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Pryss, Rüdiger, Nicolas Mundbrod, David Langer, and Manfred Reichert. "Supporting medical ward rounds through mobile task and process management." Information Systems and e-Business Management 13, no. 1 (March 11, 2014): 107–46. http://dx.doi.org/10.1007/s10257-014-0244-5.
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Keen, Justin, Emma Nicklin, Nyantara Wickramasekera, Andrew Long, Rebecca Randell, Claire Ginn, Elizabeth McGinnis, Sean Willis, and Jackie Whittle. "From embracing to managing risks." BMJ Open 8, no. 11 (November 2018): e022921. http://dx.doi.org/10.1136/bmjopen-2018-022921.
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ObjectiveTo assess developments over time in the capture, curation and use of quality and safety information in managing hospital services.SettingFour acute National Health Service hospitals in England.Participants111.5 hours of observation of hospital board and directorate meetings, and 72 hours of ward observations. 86 interviews with board level and middle managers and with ward managers and staff.ResultsThere were substantial improvements in the quantity and quality of data produced for boards and middle managers between 2013 and 2016, starting from a low base. All four hospitals deployed data warehouses, repositories where datasets from otherwise disparate departmental systems could be managed. Three of them deployed real-time ward management systems, which were used extensively by nurses and other staff.ConclusionsThe findings, particularly relating to the deployment of real-time ward management systems, are a corrective to the many negative accounts of information technology implementations. The hospital information infrastructures were elements in a wider move, away from a reliance on individual professionals exercising judgements and towards team-based and data-driven approaches to the active management of risks. They were not, though, using their fine-grained data to develop ultrasafe working practices.
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Anvari, M. "Reply to Ward and Chapman." Journal of the Operational Research Society 39, no. 12 (December 1988): 1183. http://dx.doi.org/10.2307/2583608.
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Anvari, M. "Reply to Ward and Chapman." Journal of the Operational Research Society 39, no. 12 (December 1988): 1183–85. http://dx.doi.org/10.1057/jors.1988.200.
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Tobey, Binder, Yoshida, and Yamagata. "Urban Systems Design Case Study: Tokyo's Sumida Ward." Smart Cities 2, no. 4 (October 11, 2019): 453–70. http://dx.doi.org/10.3390/smartcities2040028.
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Meeting the needs of increasing environmental and systematic pressures in urban settlements requires the use of integrated and wholistic approaches. The Urban Systems Design (USD) Conceptual Framework joins the metric-based modeling of rationalized methods with human-driven goals to form a combined iterative design and analysis loop. The framework processes information for the fundamental element of cities—humans—to large-scale modeling and decision-making occurring in district- and ward-level planning. There is a need in the planning and design profession to better integrate these efforts at a greater scale to create smart communities that are inclusive and comprehensive in aspects from data management to energy and transportation networks. The purpose of this study is to examine the applicability of this method as it pertains to a model and design integrated approach. Northern Sumida Ward, located in Tokyo, exemplifies the contextualized needs of Tokyo, and Japan, while forming a coherent internal community. Focusing on methodology, our process explores the creation of typologies, metric-based analysis, and design-based approaches that are integrated into modeling. The results of the analyses provide initial evidence regarding the validity of the USD approach in modeling changes to complex systems at differing design scales, connecting various qualities of the built environment, building and urban forms, and diagnostic comparisons between baseline and change conditions. Because of some inconsistencies and the need for further evidence gathering, the methods and processes show that there is much work to be done to strengthen the model and to continue building a more productive field of USD. However, in this framework’s continuing evolution, there is increasing evidence that combining the planning and design of urban systems creates a more resilient, economically viable, sustainable, and comfortable city.
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Chauhan, Rajeev, Summit Dev Bloria, and Ankur Luthra. "Management of Postoperative Neurosurgical Patients." Indian Journal of Neurosurgery 08, no. 03 (September 24, 2019): 179–84. http://dx.doi.org/10.1055/s-0039-1698001.
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AbstractThe patient profile undergoing neurosurgery varies from neonates to elderly, and from patients undergoing elective surgery to patients undergoing emergency surgeries. The goals of postoperative management include prevention of secondary brain injury and taking care of the major organ systems till the time patient recovers from the primary insult. Postsurgery, patients may be shifted to a neurosurgical intensive care unit or managed in a neurosurgical ward. As a general rule, all patients should be nursed 30-degree head up. We will be discussing the basic principles of postoperative management of neurosurgical patients.
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Maulani, Galih Abdul Fatah, and Teten Mohamad Sapril Mubarok. "Strategic Planning of Information Systems for Mosque in Indonesia." Business Innovation and Entrepreneurship Journal 2, no. 2 (May 31, 2020): 107–11. http://dx.doi.org/10.35899/biej.v2i2.90.
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Anticipating the era of Society 5.0, communities and organizations are required to have integrated and comprehensive information access, including the management of mosques in Indonesia. This study aims at providing a strategic planning in the form of a portfolio for future application of mosques management information system services. This study was conducted with reference to Ward and Peppard’s strategic plan for information systems, which included SWOT analysis, critical success factor method and McFarlan’s strategic grid. The results showed the mosque management must have several applications, mapped into 4 quadrants (strategic, high potential, key operation, and support). It is expected that this application portfolio can help managers of mosques in Indonesia provide faster, more accurate, and more accountable information.
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Leelananda, H. H., N. T. Sohan Wijesekera, and T. A. Peiris. "Potential of Urban Land Management using Geographic Information Systems- A Study of Thimbirigasyaya Ward Colombo." Engineer: Journal of the Institution of Engineers, Sri Lanka 41, no. 5 (December 3, 2008): 95. http://dx.doi.org/10.4038/engineer.v41i5.7109.
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Mate, Kedar S., Jeffrey Rakover, Kay Cordiner, Amy Noble, and Noura Hassan. "Novel quality improvement method to reduce cost while improving the quality of patient care: retrospective observational study." BMJ Quality & Safety 29, no. 7 (January 23, 2020): 586–94. http://dx.doi.org/10.1136/bmjqs-2019-009825.
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BackgroundHealthcare cost management strategies are limited in number and resource intensive. Budget constraints in the National Health Service Scotland (NHS Scotland) apply pressure on regional health boards to improve efficiency while preserving quality.MethodsWe developed a technical method to assist health systems to reduce operating costs, called continuous value management (CVM). Derived from lean accounting and employing quality improvement (QI) methods, the approach allows for management to reduce or repurpose resources to improve efficiency. The primary outcome measure was the cost per patient admitted to the ward in British pounds (£).InterventionsThe first step of CVM is developing a standard care model. Teams then track system performance weekly using a tool called the ‘box score’, and improve performance using QI methods with results displayed on a visual management board. A 29-bed inpatient respiratory ward in a mid-sized hospital in NHS Scotland pilot tested the method.ResultsWe included 5806 patients between October 2016 and May 2018. During the 18-month pilot, the ward realised a 21.8% reduction in cost per patient admitted to the ward (from an initial average level of £807.70 to £631.50 as a new average applying Shewhart control chart rules, p<0.0001), and agency nursing spend decreased by 30.8%. The ward realised a 28.9% increase in the number of patients admitted to the ward per week. Other quality measures (eg, staff satisfaction) were sustained or improved.ConclusionCVM methods reduced the cost of care while improving quality. Most of the reduction came by way of reduced bank nursing spend. Work is under way to further test CVM and understand leadership behaviours supporting scale-up.
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Prasetyo, Danianto Enggar, and Agustinus Fritz Wijaya. "Information System Strategic Planning For Tourism Transportation Company Using Ward And Peppard Methodology." INTENSIF: Jurnal Ilmiah Penelitian dan Penerapan Teknologi Sistem Informasi 5, no. 1 (February 1, 2021): 43–57. http://dx.doi.org/10.29407/intensif.v5i1.14609.
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Implementation of Information Systems in company business processes can increase efficiency and effectiveness. However, without adequate planning in the implementation of Information Systems, the performance can not have the desired impact. Therefore, a strategic plan is needed to implement the Information System aligned with the Company's vision and mission, and objectives. The method used in this research is the Ward and Peppard methodology. The background to the use of the Ward and Peppard methodology in this study is because the Ward and Peppard methodology contains a definitive and complete framework that focuses not only on technology but also on the organization's business needs. The results of this research are application recommendations and an application development roadmap for the next four years. It is hoped that this research can help improve the Company's business processes more effectively and efficiently by improving information management within an organization.
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Mollah, Kabirul A., and Toshiya Aramaki. "Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh." Journal of Water and Health 8, no. 1 (November 9, 2009): 184–91. http://dx.doi.org/10.2166/wh.2009.201.
