Dissertations / Theses: 'Department of Health Services'

1

Beatty, Kate, Michael Meit, O. Luzzi, A. Siegfried, Megan Heffernan, T. Nadel, and M. Searing. "The Journey to Accreditation: Clinton County Health Department." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6828.

Full text

Abstract:

Book Summary: JPHMP's 21 Public Health Case Studies on Policy & Administration , compiled by the founding editor and current editor-in-chief of the Journal of Public Health Management and Practice, provides you with real-life examples of how to strategize and execute policies and practices when confronted with issues such as disease containment, emergency preparedness, and organizational, management, and administrative problems.Feautures: Each case is co-written by a professional writer and tells a “story,” using characters, conflicts, and plot twists designed to compel you to keep reading. Case elements include the core problem, stakeholders, steps taken, challenges, results, conclusions, and discussion questions for analysis. More than 60 contributors—experts in public policy, clinical medicine, pediatrics, social work, pharmacy, bioethics, and healthcare management. Ideal for public health practitioners as well as students in graduate and undergraduate public health and medical education programs. Tracks 2016 CEPH (Council on Education for Public Health) accreditation criteria. These cases can be used as tools to develop competencies designated in the new CEPH (Council on Education for Public Health) accreditation criteria.

APA, Harvard, Vancouver, ISO, and other styles

2

Luk, Che-chung. "An analysis of the planning system of the Medical and Health Department / Hospital Services Department." [Hong Kong : University of Hong Kong], 1993. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13636868.

Full text

APA, Harvard, Vancouver, ISO, and other styles

3

Luk, Che-chung, and 陸志聰. "An analysis of the planning system of the Medical and Health Department / Hospital Services Department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1993. http://hub.hku.hk/bib/B3196462X.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

Bruce, Rebecca. "Barren River District Health Department Health Education/Risk Reduction Demonstration Projects." TopSCHOLAR®, 1989. https://digitalcommons.wku.edu/theses/2172.

Full text

Abstract:

In July 1980, the Barren River District Health Department (BRDHD), serving eight counties (combined population approximately 204,000) in Southcentral Kentucky, was selected as a demonstration site under the auspices of the federal Health Education Risk Reduction (HERR) Program. With continued HERR funding for eight years, the BRDHD developed several successful health promotion projects. Major components of these projects include: 1) community health promotion, which serves to identify high -risk groups in the community and provide them with health education-health promotion services, 2) school health education which included the development of a preschool health education curriculum, 3) teacher education workshop, which instructs primary and secondary public school teachers in health education methods, 4) smoking cessation. and 5) a large industrial wellness program. This study reports on an eight year program evaluation of the HERR demonstration. Overall, the program evaluation suggests an increase in health knowledge and some attitude and behavior change for many of the participants ii BRDHD programs.

APA, Harvard, Vancouver, ISO, and other styles

5

Hurford, Grace. "Power and politics in UK mental health services." Thesis, Nottingham Trent University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369239.

Full text

APA, Harvard, Vancouver, ISO, and other styles

6

Byrne, Geraldine. "The accident and emergency department : nurses' priorities and patients' anxieties." Thesis, Northumbria University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316497.

Full text

Abstract:

This study investigated the sources of anxiety for patients in the Accident and Emergency Department and explored how patients' anxiety was influenced by their experiences in the department and the attitudes, behaviour and communication patterns of nurses and other staff. The research was carried out in twO Accident and Emergency Departments and consisted of three stages. Stage One employed structured interviews with 96 patients to identify sources of anxiety for patients in the Accident and Emergency Department and to examine the relationship between anxiety and the patient variables of age, sex, condition and department. In Stage Two in-depth interviews were conducted with 21 qualified nurses to explore their perceptions of their work and patients. Stage Three was an observational study, involving 23 patients, which examined the nature of nurse-patient communication in the Accident and Emergency Department. A Symbolic Interactionist framework was used in order to understand events from the perspective of those involved. Patients appeared to view their stay in the Accident and Emergency Department as an event occurring within the wider context of their daily lives and were concerned with social factors related to admission and the consequences of their illness or injury. Nurses held a different perspective and were more concerned with physical care and the organisation of the patients' stay in the department. In contrast to the patients, the nurses were concerned with short-term problems. Interaction between nurses and patients consisted predominantly of brief encounters which focused on the patients' illness or injury and their progress through the department. There was little attention explicitly directed towards dealing with patients' anxieties. A complex range of factors - interpersonal, cultural, interprofessional and structural - were found to influence communication. A number of recommendations are made identifying ways to enhance nurses' ability to deal with patients' anxieties.

APA, Harvard, Vancouver, ISO, and other styles

7

Banker, Karen Lee. "Morale and the mental health worker: Burnout in the Department of Behavioral Health." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1885.

Full text

APA, Harvard, Vancouver, ISO, and other styles

8

Beatty, Kate, Jeffrey Mayer, Michael Elliott, Ross C. Brownson, Safina Abdulloeva, and Kathleen Wojciehowski. "Barriers and Incentives to Rural Health Department Accreditation." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6826.

Full text

Abstract:

Context: Accreditation of local health departments has been identified as a crucial strategy for strengthening the public health infrastructure. Rural local health departments (RLHDs) face many challenges including lower levels of staffing and funding than local health departments serving metropolitan or urban areas; simultaneously their populations experience health disparities related to risky health behaviors, health outcomes, and access to medical care. Through accreditation, rural local health departments can become better equipped to meet the needs of their communities. Objective: To better understand the needs of communities by assessing barriers and incentives to state-level accreditation in Missouri from the RLHD perspective. Design: Qualitative analysis of semistructured key informant interviews with Missouri local health departments serving rural communities. Participants: Eleven administrators of RLHDs, 7 from accredited and 4 from unaccredited departments, were interviewed. Population size served ranged from 6400 to 52 000 for accredited RLHDs and from 7200 to 73 000 for unaccredited RLHDs. Results: Unaccredited RLHDs identified more barriers to accreditation than accredited RLHDs. Time was a major barrier to seeking accreditation. Unaccredited RLHDs overall did not see accreditation as a priority for their agency and failed to the see value of accreditation. Accredited RLHDs listed more incentives than their unaccredited counterparts. Unaccredited RLHDs identified accountability, becoming more effective and efficient, staff development, and eventual funding as incentives to accreditation. Conclusions: There is a need for better documentation of measurable benefits in order for an RLHD to pursue voluntary accreditation. Those who pursue accreditation are likely to see benefits after the fact, but those who do not pursue do not see the immediate and direct benefits of voluntary accreditation. The finding from this study of state-level accreditation in Missouri provides insight that can be translated to national accreditation.

APA, Harvard, Vancouver, ISO, and other styles

9

Hale, Nathan, Tamar Klaiman, Kate E. Beatty, and Michael Meit. "Rural Health Departments and Clinical Services: Transition to Whom?" Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6845.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Vaughan, Glenys. "Ethnic origin and the use of social services : the experience of a hospital social service department." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59620.

