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Healthcare organisations face mounting challenges to maintain financial sustainability given increasing expenses, decreasing reimbursements and changing patient needs. Because of the increasing costs of operating a healthcare institution, it is no longer viable to pursue achieving financial sustainability just by adding more clinical visits and capacity, increasing hospital admission and throughput, performing more surgeries or simply working harder. To address these challenges, healthcare leaders should adopt a culture of continuous process improvement that engages and empowers clinical and operational teams to identify and eliminate waste, optimise revenue and enhance quality and safety. This paper presents a case study of Project ROSE (Revenue Optimization and Supply Enhancement), a project initiated by a community-based integrated health system in the upper Midwest. The goal was to achieve substantial financial savings within one year through revenue optimisation, supply chain improvements and service and maintenance contract enhancements. We describe the vision, goals, methods, results and lessons learned. We also discuss the implications and recommendations for other healthcare institutions that seek to implement similar initiatives that may reduce the burden on their clinical teams and allow them to work smarter, not harder. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/ business/.

Background: Sleep-related symptoms are known to influence cardiovascular health (CVH), but the relative importance of sleep duration versus quality remains uncertain. This study evaluates whether a combined measure – “satisfactory sleep health,” incorporating both adequate sleep duration and good sleep quality – better correlates with CVH status in middle-aged and older adults living near the Equator. Methods: In this population-based, cross-sectional study, 1781 middle-aged and older adults living in rural villages of coastal Ecuador were assessed for sleep duration and quality using structured interviews and the Pittsburgh Sleep Quality Index (PSQI). Satisfactory sleep health was defined as 7- to 8 h of sleep plus a PSQI score ≤5 points. CVH status was evaluated using the American Heart Association’s Life’s Simple 7 construct. Multivariate logistic regression models were used to determine the investigated associations, after adjustment for relevant confounders. Results: While adequate sleep duration alone showed no significant association with CVH, good sleep quality, and satisfactory sleep health were inversely associated with poor CVH in unadjusted models. After adjustment for demographics, level of education, and symptoms of depression, satisfactory sleep health was associated with a 21% reduction in the odds of poor CVH status (OR = 0.79; 95% CI = 0.64-0.99; P < 0.05). Conclusions: A combined assessment of sleep duration and quality provides a more robust predictor of CVH than either component alone. These findings support the inclusion of multidimensional sleep metrics in public health frameworks evaluating cardiovascular risk and highlight their potential utility in guiding targeted prevention strategies.

ABSTRACT An electrochemical bandage (e‐bandage) that generates hydrogen peroxide (H 2 O 2 ) through a combination of working, counter and reference electrodes used with an electrolyte‐providing hydrogel is being developed for wound infection management. e‐Bandage biocidal activity was previously demonstrated using Xanthan gum hydrogel. For clinical use, clinically used hydrogels would be ideal, but their use with the described e‐bandage has not been shown. The goal of this work was to evaluate the biocidal activity of off‐the‐shelf, clinically used hydrogels when used with a 1.77 cm 2 H 2 O 2 ‐producing e‐bandage. e‐Bandage electrochemical parameters and activity against methicillin‐resistant Staphylococcus aureus IDRL‐6169 and Acinetobacter baumannii ATCC‐17978 biofilms were assessed with six off‐the‐shelf hydrogels. Variations in hydrogel composition affected electrochemical parameters, which was associated with differences in biocidal activity. Results of this study inform the selection of off‐the‐shelf hydrogels for use with H 2 O 2 ‐producing e‐bandages.

Background and Objectives: There are few trainings for primary care physicians (PCPs) on how to navigate a psychiatric crisis (such as suicidal ideation, homicidal ideation, psychosis, and/or intoxication that impairs decision making capacity) in the outpatient setting. We previously published an approach to fill this gap and now report the results of our efforts to improve the curriculum and assess if confidence was maintained over time. Methods: Four, 1-h didactic sessions on screening and logistically managing patients in need of inpatient or outpatient psychiatric care were created. Objectives were based on the complexities of state law, institutional policy, and expert opinion. All 15 residents in a family residency program participated in the didactic series. Resident confidence to complete all aspects of these scenarios was measured by questionnaire before (Time 1), immediately after (Time 2), and 5 months after completion of the didactic series (Time 3). Results: From Time 1 to Time 3, resident confidence significantly increased for 10/17 (58%) aspects of assessing and managing psychiatric crises (all P < .017). There was no evidence that confidence for any measure decreased from Time 2 to Time 3. Conclusions: The revised curriculum increased family medicine resident confidence to assess and manage outpatient psychiatric crises 5 months after the training was completed.