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1
Geel, Annelize. "A community link project for Weskoppies Hospital psychiatric hospital." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-11302005-103859.
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2
Ashley-Smith, Andrew. "A psychiatric service at a community hospital." Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/26611.
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The purpose of this dissertation is to evaluate an attempt to use the facilities of a general hospital with minimal psychiatric cover to deal with acute psychiatric conditions. This is in keeping with current psychiatric opinion in South Africa as expressed by Dr. C.W. Allwood and Dr G.A.D. Hart. This dissertation will examine the needs structure, difficulties and results of the provision of a service dealing with acute psychiatric disorders in a peripheral General Hospital and make suqqestions should similar satellite facilities be established at other peripheral hospitals. Although in principle. the concept of part-time specialist cover at a peripheral general hospital is not new in medical. surgical and gynaecological departments. the previous involvement of private psychiatrists within the teaching department has been in the form of out-patient department sessions only at academic and state psychiatric hospitals as is practiced in Cape Town. This project however allowed for the evaluation of emergency cases with subsequent referral to appropriate treatment centres if needed from a peripheral hospital. A consultation-liaison service within the general wards and the opportunity to conduct seminars, lectures and in-house training for all level of professional staff were also encompassed.
3
Mueller, Maxine. "Organizing participation : an ethnography of 'community' in hospital." Thesis, University of Edinburgh, 1995. http://hdl.handle.net/1842/21438.
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A first aim of the study was to provide detailed descriptions of hospital practice as day-to-day examples of patient participation. A second aim was to extend descriptions of day-to-day practice to help explain how patient participation occurs in particular ways and not in others. Detailed examination of day-to-day practice reveals that organisation is set in motion by nurses through particular forms of language. Nurses mobilise the term 'community' to organise their day-to-day work as well as patient work. Hence, community emerged as a central topic for this ethnography. I go on to explicate the polysemicity of the language-in-use which in turn reveals how both stable and ambiguous aspects of the term community are used to constitute the day-to-day work as well as patient work. Hence, community emerged as a central topic for this ethnography. I go on to explicate the polysemicity of the language-in-use which in turn reveals how both stable and ambiguous aspects of the term comunity are used to constitute the day-to-day. Drawing on distinctions between 'shared expressions' and 'shared meanings', the analysis shows how different performance by persons lead to the appearance of distinguishable 'figures'. For example, the apparent polysemicity of the key term 'community' allows for extensions of persons-as-individuals and persons-as-members of community. That distinguishable figures emerge from day-to-day practice underlines everyday aspects of community as an organising device on the ward. I also examine the particular ways in which 'community' is employed and varies across interaction of persons constituting the day-to-day. For instance, nurse-patient, patient-patient and nurse-nurse interaction all provide work spaces in which aspects of community can be produced and reproduced differently.
4
Saifi, Khader M. M. Al. "The impact of information technology on hospital management of Gulf Corporation Council public hospitals." Thesis, University of Hull, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272025.
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Information technology (m has become crucial to the functioning of modern hospitals. It includes a range of human elements, infornlation, equipment, knowledge and systems. It is important to hospitals, as these are complex environments including many systems with diversity of functions, sub-systems, and professionals. The adoption of technology can be explained by four general theories: economic, political, social and globalization theory. Based on these theories five sets of reasons can account for the adoption of IT in a hospital environnlent. They are, practical; to solve existing problems, economic/business; to achieve d profit or reduce costs or both, rational; to achieve efficienL1' and effectiveness, social; to respond to pressure from society for political reasons and to increase positive image, and supply driven forces by which IT producers seek to sell their products and services. However, no one theory or set of reasons can by itself explain the precise drive for use of IT because nluch depends on each hospital's needs and surrounding drcunlStances. The purposes of this research are to investigate the extent to which IT is being used in Gulf Corporation Council (GCC) public hospitals, why IT has been adopted, and the impact of IT on hospital managementThe methods used in conducting this research were based lllainly on three established methods for searching and collecting infomlation; a literature review, the surveyor questionnaire, intervie,,'s and case studies. Five case studies in Qatar, the United Arab Emirates (UAE) and Bahrain were undertaken to cover Gee hospitals and medical centres populations. Most health and medical services in Gee Countries are provided by public hospitals which account for approximately 64% of total hospital provision, employ most medical professionals, mainly expatriates, and contain most patient beds. In Gee hospitals, IT is still in the early stages of implementation. IT has been found to be adopted at a low level due to reasons such as lack of awareness, other priorities in health policy strategies, and the low level of funding allocated. IT can provide hospitals with many benefits, solve many problems and has many inlpacts on human and functional systems, internal power balances and on the social status of hospitals. The benefits are found to be mostly in the areas of processing work. Therefore, the areas which were given priority for IT implementation were medical records, finance, and personnel areas. No significant impacts v"ere found on hospital structure, chain of conlllland, span of control and nUlllber of employees, however, itwas found that IT increased management power, hospitals' social in1age and hospital political power, while there were disagreements about IT impacts on employees' social relations. The evaluation of IT impacts on Gee hospital management shows that the impacts were not at the same level of intensity or direction, for example, sonle impacts ,",'ere positive and some negative; some significant, moderate or nurunlal, some ambiguous or obvious, were some were slow and some fast. Some efforts at Gee States level were made to develop a model of adopting IT but no real results were detected. However, the future role of IT in Gee public hospitals will be increasing perhaps at a slower pace, but two strategic issues should be given proper consideration; first; the role of the education system, research centers, and industrictl foundation, and the second strategy concerns hospital systems and services structure. This later is related to increased privatization of medical services, economic pressure, and changes in governments' employment strategy. The importance of this thesis is to draw the attention of decisionmakers to the role of IT as an efficient managerial tool in some respects and to provide a foundation for future studies
5
Ireland, Marilyn R. "A Survey of Hospital Employees’ Perceptions of Just Culture in a Northeastern Community Hospital." Thesis, NSUWorks, 2015. https://nsuworks.nova.edu/fse_etd/18.