Full text

Abstract:

The importance of ethnic origin as a factor in delivery of social services has been recognised internationally as relevant at different levels of organization. This study examined 500 dossiers, a random sample of clients referred in 1985 to one hospital social service department in Montreal. Age, gender, status of children, referring hospital service, problems experienced and involvement with community social service agencies were found to be related to ethnic origin, using the Kruskal-Wallis and Pearson chi-squared test. After accounting for differences between ethnic groups in age, type of problem and referring hospital service by the use of logit analysis, ethnic origin significantly affected the changes of involvement with Social Service Centres and Departments of Youth Protection. Among the implications of the results for social services in Montreal were the need for the following: recognition that some ethnic minorities have very different social service needs than the larger ethnic groups; development of skills in cross-cultural social service provision because of the clientele's varied ethnic background; consideration of the impact, desirability and viability of ethnic/socioculturally specific agencies and services. The urgent need for further research is emphasised.

APA, Harvard, Vancouver, ISO, and other styles

11

Brim, Carla B. "A descriptive analysis of non-urgent emergency department utilization." Online access for everyone, 2006. http://www.dissertations.wsu.edu/Thesis/Spring2006/c%5Fbrim%5F040606.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Lines, Lisa M. "Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation." eScholarship@UMMS, 2004. http://escholarship.umassmed.edu/gsbs_diss/710.

Full text

Abstract:

Approximately half of all emergency department (ED) visits are primary-care sensitive (PCS) – meaning that they could potentially be avoided with timely, effective primary care. Reducing undesirable types of healthcare utilization (including PCS ED use) requires the ability to define, measure, and predict such use in a population. In this retrospective, observational study, we quantified ED use in 2 privately insured populations and developed ED risk prediction models. One dataset, obtained from a Massachusetts managed-care network (MCN), included data from 2009-11. The second was the MarketScan database, with data from 2007-08. The MCN study included 64,623 individuals enrolled for at least 1 base-year month and 1 prediction-year month in Massachusetts whose primary care provider (PCP) participated in the MCN. The MarketScan study included 15,136,261 individuals enrolled for at least 1 base-year month and 1 prediction-year month in the 50 US states plus DC, Puerto Rico, and the US Virgin Islands. We used medical claims to identify principal diagnosis codes for ED visits, and scored each according to the New York University Emergency Department algorithm. We defined primary-care sensitive (PCS) ED visits as those in 3 subcategories: nonemergent, emergent but primary-care treatable, and emergent but preventable/avoidable. We then: 1) defined and described the distributions of 3 ED outcomes: any ED use; number of ED visits; and a new outcome, based on the NYU algorithm, that we call PCS ED use; 2) built and validated predictive models for these outcomes using administrative claims data; 3) compared the performance of models predicting any ED use, number of ED visits, and PCS ED use; 4) enhanced these models by adding enrollee characteristics from electronic medical records, neighborhood characteristics, and payor/provider characteristics, and explored differences in performance between the original and enhanced models. In the MarketScan sample, 10.6% of enrollees had at least 1 ED visit, with about half of utilization scored as PCS. For the top risk group (those in the 99.5th percentile), the model’s sensitivity was 3.1%, specificity was 99.7%, and positive predictive value (PPV) was 49.7%. The model predicting PCS visits yielded sensitivity of 3.8%, specificity of 99.7%, and PPV of 40.5% for the top risk group. In the MCN sample, 14.6% (±0.1%) had at least 1 ED visit during the prediction period, with an overall rate of 18.8 (±0.2) visits per 100 persons and 7.6 (±0.1) PCS ED visits per 100 persons. Measuring PCS ED use with a threshold-based approach resulted in many fewer visits counted as PCS, discarding information unnecessarily. Out of 45 practices, 5 to 11 (11-24%) had observed values that were statistically significantly different from their expected values. Models predicting ED utilization using age, sex, race, morbidity, and prior use only (claims-based models) had lower R2 (ranging from 2.9% to 3.7%) and poorer predictive ability than the enhanced models that also included payor, PCP type and quality, problem list conditions, and covariates from the EMR, Census tract, and MCN provider data (enhanced model R2 ranged from 4.17% to 5.14%). In adjusted analyses, age, claims-based morbidity score, any ED visit in the base year, asthma, congestive heart failure, depression, tobacco use, and neighborhood poverty were strongly associated with increased risk for all 3 measures (all P<.001).

APA, Harvard, Vancouver, ISO, and other styles

13

Lines, Lisa M. "Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/710.

Full text

Abstract:

Approximately half of all emergency department (ED) visits are primary-care sensitive (PCS) – meaning that they could potentially be avoided with timely, effective primary care. Reducing undesirable types of healthcare utilization (including PCS ED use) requires the ability to define, measure, and predict such use in a population. In this retrospective, observational study, we quantified ED use in 2 privately insured populations and developed ED risk prediction models. One dataset, obtained from a Massachusetts managed-care network (MCN), included data from 2009-11. The second was the MarketScan database, with data from 2007-08. The MCN study included 64,623 individuals enrolled for at least 1 base-year month and 1 prediction-year month in Massachusetts whose primary care provider (PCP) participated in the MCN. The MarketScan study included 15,136,261 individuals enrolled for at least 1 base-year month and 1 prediction-year month in the 50 US states plus DC, Puerto Rico, and the US Virgin Islands. We used medical claims to identify principal diagnosis codes for ED visits, and scored each according to the New York University Emergency Department algorithm. We defined primary-care sensitive (PCS) ED visits as those in 3 subcategories: nonemergent, emergent but primary-care treatable, and emergent but preventable/avoidable. We then: 1) defined and described the distributions of 3 ED outcomes: any ED use; number of ED visits; and a new outcome, based on the NYU algorithm, that we call PCS ED use; 2) built and validated predictive models for these outcomes using administrative claims data; 3) compared the performance of models predicting any ED use, number of ED visits, and PCS ED use; 4) enhanced these models by adding enrollee characteristics from electronic medical records, neighborhood characteristics, and payor/provider characteristics, and explored differences in performance between the original and enhanced models. In the MarketScan sample, 10.6% of enrollees had at least 1 ED visit, with about half of utilization scored as PCS. For the top risk group (those in the 99.5th percentile), the model’s sensitivity was 3.1%, specificity was 99.7%, and positive predictive value (PPV) was 49.7%. The model predicting PCS visits yielded sensitivity of 3.8%, specificity of 99.7%, and PPV of 40.5% for the top risk group. In the MCN sample, 14.6% (±0.1%) had at least 1 ED visit during the prediction period, with an overall rate of 18.8 (±0.2) visits per 100 persons and 7.6 (±0.1) PCS ED visits per 100 persons. Measuring PCS ED use with a threshold-based approach resulted in many fewer visits counted as PCS, discarding information unnecessarily. Out of 45 practices, 5 to 11 (11-24%) had observed values that were statistically significantly different from their expected values. Models predicting ED utilization using age, sex, race, morbidity, and prior use only (claims-based models) had lower R2 (ranging from 2.9% to 3.7%) and poorer predictive ability than the enhanced models that also included payor, PCP type and quality, problem list conditions, and covariates from the EMR, Census tract, and MCN provider data (enhanced model R2 ranged from 4.17% to 5.14%). In adjusted analyses, age, claims-based morbidity score, any ED visit in the base year, asthma, congestive heart failure, depression, tobacco use, and neighborhood poverty were strongly associated with increased risk for all 3 measures (all P<.001).

