ABSTRACT Introduction Coronavirus disease (COVID-19) is a pandemic of international concern that has caused significant physical and psychological health challenges to healthcare workers worldwide. This study aimed to assess and evaluate the psychological responses of healthcare workers who provided hands-on care for patients with COVID-19 at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, as it was converted to a dedicated COVID-19 hospital during the pandemic. Methods This study used a descriptive cross-sectional design to recruit 500 participants at KFMC between April 10 and May 5, 2020. This study used the 21-item Depression, Anxiety, and Stress Scale (DASS-21) to assess the psychological responses among the study participants. Results The findings of this study showed that of 500 respondents, 304 (60.9%) reported having depressive symptoms, 281 (56.3%), 318 (63.3%) having stress and anxiety symptoms. Moreover, 250 participants (50%) who lived with their families reported severe stress and anxiety. However, the results of our study indicated that healthcare workers were committed to providing care to COVID-19 patients. Conclusions Depression, anxiety, and stress symptoms were highly prevalent among healthcare workers at KFMC. Therefore, there is an urgent need for psychological interventions to identify healthcare workers with heavy psychological burdens.

ABSTRACT Introduction Delays in the discharging process can affect hospital efficiency. Improving patient flow in acute care hospitals is an essential issue that hospital management and research aim to achieve. Admission volume and LOS for hospitalized patients in the medical specialties department was examined at a tertiary care center in Riyadh, Saudi Arabia, to explore practical approaches to reduce the LOS. We aimed to identify and manage reasons for the delay in discharging patients from the medical specialties department at a tertiary care center in Saudi Arabia. Methods Admission and discharge data for hospitalized patients were collected from 2016–2018. In 2017, a FOCUS (find, organize, clarify, understand, select)–PDSA (plan, do, study, act) quality improvement method was used to improve the discharge processes, with specific measurable targets per year. The number of readmissions and mortality rates decreased significantly after the intervention was implemented, suggesting an improvement in the quality of treatment and the process of admission and discharge. Results Despite gradual increases in admissions from 2016 to 2018, the mean LOS decreased significantly between 2016 and 2018, from 9.16 to 7.47 days ( p < 0.001). The number of readmissions and mortality rates decreased after the intervention was implemented in 2017, suggesting an improvement in the process of admission and discharge. Conclusion The LOS can be reduced by implementing a quality improvement intervention, driven by a multidisciplinary committee involving healthcare personnel, to facilitate the optimal discharge mechanism through available hospital resources and services.

ABSTRACT Introduction Regular testing of the international normalized ratio (INR) is essential for people taking vitamin K antagonists as part of anticoagulation therapy. This study was undertaken to ascertain the efficacy of point-of-care testing (POCT)-INR versus conventional core laboratory testing in terms of result adequacy, waiting-time reduction, and patient satisfaction enhancement at the thrombosis clinic of the outpatient Medical Specialties Department in King Fahad Medical City, Saudi Arabia. Methods The study was conducted prospectively for 6 months (from June 2017 to December 2017) on 182 eligible participants out of 250 entitled patients who were attending the thrombosis clinic for warfarin dose adjustment and who fulfilled all the prerequisites for performing dual testing by fingerstick at the clinic and venipuncture by the core laboratory. The data-capturing template created on Microsoft Excel recorded turnaround times (TATs), clinical concordance of INR result variables by POCT, and laboratory methods. Individual patient experience was recorded to gauge satisfaction rate, and all the data were analyzed statistically. Results Of 182 patients included in the study, overall good concord was observed between POCT whole blood and laboratory plasma INR results with median bias of 0.07 and 92.3% agreement using acceptability criteria for clinical concordance of Clinical Laboratory Standards Institute (CLSI) 14-A and International Standards Organization (ISO) 17593-2007, respectively. Marked improvement in terms of patient's time spent at the clinic was noted, with substantial reduction from 180 to ∼30 minutes ( p < 0.001). Survey questionnaire responses indicated that POCT of INR was highly convenient and enhanced patient experience in terms of shorter wait time, minimal invasive procedures, and immediate result availability ( p < 0.001). Predominantly, participants (75.4%) endorsed and expressed a strong preference for the POCT procedure over conventional laboratory testing. Conclusions Whole blood INR testing for warfarin dose adjustment with validated POCT devices is adequately comparable to the core laboratory results. It also simplifies workflow steps at the thrombosis clinic, enhancing patient experience and convenience via the immediate availability of results, a less invasive procedure, and a marked reduction in waiting time. However, caution is needed with regard to higher INR results (≥4.7), which call for core laboratory confirmation.

Introduction: Data on concomitant control of both glycemia and cardiovascular risk factors among patients with type 2 diabetes (T2D) are very limited in Saudi Arabia. The aim of this study was to assess the degree of achieving glycemic control and concomitant control of cardiovascular risk factors at a primary care setting. Methods: Between February and March 2017, we retrospectively reviewed the charts and laboratory records of adult patients with T2D who received primary care services at Family Medicine clinics at King Fahad Medical City for at least a year. Outcome goals were based on 2016 American Diabetic Association (ADA) standards of diabetic care. Results: A total of 268 patients were included in the study. The mean age was 55.0 ± 10.7 years and 60% of the patients were women. Patients who achieved ADA-recommended diabetic care goals were 43.7% for glycemic control, 46.7% for blood pressure, 87.9% for total cholesterol, 52.7% for low-density lipoprotein cholesterol, 44.7% for high-density lipoprotein cholesterol, 70.8% for triglycerides, 9.4% for diet control, 1.9% for practicing exercises, 98.1% for receiving health education, and finally 38.8% for the recommended number of glycated hemoglobin testing. In addition to glycemic control, concomitant control of blood pressure, blood lipids, and both blood pressure/blood lipids were 21.3%, 9.4%, and 4.9%, respectively. In multivariate analysis, glycemic control was independently associated with the type of diabetic medications, diet control, and smoking status. Conclusion: The concomitant control of multiple diabetic care goals is alarmingly low. Further research is required to better understand the responsible system barriers and strategies to improve.