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This study aims at quantification of health losses, considering social and environmental factors. Morbidity and mortality cases of diarrhoea for children under five years old were used to estimate the disability adjusted life years (DALYs) lost for the target households in low-income communities in Dhaka, Bangladesh. Water supply facilities and sanitation systems, along with hygiene practices and their health outcomes, were studied at community level. Demographic, socio-economic and socio-cultural aspects were also studied to support the research findings and give a better understanding of the local conditions. The four selected communities, Ward 60 (W60), Ward 61 (W61), Ward 62 (W62) and Ward 65 (W65), all had different existing urban services such as water supply, sanitation, garbage management and drainage facilities. All of these services existed in W62, but W60 did not have any of the services; W61 had sanitation and drainage coverage, whereas W65 had only a water supply facility. The results conclusively showed that, compared with the null (absence of services) scenario (W60), the other three scenarios (W61, W62 and W65) showed a substantial decrease of diarrhoea (1.219, 1.284 and 2.052 DALYs/household/year, respectively) reported for children under five years old. Besides urban services, other socio-economic characteristics might also influence the prevalence of diseases.
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Rusi, Ibnur, and Ferdy Febriyanto. "Perencanaan Strategis Sistem Informasi untuk Optimalisasi Layanan Sekolah Menggunakan Ward and Peppard." Jurnal Sisfokom (Sistem Informasi dan Komputer) 10, no. 2 (August 3, 2021): 189–96. http://dx.doi.org/10.32736/sisfokom.v10i2.1170.
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Abstract— The use of technology and information systems is an obligation that must be applied by every agency or organization to simplify and optimize operational implementation. Many agencies are actively using information systems so that the agency's performance can run well, systematically, and controlled, which will impact the credibility of their agency. A good information system can be created because of good planning. Strategic planning of information systems allows producing a good information system. This is because the output produced is in the form of strategic plans and documents that methodically describe the needs of information systems. Torsina Private Vocational School is a vocational school that seeks to implement information systems in every operation to improve schools' services. Therefore, strategic planning is needed in the development of IS/IT at Torsina Private Vocational Schools so that the implementation of information systems becomes more controlled and on target. IS/IT strategic planning in this study uses the Ward and Peppard model, while the analytical tools used are Critical Success Factors (CSF's), SWOT Analysis, Value Chain, and McFarlans Strategic Grid. The existence of an analytical tool is used to support the Ward and Peppard model to determine the internal and external environmental conditions of the organization. The results of this study are strategic planning of information systems at Torsina Private Vocational Schools in the form of business strategy, IT strategy, IS/IT management strategy, and an information system portfolio that is mapped based on the level of importance.
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Kwong, Kiu Yan, and Ben Y. F. Fong. "Quality Management of Inpatient Medication Administration in Hong Kong Public Hospitals." Asia Pacific Journal of Health Management 15, no. 2 (May 21, 2020): S91–98. http://dx.doi.org/10.24083/apjhm.v15i2.395.
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Medicine maladministration can result in various side effects to patients, including serious complications, extended medical care, incapacity and death. In Hong Kong public hospitals, the pattern of medication error consists of prescribing error usually made by physicians, dispensing error resulted from pharmacists and dispensers, drug administration error caused by nurses and patient-care workers and technology-related error associated with technology used in the drug administration process. Medication Administration Record (MAR) and ward stock are the usual inpatient medication system within Hospital Authority public hospitals before the development of the electronic system, while the Inpatient Medication Order Entry (IPMOE) functions to provide real-time accessibility in patients’ medication profiles by different professions and health units. However, several factors are related with medication errors. For instance, the ambiguous handwriting orders in the MAR prescribed by physicians affect the transcription by pharmacists and the administration procedures in ward by nurses. Administering medicines in ward stock before pharmacists vetting increase the chance of making errors. Poor interface issues between users and system, and the computer over-reliance are also contributed in resultant technology-related errors. In order to reduce the occurrence of medication incidents, implementation of Automated Pharmacy Distribution Systems helps moving towards a closed loop medication management system. Modifying technologies in barcode assisted medication administration and enhancing the IPMOE with a pop-up message could help intercepting drug administration errors to patients.. The elimination of the potential risks arising from the prescribing, dispensing and drug administration processes brings the achievement of medication safety in Hong Kong public hospitals.
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Schmidtke, Kelly Ann, Ivo Vlaev, and Karen Baber. "Using behavioural economics concepts to increase organizational learning in an NHS hospital." Journal of Organizational Change Management 29, no. 7 (November 14, 2016): 1153–61. http://dx.doi.org/10.1108/jocm-02-2016-0042.
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Purpose The purpose of this paper is to assess whether the dissemination systems that hospitals use to spread information about particular safety incidents can be enhanced using behavioural economics concepts. Design/methodology/approach The current service evaluation took place within eight wards in a single acute care hospital. It was conducted as a randomized controlled trial with two groups. In the control group nothing was altered. In the intervention group ward managers received additional support to disseminate information to their nurses. Nurses were randomly selected to be surveyed during their scheduled shifts. The surveys revealed how the nurses learned about particular safety incidents and how many they remembered. Findings Nurses in the intervention group were more likely to learn about particular safety incidents than nurses in the control group. Practical implications Enhancing common dissemination systems in hospitals can increase organizational learning about safety incidents. The current study presents some means by which dissemination systems can be enhanced. Originality/value The current service evaluation is a unique application of behavioural economics concepts to enhance organizational learning of particular adverse safety incidents in an NHS hospital.
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van den Broek, Judith, Paul Boselie, and Jaap Paauwe. "Multiple Institutional Logics in Health Care: ‘Productive Ward: Releasing Time to Care’." Public Management Review 16, no. 1 (April 18, 2013): 1–20. http://dx.doi.org/10.1080/14719037.2013.770059.
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Difonzo, Marcello. "Performance of the Afferent Limb of Rapid Response Systems in Managing Deteriorating Patients: A Systematic Review." Critical Care Research and Practice 2019 (October 30, 2019): 1–16. http://dx.doi.org/10.1155/2019/6902420.
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Introduction. The clinical components of the rapid response system (RRS) are the afferent limb, to ensure identification of in-hospital patients who deteriorate and activation of a response, and the efferent limb, to provide the response. This review aims to evaluate the factors that influence the performance of the afferent limb in managing deteriorating ward patients and their effects on patient outcomes. Methods. A systematic review was performed for the years 1995–2017 by employing five electronic databases. Articles were included assessing the ability of the ward staffs to monitor, recognize, and escalate care to patient deterioration. The findings were summarized using a narrative approach. Results. Thirty-one studies met the inclusion criteria. The analysis revealed major themes enclosing several factors affecting management of patients having sudden deterioration. The monitoring and recognition process was conditioned by the lack of recording of physiological parameters, the influence of facilitators, including staff education and training, and barriers, including human and environmental factors, and poor compliance with the calling criteria. The escalation of care process highlighted the influence of cultural barriers and personal judgment on RRS activation. Mainly, delayed team calls were factors strongly associated with the increased risk of unplanned admissions to the intensive care unit and length of stay, hospital length of stay and mortality, and 30-day mortality. Conclusions. A combination of factors affects the timely identification and response to sudden deterioration by general ward staffs, leading to suboptimal care of patients, delayed or failed activation of RRS teams, and increased risks of worsening outcomes. The research efforts and clinical involvement to improve the governance of the factors limiting the performance of the afferent limb may ensure proper management of hospitalized patients showing physiological deterioration.
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Wijaya, Agustinus Fritz, and Vincentius Dhendy Radya Damara. "PERENCANAAN STRATEGIS SI/TI PADA DOCUMENT MANAGEMENT MENGGUNAKAN WARD AND PEPPARD (STUDI KASUS: PT. VISIONET DATA INTERNATIONAL)." Jurnal Bina Komputer 2, no. 1 (February 17, 2020): 33–43. http://dx.doi.org/10.33557/binakomputer.v2i1.796.
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PT. Visionet Data International is a company engaged in the field of IT that serves Total IT Managed services. Because the development of Information Systems and Information Technology (IS / IT) in fulfilling the company's vision and mission, a good plan is needed. In this research focuses on the documentation management system in which there is no good company documentation management in accordance with the provisions in force. Regarding data collection methods, this research uses interviews with company’s employees. This research is a qualitative descriptive study using the Ward and Peppard method. Which includes SWOT analysis, Value Chain analysis, PEST analysis, application mapping analysis using McFarlan Strategic Grid and analysis of Proposed Information Systems. This research results in the form of application portfolio recommendations such as the development of Document Management in the form of Web-based applications in which all processes are integrated into one. So in the process of submitting new documents to the process of issuing documents can be done in an application which can support the reduction in the use of paper in the company.