APA, Harvard, Vancouver, ISO, and other styles

14

Beatty, Kate E., Jeffrey Mayer, Michael Elliott, Ross C. Brownson, Safina Abdulloeva, and Kathleen Wojciehowski. "Patterns and Predictors of Local Health Department Accreditation in Missouri." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6866.

Full text

Abstract:

Background: The Healthy People 2020 goal for the public health system is “to ensure that Federal, State, Tribal, and local health agencies have the necessary infrastructure to effectively provide essential public health services.” To address this goal, Missouri established the first statewide, voluntary accreditation program of local health departments (LHDs) and began accrediting the LHDs in 2003. The purpose of this study was to identify organizational, structural, and workforce factors related to accreditation status of LHDs in Missouri. Methods: Using data from the National Association of County & City Health Officials (2010) and the Missouri Department of Health & Senior Services (2012), binary logistic regression analysis was performed to predict accreditation status of LHDs. Likelihood ratio tests were used to examine whether the addition of each predictor added significantly to the model compared with a model including total revenues alone. Adjusted odds ratios (aORs), 95% confidence intervals, the significance level of the likelihood ratio test, and the overall Nagelkerke pseudo-R2 for each model are reported. Results: Having a community health improvement plan (aOR = 6.2), a strategic plan (aOR = 7.9), evaluating programs (aOR = 3.6), being in a region with a high proportion of accredited LHDs (aOR = 5.5), and participating in multijurisdictional collaborations (aOR = 6.4) all increased the likelihood of accreditation. Barriers of time (aOR = 0.1) and cost (aOR = 0.3) were negatively associated with accreditation. Conclusions: Accredited LHDs were more likely to have completed the prerequisites for accreditation and collaborate with other LHDs. These activities help LHDs meet the accreditation standards. In addition, with shrinking budgets, LHDs will need additional financial and technical support to achieve accreditation. Assisting LHDs to find ways to increase the staff is important. Through collaborations with other LHDs, regional or multicounty positions can be created. Also collaborations with universities, specifically colleges or schools of public health, can provide opportunities for internships at LHDs giving practical experience while providing important assistance to LHDs.

APA, Harvard, Vancouver, ISO, and other styles

15

Woodhead, Loo Wing-ping Marina. "Environmental health policy implementation in Hong Kong : a study of cleansing services in the Urban Services Department /." [Hong Kong : University of Hong Kong], 1986. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12323391.

Full text

APA, Harvard, Vancouver, ISO, and other styles

16

Snyder, Hal Steven 1959. "AN EVALUATION OF COUNSELING SERVICES FOR FIRE DEPARTMENT PERSONNEL." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/276426.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Fernandez, Kayla Ivanna. "Utilization of Emergency Department Services by Homeless Individuals in Pomona, California| A Quantitative Study." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10751647.

Full text

Abstract:

The purpose of this study was to examine the utilization of emergency department services by homeless adults in Pomona, California achieved through quantitative cross-sectional research. The results revealed that many homeless adults frequent the emergency department for mental health reasons and those homeless adults with physical ailments required longer lengths of stay and extensive discharge planning. Most participants had insurance coverage, but many appeared to lack social or primary care resources in the community, leading to frequent emergency department usage. This study may be beneficial to individuals, communities, and professionals to better understand the healthcare experiences of homeless individuals. The tangible and nontangible barriers to healthcare, as well as outside social resources affect the general public health through risks of contagious diseases and the rise in emergency department overcrowding.

APA, Harvard, Vancouver, ISO, and other styles

18

Presley, Belinda Denise. "The Influence of On-Site Surgical Pathology Department Services in Rural Hospital Physician Satisfaction." Thesis, Walden University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3728643.

Full text

Abstract:

There is limited information regarding physician satisfaction as it relates to the presence of a surgical pathology department in rural hospitals. Physician satisfaction directly influences the quality of patient care. The theoretical frameworks that informed this study included institutional theory and population ecology. The research questions addressed differences in levels of physician satisfaction between physicians who have access to an on-site surgical pathology department and physicians who do not have such access. The research also examined differences in satisfaction between physician specialties that have or do not have access to an on-site surgical pathology department services. A quantitative, cross-sectional study was employed utilizing three primary instruments: the Henry Ford Hospital Survey, Standardized (Synoptic) Pathology Reports, and PAR Medical Colleague Questionnaire. Statistical analyses including ANOVA, linear regression, and t tests were used to examine the relationships between the study’s variables. The results revealed that there is statistically significant evidence to support that on-site surgical pathology department services influence physician satisfaction. Potential implications for positive social change from this study include a better understanding and awareness of the relationship between physician satisfaction and utilization of on-site pathology services, which may ultimately benefit healthcare facilities by more intently addressing quality of care and patient satisfaction.

APA, Harvard, Vancouver, ISO, and other styles

19

Ibrahim, Asma Jirapron Chompikul. "Patient satisfaction with health services at the Outpatient Department of Indira Gandi Memorial Hospital, Amale' Maldives /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5037998.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

Beatty, Kate E., Nathan Hale, Michael Meit, Paula Masters, and Amal Khoury. "Clinical Service Delivery along the Urban/Rural Continuum." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6870.

Full text

Abstract:

Background: Engagement in the core public health functions and ten essential services remains the standard for measuring local health department (LHD) performance; their role as providers of clinical services remains uncertain, particularly in rural and underserved communities. Purpose: To examine the role of LHDs as clinical service providers and how this role varies among rural and nonrural communities. Methods: The 2013 National Association of County and City Health Officials (NACCHO) Profile was used to examine the geographic distribution of clinical service provision among LHDs. LHDs were coded as urban, large rural, or small rural based on Rural/Urban Commuting Area codes. Bivariate analysis for clinical services was conducted by rural/urban status. For each service, the proportions of LHDs that directly performed the service, contracted with other organizations to provide the service, or reported provision of the service by independent organizations in the community was compared. Results: Analyses show significant differences in patterns of clinical services offered, contracted, or provided by others, based on rurality. LHDs serving rural communities, especially large rural LHDs, tend to provide more direct services than urban LHDs. Among rural LHDs, larger rural LHDs provided a broader array of services and reported more community capacity for delivery than small rural LHDs- particularly maternal and child health services. Implications: There are capacity differences between large and small rural LHDs. Limited capacity within small rural LHDs may result in providing less services, regardless of the availability of other providers within their communities. These findings provide valuable information on clinical service provision among LHDs, particularly in rural and underserved communities.

APA, Harvard, Vancouver, ISO, and other styles

21

Beatty, Kate, Michael Meit, Emily Phillips, and Megan Heffernan. "Rural Health Departments: Capacity to Improve Communities' Health." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6838.