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This applied research study was designed to examine hospital employees’ perceptions of safety as it relates to error reporting. Data from safety culture surveys at the research site showed a clear trend of a perception of a punitive environment for error reporting. Hospital administrators depend on error-report data to create safe and reliable systems for care; therefore, a safe reporting environment is a critical component of a safe and just culture.
A recently developed instrument was used to survey the 1,730 employees at the northeastern community hospital regarding their perception of just culture and safety in the error-reporting process. No significant relationships were established between survey scores (perceptions of just culture) and the variables of age, gender, experience, and degree of training in just culture principles for the overall study population. However, significant differences were identified when comparing groups consisting of specific positions or specialties. Notably, administration and management had a more optimistic viewpoint of just culture than other groups, particularly technologists and technicians, who had a somewhat diminished perception of just culture.
The findings of this applied research study have implications for hospital leaders seeking strategies to improve the safety cultures within their organizations. Measurement of specific dimensions of just culture may be valuable in these settings; particularly, stratification of survey results by position with analysis of gaps between leaders and frontline staff may provide a clue to the maturity of the safety culture. The study is a valuable addition to the safety culture research community as it aligns with and extends findings from previous research.
6
Hammers, Garfield Compton. "Transformation of service delivery in the Westcoast winelands region's hospitals: challenges and prospects." Thesis, University of the Western Cape, 2003. http://etd.uwc.ac.za/index.php?module=etd&.
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7
Sutton, Jane C. "Accidents to patients in hospital." Thesis, University of Nottingham, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.292535.
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8
Pooley, Janet Elizabeth. "Referrals from the community to the hospital eye service." Thesis, City University London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319639.
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9
Solheim, Karla Nyreen. "Institutional expansion, community relations, and the hospital next door." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/33038.
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Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2005.<br>Includes bibliographical references (p. 115-119).<br>Hospitals play many roles in a city: alternately, they may be caretakers of the sick, economic engines, intellectual hubs, major employers, and neighbors. This last role has evolved greatly over the last 45 years. The relationship between hospitals and the communities in which they are located has been affected by constantly changing economic, political, and social factors. During the early days of urban renewal in the 1950s and early 1960s, large teaching hospitals in Boston experienced a surge of political and economic power that allowed them to expand with few constraints, often to the detriment of their residential neighbors. Today, the same hospitals must broker complex deals with their neighbors if they wish to expand, offering up a host of community benefits. The process by which the hospital-community power dynamic has evolved has been shaped by the mediating entity of the Boston Redevelopment Agency, which is in turn influenced by the Mayor's Office in Boston. Despite their many roles in the city, it is their sheer physical presence that drives hospitals' relationships with their neighbors. The health care and employment benefits they can provide are not major bargaining chips in disputes over expansion; the important considerations are the tangible elements of power - money and land. The primacy of physical presence as a relationship driver can be illustrated by the differences in the negotiation process that hospitals directly bordering residential communities and extending into them experience, as opposed to hospitals that are not directly on the residential fringe.<br>by Karla Nyreen Solheim.<br>M.C.P.
10
Harrop, Jordan Phil. "Hospital and Community Characteristics Associated with Pediatric Appendectomy Outcomes." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1345496990.
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Nardontonia, Teresa. "Evaluation of Shared Governance Implementation at a Community Hospital." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7242.
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Shared governance is a model in which staff collaborate through a decentralized decision-making structure, sharing ownership and accountability and partnering to make decisions about clinical practice, professional development, patient experience, quality improvement, and research. The hospital shared governance project team aligned its shared governance model with the American Nurses Credentialing Center Pathway to Excellence standards. The purposes of this project were to do a process evaluation of shared governance implementation at one 64-bed community hospital in central Florida and make recommendations for continuous quality improvement. The project followed the plan-do-study-act methodology developed by Deming. Through the collection of meeting minutes and other shared governance documents, semi structured interviews with nurse leaders, and the results of an anonymous survey through SurveyMonkey, the process of shared governance implementation was evaluated. The major themes included the hospitals need to establish an effective communication system to ensure all 185 RNs are aware of its shared governance, restructure of the Nurse Practice Council, and a reinitiating of shared governance. Limitations of the project included the immaturity of the hospital at the time of implementation, nursing lack of knowledge about shared governance, lack of dedicated resources and competing priorities, and nursing leadership and unit turnover, which were barriers to shared governance implementation. Supporting shared governance contributes to social change by creating a nursing culture that promotes quality, nursing excellence, professional decision making, and a healthy work environment, ultimately improving outcomes for all stakeholders.
12
Renfro, Johnny Elbert. "Pastoral care in the clinical setting a training initiative for volunteer chaplains in a community hospital /." Online full text .pdf document, available to Fuller patrons only, 2004. http://www.tren.com.
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Dooley, Anthony Jason. "Redefining the Community Hospital: a Small Town Approach to Medical Planning and Design." Thesis, Available online, Georgia Institute of Technology, 2007, 2007. http://etd.gatech.edu/theses/available/etd-04012007-181350/.
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14
Jimenez, Ramon A. "Third Party Collection Program ;case study of Naval Hospital Oakland and Community Hospital of Monterey Peninsula." Thesis, Monterey, California. Naval Postgraduate School, 1992. http://hdl.handle.net/10945/23790.
