl, Matej Rojc, Dina Běma, Marcela Chavez, Matej Horvat, Izidor Mlakar, 2024, izvirni znanstveni članek Opis: The importance and value of real-world data in healthcare cannot be overstated because it offers a valuable source of insights into patient experiences. Traditional patient-reported experience and outcomes measures (PREMs/PROMs) often fall short in addressing the complexities of these experiences due to subjectivity and their inability to precisely target the questions asked. In contrast, diary recordings offer a promising solution. They can provide a comprehensive picture of psychological well-being, encompassing both psychological and physiological symptoms. This study explores how using advanced digital technologies, i.e., automatic speech recognition and natural language processing, can efficiently capture patient insights in oncology settings. We introduce the MRAST framework, a simplified way to collect, structure, and understand patient data using questionnaires and diary recordings. The framework was validated in a prospective study with 81 colorectal and 85 breast cancer survivors, of whom 37 were male and 129 were female. Overall, the patients evaluated the solution as well made; they found it easy to use and integrate into their daily routine. The majority (75.3%) of the cancer survivors participating in the study were willing to engage in health monitoring activities using digital wearable devices daily for an extended period. Throughout the study, there was a noticeable increase in the number of participants who perceived the system as having excellent usability. Despite some negative feedback, 44.44% of patients still rated the app’s usability as above satisfactory (i.e., 7.9 on 1–10 scale) and the experience with diary recording as above satisfactory (i.e., 7.0 on 1–10 scale). Overall, these findings also underscore the significance of user testing and continuous improvement in enhancing the usability and user acceptance of solutions like the MRAST framework. Overall, the automated extraction of information from diaries represents a pivotal step toward a more patient-centered approach, where healthcare decisions are based on real-world experiences and tailored to individual needs. The potential usefulness of such data is enormous, as it enables better measurement of everyday experiences and opens new avenues for patient-centered care.
Ključne besede: multilingual framework, risk assessment, symptom tracking, chronic diseases, patient-centered care, real-world data
Objavljeno v DKUM: 12.08.2024; Ogledov: 74; Prenosov: 18
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5. Core values of family medicine in Europe : current state and challengesEva Arvidsson, Igor Švab, Zalika Klemenc-Ketiš, 2021, izvirni znanstveni članek Opis: Background: Values are deeply held views that act as guiding beliefs for individuals and organizations. They state what is important in a profession. The aims of this study were to determine whether European countries have already developed (or are developing) documents on core values in family medicine; to gather the lists of core values already developed in countries; and to gather the opinions of participants on what the core family values in their countries are.
Methods: This was a qualitative study. The questionnaire was distributed as an e-survey via email to present and former members of the European Society for Quality and Safety in Family Practice (EQuiP), and other family medicine experts in Europe. The questionnaire included six items concerning core values in family medicine in the respondent's country: the process of defining core values, present core values, the respondents' suggestions for core values, and current challenges of core values.
Results: Core values in family medicine were defined or in a process of being defined in several European countries. The most common core values already defined were the doctor-patient relationship, continuity, comprehensiveness and holistic care, community orientation, and professionalism. Some countries expressed the need for an update of the current core values' list. Most respondents felt the core values of their discipline were challenged in today's world. The main values challenged were continuity, patient-centered care/the doctor-patient relationship and comprehensive and holistic care, but also prioritization, equity, and community orientation and cooperation. These were challenged by digital health, workload/lack of family physicians, fragmentation of care, interdisciplinary care, and societal trends and commercial interests.
Conclusion: We managed to identify suggestions for core values of family medicine at the European level. There is a clear need to adopt a definition of a value and tailor the discussion and actions on the family medicine core values accordingly. There is also a need to identify the core values of family medicine in European countries. This could strengthen the profession, promote its development and research, improve education, and help European countries to advocate for the profession.