Full text

Abstract:

Local health departments (LHD) serve a critical role in leveraging internal and community assets to improve health and equity in their communities; however, geography is an important factor when understanding LHD capacity and perspective. LHDs serve a critical role in leveraging internal and community assets to improve health and equity in their communities; however, geography is an important factor when understanding LHD capacity and perspective. Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study. LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area codes. Results demonstrate that rural LHDs differed from their urban counterparts. Specifically, rural LHDs relied more heavily on state and federal resources and have less access to local resources making them more sensitive to budget cuts. Rural LHDs also rely more heavily on clinical services as a revenue source. Larger rural LHDs provide more clinical services while urban health departments work more closely with community partners to provide important safety net services. Small rural LHDs have less partners and are unable to provide as many direct services due to their lack of human and financial resources. LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs.

APA, Harvard, Vancouver, ISO, and other styles

22

Walsh, Mike. "A study of the use made by the general public of a large urban accident and emergency department." Thesis, University of the West of England, Bristol, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.386101.

Full text

APA, Harvard, Vancouver, ISO, and other styles

23

Woolcott, John Clifford. "A health care operations research analysis of elderly fallers' emergency department services utilization and cost." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/39804.

Full text

Abstract:

Introduction: Falls in the elderly are a significant cause of morbidity. Prescription medication use has been identified as an independent risk factor for falls. Among all Emergency Department (ED) presentations by elderly persons, 14-40% are due to falls, placing considerable strain on ED resources. Aims: In my thesis I aimed to 1) Provide updated estimates of the association between the use of specific medications and falling, 2) Determine whether the care provided to elderly fallers while patients in the ED follows published recommendations and was provided in a timely fashion, 3) Estimate the cost per fall resulting in an ED presentation, 4) Design a discrete event simulation (DES) model simulating care and then simulating other approaches to care including hypothetical changes. Methods: 1) A Bayesian meta-analysis of studies assessing the association between specific classes of medication use and risk of a fall. 2) A cohort study of elderly fallers presenting to the ED. 3) DES of the ED care received by elderly fallers. Results: Use of anti-hypertensives, diuretics, sedatives and hypnotics, neuroleptics and anti-psychotics, antidepressants, benzodiazepines, and non-steroidal antiinflammatory drugs are associated with an increased risk of falling. 1) In a sample of 101 ED fall presentations, 38% of elderly fallers leave the ED without a geriatric assessment and 14% are assessed by a physiotherapist. Less than 8% of fallers received care which met the wait time benchmarks. The estimated cost per fall causing an ED presentation is $11,408 with the cost per fall-related hospitalization estimated to be $29,363. 2) Providing care in a timely fashion could significantly reduce the time an elderly faller spends in the ED and the opportunity costs associated with waiting to be seen by physician or admission to hospital. Summary: Many commonly used medications are associated with falls. The care provided by the elderly faller in the ED does not currently meet the recommendations of published guidelines, nor is it provided in a timely fashion. The economic burden of falls is significant. By not providing ED care that meets recommended wait time benchmarks significant opportunity costs are incurred by the ED.

APA, Harvard, Vancouver, ISO, and other styles

24

Amin, Khan Mandokhail Boonyong Keiwkarnka. "Patient satisfaction towards outpatient department services of medicine in banphaeo autonomous hospital Samut Sakhon Province, Thailand /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd399/4937996.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

25

Lai, Sio Kuan. "An analysis of health services in Macau : resources used, cost and financing : from the perspective of health economics." Thesis, University of Macau, 1995. http://umaclib3.umac.mo/record=b1636734.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Sikora, Kamila Janetta. "Acceptability of Seasonal Influenza Vaccines Among Low-Risk Adults In An Urban Emergency Department." Yale University, 2010. http://ymtdl.med.yale.edu/theses/available/etd-03042010-205527/.

Full text

Abstract:

Emergency departments (EDs) are the only source of medical care for many adults and have been found to be feasible venues for vaccinating high-risk patients against seasonal influenza. Since the CDC guidelines expanded in 2008 to include any adults wishing to protect themselves and those around them from the flu, the vaccination of low-risk patients in the ED has not been evaluated. This study sought to assess the acceptability among adult patients of all ages for vaccinating against seasonal influenza in the Urgent Care area of an urban ED, which treats primarily healthy adults. A convenience sample of adult patients in the Urgent Care area was surveyed in November 2009. Subjects were asked about their vaccination history, as well as their perceived need and potential acceptance of a vaccine in the ED. Demographic data obtained included age, race, education, insurance status, medical history, access to primary care and contact with high-risk individuals. 381 patients were approached, of whom 352 completed the survey (92.4%; 56% male, 44% female; mean age 36 years, Standard Deviation 12.4), and 349 were vaccine-eligible. 250 (72%) denied any significant medical history. While 169 patients (48.4%) had an influenza vaccination history, only 69 (20%) were vaccinated in 2009. Of the 280 not vaccinated this year, 179 (64%) would have accepted the vaccine in the ED. Factors associated with increased odds of vaccine acceptance in the ED included: age younger than 50 years (Odds Ratio [OR] 3.28, 95% Confidence Interval [CI] = 1.74 to 6.21, p<0.01), Latino/Hispanic ethnicity (OR 2.89, 95% CI = 1.52 to 5.51, p<0.01), and close contact with high-risk individuals (OR 2.28, 95% CI = 1.33 to 3.92, p<0.01). These results suggest that the majority of relatively healthy adult patients would accept the seasonal influenza vaccine in the ED. Although a shortage of vaccines and increased vigilance during a concurrent H1N1 outbreak may have influenced overall acceptability, we conclude that influenza vaccinations during the ED patient encounter would generally be acceptable to patients as a means to improve their overall health, and indirectly the health of their high-risk close contacts.

APA, Harvard, Vancouver, ISO, and other styles

27

Moore, Simon Peter. "Delays in the emergency department and their effects on the ambulance provider." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2067.

Full text

APA, Harvard, Vancouver, ISO, and other styles

28

White, Susan J. Baldwin. "Performing social work : an ethnographic study of talk and text in a metropolitan social services department." Thesis, University of Salford, 1997. http://usir.salford.ac.uk/14744/.

Full text

Abstract:

The central theme of this ethnographic study is captured in the word play in the title. It is, essentially, an analysis of the social work in social work. With a primary focus on the collegial discourse taking place between 'child care' social workers and managers in a social services department in the North West of England, I have undertaken an analysis of naturally occurring talk, interview data, formal policy and procedure, and written records of action taken (case files and minutes) and action to be taken (e.g. court reports, strategic planning documents). My analytic focus has been upon on the routines and linguistic practices through which `caseness' is accomplished. I argue that, although professional accounts are artfully produced against certain (situated) background expectancies, the 'materials' invoked in such accounts are not entirely local phenomena. That is to say, competent accounts are both locally accomplished and contingent upon available vocabularies. In a search for analytic adequacy, I have drawn particularly upon the temporal and rhetorical 'turns' in the human sciences. Using an unashamedly eclectic approach, I argue that 'imported' materials, such as bureaucratic time, remain malleable and, thus, may be invoked strategically and artfully by social workers in their (narrative) constructions of events and 'cases' and, indeed, themselves - allowing them to reference risk, deviance or normality, for example. However, the possibilities are far from infinite, and the liturgical nature of many encounters ensures that what is most remarkable about organizational life is not its instability, but its predictability.

