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Journal articles on the topic 'Hospital works management'
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1
Xidous, Dimitra, Tom Grey, Sean P. Kennelly, and Desmond O’Neill. "Understanding the knowledge and engagement of facilities management with dementia-friendly design in Irish hospitals: an exploratory study." Facilities 39, no. 9/10 (January 11, 2021): 601–14. http://dx.doi.org/10.1108/f-01-2020-0012.
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Purpose This exploratory study stems from research conducted between 2015–2018 focussing on dementia-friendly design (DFD) in hospitals (Grey T. et al. 2018). Specifically, this study focusses on facilities management (FM) staff in Irish hospitals to gain a preliminary understanding of the level of knowledge and engagement of FM in the implementation of dementia-friendly hospital (DFH) design. Design/methodology/approach A mixed-methods approach based on a series of ad hoc semi-structured interviews, and an online survey. The aims were, namely, assess the extent of FM engagement in hospital works; measure the level of awareness regarding DFD; and identify facilitators and barriers to DFD in hospital settings. Participants (74) comprised FM staff in 35 Irish acute care hospitals. The research findings are based on thematic analysis of ad hoc semi-structured interviews (participants, n = 4) and survey responses (participants, n = 13). Findings While FM staff reported to possess important knowledge for building DFH, they also mentioned a lack of engagement of FM in design processes and hospital works. Practical implications The research has gained insight into the role of FM in promoting a dementia-friendly approach. Lack of or poor engagement of FM in design processes and hospital works means not fully tapping into rich expertise that would be invaluable in the development, implementation and maintenance of DFH. Universal design is a key driver for facilitating their engagement in the design, implementation and maintenance of DFH environments. Originality/value This is the first study exploring the role of FM in supporting a DFD approach in acute care hospitals.
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Kitchener, Denby A., Sharon R. Sykes, and Allan G. McEwan. "An aggression policy that works." Australian Health Review 28, no. 3 (2004): 357. http://dx.doi.org/10.1071/ah040357.
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In 1999, a survey of the clinical staff in Royal Darwin Hospital showed that most instances of aggressive and abusive behaviour by patients or visitors occurring in the hospital went unreported because staff believed there would not be any follow-up investigation or action taken by management. In response, a hospital working party was formed to develop and implement an aggression management policy with practical effective strategies. The principal tool used was an Action Plan that delineated an immediate response to the aggression, as well as long-term strategies such as negotiated care and behaviour modification programs. An advocate is provided for the patient and debriefing for staff members. If the aggressive behaviour continues, early discharge of the patient could be initiated. The fundamental principle of the policy is to prevent fostering a culture of acceptance of aggressive behaviour through appropriate early intervention. In 2002, a follow-up survey showed that 82% of aggressive incidents were being reported and dealt with by management in a timely manner ? a significant improvement.
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O'Hara, P. M. "Occupational Therapy and the Pain Management Team." British Journal of Occupational Therapy 55, no. 1 (January 1992): 19–20. http://dx.doi.org/10.1177/030802269205500107.
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This article discusses the problems and challenges facing an occupational therapist in pain management, and the diverse roles the therapist is asked to play within the team structure. It is written in response to all those who contact the Gloucester Royal Hospital to find out how an occupational therapist works in the pain management team.
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David, Yadin, and Ernest Gus Jahnke. "Planning Medical Technology Management in a Hospital." Global Clinical Engineering Journal, no. 1 (March 25, 2018): 23–32. http://dx.doi.org/10.31354/globalce.v0i1.23.
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Appropriate deployment of technological innovation contributes to improvement in the quality of health care delivered, the containment of cost, and access to health care services. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for newer medical technology and are challenged to interoperate and manage legacy and newer generation of inventory simultaneously. To objectively manage this investment over it life cycle, hospitals are adopting medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with the hospital’s objectives. They can review their institution’s overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated periodically for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment’s useful lifespan, prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time-consuming, individual financial capital project evaluations. The clinical engineer’s skills and expertise are needed to facilitate the adoption of an objective methodology for implementing the program, thus improving the match between the hospital’s needs and budget projections, equipment performance and cost of ownership. Systematic planning and execution will result in a program that assures appropriate inventory level at the lowest life-cycle costs at optimal performance.
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Gunawardena, Indunil. "Effectiveness of the geriatric day hospital – a realist review." Reviews in Clinical Gerontology 21, no. 3 (February 22, 2011): 267–69. http://dx.doi.org/10.1017/s0959259811000050.
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SummaryThis research paper is a realist review on the effectiveness of medical care for older people in the geriatric day hospital (GDH), based on trial data from a Cochrane review published in 2008. The Cochrane review indicated no overall difference between GDH care and alternative services. However, health care management and policy interventions are quite complex and methodologically more diverse than clinical treatments. Hence a ‘realist review’ is a more suitable explanatory analysis, aimed at discerning what works for whom, in what circumstances, in what respect, and how. This realist review on GDH care provides an explanatory analysis and has aimed to identify where GDH care is and is not effective.
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Gola, Marco, Gaetano Settimo, and Stefano Capolongo. "Chemical Pollution in Healing Spaces: The Decalogue of the Best Practices for Adequate Indoor Air Quality in Inpatient Rooms." International Journal of Environmental Research and Public Health 16, no. 22 (November 10, 2019): 4388. http://dx.doi.org/10.3390/ijerph16224388.
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Indoor air quality (IAQ) is one of the main topics in which governments are focusing. In healthcare facilities, several studies have reported data analysis and case studies to improve users’ health. Nowadays, although many studies have been conducted related to the biological and physical risks, the chemical risks have been less investigated and only in some specific functional areas of the hospitals. Starting from some systematic reviews and research works, this paper aims to list the best healthy practices for an adequate IAQ in inpatient wards. In particular, the decalogue lists the strategies related to chemical pollution, starting from design and management, with a focus on (a) localization of hospitals and inpatient rooms, (b) hospital room, (c) microclimatic parameters, (d) ventilation systems, (e) materials and finishing, (f) furniture and equipment, (g) cleaning products and activities, (h) maintenance and (i) management activities, and (l) users and workers. The multidisciplinary approach emphasizes the need for interdisciplinary knowledge and skills aimed to find solutions able to protect users’ health status. The design and management decision-making, ranging from the adequate choices of construction site and hospital exposure, finishing materials, cleaning and maintenance activities, etc., which can affect the IAQ must be carried out based on scientific research and data analysis.
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Corrao, S. "The complex pa¬tient with diabetes and cardio-renal comorbidities: a mana¬gement model proposal." Journal of AMD 23, no. 3 (November 2020): 190. http://dx.doi.org/10.36171/jamd20.23.3.3.
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Type 2 diabetes mellitus (DM) is a metabolic disorder and its prevalence has been increasing in the world population and represents one of the chronic diseases with the highest socioeconomic impact on the health systems. It is expected that in the next decade life expectancy and population aging will increase with the consequences of the increasing incidence of diabetes and its associated comorbidities. (DM) is the main cause of chronic kidney disease and it is associated with a significant increasing in cardiovascular risk. The coexistence of cardiac and kidney diseases on a metabolic basis, named “cardiorenal metabolic syndrome”, in elderly patients affected by multimorbidity increase their clinical and care complexity. In order to assess clinical complexity it is necessary to change paradigm from a reactive approach to a proactive one and the integration of territorial, hospital and social services according to the Chronic Care Model (CCM) is important. The proactive management of the complex patient suffering from chronic diseases and multimorbidity has been implemented at the National ARNAS Civico Hospital in Palermo with the MUSE (Multidimensional aSsessment of Elderly) project. The interaction between hospital and territorial services to respond to patients’ needs should be a priority. The hospital must therefore be conceived as a highly specialized center for chronic disease management that works with primary care according to a multidimensional and multidisciplinar model of care reducing rehospitalization and negative outcomes in patients affected by chronic diseases. KEY WORDS diabetes mellitus type2; comorbidity; management model; complexity; cardiorenal syndrome.
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Taewijit, Siriwon, and Thanaruk Theeramunkong. "Learning Pattern Relation-Based Hyperbolic Embedding for Adverse Drug Reaction Extraction." International Journal of Knowledge and Systems Science 12, no. 2 (April 2021): 69–87. http://dx.doi.org/10.4018/ijkss.2021040105.
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Hyperbolic embedding has been recently developed to allow us to embed words in a Cartesian product of hyperbolic spaces, and its efficiency has been proved in several works of literature since the hierarchical structure is the natural form of texts. Such a hierarchical structure exhibits not only the syntactic structure but also semantic representation. This paper presents an approach to learn meaningful patterns by hyperbolic embedding and then extract adverse drug reactions from electronic medical records. In the experiments, the public source of data from MIMIC-III (Medical Information Mart for Intensive Care III) with over 58,000 observed hospital admissions of the brief hospital course section is used, and the result shows that the approach can construct a set of efficient word embeddings and also retrieve texts of the same relation type with the input. With the Poincaré embeddings model and its vector sum (PC-S), the authors obtain up to 82.3% in the precision at ten, 85.7% in the mean average precision, and 93.6% in the normalized discounted cumulative gain.