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15
Gray, Ann Marie. "Government and the administration of hospital services in Northern Ireland 1948 - 1973 : the Northern Ireland Hospital Authority." Thesis, University of Ulster, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.359543.
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16
Sundberg-Douse, Gail A. "The personal development process of employees in a community hospital." [Denver, Colo.] : Regis University, 2005. http://165.236.235.140/lib/GSundberg-Douse2005.pdf.
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17
Muller, Nancy J. "DO GENERAL, COMMUNITY HOSPITALS COMPETE BY SPECIALIZING IN HIGH VOLUME, HIGH REVENUE-GENERATING SERVICE LINES?" VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2307.
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To determine if general, community hospitals show evidence of specializing in the nation's six highest volume, highest revenue-generating service lines, 2003-2007 data of hospitals throughout Florida, Virginia, and Nevada were analyzed using backward deletion, stepwise regression. Service lines selected for study were cardiac surgery, cardiology, invasive cardiology, orthopedics, labor and delivery, and pulmonary services. Results do show evidence of specialization, but characteristics of hospitals vary by service line. Findings suggest that the general, community hospital, traditionally a full-service provider, may be undergoing transformation including specialization. The study demonstrates the usefulness of studying specialization at the service line level.
18
Krassy, Margaret Mary. "As things change : an ethnography of a community health nursing agency /." Access Digital Full Text version, 1995. http://pocketknowledge.tc.columbia.edu/home.php/bybib/12136505.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1995.<br>Includes tables. Typescript; issued also on microfilm. Sponsor: Elizabeth M. Maloney. Dissertation Committee: Herve Varenne. Includes bibliographical references (leaves 153-167).
19
Hayllar, Mark Richard. "Accountability and the Hong Kong hospital authority." Thesis, Brunel University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311624.
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20
Escobar, Dorothy Magasis. "The Effect of Federal Reporting Regulations on Hospital Investment in Community Building." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2973.
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The role of hospitals as partners in community health improvement is changing, especially for nonprofit hospitals receiving tax exemptions in exchange for providing benefits to the community. There are examples of reported health improvement activities funded through hospitals' charitable donations, but there's a gap in the literature on the effect of policy and legislation on hospitals' investments in community building activities that address the social determinants of health. Grounded in eco-social theory, this quantitative, correlational study compared secondary data from CA's nonprofit hospitals' annual 2009 and 2012 reports to determine what, if any, changes have occurred in the hospitals' investments in community building since the 2010 implementation of the IRS' new community benefit standard. Matched-pair t test and chi-square goodness of fit tests were used to determine if there is a relationship between IRS regulations and how hospitals distribute their charitable dollars. Independent sample t test and ANOVA were run to determine if the characteristics of the hospitals studied were predictive of the changes found. Aside from a shift in the distribution of community building investments by types of activities, this study found no significant change in the use of nonprofit hospitals' community benefit funds to address the social determinants of health. Analysis did not indicate that current public policy supports hospitals' shift from sick-care institutions to institutions that promote population health. Rather, it revealed that CA's hospitals currently make only small financial contributions to activities that address the social determinants of health missing opportunities to leverage their resources to more effectively impact multi-sector efforts to improve population health and reduce health inequities.
21
Snodgrass, Tina. "Personality Types of Registered Nurses Employed in a Rural Community Hospital." TopSCHOLAR®, 1997. http://digitalcommons.wku.edu/theses/357.
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The purpose of this study was to identify the personality types of registered nurses in a rural community. An extensive literature review revealed that no studies, utilizing the Myers-Briggs Type Indicator (MBTI) to identify personality types, had been conducted with rural nurses. Jung's Psychological Type Theory was the theoretical framework for the study. The MBTI operationalizes Jung's theory and was utilized to determine the most frequently occurring personality types of the nurses. A descriptive study was conducted at a 68 bed acute care hospital. The sample consisted of 40 experienced registered nurses working in staff positions within the hospital. Sensing, feeling, and judging were the preferred functions of the nurses, consistent with the expected tasks of the direct care giver. The greatest number of nurses were classified as ISFJ (N=9) followed by ENFP (N=6)
22
Morreale, Mark J. "Evaluation of a care map for community-acquired pneumonia hospital inpatients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22365.pdf.
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Lam, Suk-fun, and 林淑芬. "'Becoming parents' : a hospital-community partnership to enhance transition to parenthood." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/198850.
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In reality, couples face many challenges in the transition to parenthood. These challenges can hardly be imagined and are always beyond the couple expectations. In the transition process, three common difficulties that new parents encounter are postnatal depression, the decline of marital relationships and inadequate parenting competence.
This study aimed to implement and evaluate the ‘Becoming Parents’ programme for a cohort of Chinese new parents using a cluster randomized controlled trial. 138 couples were recruited to the intervention group and 150 couples to the control group. The attrition rate in intervention and control groups was around 12.3% and 3-4%, respectively, by three months post-delivery. Couples in the intervention group were invited to join the ‘Becoming Parents’ programme that consisted of two phases. Phase one consisted of three antenatal sessions which focused on enhancing their communication skills and baby caring skills. Phase two provided social support to new parents from trained volunteers for up to three months post-delivery.