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Rubbio, Iacopo, Manfredi Bruccoleri, Astrid Pietrosi, and Barbara Ragonese. "Digital health technology enhances resilient behaviour: evidence from the ward." International Journal of Operations & Production Management 40, no. 1 (May 14, 2019): 34–67. http://dx.doi.org/10.1108/ijopm-02-2018-0057.
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PurposeIn the healthcare management domain, there is a lack of knowledge concerning the role of resilience practices in improving patient safety. The purpose of this paper is to understand the capabilities that enable healthcare resilience and how digital technologies can support these capabilities.Design/methodology/approachWithin- and cross-case research methodology was used to study resilience mechanisms and capabilities in healthcare and to understand how digital health technologies impact healthcare resilience. The authors analyze data from two Italian hospitals through the lens of the operational failure literature and anchor the findings to the theory of dynamic capabilities.FindingsFive different dynamic capabilities emerged as crucial for managing operational failure. Furthermore, in relation to these capabilities, medical, organizational and patient-related knowledge surfaced as major enablers. Finally, the findings allowed the authors to better explain the role of knowledge in healthcare resilience and how digital technologies boost this role.Practical implicationsWhen trying to promote a culture of patient safety, the research suggests healthcare managers should focus on promoting and enhancing resilience capabilities. Furthermore, when evaluating the role of digital technologies, healthcare managers should consider their importance in enabling these dynamic capabilities.Originality/valueAlthough operations management (OM) research points to resilience as a crucial behavior in the supply chain, this is the first research that investigates the concept of resilience in healthcare systems from an OM perspective, with only a few authors having studied similar concepts, such as “workaround” practices.
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Evans, Ceri G., Charles d'Souza, Paul Reynolds, Caroline Linton, Lokesh Nukalapati, and Anvita Swarnkar. "Audit of availability and awareness of guidelines for the management of confusion in older patients on general wards." Psychiatric Bulletin 32, no. 4 (April 2008): 143–45. http://dx.doi.org/10.1192/pb.bp.107.015123.
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Aims and MethodConfusion in an older patient on a general hospital ward requires prompt and appropriate management. To this end, evidence-based guidelines have been produced and disseminated by Gwent Healthcare NHS Trust. An audit was carried out when it became apparent that junior doctors might not be aware of the guidelines and that their availability on the wards was limited. An action plan was generated and a second audit carried out. Our aim was to establish whether the doctors' knowledge of the guidelines and their availability on wards changed as a result of our action plan and audit.ResultsThe audit consisted of a survey of general wards at the Royal Gwent Hospital and at St Woolos Hospital to assess availability of the guidelines and a questionnaire administered to a sample of junior doctors. The guidelines were available on 17% of wards; 11% of junior doctors were aware of them. Results of the audit informed implementation of an action plan. The second audit showed a limited improvement in availability (increased to 34%) and awareness (increased to 15%) of the guidelines, with no statistically significant difference.Clinical ImplicationsApparently well-thought-out action plans may produce minimal change, but unless the audit cycle is completed this fact cannot be corroborated. In generating action plans, more consideration may need to be given to the factors that influence the spread of change in healthcare systems.
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Pillsbury, Ceil Moran, and Ting J. Wang. "Supplemental Materials For Database Management System Knowledge And Skills In The Accounting Information Systems Course." Review of Business Information Systems (RBIS) 6, no. 1 (January 1, 2002): 1–6. http://dx.doi.org/10.19030/rbis.v6i1.4572.
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Much attention has been paid to the issue of enhancing students' understanding of the increasing role of database systems in accounting practice and integrating the modeling/operational aspects of such systems into the classroom. Recent surveys indicate that a number of Accounting Information Systems (AIS) professors are expanding their coverage of database topics, albeit some are only doing so on a more cursory basis. This paper reviews the changing nature of database education in AIS classes and provides supplemental active learning instructional aids to enhance the conceptual database coverage in AIS texts. The materials provide Systems professors who have time/resource constraints or limited formal training on database systems with an easy to learn and easy to adopt set of Access 2000 exercises. Students implement a pre-designed relational data model and experience the creation and use of database tables, forms, queries and macros. The materials build on the data set present in the widely used Systems Understanding Aid by Arens and Ward (1995), but it is not necessary to use them in conjunction with that case.
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Leelananda, H. H., N. T. S. Wijeselera, and T. A. Peiris. "A System for Land Development Approval Management using Geographic Information Systems - A Case Study of Thimbirigasyaya Ward, Colombo." Engineer: Journal of the Institution of Engineers, Sri Lanka 38, no. 4 (October 22, 2005): 7. http://dx.doi.org/10.4038/engineer.v38i4.7225.
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Clay-Williams, Robyn, Natalie Taylor, Hsuen P. Ting, Teresa Winata, Gaston Arnolda, Elizabeth Austin, and Jeffrey Braithwaite. "The relationships between quality management systems, safety culture and leadership and patient outcomes in Australian Emergency Departments." International Journal for Quality in Health Care 32, Supplement_1 (January 2020): 43–51. http://dx.doi.org/10.1093/intqhc/mzz105.
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Abstract Objective We aimed to examine whether Emergency Department (ED) quality strategies, safety culture and leadership were associated with patient-level outcomes, after controlling for other organization-level factors, in 32 large Australian hospitals. Design Quantitative observational study, using linear and multi-level modelling to identify relationships between quality management systems at organization level; quality strategies at ED level for acute myocardial infarction (AMI), hip fracture and stroke; clinician safety culture and leadership and patient-level outcomes of waiting time and length of stay. Setting Thirty-two large Australian public hospitals. Participants Audit of quality management processes at organization and ED levels, senior quality manager at each of the 32 participating hospitals, 394 ED clinicians (doctors, nurses and allied health professionals). Main Outcome Measure(s) Within the multi-level model, associations were assessed between organization-level quality measures and ED quality strategies; organization-level quality measures and ED quality strategies and ward-level clinician measures of teamwork climate (TC), safety climate (SC) and leadership for AMI, hip fracture and stroke treatment conditions; and organization-level quality measures and ED quality strategies and ward-level clinician measures of TC, SC and leadership, and ED waiting time and length of stay (performance). Results We found seven statistically significant associations between organization-level quality systems and ED-level quality strategies; four statistically significant associations between quality systems and strategies and ED safety culture and leadership; and nine statistically significant associations between quality systems and strategies and ED safety culture and leadership, and ED waiting time and length of stay. Conclusions Organization-level quality structures influence ED-level quality strategies, clinician safety culture and leadership and, ultimately, waiting time and length of stay for patients. By focusing only on time-based measures of ED performance we risk punishing EDs that perform well on patient safety measures. We need to better understand the trade-offs between implementing safety culture and quality strategies and improving patient flow in the ED, and to place more emphasis on other ED performance measures in addition to time.
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Keen, Justin, Emma Nicklin, Andrew Long, Rebecca Randell, Nyantara Wickramasekera, Cara Gates, Claire Ginn, Elizabeth McGinnis, Sean Willis, and Jackie Whittle. "Quality and safety between ward and board: a biography of artefacts study." Health Services and Delivery Research 6, no. 22 (June 2018): 1–142. http://dx.doi.org/10.3310/hsdr06220.