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Fana, Thanduxolo, and Jane Goudge. "Austerity, resilience and the management of actors in public hospitals: a qualitative study from South Africa." BMJ Global Health 6, no. 2 (February 2021): e004157. http://dx.doi.org/10.1136/bmjgh-2020-004157.
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BackgroundGlobal economic recession coupled with internal inefficiencies and corruption has led to a period of austerity in the South African healthcare system.This paper examines the strategies used by management in response to austerity in the three public hospitals and their effect on organisational functioning.MethodsWe used a comparative qualitative case study approach, collecting data using a combination of in-depth interviews with managers, and focus group discussion and interviews with shop stewards and staff.ResultsAusterity, imposed by the introduction of a provincial cost containment committee, has led to a reduction in staff, benefits, shortages of equipment and delayed procurement and recruitment processes. Managers in the first hospital maintained training on labour relations for staff and managers, they jointly planned how to cope with reduced staff and initiated a new forum for HR and finance staff. These strategies improved the way actors engaged, enabling them to resolve problems. Good communication ensured that staff understood what was within the hospitals control and what was not. A second hospital relied on absorptive strategies, such as asking staff to do more with less. The result was resistance, and greater use of sick leave. Some staff gave their own money to help feed patients but were angry at management for putting them in this difficult position. Leadership in the third hospital did not manage actors well either; help from the Government’s Expanded Public Works Programme was rejected by the unions, managers did not attend meetings as they felt their contributions were not listened to. Poor communication meant that the managers and staff did not understand what was within the hospital’s control and what was not; a misunderstanding led to a physical fight between managers.ConclusionOrganisational resilience in the face of austerity requires leaders to manage different stakeholders well. Hospital managers who promote democratic or participatory leadership and management, open communication, teamwork and trust among all stakeholders will lead better functioning organisations. A special focus should be placed on such practices to develop the resilience of health systems’ organisations.
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Carrington, Robbie, Andrzej Szymczakowski, and Akademia medyczna Medyczna. "Pulmonary oedema in hypertensive crisis - from failed femoral cannulation to diagnosis." Morecambe Bay Medical Journal 8, no. 4 (August 1, 2019): 118–20. http://dx.doi.org/10.48037/mbmj.v8i4.67.
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Pulmonary oedema is a very common clinical presentation in the hospital setting with the management steps memorised by most medical student from an early stage. This management works on the basis that the patient is fluid overloaded from left ventricular systolic dysfunction (LVSD). In reality however, this is not always the case with diastolic dysfunction also causing pulmonary oedema. In the case of diastolic dysfunction there is little data to guide management.1 We present a case of a patient who developed flash pulmonary oedema (FPO) secondary to a hypertensive crisis.
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Hang, Choi, and Kim. "A Novel EMR Integrity Management Based on a Medical Blockchain Platform in Hospital." Electronics 8, no. 4 (April 25, 2019): 467. http://dx.doi.org/10.3390/electronics8040467.
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Recent advancements in information and communication technology is enabling a significant revolution in e-Health research and industry. In the case of personal medical data sharing, data security and convenience are crucial requirements to the interaction and collaboration of electronic medical record (EMR) systems. However, it’s hard for current systems to meet these requirements as they have inconsistent structures in terms of security policies and access control models. A new solution direction is essential to enhance data-accessing while regulating it with government mandates in privacy and security to ensure the accountability of the medical usage data. Blockchain seems to pave the way for revolution in the conventional healthcare industry benefiting by its unique features such as data privacy and transparency. In this paper, a blockchain-based medical platform using a smart contract is proposed to secure the EMR management. This approach provides patients a comprehensive, immutable log and easy access to their medical information across different departments within the hospital. A case study for hospital is built on a permissioned network, and a series of experimental tests are performed to demonstrate the usability and efficiency of the designed platform. Lastly, a benchmark study by leveraging various performance metrics is made and the outcomes indicate that the designed platform surpasses the ability of existing works in various aspects. The results of this work reveal that the proposed solution has the great potential to accelerate the development of a decentralized digital healthcare ecosystem.
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Amora, Ana. "The garden in the modern hospital architecture of the ‘Carioca School’ in Rio de Janeiro, Brazil." Gardens and Landscapes of Portugal 5, no. 1 (September 1, 2018): 22–38. http://dx.doi.org/10.2478/glp-2019-0003.
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Abstract The purpose of this article is to explore the role of gardens in the architecture of hospitals of the so-called “carioca school” of architecture, between the years of 1930 and 1960. In other words, to analyze gardens in the works of carioca architects who surrounded the architect Lucio Costa, or whose projects were influenced by the conceptions of this first generation of modern architects, who first graduated architecture school at the National College of Fine Arts and then, after 1945, at the National College of Architecture, in Rio de Janeiro. The importance of gardens in the architecture of hospitals was mentioned in Edward Stevens’s book “The American hospital of the twentieth century”, in 1918, a publication which can be found at the UFRJ Architecture School library, as well as in the Brazilian doctors’ book collections at the time. Stevens dedicates a chapter of this book to the landscape theme, where he states that the hospital designer and the landscape architect should work together. On the other hand, Pasteur’s discoveries and their implications in the management of hospital space did not occur without the mediation of landscaping. They resulted in changes when it came to choose the site for the hospital building within a city, as well as in its formal typology - from the Tollet model of pavilions, to the existence of green areas surrounding high buildings, and overlapping nurseries. It is also relevant to bear in mind that public nationalist buildings played an important role after the revolution of 1930 in Brazil as they represented the state, and this resulted in significant projects. We are therefore going to present four hospital buildings which were analyzed in our research on the integration of the Arts in the architecture of hospitals. Although the Lagoa Hospital, by Oscar Niemeyer, the Sanatorium Complex of Curicica, by Sérgio Bernardes, the IPPMG, by Jorge Machado Moreira, and the Souza Aguiar Hospital, by Ary Garcia Roza, all have different programs, formal typologies and links with their surrounding area, they are good examples for debating the presence of gardens in the Modern architecture of hospitals in the city of Rio de Janeiro. Three of these examples have fortunately included projects by landscape designer Roberto Burle Marx - the Lagoa Hospital, the IPPMG and the Souza Aguiar Hospital. The two former hospitals have had their buildings be surrounded by large gardens, in order to mitigate the harmful health effects related to the inclusion of hospitals within urban areas. The latter has been built in the 1960s with a complex program, in a dense historical area downtown, but adjacent to an urban park. It includes a vertical garden, which delimits, along with a panel in the hall (also by the same designer), a hallway for the user, between the urban and the healing space.
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Demetrian, Alin Dragos, Mihnea Cosmin Costoiu, Augustin Semenescu, Gigel Paraschiv, Oana Roxana Chivu, Claudiu Babis, Georgiana Moiceanu, Olivia Negoita, and Ileana Mates. "On the Reduction of the Biological Danger of Environmental Contamination by Using a “Complete and Reusable Thoracic Drainage System”." Sustainability 11, no. 10 (May 20, 2019): 2873. http://dx.doi.org/10.3390/su11102873.
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A clean environment is essential for human health and well-being. A significant share of total waste is represented by hospital waste that is produced in increasing quantities by sanitary units, with the appearance of the disposable tools. Taking into account the unfavourable environmental impact, the biological danger that this waste represents, and the restrictive legislation imposed by the European Union, urgent measures are needed to reduce their quantities. In this regard, the paper refers to the design of a completely reusable thoracic drainage system and to the positive implications that this system has on the amount of hospital waste. The research starts with the presentation of the medical system from Romania, continues with the classification of the hospital waste, then highlights the dangers and the risks caused by this and analyzes the impact on the sensitive groups. Furthermore, the paper presents the disposable bicameral and tricameral thoracic drainage device systems used in hospitals and then the advantages of using a completely reusable thoracic drainage system. The paper introduces also a research method based on the “opinion questioning”. The method uses a questionnaire with 23 items, addressed to physicians, because, despite restrictive legislation related to hospital waste management, this is not always respected. Each participant of the study works in a different hospital so that the questioned sample is representative.
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Cunningham, Paul A. "The future of community-centred health services in Australia - an alternative view." Australian Health Review 36, no. 2 (2012): 121. http://dx.doi.org/10.1071/ah11013.