The mixed linear analysis method with the intention-to-treat principle was used to evaluate the intervention effects. The couples’ postnatal depressive symptoms, marital satisfaction and parenting competence scores at three time-points, 20-24 weeks of gestation, 30-34 weeks of gestation and three months post-delivery, were collected and analyzed. After three months post-delivery, there were no intervention effects on minimizing postnatal depressive symptoms in the women (mean difference -7.51, CI -1.49 to 0.01, p=0.48) and men’s groups (mean difference -0.32, CI -0.65 to 0.58, p=0.91). There was no effect on sustaining marital satisfaction in the women’s group (mean difference 0.39, CI -1.99 to 2.77 p=0.74); however a mild effect was noted in the men’s group (mean difference -0.65 CI, -2.97 to 1.66, p=0.57) but it was not significant. There was no effect on parenting competence among either women (mean difference 1.1, CI -0.37 to 2.58, p=0.14) or men’s groups (mean difference 0.05, CI -1.42 to 1.54, p=0.93), although no significant was noted. In addition, the study found that women with no family support had a higher mean depression score (6.0, CI 1.64-10.35, p>0.5) than women cared for by four people (0.5, CI -3.86 to 4.86, p>0.5). Moreover, the mean depression score of women who were taken care of by their mothers-in-law (4.16, CI 3.44 to 4.87) was higher than those taken care by their own mothers (2.71, CI 2.15 to 3.26). In general, the couples welcomed support from volunteers.
The factors affecting the intervention may be related to the difference in the women’s employment status and the social support they received, as more women in the control group were housewives and all of them had supported by at least one caregiver in the postnatal period. However, not all women in the intervention group received social support, and the number of women supported by their mothers-in-law was higher in that group.
This is the first programme to adopt non-professional mother-volunteers to support new mothers and fathers together. Both new parents and volunteers had positive perceptions towards the programme and also expressed that the project was beneficial to them.<br>published_or_final_version<br>Nursing Studies<br>Doctoral<br>Doctor of Nursing
24
Hensley, Sarah (Sarah L. ). "Characterization of monitoring alarms in a community hospital intensive care unit." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/119844.
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Thesis: M. Eng., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2018.<br>This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.<br>Cataloged from student-submitted PDF version of thesis.<br>Includes bibliographical references (pages 71-73).<br>Because the vast majority of monitoring alarms in the adult intensive care unit (ICU) do not require intervention, care providers are slow to respond to all alarms, endangering patients. We collect, characterize, and analyze alarms, alarm annotations provided by clinical staff while responding to alarms, and physiological data from a community hospital ICU. In order to suggest opportunities for suppressing irrelevant alarms, we examine monitoring device coverage across patients and analyze the alarms observed by device, priority, and type. On average, we observe 196.3 alarms per patient-day, for a total of 23,057 alarms. From these, the electrocardiogram and pulse plethysmogram produce 86.1% of all alarms. The lowest priority alarms represent 81.1% of all alarms, while the highest priority alarms compose just 5.5% of the total. While the rate of annotations is low, also just 5.5% of possible alarms, it is comparable to the rate of care provider interactions with alarms, as measured by alarm silencing, at 9.6%. Using these annotations, we find -- surprisingly -- that the annotated nuisance threshold-violation alarms tend to have higher excursions than actionable and advisory alarms, offering a statistic for separation. When focusing on threshold-crossing alarms, we find that 22.5% of Heart Rate Low alarms may actually indicate device error. Among ST segment alarms, 44.4% occur simultaneously with at least one other ST segment alarm, producing redundant alarms. Addressing these issues represent strategies for reducing excessive alarms in this community hospital cohort of ICU patients.<br>by Sarah Hensley.<br>M. Eng.
25
Rollason, Jessica. "Epidemiology of hospital-acquired and community-onset meticillin-resistant Staphylococcus aureus." Thesis, Aston University, 2007. http://publications.aston.ac.uk/11057/.
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Seidu, Mari. "Initiating a perinatal depression screening protocol in a community-based hospital." NSUWorks, 2016. https://nsuworks.nova.edu/hpd_con_stuetd/38.
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Background: According to the World Health Organization (WHO), perinatal depression (PD) is the most common childbirth complication. About 10% of pregnant women and about 13% of postpartum women experience a mental health disorder, primarily depression (WHO, 2016). One of the WHO (2015 a) goals for maternal mental health includes providing strategies for the promotion of psychosocial well-being and prevention of mental disorders of mothers during and after delivery. Purpose: The purpose of this performance improvement project was to establish a perinatal depression risk screening protocol and improve nursing knowledge on PD at a community-based hospital in Miami. Theoretical Framework: Beck’s postpartum depression theory Method: The project gained support and buy-in from the administration and management team of the healthcare institution. It included a comprehensive literature review used as a guide to establishing a perinatal depression screening protocol. Finally, staff nurses received education on PD, followed by an assessment for improved knowledge and retention of information. Result: A paired-samples t-test was conducted to compare pretest and posttest results for Registered nurses after receiving education on perinatal depression, N = 70. The results suggested improved knowledge and retention of new information. Conclusion: The perinatal depression screening protocol provided a framework for the assessment and first-line management for perinatal depression. There was evidence of improved nursing knowledge and retention of information on maternal mood disorders, especially perinatal depression.
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Enzinger, Iwona Halina. "Teamwork Perceptions of Nurses and Nursing Assistants in a Community Hospital." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4512.