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BackgroundThere have been concerns about the quality and safety of NHS hospital services since the turn of the millennium. This study investigated the progress that acute NHS hospital trusts have made in developing and using technology infrastructures to enable them to monitor quality and safety following the publication in 2013 of the second Francis report on the scandal at Mid Staffordshire NHS Foundation Trust (The Mid Staffordshire NHS Foundation Trust Public Inquiry. Chaired by Sir Robert Francis QC.Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. HC 898. London: The Stationery Office; 2013).MethodsA telephone survey of 15 acute NHS trusts in the Yorkshire and the Humber region, and a review of board papers of all acute NHS trusts in England for January 2015, were undertaken. The telephone survey was used to identify trusts for a larger field study, which was undertaken in four acute NHS trusts between April 2015 and September 2016. The methods included the direct observation of the use of whiteboards and other technologies on two wards in each trust, an observation of board quality committees, semistructured interviews and an analysis of the quality and safety data in board papers. Published sources about national and local agencies were reviewed to identify the trust quality and safety data that these agencies accessed and used. An interview programme was also undertaken with those organisations. The Biography of Artefacts approach was used to analyse the data.FindingsThe data and technology infrastructures within trusts had developed over many years. The overall design had been substantially determined by national agencies, and was geared to data processing: capturing and validating data for submission to national agencies. Trust boards had taken advantage of these data and used them to provide assurance about quality and safety. Less positively, the infrastructures were fragmented, with different technologies used to handle different quality and safety data. Real-time management systems on wards, including electronic whiteboards and mobile devices, were used and valued by nurses and other staff. The systems support the proactive management of clinical risks. These developments have occurred within a broad context, with trusts focusing on improving the quality and safety of services and publishing far more data on their performance than they did just 3 years earlier. Trust-level data suggest that quality and safety improved at all four trusts between 2013 and 2016. Our findings indicate that the technology infrastructures contributed to these improvements. There remains considerable scope to rationalise those infrastructures.LimitationsThe four trusts in the main study were, in part, purposively selected, and deliberately biased towards sites that had made progress with designing and deploying real-time ward management systems. This limits the generalisability of the study. The study focused more on the work of nurses and nurse managers, and has relatively little to say about the experiences of doctors or allied health professionals.Future workFuture research might focus on the effects of mobile technologies and electronic whiteboards on acute wards, the value of current national data returns, and the uses and value of trust data warehouses.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Kaneshige, Thomas. "Full service security shop to ward off hackers." Network Security 1995, no. 8 (August 1995): 6. http://dx.doi.org/10.1016/1353-4858(96)89737-6.
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Dabelow, B., A. Faxvaag, and O. A. Alsos. "Doctors’ Concerns of PDAs in the Ward Round Situation." Methods of Information in Medicine 50, no. 02 (2011): 190–200. http://dx.doi.org/10.3414/me09-01-0017.
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Summary Background: Healthcare professionals in hospital care increasingly use small-screen handheld computers. Studies that have investigated doctors’ concerns about handheld usage have mainly focused on technical, organizational and performance issues. Very few have looked at the effects of Personal Digital Assistants (PDAs) on the interaction between physician and patient. Objective: The aim of this study was to explore the effects of PDA usage on the physicians’ prescription work, their concerns about using it in point-of-care situations, and the effects on the patient-physician dialog. Methods: We used a qualitative and comparative approach where 14 physicians each carried out four simulated ward rounds in which they modified the medication of patient actors using a paper-based medical chart and three versions of a PDA-based system. We analyzed ward round video recordings, semi-structured interviews with the doctors, and focus group using approaches based on ethnomethodology and grounded theory. Results: Physicians used PDA and paper differently. Physicians’ actions, as well as their non-verbal communication, were less transparent and clear for the patient when using a PDA. Doctors were worried about distractions from the handheld device and about a negative impact on the physician-patient conversation. In general, physicians were more comfortable with paper, but preferred PDA because it offered an undo function and reduced the need to memorize drug names and dosages by providing concrete alternatives in the user interface. Conclusions: Despite the many benefits, PDA usage at the point-of-care comes with the increased risk of distractions for physicians and can cause a negative patient experience. Designers of point-of-care systems need to be aware of, and address, the problems with handhelds and learn from the attributes and access capabilities of paper charts.
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Perveen, Shagufta, and Shifa S. Habib. "IDENTIFYING CONSTRAINTS FOR HOSPITAL INFECTION CONTROL MANAGEMENT VIA MCKINSEY 7S FRAMEWORK IN PAKISTAN." Pakistan Journal of Public Health 7, no. 4 (January 24, 2018): 213–22. http://dx.doi.org/10.32413/pjph.v7i4.81.
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Background: In Pakistan, structured guidelines for hospital infection control and prevention are deficient in most public sector facilities. There is dearth of literature available on management of hospital-care acquired infections and related issues. This study aims to understand infection control management as a proxy measure for quality of health care provided at a public sector tertiary care hospital in Karachi, Pakistan. In this study, we identify barriers to implementation of infection control measures and highlight key areas for quality improvement. Methods: A cross sectional study was carried out in 2008 using qualitative research methods. In-depth interviews were conducted with hospital staff belonging to three different management tiers. Results: There was lack of a centralized documented infection control policy, structure or management hierarchy in the hospital. The infection control mechanisms were managed at the individual ward level depending upon the interest of the individual Head of the Department. Lack of well-defined systems for human resource and financial management, resource allocation, documentation, communication, monitoring and evaluation for infection control further augmented the problem. Conclusion: Based on the results of this study, it is evident that quality infection control mechanisms must be organized and controlled at the hospital level not at the individual ward level. Human resource recruitment and training, budgetary allocation and designing of communication channels specific to infection control are needed at this tertiary care hospital. This is the first study to understand the management perspective for hospital infection control using 7S McKinsey framework of management in the largest tertiary care public sector hospital in Sindh.
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Drake, Gareth, and Amanda C. de C. Williams. "The neglected role of distress in pain management: qualitative research on a gastrointestinal ward." Scandinavian Journal of Pain 18, no. 3 (July 26, 2018): 399–407. http://dx.doi.org/10.1515/sjpain-2018-0045.
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Abstract Background and aims Pain management for hospital inpatients remains suboptimal. Previously identified barriers to optimal pain management include staff communication difficulties, confusion around pain management roles and a lack of suitable resources for clinical staff. The emotional, relational and contextual complexities of gastrointestinal (GI) pain create particular challenges for frontline clinical staff attempting to implement a biopsychosocial approach to its management. The current study took place over 2 years, comprised an ethnographic and a feedback phase, and aimed to examine pain management processes with clinical staff in order to generate hypotheses and initiatives for improvement. This paper focuses on two overarching themes identified in the ethnographic phase of the study, centred on the neglected role of both staff and patient distress in GI pain management. Methods Grounded theory and thematic analysis methods were used as part of action research, which involves collaborative working with clinical staff. The study took place on a 60 bed GI ward in a university hospital in London. Participants were clinical staff who were either ward-based or involved in the care of particular patients. This latter group included doctors, nurses, psychologists and physiotherapists from the Acute and Complex Pain Teams. Qualitative data on pain management processes was gathered from staff interviews, consultation groups, and observations of patient-staff interactions. Recruitment was purposive and collaborative in that early participants suggested targets and staff groups for subsequent enquiry. Following the identification of initial ethnographic themes, further analysis and the use of existing literature led to the identification of two overarching pain management processes. As such the results are divided into three sections: (i) illustration of initial ethnographic themes, (ii) summary of relevant theory used, (iii) exploration of hypothesised overarching processes. Results Initially, two consultation groups, five nursing staff and five junior doctors, provided key issues that were included in subsequent interviews (n=18) and observations (n=5). Initial ethnographic themes were divided into challenges and resources, reflecting the emergent structure of interviews and observations. Drawing on attachment, psychodynamic and evolutionary theories, themes were then regrouped around two overarching processes, centred on the neglected role of distress in pain management. The first process elucidates the lack of recognition during pain assessment of the emotional impact of patient distress on staff decision-making and pain management practice. The second process demonstrates that, as a consequence of resultant staff distress, communication between staff groups was fraught and resources, such as expert team referral and pharmacotherapy, appeared to function, at times, to protect staff rather than to help patients. Interpersonal skills used by staff to relieve patient distress were largely outside systems for pain care. Conclusions Findings suggest that identified “barriers” to optimal pain management likely serve an important defensive function for staff and organisations. Implications Unless the impact of patient distress on staff is recognised and addressed within the system, these barriers will persist.
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Tallo, Dennis Christian, and Frederik Samuel Papilaya. "Perencanaan Strategis Sistem Informasi Menggunakan Metode Ward and Peppard (Studi Kasus: Dinas Pariwisata Kabupaten Timor Tengah Selatan)." Journal of Information Systems and Informatics 3, no. 2 (June 25, 2021): 378–91. http://dx.doi.org/10.33557/journalisi.v3i2.141.
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The Timor Tengah Selatan Regency Tourism Office is one of the regional apparatus organizations that has the authority to implement the regional government's authority in the tourism sector. Information Technology Systems are factors that affect the sustainability of organization's activities. The Timor Tengah Selatan Regency Tourism Office still encounters obstacles in the application of information systems that do not support the entire business process and the lack of IS implementation makes performance inefficient. One of the contributing factors is that there are not enough human resources who have the skills in managing information systems and information technology properly. The purpose of this research is to develop a strategic planning of information systems in accordance with the needs of the organization. In the preparation of information systems strategic planning research using the Ward and Peppard approach with various analyzes such as SWOT analysis, Value Chain, and Mc. Farlan Strategic Grid. Based on the results of this study resulted in several recommendations to be carried out including the creation of Contract Making Administration System, and Mobile Tourism Information System and the development of Regency Tourism Website Timor Tengah Selatan regency, SIPD (Local Government Information System), and SIMDA (Regional Management Information System) GOODS.