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Community-centred healthcare works in conjunction with hospital-centred healthcare. Both have strengths and limitations. Community-centred healthcare has been demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care at best in a limited fashion. If hospital-centred services dominate healthcare services in Australia, as argued previously in this journal, then this has not extended to maintenance of inpatient bed provision. The author, as a hospital-based emergency specialist, has observed case load and models of care in hospitals and emergency departments for 30 years and is sceptical of promises to substantially further decrease emergency department demand and acute bed requirements. The real benefits of community, primary and preventive care should not be over sold. What is known about the topic? Community-centred healthcare has not been widely demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care for acute conditions, even when these conditions are superimposed on a chronic condition. What does this paper add? The author makes a plea for a reasoned and evidence-based approach to the distribution of finite health resources. Experts in the fields of acute, chronic and preventive health measures should present plans that less knowledgeable decision makers can implement appropriately. What are the implications for practitioners? Experienced health experts need to balance the argument, including advocacy for adequate acute care and hospital-based services. Practitioners who require acute hospital beds for the safe and humane management of their patients may need to argue for legislative definition of bed numbers per population size.
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Rizzatti, Giselly, Mauricio Fernandes Pereira, and Heloisa Cristina Martins Amaral. "The Influence of Leadership in The Conduct of the Implementation Process of Strategic Planning: A Case Study at the University Hospital of the University of St Catherine." Revista Ibero-Americana de Estratégia 11, no. 2 (July 1, 2012): 170–96. http://dx.doi.org/10.5585/ijsm.v11i2.1879.
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Teaching hospitals are undergoing profound and fast changes, especially resulting from the implementation of new policies for health. To achieve their goals and remain competitive, these organizations have been forced to adopt more effective management tools, among which are the elaboration of a strategic plan. The goal of this study is to analyze the influence of leadership in driving the implementation process of strategic planning in a teaching hospital. The study was conducted in the university hospital Prof. Polydoro Ernani de São Thiago from Federal University of Santa Catarina - HU / UFSC, where a semi-structured interview was conducted with the coordinator of the Strategic Planning Team HU / UFSC. Authors Hersey et al (1986), Northouse (2004), Schein (1997) Senge (1999), among others, were grounded theoretically in the theme of leadership. The theory of strategic planning was primarily based on works by authors Ansoff (l991), Hrebiniak (2006) and Pereira (2010). With the research results, we can conclude the great influence that leadership plays in driving the implementation process of strategic planning.
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Verri Lucca, Arielle, Luís Augusto Silva, Rodrigo Luchtenberg, Leonardo Garcez, Xuzeng Mao, Raúl García Ovejero, Ivan Miguel Pires, Jorge Luis Victória Barbosa, and Valderi Reis Quietinho Leithardt. "A Case Study on the Development of a Data Privacy Management Solution Based on Patient Information." Sensors 20, no. 21 (October 23, 2020): 6030. http://dx.doi.org/10.3390/s20216030.
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Data on diagnosis of infection in the general population are strategic for different applications in the public and private spheres. Among them, the data related to symptoms and people displacement stand out, mainly considering highly contagious diseases. This data is sensitive and requires data privacy initiatives to enable its large-scale use. The search for population-monitoring strategies aims at social tracking, supporting the surveillance of contagions to respond to the confrontation with Coronavirus 2 (COVID-19). There are several data privacy issues in environments where IoT devices are used for monitoring hospital processes. In this research, we compare works related to the subject of privacy in the health area. To this end, this research proposes a taxonomy to support the requirements necessary to control patient data privacy in a hospital environment. According to the tests and comparisons made between the variables compared, the application obtained results that contribute to the scenarios applied. In this sense, we modeled and implemented an application. By the end, a mobile application was developed to analyze the privacy and security constraints with COVID-19.
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Tejera Quintana, Rubén Jesús, Pilar Marqués-Sánchez, C. Patricia Arencibia-Sánchez, and Elba Mauriz. "Safety Climate Assessment in Operating Room Nurses Through Safety Attitudes Questionnaire (SAQ)." Archives of Nursing Research 2, no. 1 (July 17, 2018): 1. http://dx.doi.org/10.24253/anr.2.1.
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Introduction: Surgical safety is a public health concern worldwide. The attitudes and perceptions of the surgical team regarding to the safety of the patient are associated to the safety climate and the prevalence of adverse events. Objective: To evaluate the safety climate perceived by operating room nurses from several Hospitals. Method: This works presents a multicentre cross-sectional study. Data collection was obtained by means of The Safety Attitudes Questionnaire (SAQ), a self-completed questionnaire translated to the Spanish. A convenience sample with voluntary participation was selected. The safety climate was determined through six factors: Teamwork climate, Safety climate, Job satisfaction, Perception of the Unit and Hospital Management, Working conditions and Stress recognition. Results: safety climate perceived by surgical nurses shows mixed values in relation to patient safety. Perception of the management (p = 0.001)and Working condition domain (p = 0.003) are the domains worst valued. The size of the hospitals and Years of professional experience showed statistical differences in several domains. Conclusions: The variation of the safety climate perceived by nurses suggests that there are needs and opportunities for improvement in all its dimensions.
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Naniwadekar R G. "Uncomplicated adult inguinal hernia repair under local anaesthesia and spinal anaesthesia." International Journal of Research in Pharmaceutical Sciences 11, no. 3 (July 7, 2020): 3212–21. http://dx.doi.org/10.26452/ijrps.v11i3.2437.
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Multiple researchers have given numerous guidelines in the clinical management of this disorder in the late nineteenth and twentieth centuries, after comprehensive works on the subject. As a result, a very wide variety of surgical procedures are now available to the surgeon to suit the requirement. There have been numerous advances in the management of inguinal hernia. Inguinal hernias can conveniently be repaired under all kinds of anaesthesia, namely general, spinal and local. Whereas the general anaesthesia requires the services of an experienced anaesthetist and new devices and spinal anaesthesia requires postoperative impairment while local anaesthesia is safe to prescribe, easy and efficient and does not cause postoperative complications. This work consisted of a study group of twenty-five adult patients of uncomplicated inguinal hernias, who after repair of hernias, which after repair of hernias were allowed early ambulation and had a short hospital, stay of one day post operatively. The second control group consisted of similar twenty-five patients who are subjected to conventional delayed ambulation and prolonged hospital stay. The results of repair in the two groups were compared; the available literature on the subject was reviewed. The implementation of ”shortstay surgery” not only relieves the waiting list in hospitals but also offers an economic boost and provides the patient with some social advantages.
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Gabriel, Carmen Silvia, Marcia Regina Antonieto da Costa Melo, Fernanda Ludmila Rossi Rocha, Andréa Bernardes, Tatiana Miguelaci, and Maria de Lourdes Prado Silva. "Use of performance indicators in the nursing service of a public hospital." Revista Latino-Americana de Enfermagem 19, no. 5 (October 2011): 1247–54. http://dx.doi.org/10.1590/s0104-11692011000500024.
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The study aimed to identify performance indicators adopted by the Nursing Service of a public hospital and to analyze the opinions of the nurses regarding the use of these indicators to evaluate the quality of the nursing care. This is descriptive exploratory study with a quantitative approach, which used data from the management reports of the institution and applied a questionnaire in a sample of 25 nurses. It was found that the institution works with three databases of indicators, two being general and one specific for Nursing, which analyze 11 indicators. The indicators of pressure ulcer incidence and incidence of falls were the only ones considered highly relevant to qualify the nursing care for 100% of the nurses. It was concluded that the institution uses indicators for monitoring outcomes and tends to valorize the use of process indicators by the nurses to evaluate the Nursing performance, with it being necessary to expand the analysis to include multi-disciplinary indicators.
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Park, Chang-Seop. "Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices." BioMed Research International 2014 (2014): 1–12. http://dx.doi.org/10.1155/2014/543051.
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After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient’s life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician’s treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance.
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Ramdani, Boumediene, Binheng Duan, and Ilhem Berrou. "Exploring the Determinants of Mobile Health Adoption by Hospitals in China: Empirical Study." JMIR Medical Informatics 8, no. 7 (July 14, 2020): e14795. http://dx.doi.org/10.2196/14795.
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Background Although mobile health (mHealth) has the potential to transform health care by delivering better outcomes at a much lower cost than traditional health care services, little is known about mHealth adoption by hospitals. Objective This study aims to explore the determinants of mHealth adoption by hospitals using the technology-organization-environment (TOE) framework. Methods We conducted an interviewer-administered survey with 87 managers in Chinese public hospitals and analyzed the data using logistic regression. Results The results of our survey indicate that perceived ease of use (β=.692; P<.002), system security (β=.473; P<.05), top management support (β=1.466; P<.002), hospital size (β=1.069; P<.004), and external pressure (β=.703; P<.005) are significantly related to hospitals’ adoption of mHealth. However, information technology infrastructure (β=.574; P<.02), system reliability (β=−1.291; P<.01), and government policy (β=2.010; P<.04) are significant but negatively related to hospitals’ adoption of mHealth. Conclusions We found that TOE model works in the context of mHealth adoption by hospitals. In addition to technological predictors, organizational and environmental predictors are critical for explaining mHealth adoption by Chinese hospitals.