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Teamwork in healthcare is recognized as a significant factor in achieving patient safety and impacting patient outcomes. Despite the general focus on teamwork in healthcare, there has been little research on teamwork among nurses and nursing assistants working on patient care units. The purpose of this doctoral project was to identify, compare, and analyze perceptions of teamwork in a group of nurses and nursing assistants in a community hospital setting where the TeamSTEPPS program has been implemented. The framework of this project was the concept of shared mental model and Imogene King's conceptual system and middle-range theory of goal attainment. Teamwork perceptions were measured using the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ), which is composed of five constructs: (a) team structure, (b) leadership, (c) situation monitoring, (d) mutual support, and (e) communication. Sixty-three nurses and 42 nursing assistants participated in the study. There was a significant difference between nursing assistants and staff nurses with respect to the Total T-TPQ mean score (4.03 and 4.26, respectively; p < 0.03), leadership (4.11 and 4.44, respectively; p < 0.01), and communication (4.13 and 4.35, respectively; p < 0.04). Nurses had a higher level of agreement than nursing assistants for Total T-TPQ, leadership, and communication. The results underscore the need to close the gap between nursing assistants' and nurses' perceptions of teamwork. Hospital and nursing leaders should make significant efforts to improve teamwork to build cohesive and highly functional nursing teams that can improve patient safety and thus create lasting social change.
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Vandenberg, Helen Elizabeth Ruth. "Race, hospital development and the power of community : Chinese and Japanese hospitals in British Columbia from 1880-1920." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/52469.
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Although much is known about the development of general public hospitals in Canada during the turn of the twentieth century, little is known about the rich diversity of smaller community hospitals founded during this time period. From 1880 to 1920, there were at least 155 hospitals operating in British Columbia, including several Chinese hospitals, founded in Victoria, New Westminster and Vancouver, and a Japanese hospital in Steveston. These hospitals were established in a context of harsh economic, political and social restrictions for Asian populations. Yet, Chinese and Japanese hospitals developed differently because of important cultural and political differences within Canada and abroad. An initial overview of Chinese hospital development reveals that Chinese hospitals mimicked charity hospitals found in China at the time and utilized Chinese, rather than Western medicine. In contrast, the Japanese hospital, which is the primary focus of this study, was built as a ‘modern’ hospital and utilized Western scientific medicine and trained nurses. Analysis of primary and secondary sources, including two newly translated Japanese histories, demonstrates that local communities played a significant role in the development of Asian hospitals. The Japanese hospital in Steveston, for example, began as a modest Japanese-Methodist mission hospital, established by Japanese Christian missionaries themselves. As hospital debts mounted and the anti-Asian labor movement intensified, Japanese leaders endeavoured to convince the Japanese fishermen’s Benevolent Association to build and finance a new modern hospital. Over time, the hospital became closely tied to the changing needs and prosperity of the local Japanese fishing community. The hospital was utilized as a source of leverage for Japanese fishing leaders during fishing price negotiations. From the unique perspective of community leaders, the hospital became an important political tool in the fight for racial and economic equality. This study reveals that Asian hospitals were much more than institutions for restoring health or curing illness. Chinese and Japanese hospitals were grassroots community initiatives that not only met important local and cultural needs, but could also play an important role in broader issues of social justice.<br>Applied Science, Faculty of<br>Nursing, School of<br>Graduate
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Mattin, Sarah T. "Patient perceived readiness for hospital discharge." Phd thesis, Australian Catholic University, 2022. https://acuresearchbank.acu.edu.au/download/105544538a790252380c514f194c7af9972016162dc5dde7117f25cdb7788046/3627712/Martin_2022_Patient_perceived_readiness_for_hospital_discharge.pdf.
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Ensuring older adults feel prepared to discharge from rehabilitation to home is imperative for successful discharge and to reduce the risk of unplanned readmissions. Older adults account for the majority of hospital and subsequent rehabilitation admissions. With the average life expectancy increasing and the population of older adults aged 60 and over increasing it is likely that the number of older adults living in the community will continue to grow and the need for rehabilitation will increase. It is important to ensure that when older adults undergoing rehabilitation are ready for discharge back home, the transition from hospital to home is successful and preventable readmissions are avoided.
The discharge planning process for older adults in rehabilitation is often complex and multifactorial. Discrepancies in perceptions of readiness for discharge have been shown between the rehabilitation team and patients. Involving the patient in the discharge planning process from an early stage may be beneficial in terms of successful discharge and minimising the risk of unplanned readmission. There is much to consider from a Physiotherapists’ perspective when planning complex discharge for older adults including; physical function, coping, expected support, confidence, mood, environment and social supports. This may present a challenge for physiotherapists who have little or no experience with complex planning and clinical reasoning. This program of research was designed to explore patient perceptions of readiness for discharge and other factors involved in discharge including physical function, balance, mobility, balance confidence and depression risk. Additionally, this program of research aimed to increase understanding of patient and physiotherapists’ experiences with rehabilitation discharge and discharge planning.
Five studies were undertaken in this thesis, two quantitative and three qualitative. Study 1 was a quantitative study and explored the relationships between patients’ perceptions of their readiness for discharge and measures of function, balance, depression risk and balance confidence. Patients’ perceptions of readiness for discharge were assessed using a validated tool, the Readiness for Hospital Discharge Scale. The Readiness for Hospital Discharge Scale is comprised of four sub-scales; physical status, knowledge, coping, expected support. Outcomes measured included balance, gait speed, mobility, function, risk of depression and balance confidence. The cohort consisted of 101 older adults who had undertaken inpatient rehabilitation and consented to undertake outcome questionnaires and routine physical testing prior to discharge to home in community. The majority of older adults reported feeling ready for discharge. Higher levels of readiness for discharge correlated with higher scores on physical testing and lower levels of expected support post-discharge. Patients also scored relatively low on balance confidence and were below the threshold for depression risk prior to discharge to home.
Study 2 was a quantitative design and explored the same cohort to investigate if perceptions of readiness changed after one-month post-discharge. Study 2 findings indicated that patients tended to overestimate their readiness for hospital discharge at discharge. Self-reports of physical status, expected support and balance confidence decreased after being home in the community for one-month, while the risk of depression increased marginally.
