Jan 2024 DOI 10.14302/issn.2641-5526.jmid-24-4893
J. Johnson RalphCorresponding author
This evidence-based brief commentary discusses the potential of EPIC ® medicalrecords software to help or hinder in advancing High Reliability in healthcare—namely, the intent to attain repeatable, increasingly high levels of quality and safety over time. Four of EPIC’s key aspects relevant to High Reliability are examined: Standardized (High Quality) Information / Data Collection, Technological Somnambulism, Enhanced Patient Safety, and Reminders / “Hardstops.” A conclusion is drawn that EPIC, if used correctly, has vast potential to advance High Reliability high-quality and safety, specifically in medical treatment and regarding healthcare organization practice in general. However, it has hidden costs that are more than money; if unfettered, those costs can hinder its usefulness and even render it counterproductive. EPIC only works well in terms of Maximum High Reliability in healthcare as long as users and leaders remain mindful, prudent, and balanced in its use.
Dec 2019 DOI 10.14302/issn.2372-6601.jhor-19-3094
Zaichick VladimirCorresponding author
Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk, 249036, Russia.
Prostate specific antigen (PSA) does not provide the high reliability and precision that is required for an accurate screening for prostate cancer (PCa). The aim of our study was to search for a simple, rapid, direct, preferably non-invasive, and highly accurate biomarker and procedure for the screening for PCa. For this purpose the levels of bromine (Br) and zinc (Zn) were prospectively evaluated in expressed prostatic fluid (EPF). Also Zn/Br concentration ratio was calculated for EPF samples, obtained from 38 apparently healthy males and from 33, 51, and 24 patients with chronic prostatitis (CP), benign prostatic hyperplasia (BPH) and PCa, respectively. Measurements were performed using an application of energy dispersive X-ray fluorescent (EDXRF) microanalysis developed by us. It was found that in the EPF of cancerous prostates the levels of Zn and Zn/Br were significantly lower in comparison with those in the EPF of normal, inflamed, and hyperplastic prostates. It was shown that “Sensitivity”, “Specificity” and “Accuracy” of PCa identification using the Zn and Zn/Br levels in the EPF samples were all significantly higher than those resulting from of PSA tests in blood serum. It was concluded that the Zn and Zn/Br levels in EPF, obtained by EDXRF, is a fast, reliable, and non-invasive diagnostic tool that can be successfully used by local, non-urologist physicians at the point-of-care to provide a highly effective PCa screening and as an additional confirmatory test before a prostate gland biopsy.