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Schwabkey, Zaker I., Farrell C. Sheehan, Courtney Bellomo, and Mihir Raval. "Congenital dysfibrinogenaemia presented with preterm premature rupture of the membranes and vaginal bleeding." BMJ Case Reports 13, no. 9 (September 2020): e235961. http://dx.doi.org/10.1136/bcr-2020-235961.
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A 26-year-old woman was found to have congenital dysfibrinogenaemia after presenting to our hospital with premature rupture of the membranes and vaginal bleeding. Given the absence of clear guidelines for the management of pregnancy complicated by dysfibrinogenaemia, we followed expert consensus that exists among published works, with some modifications. This case was managed by a multidisciplinary team of obstetrics-gynaecology, haematology and paediatric haematology. Here we review how the patient presented, the investigations that led to the diagnosis and the treatment options.
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Simons, Joan. "An international study on innovations in the management of children’s pain." International Practice Development Journal 3, no. 2 (November 13, 2013): 1–18. http://dx.doi.org/10.19043/ipdj.32.004.
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Background: Children have a right to effective pain management and up to date guidelines are available to promote this. Despite this, many reports state that children’s pain in hospital settings is not managed well, and many children are left to suffer unnecessarily. Nearly a quarter of children surveyed said they were in pain all or most of the time they were in hospital (Picker, 2005). However, this is not the whole picture; many areas deliver effective and innovative pain management for children. Aim: The aim of this travel scholarship was to undertake a study to identify innovations and learn from examples of good practice in the management of children’s pain by visiting three areas of excellence in the UK, Sweden and Australia. Methods: The study took an Appreciative Inquiry approach, focusing on learning from good practice, and follows four stages: Discovery (the best of what is): this involved visits to the three study areas and meeting practitioners, educators and researchers to explore innovations in their pain management practice Dream (what might be): this involved meeting with the host at the end of each study week to present to them identified examples of good practice for confirmation Design (what should be): this involved writing up the findings of the three visits, exploring what innovations could be introduced to improve pain management practice across the UK Destiny: this is dissemination and implementation of the best practice examples identified Conclusions: In each area visited, confident practitioners identified innovations in their pain management practice that have improved children’s pain experience in hospital. Innovations ranged from environmental adjustments to reduce anxiety related to pain, to standardising children’s observation charts to promote the regular assessment of pain. Effective leadership was apparent at each study site. Implications for practice: Appreciative Inquiry is about identifying what works so that it can be repeated Confidence and self-belief underpin the practice of effective pain management teams An effective leader with a vision is needed to drive continuous improvement in the management of children’s pain
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Abdullah, Nur Syahidah Wong, Sylvia @. Nabila Azwa Ambad, Sakka Nordin, Jasmine Vivienne Andrew, and Karen Esther Tan. "Justifying Business Intelligence Systems Adoption: A Literature Review on Healthcare Supply Chain Perspective." Jurnal Intelek 16, no. 1 (January 26, 2021): 108–14. http://dx.doi.org/10.24191/ji.v16i1.370.
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Business Intelligence (BI) systems have played an essential position in facilitating information sharing, strategic cost-cutting, and improvement in business process management through data-driven decision-making analytics. The technological enablers of Industry 4.0 have empowered the clinician to attain accurate information in formulating predictive and data-driven diagnoses based on artificial intelligence-enabled medical devices resulting in an efficient and quality clinical pathway for patients. However, there is a noticeable distinction between the hospital's technological aptitude between clinician and non-clinician. The current technological capability of the hospital information system is to digitize daily business processes that could not offer intelligence reports for predicting, forecasting, and data-driven decision-making support. The compilation of past works of literature is expected to justify the need for the healthcare supply chain to adopt BI solutions that produce near real-time data in making efficient inventory management and procurement to support the clinician in delivering efficient and quality clinical pathways for patients by bringing the supplies at the right moment. Hence, a study of BI solutions in healthcare supply chain operation is achieved through a narrative overview of existing literature from papers published online. The results show that appropriate technological tools, resource competencies, and supplier management platform as the essential dimensions to support the business intelligence adoption effort. The study, therefore, not only identified the critical dimensions in facilitating BI adoption but also offer practical awareness to the healthcare policymakers to better understand the strategic need for BI systems in managing the entire hospital operations to gain a competitive advantage.
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Hulter, Pauline, Bettine Pluut, Christine Leenen-Brinkhuis, Marleen de Mul, Kees Ahaus, and Anne Marie Weggelaar-Jansen. "Adopting Patient Portals in Hospitals: Qualitative Study." Journal of Medical Internet Research 22, no. 5 (May 19, 2020): e16921. http://dx.doi.org/10.2196/16921.
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Background Theoretical models help to explain or predict the adoption of electronic health (eHealth) technology and illustrate the complexity of the adoption process. These models provide insights into general factors that influence the use of eHealth technology. However, they do not give hospitals much actionable knowledge on how to facilitate the adoption process. Objective Our study aims to provide insights into patient portal adoption processes among patients and hospital staff, including health care professionals (HCPs), managers, and administrative clerks. Studying the experiences and views of stakeholders answers the following question: How can hospitals encourage patients and HCPs to adopt a patient portal? Methods We conducted 22 semistructured individual and group interviews (n=69) in 12 hospitals and four focus groups with members of national and seminational organizations and patient portal suppliers (n=53). Results The effort hospitals put into adopting patient portals can be split into three themes. First, inform patients and HCPs about the portal. This communication strategy has four objectives: users should (1) know about the portal, (2) know how the portal works, (3) know that action on the portal is required, and (4) know where to find help with the portal. Second, embed the patient portal in the daily routine of HCPs and management. This involves three forms of support: (1) hospital policy, (2) management by monitoring the numbers, and (3) a structured implementation strategy that includes all staff of one department. Third, try to adjust the portal to meet patients’ needs to optimize user-friendliness in two ways: (1) use patients’ feedback and (2) focus on optimizing for patients with special needs (eg, low literacy and low digital skills). Conclusions Asking stakeholders what they have learned from their efforts to stimulate patient portal use in hospitals elicited rich insights into the adoption process. These insights are missing in the theoretical models. Therefore, our findings help to translate the relatively abstract factors one finds in theoretical models to the everyday pragmatics of eHealth projects in hospitals.
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Sakya, Jaswan, Sujit Kumar Sah, Khakindra Bahadur Bhandari, Laxmi Raj Pathak, Santosh Bikram Bhandari, Sudha Ghimire, Bhimsen Devkota, and Jurgen Hussmann. "Perception of Community and Hospital Personnel on Burn Treatment and Outcome in Nepal." Journal of Nepal Medical Association 56, no. 214 (December 31, 2018): 924–30. http://dx.doi.org/10.31729/jnma.3889.
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Introduction: Globally, eleven million people sustain burn injuries every year enough to require medical attention. WHO has estimated Disability associated limited years of 84,000 per year just due to deformities and 2100 people die every year due to burn injuries in Nepal. The overall objective of the study is to explore the effectiveness of burn injuries treatment and management approach of hospitals.Methods: This qualitative study approached to 40 Health Personnel for Key Informants Interviews and 18 Focus Group Discussions with community people at the ten referral hospitals of eight district from May-June 2016. Qualitative data were analyzed using At.Lasti Software. Results: Female burn victims are brought late to the hospital compared to male patients and false reporting about incident is usually done by her attendants. More than three-fourth (80%) of the hospitals and about one-third male and female from FGD reported that the community people seek home remedy first rather than medical treatment. Majority of the medical doctors and nursing chiefs reported that first degree cases accounts for 50% of the total burn cases with a success rate of 80%. Medical and Nursing staff reported that deformities like hypertrophic scar, keloids, joint stiffness and compartment syndrome are mostly observed during the treatment. Hypothermia and sepsis were the major causes of death in most of the burn patients.Conclusions: Usually, people who engaged in house and agriculture works, have visited public health posts/hospitals more frequently due to financial constraints and transportation issues where quality of burn care services are unavailable.
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Lee, Hyeon-Ju, and Youn-Jung Son. "Factors Associated with In-Hospital Mortality after Continuous Renal Replacement Therapy for Critically Ill Patients: A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health 17, no. 23 (November 26, 2020): 8781. http://dx.doi.org/10.3390/ijerph17238781.