Study 3 examined both the formal and informal factors considered by experienced rehabilitation physiotherapists when discharge planning for older adults. A focus group with semi-structured interview questions was used with experienced physiotherapists who had worked in rehabilitation for more than five years. Experienced physiotherapists appeared to take a ‘down the track’ perspective when planning discharge. While the current status of the patient was assessed and taken into consideration, experienced physiotherapists also anticipated disease progression, functional or cognitive decline and the likelihood of change in the future.
Study 4 explored the factors considered by novice physiotherapists when discharging older adults from rehabilitation. A qualitative design focus group was conducted with six novice physiotherapists who had less than three months experience in rehabilitation. The same semi-structured interview questions were used for the novice group as for the experienced physiotherapists. Novice physiotherapists are comprehensive when checking function and mobility and have a good insight into the complex nature of discharge planning from rehabilitation. However, they reported forgetting to check on certain aspects related to discharge until the last minute.
Study 5 was a qualitative design and explored patient perceptions of their readiness for discharge at two timepoints. Semi-structured interviews were conducted one on one and face to face with patients within 72 hours prior to discharge. Prior to discharge, only half the cohort reported feeling ready. However, once home, all patients reported retrospectively they actually were ready to return home when discharged. All reported improved function and mobility post-discharge and overall, patients reported a positive experience with their time in the rehabilitation unit, and the transition from hospital to home.
The findings of this program of research indicate a concerning trend where older adults tend to overestimate their readiness for discharge, physical capacity and the amount of support expected once back at home in the community. There also appeared to be an increase in depression risk one-month post-discharge. With a growing ageing population, successful discharge from hospital and the need to prevent unplanned readmission is paramount to reduce unnecessary burden on the health care system. This body of research may help to inform future directions on areas of required research, information dissemination to health providers and how to best help keep our older Australians living in their own homes for longer.
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Eiu-Seeyok, Busarin. "Quality and safety of inter-hospital transfers care of critically ill patients from rural community hospitals to the Tertiary Regional Hospital in Thailand : a focused ethnographic study." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/33222.
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Background: The safety of critically ill patients during inter-hospital transfer is recognised as a globally important issue. However, little evidence exists pertaining to the care provided by transfer nurses throughout the processes of inter-hospital transfer in rural community hospitals where there is a high risk of adverse clinical events occurring during transportation. Aim: The overall aim of the study was to explore transfer nurses' understanding of the delivery of quality of care during the transfer of critically ill patients from rural community hospitals to a tertiary regional hospital in Thailand. Design and Methods: The theory of symbolic interactionism (Blumer, 1986) and focused ethnography methodology were used. Data were collected using multiple qualitative methods including sixteen semi-structured interviews with transfer nurses, fourteen observations of critically ill patients' transfers from three rural community hospitals to a tertiary centre and twenty-three subsequent handover events and the analysis of transfer documents from four hospital settings (e.g. one regional hospital and three rural community hospitals) in Thailand. Translation from Thai into English and back translation into vernacular language was required. Inductive, thematic analysis was conducted to identify major themes by using qualitative data analysis software, NVivo 10 to assist data management during the analysis. Results: Five major themes emerged including (i) protective factors influencing safe transfer care, (ii) barrier factors influencing safe transfer care, (iii) behavioural patterns in transfer care processes, (iv) maintaining the health condition of the patients, and (v) overcoming adverse events. These particular themes elaborate the meaning of the quality and patient safety of transfer care, the provision of care for safe transfer care, and significant contextual factors that influence the quality of inter-hospital transfer care for critically ill patients. In addition, Donabedian's model (Donabedian, 1966, 1988) incorporated within the concept of context and culture was utilised to assist in conceptualising the framework for the quality of inter-hospital transfer care of critically ill patients in Thailand. Conclusion: The Donabedian model is useful as it is simple, but it does not include detail of the organisational context and culture as determinants of care quality. A conceptual framework for the quality of inter-hospital transfer care of critically ill patients in Thailand was therefore proposed. This study has expanded on current theoretical knowledge of the quality of inter-hospital transfer care by elaborating the patterns of thought and the behaviour of transfer nurses during provision of care throughout the processes of the inter-hospital transfer. It also highlights the limitations of organisational structure and the environment in which transfer work takes place, including issues on handover processes in hospital transfer care. The results can be useful to transfer nurses in that they facilitate greater understanding of the provision of better quality of care. They also help to inform hospital policy makers how to ensure safety of critically ill patients being transferred from community hospital settings.
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Williams, E. E. "Psychological contributions to the control of hospital-acquired infections." Thesis, University of Liverpool, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.333154.
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Godfrey, Lynne. "Screening for diabetic retinopathy : a hospital based screening service." Thesis, City University London, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287666.
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Osman, Liesl M. "Patient self management and hospital admission in acute asthma." Thesis, University of Aberdeen, 1993. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU601997.