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Anderson, L. "The role and resources required for the introduction of generic ward assistants using GRASPR systems workload methodology: a quantitative study." Journal of Nursing Management 5, no. 1 (January 1997): 11–17. http://dx.doi.org/10.1046/j.1365-2834.1997.02422.x.
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Clark, Kevin W., Susan Moller, and Lauri O'Brien. "Electronic patient journey boards a vital piece of the puzzle in patient flow." Australian Health Review 38, no. 3 (2014): 259. http://dx.doi.org/10.1071/ah13192.
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Objective Internationally, there is growing interest in the applicability of visual management in healthcare, although little is known about the extent of its effectiveness. In the past 5 years technical advances have permitted the integration of all relevant data into a singular display that can improve staff efficiency, accelerate decisions, streamline workflow processes and reduce oversights and errors in clinical practice. The aim of the case study is to describe the features and application of electronic patient journey boards (EPJBs) as an enabler to accelerate patient flow that has been demonstrated and evaluated in Queensland Health hospitals. Methods In 2012 and 2013 we collected ward-specific data that was sourced from the Queensland Hospital Admitted Patient Data Collection, determining the top 10 overnight diagnostic-related groups (DRGs) for each ward participating in the pilots. The Statistical Output Unit within Queensland Health then provided data and analysis on the ALOS for each of these DRGs for the period following an EPJB installation, along with the ALOS for the same DRGs for the corresponding period in the previous year. Results Patient length of stay reduced and display of estimated discharge dates improved with the introduction of EPJBs along with improved communication and information management resulting in time savings from 20 min per staff member per shift to 2.5 h per ward a day. Conclusion Queensland and South Australian Health systems have succeeded in ‘making the hospital patient journey visible’ through an innovative combination of information management and prominent display of key information related to patient care portrayed on large liquid crystal display (LCD) screens in hospital wards. What is known about the topic? No published studies have explored health services developing, piloting and evaluating Electronic Patient Journey Boards in a variety of clinical settings. What does this paper add? Until recently, paper-based health records and scheduled meetings were the only way for healthcare staff to communicate information to one another. In practice, this means that information vital to patient care is infrequently communicated between team members, is recorded in different places and in different ways, and is heavily reliant on care providers seeking out the information they need to perform effectively in their role. What are the implications for practitioners? This paper can be beneficial for managers and decision-makers of all healthcare organisations when considering streamlining a patients’ journey through a hospital with the assistance of visual management tools.
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Sarre, Sophie, Jill Maben, Peter Griffiths, Rosemary Chable, and Glenn Robert. "The 10-year impact of a ward-level quality improvement intervention in acute hospitals: a multiple methods study." Health Services and Delivery Research 7, no. 28 (August 2019): 1–172. http://dx.doi.org/10.3310/hsdr07280.
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Background The ‘Productive Ward: Releasing Time to Care’™ programme (Productive Ward; PW) was introduced in English NHS acute hospitals in 2007 to give ward staff the tools, skills and time needed to implement local improvements to (1) increase the time nurses spend on direct patient care, (2) improve the safety and reliability of care, (3) improve staff and patient experience and (4) make structural changes on wards to improve efficiency. Evidence of whether or not these goals were met and sustained is very limited. Objective To explore if PW had a sustained impact over the past decade. Design Multiple methods, comprising two online national surveys, six acute trust case studies (including a secondary analysis of local audit data) and telephone interviews. Data sources Surveys of 56 directors of nursing and 35 current PW leads; 88 staff and patient and public involvement representative interviews; 10 ward manager questionnaires; structured observations of 12 randomly selected wards and documentary analysis in case studies; and 14 telephone interviews with former PW leads. Results Trusts typically adopted PW in 2008–9 on their wards using a phased implementation approach. The average length of PW use was 3 years (range < 1 to 7 years). Financial and management support for PW has disappeared in the majority of trusts. The most commonly cited reason for PW’s cessation was a change in quality improvement (QI) approach. Nonetheless, PW has influenced wider QI strategies in around half of the trusts. Around one-third of trusts had impact data relating specifically to PW; the same proportion did not. Early adopters of PW had access to more resources for supporting implementation. Some elements of local implementation strategies were common. However, there were variations that had consequences for the assimilation of PW into routine practice and, subsequently, for the legacies and sustainability of the programme. In all case study sites, material legacies (e.g. display of metrics data; storage systems) remained, as did some processes (e.g. protected mealtimes). Only one case study site had sufficiently robust data collection systems to allow an objective assessment of PW’s impact; in that site, care processes had improved initially (in terms of patient observations and direct care time). Experience of leading PW had benefited the careers of the majority of interviewees. Starting with little or no QI experience, many went on to work on other initiatives within their trusts, or to work in QI at regional or national level within the NHS or in the private sector. Limitations The research draws on participant recall over a lengthy period characterised by evolving QI approaches and system-level change. Conclusions Little robust evidence remains of PW leading to a sustained increase in the time nurses spend on direct patient care or improvements in the experiences of staff and/or patients. PW has had a lasting impact on some ward practices. As an ongoing QI approach continually used to make ongoing improvements, PW has not been sustained, but it has informed current organisational QI practices and strategies in many trusts. The design and delivery of future large-scale QI programmes could usefully draw on the lessons learnt from this study of the PW in England over the period 2008–18. Funding This National Institute for Health Research Health Services and Delivery Research programme.
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Sensuse, Dana Indra, and Miftahul Maulana. "PERANCANGAN STRATEGIS SISTEM INFORMASI: STUDI KASUS DIREKTORAT JENDERAL PENYELENGGARAAN HAJI DAN UMRAH DEPARTEMEN AGAMA RI." Jurnal Sistem Informasi 7, no. 1 (July 15, 2012): 1. http://dx.doi.org/10.21609/jsi.v7i1.289.
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Pengembangan manajemen dan keorganisasian yang didukung dengan sistem informasi berbasis komputer merupakan instrumen strategis yang dibutuhkan dalam menghadapi era globalisasi pelayanan. Hal ini karena dukungan teknologi informasi dapat memudahkan pengambilan keputusan yang akurat, dapat dipercaya, cepat, dan ekonomis. Kebutuhan yang sama juga dialami oleh manajemen dan keorganisasian di lingkungan Departemen Agama, dan secara khusus Direktorat Penyelenggaraan Haji dan Umrah (Ditjen PHU). Sebagai contoh, pelaksanaan penyelenggaraan haji di Indonesia telah menggunakan perangkat pendukung sistem informasi berbasis komputer yang dikenal dengan Sistem Komputerisasi Haji Terpadu (SISKOHAT). Dengan mengamati tugas dan tanggung jawab serta ruang lingkup pekerjaan di lingkungan Ditjen PHU secara keseluruhan, maka kebutuhan yang mengarah pada perancangan strategis sistem informasi semakin mendesak. Penggunaan metodologi Ward and Peppard untuk mendapatkan perancangan strategis sistem informasi pada Ditjen PHU dengan mengombinasikan penggunaan metode analisis dari McFarlan dan standar yang dikeluarkan oleh Information Technology Infrastructure Library (ITIL) dalam pemetaan kondisi TI di lingkungan Ditjen PHU sehingga akan didapatkan pengelolaan TI Ditjen PHU menjadi selaras antara sistem informasi, infrastruktur, dan manajemen informasi. Management and organizational development are supported by computer-based information system is a strategic instrument needed in the era of globalization of services. This is because information technology support to facilitate decision making accurate, reliable, fast, and economical. The same requirement is also experienced by the management and organization in the Ministry of Religious Affairs, and in particular the Directorate of Operation of Hajj and Umrah (DG PHU). For example, the implementation of the hajj operation in Indonesia has been using the computer-based information systems support, known as Haji Integrated Computerized Systems (SISKOHAT). By observing the duties and responsibilities and the scope of work within the Directorate General of PHU as a whole, the need for a strategic lead to the design of information systems is increasingly urgent. Ward and Peppard use of the methodology for the strategic design of information systems at DG PHU by combining the use of methods of analysis of McFarlan and standards issued by the Information Technologi Infrastructure Library (ITIL) in IT in mapping environmental conditions that would be obtained PHU Directorate of IT management to be aligned DG PHU between information systems, infrastructure, and information management.