APA, Harvard, Vancouver, ISO, and other styles

29

Carpenter, Tyler, Kate E. Beatty, Ross Brownson, and Paul Erwin. "Accreditation Seeking Decisions in Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6848.

Full text

Abstract:

background: Accreditation of local health departments (LHDs) has been identified as a crucial strategy for strengthening the public health infrastructure. This study seeks to identify the role of organizational and structural factors on accreditation-seeking decisions of LHDs. data sets and sources: Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study. . LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area codes. “Micropolitan” includes census tracts with towns of 10,000 - 49,999 population and census tracts tied to these towns through commuting. “Rural” includes census tracts with small towns of fewer than 10,000 population, tracts tied to small towns, and isolated census tracts. analysis: Binary logistic regression analysis was conducted to predict PHAB accreditation decision. Predictors included variables related to rurality, governance, funding, and workforce. findings: From a sample of 448, approximately 6% of LHDs surveyed had submitted their letter of intent or full accreditation application. Over two-thirds were not seeking accreditation or deferring to the state agency. LHDs located in urban communities were 30.6 times (95% CI: 10.1, 93.2) more likely to seek accreditation compared to rural LHDs. LHDs with a local board of health were 3.5 times (95% CI: 1.6, 7.7) more likely to seek accreditation (controlling for rurality). Additionally, employing an epidemiologist (aOR=2.4, 95% CI: 1.2, 4.9), having a strategic plan (aOR=14.7, 95% CI: 6.7, 32.2) were associated with higher likelihood of seeking PHAB accreditation. conclusions: Rural LHDs are less likely to seek accreditation. This lower likelihood of seeking accreditation likely relates to a myriad of challenges. Simultaneously, rural populations experience health disparities related to risky health behaviors, health outcomes, and access to medical care. Through accreditation, rural LHDs can become better equipped to meet the needs of their communities.

APA, Harvard, Vancouver, ISO, and other styles

30

Harris, Jenine K., Kate E. Beatty, J. P. Leider, Alana Knudson, Britta L. Anderson, and Michael Meit. "The Double Disparity Facing Rural Local Health Departments." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6825.

Full text

Abstract:

Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities.

APA, Harvard, Vancouver, ISO, and other styles

31

Burns-Johnson, Toshiba L. "Are Government Websites Achieving Universal Accessibility?: An Analysis of State Department of Health and Human Services’ Websites." Thesis, School of Information and Library Science, 2007. http://hdl.handle.net/1901/417.

Full text

Abstract:

Research reports that the search for health information is the fourth most popular activity being done on the web (Pew Internet & American Life Project, 2004). However, for disabled persons, barriers experienced when interfacing with the Internet may cause healthcare websites to be inaccessible to them. This study explores the level of accessibility of healthcare websites and the relationship between accessibility and usability by determining how compliant state department of health and human services websites are with accessibility and usability guidelines. A content analysis of each state’s department of health and human services website was conducted. Results revealed that state department of health and human services websites are not very compliant with accessibility guidelines, are somewhat compliant with usability guidelines, and overall are not very accessible. The findings also indicate that there is a significant moderate relationship between accessibility and usability which suggests that the two concepts are interconnected.

APA, Harvard, Vancouver, ISO, and other styles

32

Beatty, Kate, Tyler Carpenter, Ross Brownson, and Paul Erwin. "Accreditation Seeking Decisions in Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6854.

Full text

Abstract:

Background: Accreditation of local health departments (LHDs) has been identified as a crucial strategy for strengthening the public health infrastructure. Research Objective: To identify the role of organizational and structural factors on accreditation-seeking decisions of LHDs. Of particular interest is the effect of rurality on the likelihood of seeking accreditation through the Public Health Accreditation Board (PHAB). Data Sets and Sources: Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study (2013 Profile Study). The 2013 Profile Study includes a core questionnaire (core,) that was sent to all LHDs, and two modules, sent to a sample. Variables were selected from the core and module one for this project. LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area codes for the zip code of the LHD address. “Micropolitan” includes census tracts with towns of between 10,000 and 49,999 population and census tracts tied to these towns through commuting. “Rural” includes census tracts with small towns of fewer than 10,000 population, tracts tied to small towns, and isolated census tracts. Both “micropolitan” and “rural” categories are considered rural by the Federal Office of Rural Health Policy. Study Design: Cross-sectional. Analysis: Binary logistic regression analysis was conducted to predict PHAB accreditation decision. The variable for PHAB accreditation decision was created from the 2013 Profile Study question, “Which of the following best describes your LHD with respect to participation in the PHAB’s accreditation program for LHDs?” LHDs that selected “My LHD has submitted an application for accreditation” or “My LHD has submitted a statement of Intent” were coded as “Seeking PHAB Accreditation.” LHDs that selected “My LHD has decided NOT to apply for accreditation” or “The state health agency is pursuing accreditation on behalf of my LHD” were coded as “Not Seeking PHAB Accreditation.” Predictors included variables related to rurality, governance, funding, and workforce. Findings: From a sample of 448, approximately 6% of LHDs surveyed had either submitted their letter of intent or full accreditation application. Over two-thirds were either not seeking accreditation or deferring to the state agency. LHDs located in urban communities were 30.6 times (95% CI: 10.1, 93.2) more likely to seek accreditation compared to rural LHDs. LHDs with a local board of health were 3.5 times (95% CI: 1.6, 7.7) more likely to seek accreditation (controlling for rurality). Additionally, employing an epidemiologist (aOR=2.4, 95% CI: 1.2, 4.9), having a strategic plan (aOR=14.7, 95% CI: 6.7, 32.2), and higher per capita revenue (aOR=1.02, 95% CI: 1.01, 1.02) were associated with higher likelihood of seeking PHAB accreditation. Conclusions: Specific geographic, governance, leadership, and workforce factors were associated with intention to seek accreditation. Implications: Rural LHDs are less likely to seek accreditation. This lower likelihood of seeking accreditation likely relates to a myriad of challenges (e.g., lower levels of staffing and funding). Simultaneously, rural populations experience health disparities related to risky health behaviors, health outcomes, and access to medical care. Through accreditation, rural LHDs can become better equipped to meet the needs of their communities.

APA, Harvard, Vancouver, ISO, and other styles

33

Duffy, Brianne Michelle. "Identification of stressors related to emergency department employment." Honors in the Major Thesis, University of Central Florida, 2003. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/315.

Full text

Abstract:

This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.
Bachelors
Health and Public Affairs
Nursing

APA, Harvard, Vancouver, ISO, and other styles

34

Johnson, Lula Juanita. "The effects of home based primary care with chronically ill older adults on visits to the emergency department, hospitalization, and bed days of care." free to MU campus, to others for purchase, 2004. http://wwwlib.umi.com/cr/mo/fullcit?p1422981.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Asiimwe, Sarah. "Use of health information for operational and strategic decision-making by division level managers of Kampala City Council Health Department." Thesis, University of the Western Cape, 2002. http://etd.uwc.ac.za/index.php?module=etd&amp.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Turnberg, Wayne L. "Respiratory infection control practices among healthcare workers in primary care and emergency department settings /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/8475.