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This study describes self management behaviour and attitudes among asthmatics, in usual self care, in acute episodes and in behaviour in the month before admission. It relates these behaviours to morbidity, admission history (single admittees versus multiple admittees) and outpatient status (current, discharged or never outpatient). Two hundred and thirty four patients between 16 and 65 years old were interviewed for the study. One hundred and thirty were in hospital at interview, the remainder were not in hospital but had all had a hospital admission between January and December 1987. Details of admissions in the following twelve months were collected for the hospitalised interviewees. In both hospitalised and non hospitalised groups self management was related to being in current specialist care, rather than to admission history. Patients in current specialist care were more compliant and acted at earlier stages of deterioration. When care type was controlled for, patients with multiple admissions were more non compliant with regular medication, and non compliant patients had significantly more frequent episodes. Forty (30%) of the hospitalised group were readmitted within 12 months of interview. Readmission was not related to self management before the 1991 admission or asthma attitudes. It is argued that this is because patients are likely to be referred to specialist care after an admission (almost 50% of first admissions and almost 100% of second admissions) and that this referral will change both their medical management and their self management. Hence, pre admission behaviour and attitudes cannot predict post admission risk. The study concludes that patient behaviour is most strongly influenced by being in specialist care, and that differences in self management, particularly compliance with prophylaxis and early action in deterioration, affect the risk of severe episodes and hospital admission.
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Yeung, Yiu-cheong. "A case series of community-acquired pneumonia in a regional hospital in Hong Kong." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B3688702X.
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Schoonover, Heather Diane. "Barriers to research utilization among registered nurses working in a community hospital." Online access for everyone, 2006. http://www.dissertations.wsu.edu/Thesis/Spring2006/H%5FSchoonover%5F033106.pdf.
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Torres, Beth. "FRONTLINE NURSING LEADERS AND STAFF RETENTION IN AN ACUTE CARE COMMUNITY HOSPITAL." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1724.
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The current and projected nursing shortage makes it imperative for healthcare organizations to examine factors that promote staff retention. Previous studies identify nursing leadership as a key component influencing staff retention and turnover. This study supplements these studies by identifying key behaviors and attitudes of frontline nursing leaders that influence staff retention. Using a grounded theory qualitative approach, the researcher interviewed 19 frontline nursing leaders in an acute care community hospital. The researcher also explored the extent to which nursing leaders felt current leadership education and training programs support their practices that promote staff retention. The goal of the study was to create a theory or model of nursing leadership and staff retention grounded in the data. Five major themes emerged from the interview data analysis process using grounded theory strategies. These themes include organizational culture and policies, nursing leaders training and development, behaviors and attitudes, employee factors, and turnover. The researcher interpreted the data within a systems theory conceptual framework. Using this framework aided the researcher in creating a model of frontline nursing leaders and staff retention. This model illustrates the inter-relationship of the five major themes from a systems perspective. The usefulness of the data collected in this study is predicated on three major domains: competency identification; human resource management and development; and education. Competencies form the foundation for the education and practice of frontline nursing leaders (Barker et al., 2006). These role-specific, evidenced-based expectations should be clearly delineated in competency-based job descriptions, which in turn merge into performance evaluations. Explicitly defined competencies provide a conceptual framework for collegiate and hospital-based education and training programs to train current and future frontline nursing leaders.
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Simpson, Cheryl. "Quality Improvement Initiative About Patient Engagement With Clinicians in a Community Hospital." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4103.
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Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop and implement strategies to develop an e-learning module. The project used practice-focused questions to determine if knowledge about patient engagement and the Shared End-Stage Renal Patients - Decision Making Tool could improve staff knowledge and awareness about patient engagement. A quantitative pretest, posttest approach was used to compare pretest scores to posttest scores after the e-learning module was viewed. Nine clinicians participated in the project study. Results showed that clinicians' knowledge and awareness about patient engagement increased from a mean pretest score of 5.22 to a mean posttest score of 6.22, (p = 0.08617). The sample of only 9 participants may have contributed to the lack of statistical significance after viewing the educational presentation. The e-learning module will provide positive social change as staff and students of renal programs learn about and apply the principles of patient engagement to their clinical practice.
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Buffenbarger, Jennifer Sylvia. "Nurses' Experiences Transitioning from Staff Nurse to Management in a Community Hospital." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2346.
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This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume and remain in a management/leadership role. Data collection included audio-recorded interviews with seven current or past full-time nurse managers, and observation of three of the participants at a leadership meeting. Interview transcripts were open coded and thematically analyzed. Observation data were categorized according to empowerment and servant leadership characteristics. Five themes were identified that related to research questions: struggling in management transition, seeking opportunity for transformation, being committed but powerless, embarking unprepared on an unplanned journey, and having the presence to lead others by serving. The findings of this study guided development of a 12-month program for new nurse managers that integrated characteristics of servant leadership to empower leaders and others. These contributions may promote positive social change by preparing new nurse managers for their role and developing their skills to become successful nurse managers.
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Watson, William. "Haven of change : the history of a secure psychiatric hospital." Thesis, University of Cambridge, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259691.
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Haruna, Mohammed Awaisu. "Managing the treatment of mental illness in a Nigerian hospital." Thesis, Lancaster University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337582.
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Soderlund, R. Neil. "Hospital casemix, costs and productivity in the NHS internal market." Thesis, University of Oxford, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318634.
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Pugner, Klaus Markus. "Hospital governance in England and Germany in the mid-1990s." Thesis, London School of Economics and Political Science (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391452.
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Spandler, Helen. "Asylum to action : Paddington Day Hospital, therapeutic communities and beyond." Thesis, Manchester Metropolitan University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247203.
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Frascina, Anthony Cosimo. "The integration of hospital information systems through user centred design." Thesis, Sheffield Hallam University, 1994. http://shura.shu.ac.uk/3185/.