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Singh, Rajesh Kumar, and Milind B. Kamble. "Applicability of respiratory severity score and modified TAL criteria in pediatric age group for grading and management of acute respiratory illness." International Journal of Contemporary Pediatrics 7, no. 3 (February 25, 2020): 532. http://dx.doi.org/10.18203/2349-3291.ijcp20200676.
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Background: Acute respiratory tract infections (ARI) are the leading cause of death in children in the world (11.9 million per year) with the greatest number of deaths occurring in developing countries like India. We compared respiratory severity scoring system RSS (Respiratory Severity Score) with Modified TAL, so that we can find out which of the above scores are better and whether they can be implemented to assess pediatric ARI patients.Methods: This prospective observational study was conducted in Pediatrics wards, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra and data were collected from 290 children below 12 years of age by purposive sampling. All the children presenting with respiratory symptoms were subjected to these scoring system (RSS AND MODIFIED TAL) at the time of admission and were classified based on the scores obtained in respective scoring system. Data was analysed using frequencies, percentages and contingency tables and comparison was made between the above scoring systems to find which one is better applicable in pediatric ARI patient.Results: Incidence of pediatric patients presenting with only respiratory tract infections who are admitted in ward was 25.15 %, with more incidence being reported in children below 12 months (49.31%), males more affected. For both the ARI scoring systems (RSS and MOD TAL) as the severity increased so is the number of patients requiring oxygen and duration of hospitalization increased significantly (p<0.05), with RSS having stronger association.Conclusions: Both the scoring systems predicted that on admission if the score is more than chances of requirement of oxygen is more and also duration of hospitalization is more, with RSS being better predictor.
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Ahmadi, Ahmadi, Sutrisno Sutrisno, Arie Handito, and I. Nengah Putra A. "DEVELOPMENT STRATEGIES IN ARSENAL AS A UPT DISSENLEKAL NAVY DISTRIBUTION LOGISTICAL SUPPLIES CLASS V." JOURNAL ASRO 10, no. 1 (May 7, 2019): 62. http://dx.doi.org/10.37875/asro.v10i1.92.
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Planning Information Systems and Information Technology (SI/IT) is part of the Strategic Plan (Renstra) of an institution. Every institution or organization must have a framework for developing information systems and documentation that is adequate and in line with developing systems and technologies. A comprehensive and integrated strategic information system planning is needed by a supply and logistics institution, especially Arsenal with capacity as the Dissenlekal Task Force of the Indonesian Navy Headquarters (Mabesal) in the management of TNI AL Class V logistics. In general this research is a efforts in developing strategic IS/IT planning and identification of their needs at the Arsenal institution as UPT Dissenlekal Mabesal to be more optimal so that it can be integrated and support the strategic planning of logistics supplies within the Navy. The basic concept in this research begins with the preparation of the IS/IT Strategic Plan framework using the Ward and Peppard model approach, then in the evaluation process the translation of the Strategic Plan IS/IT and management of the institution's basic tasks using Balance Scorecard. Some analytical methods such as Value Chain Analysis, SWOT Analysis, PEST Analysis and Five Force Model Analysis are used to analyze the internal and external institutional environment. Next is the McFarlan Analysis Strategic Grid method that is used for application portfolio planning. The results of this research are the recommendations of the relevant IS/IT blue print strategic planning owned by Arsenal UPT Dissenlekal Mabesal and development priorities by referring to the institution's main task plan based on data obtained through the implementation of analytical methods. The information produced will be integrated data for administrative needs and services for related work units. The optimal implementation of information data processing as well as increasing the role of stakeholders in the provision of infrastructure will improve the quality of logistics management services in the fifth grade of the Navy Navy logistics in a comprehensive and integrated manner.
Keywords : IS/IT Strategic Planning, Ward and Peppard Model, information systems, information technology
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Hijriani, Astria, and Aprillia Dewi. "Priority Determination of Application Candidate Using Ward and Peppard’s Composite Matrix Portfolio and Business Process Analysis for Customer Relationship Management (CRM)." Systemic: Information System and Informatics Journal 4, no. 1 (November 15, 2018): 30–38. http://dx.doi.org/10.29080/systemic.v4i1.322.
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By using CRM, the organization will be able to identify of what customer requires and needs, thus will improve the service. The designing of CRM the Computer Science Department using Zachman Framework is one of the approach methods that can describe a more complex and thorough system information design. Zachman Framework has not provided a method for determining the priority of the application candidates that will be designed. Even though there are several methods to determine the priority of candidates of the information system, in this research the authors use the Ward and Peppard’s composite matrix portfolio and business process analysis for priority to determine the priority of application candidates. The phase of candidates determination by using Ward and Peppard’s composite matrix and business process is the identification of information related to Computer Science Department, SWOT analysis, business process and value chain analysis, the analysis of ISO 9001:2008 quality procedure implementation related to customer, the determination of application’s candidate, and the implementation of the questionnaire mapping of application candidate. The results are in the form of mapping for each application candidate/application system into four quadrants which are provided in composite matrix for the decision-making process. The matrix consists of key operational, strategic, high potential and support. The mapping of application candidate/information system is suitable with the contribution of each information system toward the CRM in Computer Science Department, University of Lampung. The mapping on Ward and Peppard’s composite matrix is then used to separate the application candidates into two groups, the main priority of application group/information system and non-main priority of application group/information system. There are five information systems which are classified into main priority application group/information system and recommended to be developed in further research.
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Tran, Quangdung, Drew Steve, and Rodney Anthony Stewart. "Effects of Supply Chain Characteristics on E-Procurement Institutionalization in the Construction Sector." International Journal of Enterprise Information Systems 17, no. 3 (July 2021): 85–96. http://dx.doi.org/10.4018/ijeis.2021070106.
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This study seeks to investigate the effects of supply chain characteristics on e-procurement institutionalization in construction companies. Data was collected through the in-depth structured interviews with 47 managers from a sample of 31 construction firms in Vietnam. The technique of cluster analysis with the Ward algorithm, the silhouette coefficient, and the t-test were used to analyze the data. The findings showed that the supply chain characteristics in terms of the size, ownership type, and operating market of strategic partners were significantly associated with the level of e-procurement institutionalization in construction companies. Along with the findings, this study's results will be helpful to policy-makers in formulating supportive policies and actions to effectively improve the low status of e-procurement adoption as well as accelerate the diffusion of the technology in the industry.
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Li, Chun Kit, Oi Fung Wong, Shing Ko, Hing Man Ma, and Chau Hung Albert Lit. "A preliminary report of clinical experience in managing patients with sepsis and septic shock in emergency medicine ward." Hong Kong Journal of Emergency Medicine 26, no. 1 (June 11, 2018): 15–25. http://dx.doi.org/10.1177/1024907918779318.
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Background: Sepsis and septic shock are common causes of hospital admission, morbidity, and mortality, posing a significant burden on the health-care systems. Objective: The objective of this study was to report the clinical experience of management and outcomes of sepsis patients in the emergency medical ward of a community hospital. The risk factors associated with adverse outcomes of sepsis patients were also analyzed. Methods: This was a retrospective cohort study of patients with sepsis or septic shock managed in the emergency medical ward of North Lantau Hospital from 1 March 2015 to 31 March 2017. Their characteristics, clinical outcomes, risk factors associated with in-hospital mortality, 28-day mortality, and prolonged hospital stay (>14 days) were analyzed. Results: A total of 68 eligible patients met the inclusion criteria during the study period. The mean age of the patients was 73 (standard deviation, 16.7; range, 34–100) years. The mean Sequential Organ Failure Assessment score of all the cases was 4.5 (standard deviation, 2.4); range, 2–11). The most common source of infection was pneumonia (50%). During the stay in the emergency medical ward, 35 cases (49%) required vasopressor support for management of septic shock, and 12 cases required non-invasive ventilation (NIV) support. Five patients were eventually transferred to tertiary hospital (Princess Margaret Hospital) for further management. There were five in-hospital mortality cases and two 28-day mortality cases. From the univariate analysis, factors associated with in-hospital mortality included Sequential Organ Failure Assessment score >6 (p < 0.000), increasing number of organ dysfunction (p < 0.000), presence of chronic liver disease (p = 0.025), respiratory dysfunction during admission (p = 0.028); factors associated with 28-day mortality were advanced age (p < 0.000), increasing number of organ dysfunction (p = 0.033), presence of congestive heart failure (p = 0.004), and the presence of cancer (p = 0.034); factors associated with prolonged hospital stay were advanced age, presence of chronic obstructive airway disease (p = 0.003), advanced age (p = 0.041), and the use of NIV support (p = 0.001). In multivariate analysis, weak associations between in-hospital mortality and Sequential Organ Failure Assessment score >6 (p = 0.226) and increased number of organ dysfunction (p = 0.108) were demonstrated; there was a trend of prolonged length of stay with increased age (p = 0.139). Conclusion: Our experience and knowledge in managing sepsis patients in the emergency medical ward with implementation of critical care bed services increased significantly. These preliminary results demonstrated that, with appropriate patient selection, sepsis patients can be safely managed in the emergency medical ward. Further study with larger sample size is needed to identify risk factors of adverse outcomes in this group of patients managed in the emergency medical ward.