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Continuous renal replacement therapy (CRRT) is a broadly-accepted treatment for critically ill patients with acute kidney injury to optimize fluid and electrolyte management. Despite intensive dialysis care, there is a high mortality rate among these patients. There is uncertainty regarding the factors associated with in-hospital mortality among patients requiring CRRT. This review evaluates how various risk factors influence the in-hospital mortality of critically ill patients who require CRRT. Five databases were surveyed to gather relevant publications up to 30 June 2020. We identified 752 works, of which we retrieved 38 in full text. Finally, six cohort studies that evaluated 1190 patients were eligible. The in-hospital mortality rate in these studies ranged from 38.6 to 62.4%. Our meta-analysis results showed that older age, lower body mass index, higher APACHE II and SOFA scores, lower systolic and diastolic blood pressure, decreased serum creatinine level, and increased serum sodium level were significantly associated with increased in-hospital mortality in critically ill patients who received CRRT. These results suggest that there are multiple modifiable factors that influence the risk of in-hospital mortality in critically ill patients undergoing CRRT. Further, healthcare professionals should take more care when CRRT is performed on older adults.
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Abdallah, Ayman Bahjat, and Rasha Zuhair Alkhaldi. "Lean bundles in health care: a scoping review." Journal of Health Organization and Management 33, no. 4 (June 28, 2019): 488–510. http://dx.doi.org/10.1108/jhom-09-2018-0263.
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Purpose The purpose of this paper is to review original research on lean management (LM) in health care to identify potential research gaps and present recommendations for future research. The paper also discusses the current state of implementing LM practices in health care. In addition, it presents and highlights “lean bundles” imported from manufacturing, namely, total quality management (TQM), human resource management, just-in-time and total productive maintenance, as a potential implementation strategy of LM in hospitals to optimize overall health care performance. Design/methodology/approach The scoping review was conducted based on the guidelines specified by Arksey and O’Malley (2005). Relevant included studies were retrieved by searching various electronic databases. The PRISMA guidelines were applied to identify and select eligible studies. Findings The majority of previous studies used selected practices to measure LM in health care. In most cases, these practices reflected a narrow and biased view of LM. Lean bundles which comprehensively view LM and reflect all its aspects have rarely been discussed in the health care literature. Evidence about the contribution of lean bundles to hospital performance needs to be addressed in future studies. Practical implications This paper demonstrates the implementation of the four lean bundles in hospitals. It argues that, instead of adopting one dimension or selected practices of LM, hospitals viewing LM as a comprehensive multi-dimensional approach through the adoption of the four lean bundles are expected to maximize their performances. Originality/value This is one of the first works to comprehensively review and discuss lean bundles in the context of health care. It argues that the adoption of the four lean bundles by hospitals will enable them to yield the maximum LM performance benefits. In addition, a proposed survey questionnaire based on the literature review is provided to assist researchers in conducting future empirical studies.
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Budiyanti, Helda, and Nyoman Anita Damayanti. "Penilaian Kebutuhan Pelatihan pada Tingkat Individu Petugas Rekam Medis." Jurnal Administrasi Kesehatan Indonesia 3, no. 1 (January 1, 2015): 70. http://dx.doi.org/10.20473/jaki.v3i1.2015.70-79.
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ABSTRACT The increased number of complaint patient indicated performance gap of medical records officer. Training needs assessment was a systematically order of process to discover and identified the existence of a disparity performance caused by a lack of knowledge, attitude and skills in doing the work. Individual analysis identified a disparity between requirements of work to requirement an organization that owned by their respective employee. The purpose of this study was to develop a training needs medical records staff at Undaan Surabaya Eye Hospital, based on the training needs assessment through individual analysis.This was a descriptive study, subject of research were medical record officers who works in Undaan Surabaya Eye Hospital. More that 56,00% was included in good category knowledge. The most medical records officers has 88% excellent working attitude, skilled officers medical records in conducted technical work related duties 77.78% good category, and softkills as a whole into the category of a good 49,5%. This study concluded be taken from this study was the training needs of medical record staff in Undaan Eye Hospital Surabaya generally was training on knowledge and skill of management medical records. Keywords :individual analysis, medical record staff, training need assessment
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Moghbeli, Fateme, Mostafa Langarizadeh, Azita Kouhestani, and Azam Orooji. "Modeling the Acceptance of Hospital Information Systems among Nurses: An Extended Technology Acceptance Model." Iranian Journal of Medical Informatics 7 (May 23, 2018): 1. http://dx.doi.org/10.24200/ijmi.v7i0.147.
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Introduction: The perceived usefulness and perceived ease of use have been considered as the main factors affecting the acceptance of the new technologies since last few decades. However, it appears that these only two factors cannot describe the users’ behavior in the environments like the Hospital Information System. From the technology acceptance standpoint at the individual acceptance level, the present paper tends to develop a Technology Acceptance Model with introducing some external factors.Material and Methods: This study was conducted in 2017. The research population was included 185 nurses who works in Health Information Management (HIM) departments of Tehran University of Medical Sciences. A questionnaire was developed in order to gather the required data. The validity was obtained by panel of experts and the reliability was examined and then confirmed in a 50 person sample using the Cronbach’s Alpha (a=0.93). The Likert’s five item scale was applied. The data were analyzed using descriptive statistics, exploratory factor analysis, and path analysis.Results: The behavioral intention was affected significantly and positively by the factors of perceived usefulness, perceived ease of use, self-efficacy, end user support, social norm, trust, job relevance, and training, with trust having the highest level of effects. Also perceived ease of use had a significant effect on perceived usefulness along with an indirect effect on behavioral intention through perceived usefulness. The factors of anxiety, voluntariness, and facilitating conditions showed no significant effects on behavioral intention.Conclusion: The factors of trust, perceived usefulness, social norm, end user support, and self-efficacy have an impact on the behavioral intention of the users utilizing the Hospital Information System in the concerning hospitals. These factors could explain 72% of the changes of behavioral intention. Concentrating on them would lead to the improvement of the acceptance and Hospital Information System efficiency.
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Roy Adi Wijaya, Matias, Jati Utomo Dwi Hatmoko, and Suripin Suripin. "Assessment of Lean Construction Principles: A Case Study at Semarang Medical Centre Hospital Project." MEDIA KOMUNIKASI TEKNIK SIPIL 21, no. 2 (June 8, 2016): 91. http://dx.doi.org/10.14710/mkts.v21i2.11235.
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The lean construction frameworks have been developed for years to enhance the poor performance of Indonesian project delivery system which influenced by the waste of non-value adding activities. Never the less most of the developments were limited on working process and lack in people empowerment. Toyota Way which integrate working process optimization and people empowerment, was developed as a lean construction frame works. This paper aimed to assess the implementation of Toyota Way principles in project delivery system by observing project’s delivery current state (status quo). The assessment began by conducting a questionnaire survey about Toyota Way implementation which then validated by interview with involved stakeholders and field observation. The assessment showed that project’s stakeholders were still unfamiliar with Toyota Way concept. Although some Toyota Way guidelines have been used in projects completion process such as visual management and training program, it found that those guidelines had not fully implemented. The project delivery system was lack of process focus and concerns more on relationship inter-parties. It also found thatToyota Way implementation will constrained by the difficulties to change the status quo of project delivery. Moreover, it seems that construction projects need practical guidelines to simplify the Toyota Way implementation in project delivery system such as project flow evaluation and system of reflection.
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Pellegrini, Massimo, Michael Kob, Rita Trovato, Marion Schrei, Valentina Corazzini, Nicoletta Facchin, Mariantonietta Mazzoldi, and Lucio Lucchin. "Management Strategy of Obesity in the Public Health System: Proposal of a New Model to Optimize Human Resources and Patient’s Motivation." Open Nutrition Journal 12, no. 1 (April 30, 2018): 3–9. http://dx.doi.org/10.2174/1874288201812010003.
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Introduction: Obesity, a disease characterized by an excess of adipose tissue, is a worldwide issue of growing interest in public health. Methods: The multifactorial etiology and pathogenesis of obesity strongly orient the scientific community in considering it as a chronic disease without an effective therapy that works for all patients affected by this clinical condition. This leads to a proliferation of non-scientific and dangerous treatment proposals and fake news. The Dietetic and Clinical Nutrition Unit at Bolzano Hospital in Italy has adopted a new strategy based on transparency to optimize time for the first visit and particularly to increase patients’ knowledge and motivation. Results: This new strategy provides a preliminary consultation between patients who ask for a nutritional examination and a clinical team composed of a clinician, a dietician and a psychologist. We discuss the preliminary results obtained during the period between February 2010 and March 2016.
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Sieradzki, Gregory, Helene Esperou, and Anne De Jesus. "Sharing experiences and building collective projects in quality management: The strength of UNICANCER group." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 226. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.226.
