JMIRx Med

ObjectiveThere is no validated questionnaire in Japan to measure the culture of safety in ambulatory care clinics. Therefore, we developed the Japanese version of the Medical Office Survey on Patient Safety Culture (MOSPSC) of the Agency of Healthcare Research and Quality (AHRQ) in the United States with the aim to establish a tool for evaluating and benchmarking the safety culture of outpatient clinics in Japan. Materials and methodsThis research uses both qualitative and quantitative approach...

Safety is a foundational concern in adolescent behavioral health crisis units (BHCUs), where therapeutic care must be delivered in complex, rapidly evolving environments. However, limited research has explored how key personnel involved in shaping the environment of care in such units, such as clinicians and healthcare designers, understand and prioritize safety. To address this gap, one-hour, online semi-structured interviews were conducted with a panel of experts (N = 13) at a national level i...

IntroductionMedication errors (MEs) are common events in the hospital that compromises the patient safety. Despite high prevalence of MEs being reported, there is a limited information at the outpatient settings. MethodThis study assessed the prevalence and characteristics of MEs by analyzing the data of pharmacist-led interventions recorded between 1st November 2024 to 30th September 2025 at the outpatient department of pharmacy, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH). Resu...

Limited research has examined the use of physical mock-ups and artificial intelligence (AI) to evaluate design features in adolescent mental and behavioral health environments, such as the Crisis Stabilization Unit (CSU). This mixed-methods study investigated caregiver workflows and environmental features in adolescent CSUs (e.g., furniture and open vs. enclosed nursing station designs) through physical mock-up simulations with expert and novice clinicians/designers (N = 17). Participants feedba...

PurposeAmbient Documentation Tools (ADT) are an emerging technology designed to help clinicians complete documentation better with less time and effort. This study aimed to understand the impact of ADT on the pharmacist care experience. MethodsData from Epic Signal, surveys, and interviews were collected between February 2024 and October 2025 from 41 medication therapy disease management (MTDM) pharmacists across 33 primary care and subspecialty clinics at a large integrated health system who w...

BackgroundPharmaceutical care is a patient-centered practice model in which pharmacists assume responsibility for identifying, preventing, and resolving medication-related problems to optimize therapeutic outcomes. In Nigeria, pharmaceutical care activities within hospital settings have expanded over time; however, evidence describing the frequency of specific pharmacist intervention activities and the structural barriers influencing their delivery at the facility level remains limited. Objecti...

Emergency nursing is essential to healthcare systems worldwide. Triage plays a pivotal role in emergency nursing, prioritizing patients based on the urgency of their medical condition and focusing on rapid assessment and prioritization of patient care according to their condition and its severity. In the emergency department, the triage nurse assesses vital signs and gathers information from the patient to determine the severity of their condition. This aims to provide appropriate medical interv...

BackgroundHospital drug formularies function within Complex Adaptive Systems (CAS), where the alignment between drug supply and disease patterns is critical for patient care and cost-effectiveness. However, measuring this adaptability is challenging due to conflicting priorities among stakeholders and a lack of standardized assessment tools. ObjectivesThis study aims to analyze the perspectives of three key stakeholder groups-clinical providers, non-clinical service providers, and policymakers-...

Artificial intelligence (AI), particularly large language models (LLMs), is increasingly explored in healthcare, yet its real-world usability and safety in high-risk clinical pharmacy tasks remain uncertain. Vancomycin therapeutic drug monitoring (TDM), which requires precise pharmacokinetic calculations and context-sensitive interpretation within a narrow therapeutic window, provides a stringent test case for AI-assisted decision support. This proof-of-concept study developed and evaluated a hy...

BackgroundApproximately 33% of U.S. Veterans live in rural areas, often facing significant barriers to accessing healthcare due to staffing shortages at VA facilities. The Contract Buyout (CBO) program, authorized under the PACT Act of 2022, was designed to address rural healthcare staffing shortages by enabling Veterans Health Administration (VHA) facilities to buy out existing service contracts to work in rural VA facilities. Despite its potential, uptake of the program has been limited, with ...