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Gunja, Naren, Ian Dunlop, Milan Vaghasiya, Kevin Kuan, and Simon Poon. "Patient-centric implementation of an electronic medication management system at a tertiary hospital in Western Sydney." BMJ Health & Care Informatics 25, no. 3 (July 2018): 169–75. http://dx.doi.org/10.14236/jhi.v25i3.1005.
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BackgroundTraditional implementations of electronic medication management (EMM) systems have involved two common formats – a ‘big bang’ approach on the day of go-live, or a phased ward-by-ward approach over months.ObjectiveTo describe the patient-centric roll-out, a novel implementation model in converting from paper to EMM.MethodThis model iteratively converted a large tertiary teaching hospital to electronic from paper medication charts, commencing the roll-out in the emergency department (ED). The tenet of ‘one patient, one chart’ was maintained with new patients commenced on EMM, while existing inpatients were maintained on paper charts until their discharge. In the second week, all other intake points commenced patients on EMM, and in the third week, all remaining patients were manually converted to EMM. The implementation was assessed with training completion rates, staff satisfaction surveys, focus group interviews and incident logs.ResultsAt go-live, 79% of doctors, 68% of nurses and 90% of pharmacists were trained in the EMM system. The ED converted to electronic prescribing within 24 hours; by day 20, all patients were on EMM. Two hundred and thirty issues were logged, none critical, of which 22 were escalated. Of the 51,063 medications administered, there were 13 EMM-related clinical incidents including three double dosing errors, none of which led to an adverse event or death. Overall, 77% of staff surveyed were satisfied with the EMM implementation.ConclusionsThe patient-centric roll-out model represents an innovative and safe approach with a single medication chart reducing transcription and improved medication safety for the patient and the organisation.
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Mclaughlin, N., G. D. Lesliet, T. A. Williams, and G. J. Dobb. "Examining the Occurrence of Adverse Events within 72 hours of Discharge from the Intensive Care Unit." Anaesthesia and Intensive Care 35, no. 4 (August 2007): 486–93. http://dx.doi.org/10.1177/0310057x0703500404.
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Adverse events have negative consequences for patients, including increased risk of death or permanent disability. Reports describe suboptimal patient care on hospital wards and reasons for readmission to the intensive care unit (ICU) but limited data exists on the occurrence of adverse events, their characteristics and outcomes in patients recently discharged from the ICU to the ward. This prospective observational study describes the incidence and outcomes of adverse events within 72 hours of discharge from an Australian ICU over 12 weeks in 2006. Patients were excluded if they were admitted to ICU after booked surgery or uncomplicated drug overdose, were discharged from ICU to the high dependency unit or had a ‘do-not-resuscitate’ order. Clinical antecedents and preventability were determined for each event. Seventeen (10%) of the 167 discharges that met the inclusion criteria were associated with an adverse event, with nine (52%) judged as probably preventable. Seven adverse events occurred from discharges between 1700 and 0700 hours and seven were on weekends. The most common adverse events were related to fluid management (47%). Outcomes included three ICU readmissions, two high dependency unit admissions and two required one-to-one ward nursing. Two adverse events resulted in temporary disability, seven resulted in prolonged hospital stays and two were associated with death. Delay in taking action for abnormal physiological signs and infrequent charting were evident. Whilst the adverse event rate compared favourably with other reports, 64% of the events were considered preventable. A review of support systems and processes is recommended to better target transition from the ICU.
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NAÇO, Majlinda, Haxhire GANI, Nertila KODRA, Etmont ÇELIKU, Alma LLUKAÇAJ, and Eden NAÇO. "Preoperative Evaluation, Anesthesia and Outcome of a Super Morbidly Obese Patient." Albanian Journal of Trauma and Emergency Surgery 4, no. 2 (July 20, 2020): 733–37. http://dx.doi.org/10.32391/ajtes.v4i2.148.
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Background; Nowadays anesthesia and outcome of morbidly obese patients became not only challenges but and an obligation in abdominal surgery. Sometimes morbidly obese patients postponed from all the kinds of surgery till it is life-threatening. The ward of anesthetists is obligate for a very careful preoperative evaluation, anesthesia, and outcome of morbidity obese patients. These include the preoperative evaluation of obesity, particularly on cardiac, respiratory, and metabolic systems; airway management; perioperative management (i.e., hemodynamic, respiratory, and hyperglycemic) and postoperative care.
Case description: A 62 years old female with BMI=63.7 kg/m² with severe hypertension treatment came to a surgery ward for the plastic abdomen. After a careful preoperative preparation for the respiratory system and prophylaxis for thrombosis home, we started preoperative care 72 hours before surgery done in our hospital. We used general anesthesia for operation, the surgery lasts 190 minutes, and the patient was extubated according to weaning criteria only 16 hours after surgery. The patient stayed 2 days in intensive care and left a safe hospital on her ten days of recovery.
Discussion: Super obese surgical patients represent numerous challenges to the anesthetist.
Conclusion: A better understanding of the pathophysiology and complications that accompany obesity may improve their care and outcome.
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Holik, Muhamad Abdul. "Strategy System and Information Technology Planning In PT.Trikarsa Sempurna Sistemindo." ComTech: Computer, Mathematics and Engineering Applications 6, no. 3 (September 1, 2015): 402. http://dx.doi.org/10.21512/comtech.v6i3.2246.
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This research is to provide strategic design of information systems/information technology to the PT. Trikarsa Sempurna Sistemindo. With the design of information systems strategy, it is expected that within the next four years (2012-2015) business developments of PT TSS can be supported appropriately by the system and information technology that has been invested in PT TSS. Data in this research is collected through discussion, study and questionnaires. The collected data is then processed using the methodology of Ward and Peppard and supporting tools that generate qualitative analysis of information. From the analysis, it can be concluded that in order to make the achievement of a good business then PT TSS should do three thing. First, improve work efficiency by automating various processes of information management. Second, improve management effectiveness by satisfying the information needs for decision making. Third, improve or enhance the competitiveness of the organization by changing styles and ways of doing business.
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Knaup, P. "Section 2: Patient Records: Electronic Patient Records and their Benefit for Patient Care." Yearbook of Medical Informatics 15, no. 01 (August 2006): 40–42. http://dx.doi.org/10.1055/s-0038-1638475.
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SummaryTo summarize current excellent research in the field of patient records.Synopsis of the articles selected for the IMIA Yearbook 2006.Current research in the field of patient records analyses users’ needs and attitudes as well as the potential and limitations of electronic patient record systems. Particular topics are the questions physicians have when assessing patients during ward rounds, the timeliness of results when ordered electronically, the quality of documenting haemophilia home therapy, attitudes towards patient access to health records and adequate strategies for record linkage in dependence on the intended purpose.The best paper selection of articles on patient records shows examples of excellent research on methods used for the management of patient records and for processing their content as well as assessing the potential, limitations of and user attitudes towards electronic patient record systems. Computerized patient records are mature, so that they can contribute to high quality patient care and efficient patient management.
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Lee, Ju-Ry, Eun-Mi Kim, Sun-Aee Kim, and Eui Geum Oh. "A Systematic Review of Early Warning Systems’ Effects on Nurses’ Clinical Performance and Adverse Events Among Deteriorating Ward Patients." Journal of Patient Safety 16, no. 3 (April 26, 2018): e104-e113. http://dx.doi.org/10.1097/pts.0000000000000492.
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Enos Barasa Mukadi, Waruiru Nancy; Ndung’u J. B. Ikenye;. "Effects of Family Financial Management on Marital Stability of Persons in Lanet/Umoja Ward in Nakuru-North Sub-County, Nakuru County." Editon Consortium Journal of Psychology, Guidance, and Counseling 1, no. 3 (September 30, 2019): 84–91. http://dx.doi.org/10.51317/ecjpgc.v1i3.91.