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226 Background: UNICANCER is a hospital group entirely devoted to fighting cancer. UNICANCER groups together 20 French Comprehensive Cancer Centers (FCCC), which are private, non-profit establishments with a threefold mission of patient care, research and oncology teaching. They share the same organizational model to take care the patients and they have organized an informal network of quality and risk management In 2005, the FCCC federation (former Unicancer group) was created a Quality department in order to build a common approach to improve the quality of care and patient management in Cancer Centers. One the most important tools to set up this shared works were comparative analysis and feedback system. Methods: Every year, the quality department of Unicancer group coordinated the results of several indicators recorded by each centers. These results were summarized in the benchmarks dashboards to identify the priority actions for the group. Results: Between 2006 and 2014, some collaborative projects have been carried out in various fields: (1) development of the culture of continuous improvement, (2) involvement to the national implementationof hospital quality and safety indicators in France, (3) development of specific indicators of cancer care, (4) implementation of questionnaire survey to assess the in- or outpatient satisfaction. As far as concerned the different results of external assessment (1) the values of quality and safety indicators are above the national average, (2) the Cancer Centers have the best level of “certification” for the French National Authority for Health. Conclusions: The teamwork and benchmarking is an innovative way of working. The level of quality of care and patient management increases steadily in Cancer Centers in France. The next step consists of developing a common standard to keep competitive edge. [Table: see text]
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Tran, Thi Thu Thuy, Thi Huong Nguyen, Van Bang Nguyen, and Thi Thanh Xuan Le. "Self-reported social support at works among nurses and associated factors. Results from a cross-sectional study in a provincial hospital in 2020." Journal of Health and Development Studies 05, no. 04 (July 15, 2021): 18–28. http://dx.doi.org/10.38148/jhds.0504skpt20-079.
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Objective: This study aimed to measure nurses' self-perceived social support and identify associated factors at one Vietnamese provincial hospital in 2020. Methods: A cross-sectional study was implemented among clinical nurses of 22 treatment wards working at the hospital for over six months. Two hundred sixty-one nurses returned the self-reported questionnaires containing the Vietnamese 22-item Job Content Questionnaire and set of questions on personal and work characteristics. Descriptive analysis (frequency, mean, standard deviation), crude analysis (t-test and ANOVA), and multivariate linear regressions were conducted to describe the social support (i.e., supervisor' and co-worker's supports) and their associations with other factors at the significant level p less than 0.05. Results: The study achieved a relatively high response rate (82.1%). Social supports, including supervisor and co-worker's supports, were 24.04, 11.89, and 12.16, respectively. Multivariate Linear regressions showed an inverse association of job demand and positive correlation of job control with both supervisor and co-workers' support among participating nurses (p<0.01). Older nurses, nurses with fewer years of work experience or fixed-term contract reported more perceived support from their superiors (p<0.05). Conclusions: Nurses with different characteristics reported dissimilar perceived levels of social supports at work. Head nurses responsible for nursing management should encourage a supportive working environment where nurses can feel comfortable asking for and receive assistance from others. In addition, appropriate training would be helpful to increase nurses' recognition and usage of available resources at work. Keywords: Social support, supervisor's support, co-worker's support, clinical nurses, provincial hospital, Vietnam
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Campbell, Bruce W. "Effective change management in a regional Sub-acute Ambulatory Care Services setting." Australian Health Review 36, no. 1 (2012): 39. http://dx.doi.org/10.1071/ah11031.
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Government policies and community expectations in Australia continually lead to calls for healthcare change. These changes are often met with resistance from clinicians and managers. Making change happen requires consideration of the way policies, culture, context, shared vision and leadership can drive or impede change. This reflective case study critically investigates one change process; the evolution of a Sub-acute Ambulatory Care Services (SACS) program in an Australian regional hospital over a 3-year period. The new Community Rehabilitation Services (CRS) program evolved from a merger of Centre and Home Based Rehabilitation (CBR and HBR). Hospital amalgamations, closures and privatisation, and the Department of Health policy relating to SACS, ambulatory care and rehabilitation were some of the key elements explored in this paper. What is known about the topic? Healthcare is an industry constantly focussed on improving services and care to patients. There has been a lot written about change management in healthcare. Change can be difficult to implement and is a dynamic phenomenon. There are many factors which can assist or hinder change. What does this paper add? This reflective case study outlines the change process in this particular regional healthcare setting context within a multidisciplinary team. This paper adds to the body of knowledge by considering the influences of the unique history and culture of the setting, and the complex interrelated nature of factors which can affect change. What are the implications for practitioners? Healthcare service managers need to understand that the change process is complex and can be confusing. Government policy constantly drives change in this industry to improve patient care, but how an organisation works through this is unique to the setting. One size does not fit all, and understanding the organisation, staff, culture and having a vision at that point in time is an essential prerequisite. Any change requires working with people who need time to adapt, up skill and learn new processes and procedures. Reanalysing the change process and being flexible during the journey can assist in reaching the desired change outcome.
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Cox, Keith, Deme Karikios, Jessica K. Roydhouse, and Kate White. "Nurse-led supportive care management: a 6-month review of the role of a nurse practitioner in a chemotherapy unit." Australian Health Review 37, no. 5 (2013): 632. http://dx.doi.org/10.1071/ah13069.
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Objectives This case study evaluates the oncology nurse practitioner (NP) role in a chemotherapy unit. Background The NP works in the cancer centre of a major metropolitan public hospital. The NP role was established in the chemotherapy unit in 2007. The NP reviews all patients that have an unscheduled presentation to the unit, with symptoms relating either to their disease or treatment. Methods All unscheduled occasions of service provided by the NP in the chemotherapy unit over 6 months were recorded. Data were collected on patient demographic characteristics, medical problems and reason for presentation. Data on duration of care, interventions and outcomes administered by the NP were captured. Results There were 87 occasions of service (72 patients) during the study period. Nausea, vomiting or dehydration were the most common presenting problems and most presenting problems were moderate or severe (n = 73, 84%). The median time to review for the NP was 5 min and nearly all consultations (n = 83, 96%) took 30 min or less. Following NP consultation, most occasions of service did not require subsequent hospital admission (n = 52, 60%), medical advice (n = 61, 70%) or medical review (n = 75, 86%). Conclusions The NP is a valuable asset to a busy department, increasing access to timely and appropriate healthcare for patients on chemotherapy. What is known about the topic? Models of care for oncology NP roles are being developed in Australia, but few published reports and descriptions of the work of oncology NP exist. What does this paper add? This paper presents a description and evaluation of occasions of service for an oncology NP in a chemotherapy unit and the impact of the NP’s role on the hospital and clinical workload. What are the implications for practitioners? This paper can inform the development of other oncology NP roles in Australian chemotherapy units, and highlights potential areas of evaluation for new NP roles in cancer care.
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Adamyk, Victoriia, and Yulia Dyshkant. "MODERNIZATION OF THE ORGANIZATIONAL CULTURE OF THE HEALTHCARE INSTITUTION IN THE CONDITIONS OF MEDICAL REFORM." Economic Analysis, no. 30(4) (2020): 140–46. http://dx.doi.org/10.35774/econa2020.04.140.
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Subject, aim of research. The subject of the study is the modernization of the organizational culture of health care facilities in the implementation of the second stage of medical reform in Ukraine. The aim is to identify the factors and problems of the organizational culture of medical institutions, as well as directions and tools for its modernization in the context of medical reform. Methods and methodology of work. The methodological basis is the scientific works of domestic and foreign scientists. The research is based on a systematic approach and methods of strategic analysis, in particular SWOT-analysis, comparative analysis, export valuation method, questionnaire method, etc. Research results. The article emphasizes that the main factor of health care facilities modernization in Ukraine is the medical reform. The main challenges facing secondary hospitals are highlighted: increased competition of healthcare market, expanding the range of funding sources, technological change, demand transformation and epidemiological threat. The main directions of modernization of health care institutions organizational culture are identified. Among them there are strengthening its functional component with separation of responsibilities and capabilities of hospital management and medical staff; innovative development; communication with colleagues from other institutions, including foreign ones, and patients respectively to the requirements of digitalization; staff training, the use of crisis management tools, etc. The project profile of the evaluation components of the effectiveness of the organizational culture of health care institutions modernization has been formed. The important role of PR-management and image-making in the formation of corporate culture of modern medical institutions is emphasized.
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Quader, Mohd Abul. "Socio-Demographic Characteristics of Blood Donor in a Tertiary Care Specialized Hospital." Bangladesh Journal of Medicine 32, no. 2 (June 5, 2021): 113–19. http://dx.doi.org/10.3329/bjm.v32i2.53798.
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Background: Blood donors are the backbone of a transfusion service. To ensure a safe and appropriate transfusion service, donor demography is to be optimized for proper strategic management. The purpose of this study was to assess the socio-demographic profile of blood donors to make targets for national interventions and to promote blood donation.
Methods: This descriptive type cross sectional study was conducted in Transfusion Medicine department of Popular Medical College Hospital from 1st January 2015 to 30th June 2018. All the blood donors who came to donate blood in this department were included in this study. Their signed consent was obtained to include in this study with their socio-demographic determinants. Frequency, percentage and p value<0.05 were calculated for statistics.