BackgroundPatient satisfaction and loyalty are key indicators of healthcare quality and are influenced by multiple service domains. Understanding which aspects of care drive these outcomes is essential for Health Insurance Organization (HIO) hospitals aiming to improve patient experience. MethodsAn analytical cross-sectional study was conducted across four hospitals in Alexandria, Egypt. A total of 983 patients were recruited using stratified random sampling from various hospital departments. D...

BackgroundA Hospital Medicine Advanced Practice Provider (HMAPP)-led care model developed in response to the high acuity and increased patient volumes associated with the Covid-19 pandemic. Although anecdotally perceived as a successful model, questions remained if there was adequate pre-planning and formal implementation strategy for stakeholder buy-in. ObjectiveTo elicit HM physicians and APPs perceptions of the HMAPP-led care model implementation and consider necessary steps for optimal futu...

BackgroundElectronic Health Records(EHR) are very crucial for Clinical Decision Support Systems and for proper care to be delivered to ICU heart failure patients, there is often missing data due to monitoring device errors thus the need for robust imputation methodologies. ObjectiveTo compare and evaluate three different methodologies for imputing missing data for heart failure patients from the MIMIC-III database: Denoising Autoencoder (DAE), Self-Attention Imputation for Time Series (SAITS), ...

ObjectiveTo evaluate the views of physicians in Trinidad and Tobago towards low value care MethodsPhysicians were surveyed using a cross sectional study design. An online questionnaire was disseminated through social media platforms using convenience sampling. A descriptive analysis was performed. ResultsData from 218 physicians were analysed. Most participants worked in internal medicine (n=59, 27.1%) and the majority of participants were junior doctors (n=147, 67.4%). Most participants (n=97...

Background Artificial intelligence (AI) is increasingly being integrated into healthcare systems, with growing applications in clinical decision support, workflow optimization, and population health management. While substantial investments have been made in digital infrastructure, the successful adoption of AI in primary care depends critically on the readiness, awareness, and educational preparedness of healthcare professionals. Global health authorities emphasize the need for ethically ground...

ObjectiveTo meet the World Health Organization (WHO) requirement of strengthening integrated Emergency, Critical and Operative (ECO) care, it is necessary to develop ECO-related guidance and tools for Quality Improvement (QI) in Emergency Units (EUs). This study aimed to identify the barriers and facilitators for QI in EUs in Low- or Middle-Income- countries (LMICs) and explore potential measures for assessing quality of care, to inform guidance and tool development across all quality domains. ...

PurposeAlthough numerous research studies have demonstrated the positive impact of clinical pharmacy services, these benefits do not translate into sustained practice changes without support from hospital pharmacy leaders. Factors influencing leadership decisions to expand pharmacy services remained unclear. This study aimed to identify barriers to implementing pharmacy practice model changes and gain insights on potential methods of overcoming these barriers from the hospital pharmacy leader pe...

ObjectiveThis binational cross-centre study analyses a consented audiological-vestibular test battery for characterising age-related hearing loss, enabling precise phenotyping of suprathreshold functional, physiological, and vestibular factors beyond audibility. DesignStatistical analysis of centre effects to assess comparability of the test battery measured at two centres (Germany and France); statistical analysis of age and pure-tone average (PTA) effects per test to identify potential covari...

Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia, with type 1 characterized as an autoimmune destruction of pancreatic beta cells and type 2 characterized by insulin resistance with progressive beta cell dysfunction. This study applied an existing binary classification algorithm (ALTARN) to accurately predict DM. ALTARN, as a tabular attention residual neural network, uses residual connection to find complex patterns present in tabular columns. We achieved an average...

BackgroundBehavioral telemetry--the analysis of clinical actions NOT taken--may identify care process failures associated with adverse outcomes. While missed nursing care predicts outcomes in survey-based studies, objective EHR-derived measures are lacking. We hypothesized that missing routine cognitive assessment in ICU patients with low acute physiologic derangement would predict mortality independent of illness severity. MethodsRetrospective cohort study using MIMIC-IV (2008-2022, Beth Israe...