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The development of computer systems in UK hospitals has in recent years been focused on the provision of hospital-wide information systems, known as Hospital Information Support Systems (HISS). This development has been motivated by National Health Service reforms and a realisation that earlier fragmented systems were not meeting the requirements of clinical and nursing staff in the most effective way. Such systems were often developed by external, centralised agencies using systems analysis techniques appropriate to the development of information systems in product orientated organisations. However, the hospital ward, an environment existing at the 'sharp end' of health care, in which many diverse and non-computer related activities take place, presents the system designer with many of the classic problems with which the discipline of Human Computer Interaction (HCI) is concerned. Although a HISS has the potential to improve both the work conditions of clinical staff and the delivery of health care, this may be impeded by many of the common obstacles associated with the introduction of a large and complex computer system into a work environment where tasks are ill defined. This thesis reports on a project that is based upon the application of HCI methods to the health care environment and their contribution to the solution of the problems that such an environment presents. Requirements for the users' interface to the potential HISS are derived using a task analytic approach, involving Task Analysis for Knowledge Descriptions (TAKD). A prototype system has been designed and subsequently evaluated in a hospital ward. The contribution of TAKD to the design and its further applicability to the environment are assessed. The research represents an original application of a formal task analysis method to the design of ward based computer systems, and as such makes a valuable contribution to the areas of medical informatics and HCI. It shows that TAKD has real but limited applicability in this sphere, in that its use can lead to the design of more usable interfaces, while there is a need to combine it with methods aimed at broader systems design if these benefits are to accrue in the development of a HISS. The potential for the integration of task analysis with Design Rationale methods is also demonstrated.
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Walters, Geraldine. "Strategies for dealing with pre-hospital cardiac arrest in London." Thesis, University of Surrey, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305057.
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Bullard, Andrew J. III. "Hospital ministry: a volunteer training program for chaplains, laity and spouses at the Martin army community hospital in Columbus, Georgia." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 1999. http://digitalcommons.auctr.edu/dissertations/318.
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The model of ministry developed in this dissertation is intended to demonstrate how military hospital chaplains can respond more qualitatively to the needs of patients and care providers at Martin Army Community Hospital at Fort Benning, in Columbus, Georgia. Fort Benning, is an installation unit of the United States Army. The model calls for the implementation of a Volunteer Training Program that builds on the skills and experience of active and reserve duty chaplains, as well as those of laity and spouses, to conduct pastoral ministry and visitation. This project grew out of a drastic need to assist chaplains in the Department of Ministry and Pastoral Care in ensuring adequate coverage for patients and care providers at the Hospital. The model seeks to establish a “Ministry of Presence,” i.e., to have so many trained volunteers available throughout the Hospital that the care needs of patients at any given time do not go unmet. Historically, the Unit Ministry Team has been hampered in its efforts to provide adequate coverage for the ministry and pastoral care needs of patients and care providers. This situation resulted primarily from the fact that excessive meetings, conferences, miscellaneous duty requirements. and other low-priority tasks consumed a disproportionate amount of the Ministry Team members’ time. While some effort was made to reduce the number of non-essential functions, duties that were not directly related to pastoral care still constituted ma] or distractions and prevented the Unit Team’s members from attending to the more essential tasks of ministering to the needs of patients. The implementation of the Volunteer Training Program brought relief to the overwhelmed Unit Ministry Team in the form of an “army” of volunteers who were trained to function as chaplains. The presence of support staff allowed the chaplaincy staff to attend to other tasks and helped ensure that a trained and caring person was available when needed. The Program is an intensive experience structured around one week of instruction, readings, simulated counseling sessions, role-playing visitations, writing verbatim reports, peer review, and dialogue-feedback sessions with a volunteer supervisor. The training gave active and reserve duty chaplains additional experience in hospital ministry and fulfilled the basic requirements for continuing education units for lay person. Overall, the Volunteer Training Program was successful in that it enhanced the presence of trained chaplain’s volunteers and ensured that the care needs of patients were meant. The Program precipitated an increased awareness of the importance of pastoral care and a greater sensitivity to the need for hospital ministry. In addition, this Program inspired chaplains at other military hospitals to consider such a program for the hospitals at which they are stationed. Most importantly, the Volunteer Training Programsignificantly improved the capacity of the Department of Ministry and Pastoral Care at Martin Army Community Hospital to provide effective pastoral ministry and patient care.
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Small, Neil A., J. R. Green, Joanna Spink, A. Forster, K. Lowson, and J. Young. "The patient experience of community hospital - the process of care as a determinant of satisfaction." Blackwell Publishing, 2006. http://hdl.handle.net/10454/4040.
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no<br>Aims and objectives; We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient satisfaction and in linking qualitative findings with trial results are explored.
Design A sample of 13 patients randomized to the community hospital arm of the RCT joined the qualitative study. Official documentation from the hospital were accessed and six staff interviewed to identify assumptions underlying practice.
Results Analysis of interviews identified a complex picture concerning expectations These could be classified as ideal, realistic, normative and unformed. The hospital philosophy and staff views about service delivery were closely in harmony, they delivered rehabilitation in a home-based atmosphere. The formal, or 'hard', process of rehabilitation was not well understood by patients. They were primarily concerned with 'soft' or process issues ¿ where and how care was delivered.
Conclusions We identify a model of community hospital care that incorporates technical aspects of rehabilitation within a human approach that is welcomed by patients. If patients are to be able to participate in making informed decisions about care, the rationale for the activities of staff need to be more clearly explained. Recommendations are made about the appropriate scope of qualitative findings in the context of trials and about techniques to access patient views in areas where they have difficulty in expressing critical impressions.
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Bradley, Terence. "Factors associated with variation in general practice referral rates to hospital." Thesis, Queen's University Belfast, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.484067.
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O'Hare, John D. G. "The development and function of pharmaceutical services in psychiatric hospital practice." Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335450.
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Emerson, Andrew. "Hospital hostels : an evaluation of four psychiatric care facilities in Hampshire." Thesis, University of Southampton, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.239475.
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