Full text

APA, Harvard, Vancouver, ISO, and other styles

37

Watt, Ian. "Why Are You Here? Exploring the Logic Behind Nonurgent Use of a Pediatric Emergency Department." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804858/.

Full text

Abstract:

Caregivers often associate fevers with permanent harm and bring children to emergency departments (EDs) unnecessarily. However, families using EDs for nonurgent complaints often have difficulty accessing quality primary care. Mutual misconceptions among caregivers and healthcare providers regarding nonurgent ED use are a barrier to implementing meaningful interventions. The purpose of this project was to identify dominant themes in caregivers’ narratives about bringing children to the ED for nonurgent fevers. Thirty caregivers were recruited in a pediatric ED for participation in qualitative semi-structured interview from August to November 2014. Interview transcripts were coded and analyzed for themes. Caregivers’ decisions to come to the ED revolved around their need for reassurance that children were not in danger. Several major themes emerged: caregivers came to the ED when they felt they had no other options; parents feared that fevers would result in seizures; caregivers frequently drew on family members and the internet for health information; and many families struggled to access their PCPs for sick care due to challenging family logistics. Reducing nonurgent ED utilization requires interventions at the individual and structural level. Individual-level interventions should empower caregivers to manage fevers and other common illnesses at home. However, such interventions may have limited impact on utilization outcomes among families with poor access to primary care. Afterhours primary care should be expanded to accommodate families with rigid work schedules and limited transportation resources.

APA, Harvard, Vancouver, ISO, and other styles

38

Church, Kay L. "Comparative analysis of the use of health information telephone system in two groups of emergency department patients." Virtual Press, 1994. http://liblink.bsu.edu/uhtbin/catkey/917023.

Full text

Abstract:

This study examined the effect a telephone health care information system has on emergency department patients. The research questions address the patient's acuity and the length of time between the onset of symptoms and seeking treatment.A convenience sample of 80 ambulatory emergency department patients treated over a four month period, in one emergency department of a Midwest hospital with a published telephone health care information system. The sample was divided into two groups according to the treatment. The treatment group had accessed the telephone health information system prior to emergency department visit and the control group of patients had not. The procedure for the protection of human subjects were followed.Data was collected by two instruments, a demographic questionnaire completed by the subjects, and a patient acuity scale completed by the treating emergency nurse. Acuity is scored on a 1 through 5 point scale. Subjects selected the best time interval representing the onset of symptoms and treatment. The Whitney-Mann U test was used to test differences in mean ranks. When comparing individuals who used Ask-A-Nurse, there was no significant difference between the two groups and acuity scores. There were no differences between the frequency of time interval ranges in the two groups, however a pattern indicated the subjects sought treatment sooner if the telephone health care information systems was assessed. The ability of the telephone health care information system to refer nonemergency patients to physician's offices or medical clinic and avoid overcrowded emergnecy department appears limited. Implications call for an increased method of screening and providing information to emergency patients who need health care advice.
School of Nursing

APA, Harvard, Vancouver, ISO, and other styles

39

Fleming, Wanda C. "Strategies for Recruiting and Retaining Rural Emergency Department Physicians." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3880.

Full text

Abstract:

Recruiting and retaining physicians to work in rural emergency departments (EDs) have reached a crisis level, threatening the availability of services to rural residents. In this study, a case study design was used to explore strategies that rural ED administrators use to recruit and retain physicians to work in their facilities. The study population consisted of 5 rural hospital administrators operating EDs in central Mississippi. These administrators were charged with the responsibility to recruit and retain ED physicians. The on-going staffing of ED physicians, with no lapses in coverage, was evidence that these administrators successfully recruited and retained ED physicians at their facilities. The conceptual framework that grounded this study was strategic human resource management. Semistructured interviews were used to collect data from participants, and the modified van Kaam method of data analysis was used to create and cluster themes, validate data, and to construct and describe textural meaning. One of the dominate themes that emerged from the study was the challenge of maintaining rural ED physician coverage. Deterrents to maintaining ED coverage included insufficient pools of available physicians, changing technological demands, and financial constraints. A second dominate theme permeating the study was the insufficient focus on retention of rural ED physicians. Study findings may contribute to social change by providing a replicable recruitment and retention model for recruiting and retaining rural ED physicians. The most successful strategies to recruit and retain ED physicians, as identified in this study, were provision of financial incentives and development of a sense of family and community.

APA, Harvard, Vancouver, ISO, and other styles

40

Net, Ny Santhat Sermsri. "Patient satisfaction with health services at the Out-patient department clinic of Wangnumyen Community Hospital, Sakaeo province, Thailand /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd399/4937988.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

41

Mfuko, Ncedo. "An assessment of primary health care services from the : perspective of the recipients in the Khayelitsha community health centre." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3124_1305890834.

Full text

Abstract:

The general aim of this study is to undertake an assessment of the health care service provision in the Khayelitsha Community Health Centre taking into consideration the underlying principles of the Primary Health Care. More specific objectives include: an overview and discussion of the framework approach to primary health care and its use
the documentation of the practice of primary health care in the Khayelitsha Community Health Centre
an analysis of the results and findings which will highlight the obstacles in the pursuit of a better primary health care service. The perspective of the patients and nurses will be solicited and examined with a view to highlighting factors that facilitate and constrain the delivery of service
and finally to draw conclusions and make recommendations.

APA, Harvard, Vancouver, ISO, and other styles

42

Coetzee, Jacobus. "Investigating occupational therapists management skills as business unit managers within the Free State Department of Health." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97316.

Full text

Abstract:

Thesis (MBA)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: The aim of this study was to investigate the management skills of occupational therapy business unit managers on Assistant Director Level in the Public Health Sector (PHS) of the Free State (FS). For the purpose of this study, management skills referred to the occupational therapy business unit manager’s perception of the importance and competency experienced while doing their work within the Free State Department of Health. Occupational therapy form an integral part of the Free State Department of Health, which is a provincial public sector entity and solely responsible for health services to the majority of the population. An inquiry was initiated based on the researchers’ observation of occupational therapy business unit manager’s challenges regarding knowledge and skill when exposed to management. The investigation was conducted by making use of a questionnaire for the quantitative typical descriptive study design and semi-structured telephonic interviews for the qualitative study design. Electronic self-administrative questionnaires were distributed to all the occupational therapy business unit managers in the service of the Free State Department of Health. Ten (n=10) questionnaires, a hundred percent of employed occupational therapy business unit managers, were used for the analysis of quantitative data. Subsequently to this base-line data gathered, semi-structured telephonic interviews with open-ended questions were conducted among the target population. In conclusion the results of the study showed that the occupational therapy business unit managers in the PHS of the FS perceive a gap between their current and desired performance management skill levels. This was found to be in accordance with studies worldwide as clinicians promoted to a managerial post would prefer to utilize gained qualifications and experiences as managers within their specialty field.