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This study investigated the effects of Family financial management on marital stability of married persons in Lanet/ Umoja Ward in Nakuru-North Sub-County, Nakuru County. The study used the theories of Functioning Family Systems mainly by Murray Bowen, which focuses on patterns that develop in families in order to defuse anxiety. A target population of 498 married persons was randomly selected featuring those who have been in marriage for ten years or less. A smaller sample of 50 married persons (representing 10%) was randomly extracted. Descriptive statistics were used to describe how the dependent variable related to the independent variables in terms of percentages. The study indicated that management of family finances significantly affected marital stability. This is because some married persons dedicate most of their time in pursuit of wealth and in the process, literally forget their families. They seek to invest for their family at the expense of investing in their families. The study recommends that spouses intending to get married should undertake premarital counseling regarding financial management to guarantee marital stability.
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Heriadi, Agustono, Mohammad Suyanto, and Sudarmawan Sudarmawan. "Perencanaan Strategis Sistem Informasi STMIK Cahaya Surya Kediri." Creative Information Technology Journal 1, no. 1 (April 2, 2015): 15. http://dx.doi.org/10.24076/citec.2013v1i1.6.
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Meningkatnya jumlah perguruan tinggi mengakibatkan semakin tingginya persaingan. STMIK Cahaya Surya Kediri adalah sebuah institusi pendidikan tinggi yang memiliki satu program pendidikan S1 Sistem Informasi. Dalam industri usaha jasa, sistem informasi merupakan alat yang dapat membantu memenangkan persaingan. Perencanaan strategis sistem informasi menjadi salah satu kunci sebelum menerapkan sistem informasi dan teknologi informasi pada perusahaan. Perencanaan strategis yang tepat dapat mendukung rencana dan pengembangan bisnis perusahaan. STMIK Cahaya Surya Kediri belum memiliki perencanaan strategis sistem informasi. Bentuk perencanaan strategis sistem informasi yang akan dibahas dalam kajian ini menggunakan metodologi Ward and peppard dengan alat bantu metode analisis Value Chain untuk analisa lingkungan bisnis internal, Five Forces Model untuk analisa lingkungan bisnis eksternal, dan McFarlan Strategic Grid untuk analisa kondisi SI/TI internal saat ini. Hasil dari analisis ini mendefinisikan perencanaan strategis sistem informasi berupa strategi bisnis sistem informasi, strategi manajemen sistem informasi dan teknologi informasi, strategi sistem informasi, gap analisis sistem informasi, dan rencana implementasi.The increasing the number of college resulting in the higher competition. STMIK Cahaya Surya Kediri is an institution of higher education that have an educational program S1 Information System. In the business services industry, information system is a tool that can help win the competition. Strategic planning of information systems to be one of the key before implementing information systems and information technology in the enterprise. Proper strategic planning to support the company's plans and business development. STMIK Cahaya Surya Kediri not have a strategic planning information system. Form of strategic planning of information systems that will be discussed in this study using a methodology Ward and Peppard with aids Value Chain analysis method for internal business environment analysis, Five Forces Model for the analysis of the external business environment, and McFarlan Strategic Grid to analyze the condition of the IS/IT internal current. The results of this analysis defines the strategic planning of information systems in the form of business strategy information systems, information systems and information technology management strategy, information systems strategy, information systems gap analysis, and implementation plan.
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Outcalt, Kenneth W. "Stand Density Affects Growth of Choctawhatchee Sand Pine." Southern Journal of Applied Forestry 10, no. 3 (August 1, 1986): 128–31. http://dx.doi.org/10.1093/sjaf/10.3.128.
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Abstract Choctawhatchee sand pine (Pinus clausa var. immuginata D. B. Ward) was grown for 20 years at densities of 400, 600, and 800 trees per acre. Growing Choctawhatchee sand pine at 400 trees per acre resulted in significantly larger trees, but less wood was produced per acre than at higher densities. The ideal density depends on the management objectives, but for rotations of 20-25 years and chip harvesting systems, a density of 600 trees is recommended. For rotations of 30-35 years with conventional bolt and log harvests, 400 to 500 trees per acre seems better. South. J. Appl. For. 10:128-31, Aug. 1986.
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Sembodo Suroso, Jarot, Harisno, Tuga Mauritsius, and Agung Setyawan. "Information System Strategic Planning for Department of Housing and Settlement Region in the Jakarta Provincial Government - Indonesia." MATEC Web of Conferences 164 (2018): 01018. http://dx.doi.org/10.1051/matecconf/201816401018.
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This research was conducted in the Unit Pengelola Rumah Susun—UPRS (Flats Manager Unit) in Jakarta Provincial Government and based on the existence of problems strategic planning of information systems. The purpose of this study is to provide a proposal of Information System Strategy and Management Information System for UPRS. The strategic planning of the information systems on research was conducted using the method of Ward and Peppard. The IS strategic planning in the UPRS which is proposed in this research is hope to be used to integrate each business process and IS system which is connected to the Jakarta Smart City. IS is needed with the competent human resources to manage the IS/IT of the UPRS to increase the service quality to the flat occupants and to increase the employees productivity in implementing their job functions.
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Wambua, Agnes, James Chege, and Amos Ngira. "BIO-PHYSICAL AND SOCIO-ECONOMIC EFFECTS OF QUARRYING ACTIVITIES IN SELECTED QUARRIES IN TEZO WARD-KILIFI COUNTY." International Journal of Environmental Sciences 4, no. 1 (August 16, 2021): 1–17. http://dx.doi.org/10.47604/ijes.1341.
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Purpose: Using a Systems’ Approach, this study explores what aspects are essential for stone quarries to adopt a functional environmental management plan and whether compliance with environmental laws enhances business performance. The specific objectives of the study were: To evaluate the bio-physical effects of quarrying activities in selected quarries in Tezo ward and to evaluate the socio-economic effects of quarrying activities in selected quarries in Tezo ward.
Methodology: The study adopted descriptive survey design; the research data collection instrument was questionnaires. The study adopted purposive sampling; a survey of 134 respondents representing 80 quarry workers, 40 quarry owners, 10 EIA Experts, 3 NEMA staff and 1 County geologist were sampled purposively. Weighted and the Consolidated Scores were entered on Microsoft Excel for cleaning and later transferred to Statistical Package for Social Sciences (SPSS version 23.0) for statistical analyses. Data was presented inform of graphs, pie-charts, tables and narration in the thematic areas.
Findings: The study found out that there were health and ecological problems associated with quarrying. The application of heavy quarrying machines resulted to soil erosion, destruction of flora and threatens biodiversity aesthetic. The study revealed that quarrying was a source for livelihood among the community and more men (90%) were involved in quarrying due to masculinity nature of the task. EMPs were found to be significant in management of quarries. The development of EMPs and EIA was influenced by different actors and informal sector was a significant influencer of EMPs implementation. The study concluded that EMPs were effective in management of quarries despite varied challenges facing the NEMA official and the EIA experts.
Unique contribution to theory, practice and policy: The study recommends the need for transparency in the EIA as well as in the development of EMPs, to avoid discrimination and non-adherence. Further research is needed to understand the perception of community members on the effectiveness of EMPs in sustainable management of quarries and environment in general.
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Topani, Hendra Maya. "THE STRATEGIC PLANNING OF IS/IT AT PT. LINTAS GROUP." CommIT (Communication and Information Technology) Journal 5, no. 2 (October 31, 2011): 38. http://dx.doi.org/10.21512/commit.v5i2.558.
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The purpose of this study is to find the requirement of Information Systems and Information Technology (IS/IT) in the development of the construction of Base Transceiver Station tower (BTS). The methodology that is used is the method of Ward and Peppard. The relevant data were extracted from interviews with the management. Questionnaires were distributed to 16 respondents, and observation was made accordingly. The results of this study are in the form of the application portfolio recommendation, proposal of the IT Division enhancement and the action time of IS/IT. The planning of IS/IT is as a guiding framework for the development of future changes at PT. Lintas Group.Keywords: Information System, Technology Information, application portfolio, telecommunication.
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Fisher, Nigel, and Judy Roberts. "Primary health care service for long-stay psychiatric in-patients." Psychiatric Bulletin 22, no. 10 (October 1998): 610–12. http://dx.doi.org/10.1192/pb.22.10.610.
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Aims and methodA retrospective review of the activity of a general practitioner employed specifically to provide a primary health care service to the residents of an ‘old long-stay’ psychiatric ward was undertaken.ResultsAll but one patient had a chronic physical health problem requiring active management. Presenting pathology covered all organ systems. The review indicated that these health problems had not previously been satisfactorily managed by psychiatrists. This service was acceptable to and valued by patients.Clinical implicationsThe success of the service was only achieved by dedicating specific resources to meet primary health care needs. The extent to which this model could be extended to ‘new long-stay’ populations located in dispersed hospital hostels is less certain.