Results: Out of the 15702 blood donors, male donors were more with a ratio of 6.78:1. Though the younger age group (25-31 years) showed highest donor population (32.61%), but the younger age group (18-38 years) have maximum donation (86.21%). Unmarried donors were 59.07% among the donors and middle class income group also showed highest donors (59.09%). Student donors (30.55%) were more among the donors. Muslims donors (79.01%) were more than others religious donors. Regarding education level of donors, higher secondary and above level showed highest donation (90.97%) which was statistically significant (p<0.001). Among the donors 78.05% showed their future intension to donate. Conclusions: Works on differences in socio-demographic characteristics of blood donors in times of increasing demand appears to be fruitful to target national interventions and to promote blood donation.
Bangladesh J Medicine July 2021; 32(2) : 113-119
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Khan, Muhammad Kashif, Aamir Ali Syed, Shahid Khattak, Syed Ather Kazmi, and Aasim Yusuf. "Surgical management of gastric cancer: Single center experience from a developing country." South Asian Journal of Cancer 04, no. 03 (July 2015): 127–29. http://dx.doi.org/10.4103/2278-330x.173169.
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Abstract Background: Geographical distributional of gastric cancer (GC), differences in stage at the time of presentation and varying surgical expertise have resulted in different management strategies around the world. The aim of this study is to determine postoperative morbidity/mortality and overall survival in patients with GC treated at a cancer hospital in Pakistan. Patients and Methods: A retrospective review of patients who underwent surgical resection with curative intent for GC from June 2006 to July 2012 was performed. Primary end point was overall survival after a minimum follow-up of 15 months. For categorical data, frequencies were calculated, and means were measured for continuous variables. Chi-square test was used to compare categorical data and Kaplan–Meir survival analysis was performed to estimate 5 years survival outcome using SPSS. Results: Majority of the patients were males with median age of 51 years. Perioperative chemotherapy was offered to 75 patients while upfront surgery was performed in 23 patients. In perioperative chemotherapy group 51 patients and 22 in the upfront surgery group ended up having curative resection. The 5 years survival (n = 98) was found to be of 37%. The 5 years survival of patients in perioperative chemotherapy group (n = 75) was 44% while those who had a curative resection (n = 73) had survival of 46%. Conclusion: Gastric adenocarcinoma is an aggressive disease. Perioperative chemotherapy works well in Pakistani population as the results at our institution are comparable with international data.
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Alselisly, Ahmed Mohamed, Hieder Al-Shami, and Ahmed Mohamed Salah. "Surgical management of cerebral venous sinus thrombosis: Case series and literature review." Surgical Neurology International 12 (March 30, 2021): 133. http://dx.doi.org/10.25259/sni_804_2020.
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Background: Cerebral venous sinus thrombosis (CVST) is not a common type of stroke (5%) but still hazardous to be misdiagnosed or mistreated. Aggressive medical treatment is usually failed to hinder increase intracranial tension. Therefore, decompressive craniectomy (DC) is the final measure to mitigate the deleterious effect of supratentorial herniation. The purpose of the study is to illustrate our experience with the surgical treatment of CVST and reviewing the previous works of literature. Methods: Forty-two patients were admitted to Kasr Al-Ainy University Hospital from June 2019 to March 2020. The admission was either to the neurology department or intensive care unit or neurosurgery department. Every patient who was diagnosed with CVST received an emergency neurosurgery consultation. Seven patients were operated on with DC according to the criteria mentioned above. Therapeutic heparin was given in addition to intracranial pressure lowering measures. Results: The mean and standard deviation of the age was (25.14 ± 10.1) years. There were five females (71.45%) in our series. The mean and standard deviation of clinical manifestations are (8.5 ± 7.77) weeks with range (3– 14 weeks). Most of the cases were presented by a decreased level of consciousness (6/7) and anisocoria (6/7), followed by fits (3/7). Four cases out of seven had the previous history of oral contraceptive administration. Conclusion: DC provides an urgent last arm for intractable increased intracranial tension. Patients with CVST need urgent consultation for neurosurgical intervention.
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Kennedy, Richard, and Andrew J. Winter. "Reducing time to treatment of bacterial sexually transmitted infections in an HIV cohort." BMJ Open Quality 9, no. 2 (April 2020): e000603. http://dx.doi.org/10.1136/bmjoq-2018-000603.
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Sexually transmitted infections (STIs) are known to increase the risk of transmission of HIV and care of sexual health needs should form part of routine HIV care. Delayed treatment of STIs can lead to complications and avoidable onward transmission. Management of acute STIs in UK specialist sexual health services usually involves a multidisciplinary approach to ensure patient recall, antimicrobial treatment and partner notification. While this works well in dedicated sexual health clinics, we found this was less optimal in our hospital-based HIV care unit. We describe a quality improvement project to improve interdisciplinary pathways by using electronic shared worklists that reduced time to treatment for chlamydia and gonorrhoea infections. Use of electronic shared worklists could be applied to other settings where rapid treatment is required or has transmission implications.
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Khan, Zana, Sophie Koehne, Philip Haine, and Samantha Dorney-Smith. "Improving outcomes for homeless inpatients in mental health." Housing, Care and Support 22, no. 1 (December 5, 2018): 77–90. http://dx.doi.org/10.1108/hcs-07-2018-0016.
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Purpose The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding. Design/methodology/approach This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures. Findings Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care. Originality/value The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.
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Euchi, Jalel. "Optimising the routing of home health caregivers: can a hybrid ant colony metaheuristic provide a solution?" British Journal of Healthcare Management 26, no. 7 (July 2, 2020): 192–96. http://dx.doi.org/10.12968/bjhc.2019.0096.
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Background/Aims Consolidation of a unified health system requires the development of strategies that respond to various existing health needs, thus accommodating new and chronic conditions. Home care is a viable alternative to hospital care to meet the needs of the elderly population as well as those with other conditions that could be managed at home, which leads to a greater demand for home health services. One issue this raises is routing (assigning routes and transport) caregivers, where the goal is to minimise the total cost. Methods A hybrid ant colony algorithm is proposed to solve the problem of routing home health care workers. The algorithm was tested in cases drawn from the literature and compared with works existing in the literature. Results The algorithm provided good quality results with low computation times. Conclusions The comparison results supported the efficacy of the suggested methodology, which can provide decision support for medical managers of home health care.
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Rezeki, Vina, Arifah Devi Fitriani, Iman Muhammad, and Lucia Lastiur. "Analysis of the Effect of Motivation and Training on the Performance of Nurses in Datu Beru Takengon Public Hospital." Journal La Medihealtico 1, no. 5 (November 7, 2020): 54–60. http://dx.doi.org/10.37899/journallamedihealtico.v1i5.160.
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Nurses who work in emergency room must have more skills, which is implied for every nurse who works in the emergency room to have a good performance. The study aims to analyze the influence of motivation and training on the performance of nurses in the emergency room at Datu Beru Takengon General Hospital in 2018.The design used a quantitative analytic survey. The population were all nurses in the emergency room of Datu Beru Hospital in Takengon by totalling 32 nurses and all were taken as the sample by using total population technique. Data analysis was performed by univariate, bivariate and multivariate analyses.The results showed that out of 15 respondents who had less motivation had a poor performance in the category of less than 9 people (60%) and of the 17 respondents who were motivated, motivation with nurse performance with Chi-Square statistical test obtained p-value =.032 <α .05, which means that there is an influence between training and nurse performance .001 <α .05, which means there is an influence between training and nurse performance.The conclusion is that there is an influence between motivation and training on the performance of nurses in the emergency room. It is recommended that the hospital management pay attention to the performance of the nurses, by giving riward to nurses who have good performance and giving sanctions to nurses who break the rules.
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Tomar, Avantika, and Amit Dhiman. "Exploring the Role of HRM in Service Delivery in Healthcare Organizations: A Study of an Indian Hospital." Vikalpa: The Journal for Decision Makers 38, no. 2 (April 2013): 21–38. http://dx.doi.org/10.1177/0256090920130202.