APA, Harvard, Vancouver, ISO, and other styles

43

Rea, David J. "Surviving the Surge: Real-time Analytics in the Emergency Department." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1624914727282486.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Sokhanya, In Santhat Sermsri. "TB preventive behavior of patients consulting at the general Outpatient department at Paholpolpayuhasana Hospital, Kanchanaburi province, Thailand /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5037984.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

Booi, Mlungisi Wellington. "Performance management of health professionals : an evaluation research study of health services in the subdistrict of Buffalo City in the Provincial Department of Health in the Eastern Cape." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1020017.

Full text

Abstract:

Integrative Summary In 1997 the Minister of Public Service and Administration of South Africa, Zola Skweyiya, introduced the White Paper on Transforming Public Service Delivery(Department of Public Service and Administration(DPSA,1997: 1). It was premised on what was called Batho Pele (DPSA, 1997: 9), giving effect to Section 197 of the Constitution, Act 108 of 1996 as amended. A linkage to performance management can be found from the assertion made in the White Paper that in future the Batho Pele would form the basis of any assessment of the performance of individual staff and that would contribute to improving the delivery of service (DPSA, 1997:16). Another factor that contributed to the utilisation of a performance management system was the recommendation put forward by the Public Service Commission of South Africa( PSC,2004: 16),that called for public institutions to adopt a clear, comprehensive performance management and evaluation framework for the delivery of public service. That was expected to turn around the ailing public institutions whose record of serving the public with pride and dignity was on the decline. The research aim was to evaluate the effectiveness of the performance management system in creating and resolving role conflict with health professionals employed by the Buffalo City sub-district. The research goal was divided into three objectives, namely: evaluation of the effectiveness of the performance management system as a managerial tool for health managers to manage their subordinates including both professional and support staff, evaluation of the effectiveness of the performance system from the perspective of the health professional as a subordinate and to analyze the functioning and effectiveness of the system in creating and resolving role conflict between professional conduct and organisational requirements. The respondents noted that the implementation of the system was not matched with appointment at managerial level with officials having relevant managerial capacity. Further to that resources at the coal face of service delivery continued to deteriorate and became very scarce and there is no documented proof that has been found of an effort made to check the compatibility of the system to health professionals. The literature identified negative effects that have emanated from the implementation of the performance management system. The study was conducted by interviewing health professionals from the entry level to the management level within the Buffalo City sub-district from three mini hospitals or Health Care Centres. The respondents indicated that there are positives that have been achieved by the implementation of the system, such as the skills gap identification as well as specific targets contained in annual performance contracts. These targets help motivate health professional to focus on that particular direction of activities. Unfortunately it has been clearly documented that the performance management system has also contributed to the development of role conflict in a number of professionals. It has been documented that the system has not been crafted with a health professional in mind and, as such, appears to favour quantity rather than quality of health services as advocated by the codes of practice of different health professionals. There are a number of recommendations that were put forward by the respondents to try to salvage the system and in mitigation of the identified negative factors. For the improvement of the system, the Eastern Cape Provincial Department of Health has to firstly customise the annual contracts to contain only the fundamental information. Secondly need to improve the transparency pertaining to financial pressures facing the Health Department. Thirdly the provision of essential enablers, need to be prioritised. Fourthly there is a need to upgrade the system to incorporate 360 degree feedback. Further research recommendations include a bigger sample incorporating different research methods and to also incorporate searches for measures that can be implemented to improve the system to be more relevant to health professionals. This document is organised and presented in three sections. The first section is the evaluation report with a review of literature, research methodology, findings, discussion and conclusion. The second section is where an indepth literature review is located and the last section details the research methodology.

APA, Harvard, Vancouver, ISO, and other styles

46

Bigger, Sharon. "Advance Care Planning Protocols and Hospitalization, Rehospitalization, and Emergency Department Use in Home Health." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/etd/3858.

Full text

Abstract:

Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA). Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious illnesses such as HIV/AIDS, cancer, dementia, and end stage renal disease. Meanwhile, the U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses. Effective January 1, 2016, the Center for Medicare and Medicaid Innovation implemented the Home Health Value-Based Purchasing (HHVBP) Model among home health agencies (HHAs) in nine states representing each geographic region in the United States. Agencies in these states began competing on value in the HHVBP model, and reimbursement rates began to be tied to quality performance (innovation.cms.gov). As part of HHVBP, CMS implemented an additional process-level mandate requiring them to report on ACP, though this data is not publicly available. It is currently unknown how ACP protocols in HHAs may affect agencies’ overall rates of acute care services use. Methods. Electronic surveys about ACP protocols were distributed to HHAs. Existing data about demographics, diagnoses, hospitalization, rehospitalization, and ED use were accessed online via CMS websites. Descriptive and regression analyses were conducted using the electronic survey results and the existing data. Results. Associations between the variables were observed and compared to the hypotheses. Statistical significance was found in the relationship between ACP protocols and hospitalization, where one increased the other increased. Several trends were found: Agencies with increased total percentage of cardiac and pulmonary diagnoses tended to have increased hospitalization rates; agencies with increased average age of patients tended to have increased ACPP scores; and agencies with increased proportion of Black patients tended to have higher hospitalization rates.

APA, Harvard, Vancouver, ISO, and other styles

47

Mcguire-Wolfe, Christine Michelle. "Practices and Factors Influencing Sharps Use and Safety in a Suburban FIre Department and Among Emergency Medical Services Personnel." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4541.

Full text

Abstract:

Needlestick injuries (NSIs) are a recognized risk for occupationally-related transmission of bloodborne pathogens (BBP). The occurrence of NSIs and BBP exposures among firefighters (FFs) and emergency medical services (EMS) personnel has been documented. The purposes of this study were: 1) to define the problem of NSI among FFs and EMS personnel in a suburban fire department (FD) and identify practices and factors that influence sharps use and safety; 2) design and implement and intervention to promote safer sharps device usage; and 3) to measure the effectiveness of the intervention among FFs and EMS personnel. A multi-phase, mixed methods approach was used that included a diagnosis phase that utilized a mixed methods exploratory design, an intervention period, and a quantitative evaluation phase that used a before and after evaluation design. In the diagnosis phase, data regarding sharps device practices were obtained through a count of discarded sharps devices. Qualitative data regarding sharps practices and factors which influenced those practice were obtained via focus groups. The PRECEDE/PROCEED model (PPM) was used as the theoretical framework for assessment, planning, implementation, and evaluation of an intervention to increase the occurrence of safer sharps device behaviors and decrease the frequency of riskier sharps device behaviors. The evaluation phase included a post-intervention sharps count and a post-intervention survey to assess changes in sharps practices and the impact of the intervention. During the baseline sharps count, 2743 sharps devices were counted and classified according to pre-established categories of safer or risky behaviors for NSI. Altered safety devices on IV stylets were the highest count for unsafe behaviors (n=105), followed by recapped traditional needles (n= 53). A statistically significant increase in risky behaviors was observed in discarded sharps from engines, as opposed to ambulances, among all sharps devices combined (p=0.000) and IV stylets (p=0.000). When comparing advanced life support (ALS) medications to all other medications, a statistically significant increase in unsafe behaviors occurred among all sharps devices combined (p=0.000) and prefilled syringes (p=0.000). Input from eight focus groups of firefighters allowed for identification of multiple themes which guided the development of an intervention. The intervention included distribution of a hands-on training kit and booklet, expansion of an existing required BBP training, and posters to increase awareness regarding NSI prevention. In the evaluation phase, a total of 2178 sharps devices were counted and classified in a post-intervention sharps count. Altered safety devices on IV stylets were the highest count of unsafe behaviors (n=50). Recapped traditional needles were the second highest count of unsafe behaviors (n=27), but experienced an 18.7% drop in frequency when compared to baseline. When comparing riskier behaviors to the pre-intervention baseline sharps count, statistically significant decreases in risky behaviors were observed in all sharps devices combined ( 2=25.71, p=0.000), IV stylets (2=16.87, p=0.000), and traditional needles (=5.07, p=0.024). A post-intervention survey, consisting of 15 Likert scale questions, was returned by 165 out of 383 active field personnel (41.3%). Results indicated high frequencies of strongly agree and somewhat agree responses regarding risk perception; the importance of using safer needle devices; the impact of the intervention on safer needle practices and sharps safety awareness. Critical predisposing, reinforcing, enabling, and environmental factors which influenced sharps device practices were identified. This study identified factors and practices which influenced unsafe sharps device behaviors. Due to the statistically significant decreases in risky behavior in the post-intervention sharps count and the positive responses in the post-intervention survey, it can be concluded that the intervention did positively impact sharps device behavior and reduced the risk of NSI. The implications of the study are numerous and include a need to explore these practices and factors at other fire departments and EMS agencies, address gaps in regulations; promote research targeting FFs and EMS personnel in regard to NSI, and promote a nationwide effort to prevent NSI among emergency responders.