Ključne besede: value orientation, family practice, continuity of patient care, patient-centered care, Europe
Objavljeno v DKUM: 06.08.2024; Ogledov: 109; Prenosov: 12
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6. Safety culture and the positive association of being a primary care training practice during COVID-19 : the results of the multi-country European PRICOV-19 studyBianca Silva, Zlata Ožvačić Adžić, Pierre Vanden Bussche, Esther Van Poel, Bohumil Seifert, Cindy Heaster, Claire Collins, Canan Tuz Yilmaz, Felicity Knights, Zalika Klemenc-Ketiš, 2022, izvirni znanstveni članek Opis: The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
Ključne besede: safety culture, patient safety, quality of care, primary health care, COVID-19, medical education, vocational training, PRICOV-19, infectious disease, multi-country, general practice
Objavljeno v DKUM: 04.07.2024; Ogledov: 128; Prenosov: 17
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7. Kakovost oskrbe v odnosu na oceno kakovosti vodenja kronične bolezni bolnikov s koronarno boleznijoKsenija Tušek-Bunc, Marija Petek Šter, Davorina Petek, 2018, izvirni znanstveni članek Opis: Purpose: Patient-centered assessment of chronic illness care is replacing the assessment of satisfaction, which does not cover all dimensions of care. Pa- tient assessments reflect both the qual- ity of chronic illness care and provide feedback to healthcare workers about their work. The study aim was to inves- tigate the patient-centered assessment of coronary heart disease (CHD) pa- tients and its correlation with the care that was delivered. Methods: This cross-sectional study evaluated data obtained from the patient medical records and surveyed patients using the Patient Assessment of Chronic Illness Care (PACIC) ques- tionnaire. A descriptive analysis of the overall and domain-specific responses to the PACIC questionnaire was con- ducted and the association of the results with delivery of care data in the patient records was determined by Pearson's correlation coefficient. Results: The study sample included 768 of 1080 CHD patients (71,1%) at 36 family medicine practices who com- pleted the PACIC questionnaire. The mean age of the re- spondents was 68.3 +- 10.7 years and the overall PACIC score was 3.3 +- 0.9. The highest PACIC scores were deliv- ery system design (3.7), patient activation (3.7), and prob- lem solving (3.6). Follow-up received the lowest score (2.8). Quality of delivered care and PACIC scores were correlated (r = 0.10, p = 0.009). Conclusions: CHD patients highly rated all aspects of chronic care included in the PACIC questionnaire. They were least satisfied with the follow-up and coordination as- pects of chronic care. The process indicators of care were positively correlate with patient assessment of care.
Ključne besede: coronary heart disease patients, patient's assessment of chronic illness care, quality of care
Objavljeno v DKUM: 05.04.2024; Ogledov: 199; Prenosov: 9
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8. The safety of patient management in family medicine in Slovenia during Covid-19 : a crosssectional studyMaja Cvetko Gomezelj, Špela Miroševič, Alina Verdnik Tajki, Ksenija Tušek-Bunc, Esther Van Poel, Sara Willems, Zalika Klemenc-Ketiš, 2023, izvirni znanstveni članek Opis: Abstract Background During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staf and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia. Methods A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients’ management variables. Results From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p=0.017) and more often reported that at least once patient with an urgent condition was seen late due to not com‑ ing to their FP (p=0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p=0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p=0.012). Conclusion Covid-19 afected the safety of patient management in FMP in Slovenia. The most common prob‑ lem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.
Ključne besede: Covid-19, family medicine, patient safety, patient management, quality of care, PRICOV-19, primary health care, general practice, timeliness
Objavljeno v DKUM: 29.03.2024; Ogledov: 249; Prenosov: 18
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10. Patient safety in cross-border careEva Turk, Stephen Leyshon, Morten Pytte, 2015, izvirni znanstveni članek Opis: Patient safety is a right and it raises particular issues in the context of cross-border care. Patients should be able to have trust and confidence in the healthcare structure as a whole; they must be protected from the harm caused by poorly functioning health systems, medical errors and adverse events. This paper addresses the state of cross-border healthcare in the European Union, the state of patient safety, the question of quality assurance and the role of accreditation as a risk based approach.
Ključne besede: patient safety, cross-border care, accreditation, healthcare, EU
Objavljeno v DKUM: 08.10.2018; Ogledov: 1087; Prenosov: 135
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