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The new service management school of thought acknowledges a set of new human resource management (HRM) practices, underpinned by the concept of satisfaction mirror between customers and front-line workers. HRM practices in the cycle of success include careful selection, high-quality training, well-designed support systems, empowerment, teamwork, appropriate measurement, rewards and recognition, and the development of a service culture. The model for achieving cycle of success in interactive service works is known as the high involvement work systems (HIWS). There is some research evidence about the positive influence of high involvement HR practices on effective service delivery. This exploratory study examines the role played by HR practices in maintaining the quality of service delivery, in the context of healthcare services. It specifically studies the administrative factors and HR policies that aid effective service quality and the practices that bring down the quality of care provided in a private sector Indian hospital. This being a relatively new area, an inductive approach was used. The study relied on semi-structured interviews for the purpose of data collection. Along with data collection, core theoretical concepts were identified and tentative linkages were developed between the theoretical core concepts and the data. The findings show that the emphasis is more on supreme hospitality and patient amenities than medical treatment. The healthcare industry is witnessing a significant change. A consultant is no longer the ‘king’; this position has now been taken by the patients. Of late the emphasis is on patient satisfaction in terms of the facilities provided rather than the nature of medical treatment given. This is primarily so for organizations such as this hospital which aim at providing world-class care and for which ‘patient centricity’ is the hallmark. HR specific issues such as standardization of nursing activities, appraisal systems, effective communication channels, and compensation structure, all affect the quality of service provided in a hospital. Similar research can be conducted across other healthcare organizations to replicate and validate the findings regarding the changing scenario in the industry.
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Abbas, Kun Arifi. "Fluid Resuscitation in Trauma." Indonesian Journal of Anesthesiology and Reanimation 1, no. 2 (September 6, 2020): 52. http://dx.doi.org/10.20473/ijar.v1i22019.52-57.
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Introduction: Trauma is a problem faced everyday in the emergency room of the hospital where the researcher works. The degree of trauma from the mildest to life threatening can be found in sufferers. The cause of death in trauma sufferers is hypovolemic shock due to bleeding. The amount of blood loss volume from the patient can be estimated by looking at the clinical signs of the patient. Literature Review: In the condition of tissue hypoperfusion, it will cause a chain process which will eventually lead to cell death. Hypoperfusion causes anaerobic metabolism, lactic acidosis (coagulopathy, enzyme dysfunction), Na-K pump malfunction (cellular swelling and cell death), there is hypothermia (increase of oxygen demand, coagulopathy). Hypoperfusion will cause a vicious circle, in which processes that aggravate one another will occur. With the administration of fluids (crystalloid, colloid, transfusion) will improve the hypoperfusion that occurs in the body. Conclusion: The management of hypovolemic shock due to bleeding requires an understanding of the physiology and pathophysiology that occurs due to bleeding. To get maximum results and improve outcome from sufferers, it needs solid team work. Treatment can be different depending on the conditions, equipment and facilities of the hospital / emergency room as well as the policies of each place.
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Shatalin, Daniel, Yaacov Gozal, Sorina Grisaru-Granovsky, and Alexander Ioscovich. "Five years’ experience in an anesthesiology antenatal clinic for high-risk patients." Journal of Perinatal Medicine 46, no. 3 (April 25, 2018): 287–91. http://dx.doi.org/10.1515/jpm-2017-0016.
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Abstract Introduction: The aim, of this study is to describe our approach and outcomes in an outpatient anesthesia/analgesia antepartum clinic among ambulatory high-risk obstetric patients. Methods: This was a retrospective evaluation of the activity of the anesthesiology antenatal clinic from its inception in 2010 until 2016 (a 5-year period). The clinic works in collaboration with the Department of Obstetrics and Gynecology. The catchment area of the study University Affiliated Hospital attends a multiethnic population characterized by high parity. Results: There were 241 referrals over the 5 years, each of whom was discharged with a consult and a delivery management plan and 228 (95%) of which were performed as planned. Mean gestational age at consultation was 34.4 weeks (range: 20–37). There were no preconceptional consultation. No limitations regarding mode of anesthesia/analgesia was considered for 47% of the referrals. Nulliparous women accounted for 50% of the referrals and 17% were in their second pregnancy. The greatest number of referrals (30%) was for musculoskeletal conditions. No maternal death encountered. The mode of delivery was vaginal in 139 (65%) women; elective cesarean section in 44 (21%) women; and emergent cesarean section in 30 (14%) women. The neonatal outcomes were unremarkable; 210 (87%) in hospital births, 97.1% had an a 5′ Apgar score of 9. Conclusion: Our findings reveal the need for high-risk obstetric patients consult with a dedicated obstetric anesthesiologist to devise a management plan for labor and delivery that is tailored to their comorbidity and obstetric status, to ensure an optimum outcome for mother and child.
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Chantler, Cyril. "Health-care technology assessment: a clinical perspective." International Journal of Technology Assessment in Health Care 20, no. 1 (January 2004): 87–91. http://dx.doi.org/10.1017/s0266462304000844.
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Health technology assessment needs to relate to contemporary questions which concern public health-care systems: how to keep people healthy, how to focus on the needs of those with chronic disabilities and integrate care between the hospital and the community, how to encourage and audit effective teamwork, and how to establish a consensus about what is effective and affordable. Clinicians have an ethical responsibility to practice efficiently and economically, for profligacy in the care of one patient may mean that another is treated inadequately. For similar reasons, clinicians need to play a full role in the management of services. Advice from health technology assessment is vital and needs to be accurate, relevant, timely, clear, and accessible. As well as being concerned about what works, we need also to eliminate from practice what does not. Regular audit and appraisal of practice against the evidence base should be useful in this respect. Alternative approaches to management, such as the provision of care as opposed to aggressive treatments, need to be evaluated, and health technology assessment needs to consider how services are delivered, not just specific treatments.
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Akida, A. W., M. Isinta, F. O. Ndiawo, D. Agedo, and J. Tsinanga. "(P2-54) Legislation Shaped by an Emergency: Methanol Poisoning Experience at Kenyatta National Hospital, Kenya." Prehospital and Disaster Medicine 26, S1 (May 2011): s153. http://dx.doi.org/10.1017/s1049023x11004985.
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IntroductionMethanol poisoning is an uncommon medical emergency linked with consumption of traditional brews made with methanol and formalin and associated with high-mortality rates.ObjectivesHealthcare workers will review the latest worldwide trends of methanol poisoning cases, explain the factors perpetuating methanol poisoning in Kenya, describe the pathophysiological concepts associated with methanol intoxication, and discuss the latest measures to combat methanol poisoning in Kenya and their worldwide applicability.BackgroundMethanol intoxication is an acute illness resulting from consumption of toxic quantities of methanol. The largest tragedy occurred in September 2006 in Nicaragua. A total of 800 fell ill, 46 were killed. In the US, the last incidence was in 1951. Cases were reported in Africa, Tunisia, Tanzania, Uganda, but Kenya, it runs the most rampant. The majority of victims (79%) are young males, (22–30 years of age). Most are single, childless, and have a low-educational status. Motivating factors for intoxication include stress, idleness, peer-pressure, availability of alcohol, and curiosity.PathophysiologyToxicity results from liver enzymatic metabolism of methanol to formaldehyde and formic acid causing severe metabolic acidosis. Common features include inebriation, abdominal pains, bilateral blindness, and complications, including severe renal failure and death. The goals of management include comprehensive assessment, laboratory works, and radiography. Ethanol, fomepizole, and folate are the all-important antidotes.Recommended MeasuresKenyatta National Hospital, the main recipient of these emergencies established emergency measures other than public awareness campaigns. Nationally, policies embrace an inter-sectoral Approach - Medical Services and Public Health Ministries will avail resources and build health worker capacity in research and continuous education. Recently, local brews were legalized through the Alcoholic Drinks Control Act 2010 for quality control. Ministries of Education and Youth Affairs will coordinate and initiate youth development and support programs to create employment.
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Fortinsky, Richard, and Caroline Stephens. "3D Team Care Management Trial for Cognitively Vulnerable Older Adults: Who Participates and How Does the Team Work?" Innovation in Aging 4, Supplement_1 (December 1, 2020): 744. http://dx.doi.org/10.1093/geroni/igaa057.2677.
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Abstract Community-dwelling older adults often experience cognitive symptoms, and three common conditions that contribute to changes in cognition are dementia, depression and delirium. Despite the clinical inter-connectedness among these medical conditions, hereafter referred to collectively as cognitive vulnerability, little is known about the potential for success of clinical interventions that simultaneously address these conditions. From the perspective of older adults with cognitive vulnerability and their families, hospital admissions and emergency department (ED) visits are disorienting and often lead to declines in functional capacity and well-being, and significant family distress, threatening continued independent living. In this Symposium, we present details about an ongoing clinical trial testing a novel in-home, multidisciplinary team care management intervention for older adults with cognitive vulnerability and their families. This care management intervention led by nurse practitioners, called the3D Team care model, aims to help reduce ED visits and hospitalizations and achieve other health-related outcomes. The first presentation will provide study background and design features as well as characteristics of study participants. The next two presentations by the3D Team nurse practitioners will provide details about how the multidisciplinary team works, and how each team member provides interventions intended to address risk factors for adverse health outcomes. The fourth presentation by the3D Team community health educator will explain how needs related to social determinants of health are addressed. The Discussant will place this clinical trial within the broader context of multidisciplinary team care for older adults with cognitive vulnerability led by nurse practitioners trained in geropsychiatry.