APA, Harvard, Vancouver, ISO, and other styles

48

Shetler, Michael Ray. "Waste minimization, household hazardous waste, and a model curriculum guide for regional occupational programs for the County of Riverside Department of Health Environmental Health Services." CSUSB ScholarWorks, 1990. https://scholarworks.lib.csusb.edu/etd-project/528.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Mangwanya, Maonei Gladys. "An assessment of the budgeting system in the Eastern Cape Department of Health to ensure effective and efficient health care service delivery." Thesis, University of Fort Hare, 2016. http://hdl.handle.net/10353/2061.

Full text

Abstract:

The National Department of Health is the executive department of the South African government which is assigned to the national health issues of the country. This research was however aimed specifically on the budgeting process within the Eastern Cape Provincial Department of Health. This was provisioned by assessing the significance of the budgeting system and its correlation to efficient and effective healthcare service delivery. The aim of the research was to highlight on how policies have an effect on the budgeting system at the provincial level, considering the provincial health department is responsible for the provision of publicly funded health services. This research assessed the budgeting system in the Eastern Cape Department of Health in an attempt to propagate effective and efficient health service delivery for the general citizenry. This was a qualitative study design which harnessed the merits of secondary data as the main code of the research design which enabled the comprehension of the budgeting system in the Eastern Cape Department of Health. Data was analysed using thematic analysis to examine the distinctive themes and sub-themes identified from within the reviewed literature. The Eastern Cape Province is succumbing to insufficient funding at provincial level and this has a clear-cut reflection on the administration of services within respective departments, particularly the Health Department. This is despite the fact that the Public Finance Management Act, 1999 promotes the objectives of good financial management aimed at maximizing service delivery through the effective use of the limited resources. Resultantly it was fundamental to comprehend on the issues underpinning the scope of budget reporting as well as budget accountability and the effect it has on service delivery in the Eastern Cape Department of Health. Recommendations were thus given based on the discussed and derived themes to ensure that there is an appropriate budgeting system to ensure efficient and effective provision of health care services in the Eastern Cape Department of Health.

APA, Harvard, Vancouver, ISO, and other styles

50

Agasteen, Anantharaj Kingsly Anand. "Improving management of patient flow at Radiology Department using Simulation Models." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-302558.

Full text

Abstract:

The Swedish healthcare system is considered to have good healthcare productivity and efficiency with moderate cost but seems to have some future challenges. Sweden is moving towards the aging population as it requires development in medical care techniques and technologies to provide care to elderly patients. This increases the pressure on the healthcare system. Hence, the number of patients in the hospital increase, as a result, the flow of patients within the wards are increased. Furthermore, the pandemic has increased the number of people admitted to hospitals. As a consequence, even for high-priority cases, the wait times are rising. The Skaraborg Hospital Group, SHG, and other general hospitals, in particular, are focusing on how to handle patient flow at various levels within departments and clinics by improving patient flow quality. Production and capacity preparation (PCP) is a commonly used industry tool for resolving bottlenecks. Hence, this method needs to be adopted within the hospital and by the healthcare sector to a larger extent. Since many patients from different specialty departments use the Radiology department's facilities, it is often a "bottleneck" in inpatient traffic at hospitals. Furthermore, the influx of patients with covid-19 has increased the department's workload. This master's thesis aims to assist the Radiology department in improving their production and capacity planning to increase unit flow performance. The project involves supporting key staff in the department in estimating demand to align different patient movements with equipment and personnel services. Improving radiology department flow efficiency can lead to more even and healthy patient flows around the hospital, reducing "buffers" of patients and longer stays at different specialist clinics.
Det svenska sjukvården anses ha god hälsovårdsproduktivitet och effektivitet till måttliga kostnader men verkar ha några framtida utmaningar. Sverige går mot den åldrande befolkningen eftersom det kräver utveckling av tekniker och tekniker för medicinsk vård för att ge äldre patienter vård. Detta ökar trycket på sjukvården. Därför ökar antalet patienter på sjukhuset, vilket leder till att patientflödet inom avdelningarna ökar. Dessutom har pandemin ökat antalet personer som läggs in på sjukhus. Som en konsekvens ökar väntetiderna även för fall med hög prioritet. Skaraborg sjukhusgrupp, SHG och andra allmänna sjukhus fokuserar särskilt på hur man hanterar patientflöde på olika nivåer inom avdelningar och kliniker genom att förbättra patientflödeskvaliteten. Produktion och kapacitetsberedning (PCP) är ett vanligt branschverktyg för att lösa flaskhalsar. Därför måste denna metod i större utsträckning antas inom sjukhuset och inom sjukvården. Eftersom många patienter från olika specialavdelningar använder Radiologiavdelningens anläggningar är det ofta en "flaskhals" i slutenvården på sjukhus. Dessutom har inflödet av patienter med covid-19 ökat avdelningens arbetsbelastning. Detta examensarbete syftar till att hjälpa Radiologiavdelningen att förbättra sin produktionsoch kapacitetsplanering för att öka enhetsflödesprestanda. Projektet innebär att stödja nyckelpersoner på avdelningen för att uppskatta efterfrågan för att anpassa olika patientrörelser till utrustning och personal. Förbättrad radiologisk avdelnings flödeseffektivitet kan leda till jämnare och hälsosammare patientflöden runt sjukhuset, vilket minskar "buffertar" hos patienter och längre vistelser på olika specialistkliniker.

APA, Harvard, Vancouver, ISO, and other styles

Dissertations / Theses on the topic 'Department of Health Services'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles