The migration of Flemish doctors in the Netherlands.

NARCIS (Netherlands)

Heuvel, J. van den; Maeseneer, J. de; Velden, L. van der

2007-01-01

The cross border migration of Flemish general practitioners (GPs) to the Netherlands was examined. In the recent past Belgium experienced a surplus in GPs, while in the Netherlands a shortage was observed. Despite the availability of potential incentives in respect of income and professional

[The stigmatising of schizophrenia and autism in the Flemish daily papers].

Science.gov (United States)

Thys, E; Struyven, C I; Danckaerts, M; De Hert, M

2014-01-01

A considerable social stigma is attached to many types of psychiatric disorders. However, research also shows that there are differences in the degree of social stigma attached to psychiatric disorders. There is evidence that the portrayal of schizophrenia in the media is particularly negative. To compare the degree of stigma in reporting of autism and schizophrenia in the Flemish daily newspapers. Via the websites of the seven Flemish daily newspapers, we searched for all articles published between 2008 and 2012 containing the keywords autism/autist(ic) and schizophrenia/schizophrenic. The collected articles (n = 4,181) were then graded to their stigmatising content. In the collected articles the coverage of autism was mostly positive, whereas the coverage of schizophrenia was predominantly negative. The contrast between the reporting on autism and on schizophrenia was very substantial (p social stigma attached to schizophrenia is poignantly reflected in the Flemish newspapers. The fact that a disorder such as autism, which has many features in common with schizophrenia, is depicted in a much more favourable way than schizophrenia indicates that a more positive image of schizophrenia is not only desirable but also achievable.

Impact of brief communication training among hospital social workers.

Science.gov (United States)

Bunting, Morgan; Cagle, John G

2016-01-01

Hospital social workers are often the fulcrum of communication between physicians, patients, and families especially when patients are facing life-threatening illness. This study aims to understand the impact of a brief training for hospital social workers. The training is designed to improve communication skills and self-efficacy, as well as lessen fears of death and dying. Repeated-measures tests were used to assess outcomes across three time points. Twenty-nine university-based hospital social workers participated. Results trended in the desired directions. Communication self-efficacy improved immediately following the training, and this was sustained 1 month following training completion. Although participants were relatively experienced, improvement was still demonstrated and maintained suggesting brief communication training is promising for hospital social workers across the career.

Business continuity and risk management at a strategic level: Case study of the Flemish government.

Science.gov (United States)

Bouve, Joris; Steens, Herman-Peter; Ruebens, Martin

2018-01-01

The Flemish government comprises a number of different departments and agencies with the autonomy to optimise their service level in a proactive and resilient manner. Recently, the Flemish government defined four organisational values: openness, decisiveness, trust and agility. In addition, the Internal Audit Agency developed guidelines concerning internal control and organisational management, in which risk management was emphasised. In combination with goal setting and process management, this paper considers risk management as a starting point for the overall management of Flemish government entities. The paper then develops tools to support the establishment of business continuity and risk management processes. These tools fit into the organisation's strategic framework and are easy to understand, pragmatically designed and flexible in their use. The paper goes on to illustrate how the Department of the Chancellery and Public Governance is implementing BCM and risk management, and how it is integrating BCM, risk management and crisis management. It will then focus on the Flemish government's long-term strategy across the boundaries between the different entities and the question of how risk management can become a useful tool for policy makers.

A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research.

Science.gov (United States)

Hemsley, Bronwyn; Balandin, Susan

2014-12-01

Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.

The party of the people versus the cultural elite: Populism and nationalism in Flemish radical right rhetoric about artists

OpenAIRE

de Cleen, Benjamin

2016-01-01

This article discusses the interplay between nationalism and populism in the Flemish \\ud (North-Belgian), Vlaams Bloc/Vlaams Belang’s (VB), populist radical right rhetoric about \\ud expressive culture. Building on a discourse theoretical analysis of three extensive case \\ud studies (concerts against the VB, the opposition between the VB and the Flemish theatres, \\ud and the VB’s criticism of the Flemish National Songfest), and a number of other \\ud controversial moments the article shows that...

Technological aspects of hospital communication challenges: an observational study.

Science.gov (United States)

Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

2015-06-01

To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

The Effects of Hospital-Level Factors on Patients' Ratings of Physician Communication.

Science.gov (United States)

Al-Amin, Mona; Makarem, Suzanne C

2016-01-01

The quality of physician-patient communication influences patient health outcomes and satisfaction with healthcare delivery. Yet, little is known about contextual factors that influence physicians' communication with their patients. The main purpose of this article is to examine organizational-level factors that influence patient perceptions of physician communication in inpatient settings. We used the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and American Hospital Association data to determine patients' ratings of physician communication at the hospital level, and to collect information about hospital-level factors that can potentially influence physician communication. Our sample consisted of 2,756 hospitals. We ran a regression analysis to determine the predictors of poor physician communication, measured as the percentage of patients in a hospital who reported that physicians sometimes or never communicated well. In our sample of hospitals, this percentage ranged between 0% and 21%, with 25% of hospitals receiving poor ratings from more than 6% of patients. Three organizational factors had statistically significant negative associations with physician communication: for-profit ownership, hospital size, and hospitalists providing care in the hospital, On the other hand, the number of full-time-equivalent physicians and dentists per 10,000 inpatient days, physician ownership of the hospital, Medicare share of inpatient days, and public ownership were positively associated with patients' ratings of physician communication. Physician staffing levels are an understudied area in healthcare research. Our findings indicate that physician staffing levels affect the quality of physician communication with patients. Moreover, for-profit and larger hospitals should invest more in physician communication given the role that HCAHPS plays in value-based purchasing.

Climate policy in Belgium and the Flemish District

International Nuclear Information System (INIS)

Sereno, M.

2001-01-01

According to the agreement of the Environment Ministers' Council of the European Union Belgium will have to reduce its overall greenhouse gas emissions by 7,5 % during the first commitment period (2008-2012) in relation to the reference year 1990. International climate change policy is implemented by Belgian federal authorities responsible for fiscal, labelling and product policies and regional authorities (Flanders, Wallonia and Brussels) responsible for energy, environmental and agricultural policies. This article discusses the important issues raised by Belgian federal and Flemish regional climate change policy. It focuses onto the Belgian national climate change plan' and the Flemish Region's policies as laid down in its regional Environmental Policy Plan. The overall context of this article is given in by the international climate change negotiations in The Hague during the sixth Conference of the Parties in execution of the United Nation's Framework on Climate Change. In conclusion of this article a brief overview of the Belgian point of view on the failed negotiations in The Hague is given. 6 refs

Quantifying the economic impact of communication inefficiencies in U.S. hospitals.

Science.gov (United States)

Agarwal, Ritu; Sands, Daniel Z; Schneider, Jorge Díaz

2010-01-01

Care delivery is a complex enterprise that involves multiple interactions among multiple stakeholders. Effective communication between these dispersed parties is critical to ensuring quality and safety and improves operational efficiencies. Time and motion studies in hospital settings provide strong evidence that care providers-doctors and nurses-spend a significant proportion of their time obtaining or providing information (i.e., communicating). Yet, surprisingly, no studies attempt to quantify the economic waste associated with communication inefficiencies in hospital settings at a national level. Our research focuses on developing models for quantifying the economic burden on hospitals of poor communications. We developed a conceptual model of the effects of poor communications in hospitals that isolates four outcomes: (1) efficiency of resource utilization, (2) effectiveness of core operations, (3) quality of work life, and (4) service quality, identifying specific metrics for each outcome. We developed estimates of costs associated with wasted physician time, wasted nurse time, and increase in length of stay caused by communication inefficiencies across all U.S. hospitals, using primary data collected from interviews in seven hospitals and secondary data from a literature review, the Bureau of Labor Statistics (BLS), and the Agency for Healthcare Research and Quality (AHRQ). We find that U.S. hospitals waste over $12 billion annually as a result of communication inefficiency among care providers. Increase in length of stay accounts for 53 percent of the annual economic burden. A 500-bed hospital loses over $4 million annually as a result of communication inefficiencies. We note that our estimates are conservative as they do not include all dimensions of economic waste arising from poor communications. The economic burden of communication inefficiency in U.S. hospitals is substantial. Information technologies and process redesign may help alleviate some of

Structure across the northeastern margin of Flemish Cap, offshore Newfoundland from Erable multichannel seismic reflection profiles: evidence for a transtensional rifting environment

Science.gov (United States)

Welford, J. Kim; Hall, Jeremy; Sibuet, Jean-Claude; Srivastava, Shiri P.

2010-11-01

We present the results from processing and interpreting nine multichannel seismic reflection lines collected during the 1992 Erable experiment over the northeastern margin of Flemish Cap offshore Newfoundland. These lines, combined into five cross-sections, provide increased seismic coverage over this lightly probed section of the margin and reveal tectonically significant along-strike variations in the degree and compartmentalization of crustal thinning. Similar to the southeastern margins of Flemish Cap and the Grand Banks, a transitional zone of exhumed serpentinized mantle is interpreted between thinned continental and oceanic crust. The 25 km wide transitional zone bears similarities to the 120 km wide transitional zone interpreted as exhumed serpentinized mantle on the conjugate Irish Atlantic margin but the significant width difference is suggestive of an asymmetric conjugate pair. A 40-50 km wide zone of inferred strike-slip shearing is interpreted and observed to extend along most of the northeastern margin of Flemish Cap. Individual shear zones (SZs) may represent extensions of SZs and normal faults within the Orphan Basin providing further evidence for the rotation and displacement of Flemish Cap out of Orphan Basin. The asymmetry between the Flemish Cap and Irish conjugate pairs is likely due in large part to the rotation and displacement of Flemish Cap which resulted in the Flemish Cap margin displaying features of both a strike-slip margin and an extensional margin.

How does wireless phones effect communication and treatment in hospitals?

DEFF Research Database (Denmark)

Paasch, Bettina Sletten

The use of wireless phones in hospital units are increasing, inducing practitioners to carry a working phone each. A study performed in a medical hospital unit demonstrates that wireless phones can impair communication between health care practitioners and patients (Paasch, in press). Also wireless...... phones can compromise patient safety, both by disturbing the practitioners’ concentration, causing mistakes, and by transporting bacteria between patients. This qualitative Ph.D.-study wishes to further investigate the effect of wireless phones on communication and treatment in hospital units, using...... participant observations, ethnographic interviews and video observations. The study will explore how wireless phones mediate and is mediated by practitioners communication with each other and patients. As hospitals are constructed and reconstructed by all communication within, this insight will enable...

Pediatric primary care providers' perspectives regarding hospital discharge communication: a mixed methods analysis.

Science.gov (United States)

Leyenaar, JoAnna K; Bergert, Lora; Mallory, Leah A; Engel, Richard; Rassbach, Caroline; Shen, Mark; Woehrlen, Tess; Cooperberg, David; Coghlin, Daniel

2015-01-01

Effective communication between inpatient and outpatient providers may mitigate risks of adverse events associated with hospital discharge. However, there is an absence of pediatric literature defining effective discharge communication strategies at both freestanding children's hospitals and general hospitals. The objectives of this study were to assess associations between pediatric primary care providers' (PCPs) reported receipt of discharge communication and referral hospital type, and to describe PCPs' perspectives regarding effective discharge communication and areas for improvement. We administered a questionnaire to PCPs referring to 16 pediatric hospital medicine programs nationally. Multivariable models were developed to assess associations between referral hospital type and receipt and completeness of discharge communication. Open-ended questions asked respondents to describe effective strategies and areas requiring improvement regarding discharge communication. Conventional qualitative content analysis was performed to identify emergent themes. Responses were received from 201 PCPs, for a response rate of 63%. Although there were no differences between referral hospital type and PCP-reported receipt of discharge communication (relative risk 1.61, 95% confidence interval 0.97-2.67), PCPs referring to general hospitals more frequently reported completeness of discharge communication relative to those referring to freestanding children's hospitals (relative risk 1.78, 95% confidence interval 1.26-2.51). Analysis of free text responses yielded 4 major themes: 1) structured discharge communication, 2) direct personal communication, 3) reliability and timeliness of communication, and 4) communication for effective postdischarge care. This study highlights potential differences in the experiences of PCPs referring to general hospitals and freestanding children's hospitals, and presents valuable contextual data for future quality improvement initiatives

Multicultural Teaching in Flemish Secondary Schools: The Role of Ethnic School Composition, Track, and Teachers' Ethnic Prejudice

Science.gov (United States)

Vervaet, Roselien; Van Houtte, Mieke; Stevens, Peter A. J.

2018-01-01

In this study, we investigate the association between a school's ethnic composition, the track in which teachers teach, and their level of involvement with multicultural teaching (MCT) in the Flemish context, taking into account the ethnic prejudice of teachers. Multilevel analyses of data from 590 Flemish teachers in 40 Belgian secondary schools…

Hospital communication between perception and cost savings: an Italian case study.

Science.gov (United States)

Pennacchini, M; Pensieri, C; Binetti, P

2012-07-01

Communication field is very much studied by Companies but not so much from the Italian NHS. We aim to study the suffering communication that patients, relatives and customers feel when they approach a hospital. The research was carried out in an Italian region: Lazio. The Objective was to take a picture of the current state of Regional Health-Care System (RHS) communication by local Visual Communication (VC), telematic, internal perception, communication propensity and perception of hospital's brand. We have sampled 7 hospitals (114 items): Web-site's analysis, Location's VC, Urp's manager interview, Focus-group, Analysis Valuator of the Hospital's Brand (AVoHB). WEB: 14% of web-sites had a positive score, 86% had an Hospital Service Guide, 43% hadn't Urp's e-mail, 29% had a ward's map, 0% was W3C. Average: -17pt. on ±74pt. VISUAL COMMUNICATION: 100% had a Help-desk at the entrance, 100% had readable signpost, 43% had a readable badge, 29% had chromatic signpost, 0% had an assistance signpost and none of them had the Toilettes signpost. Average: -10,42pt. on ±58pt. FOCUS-GROUP: Staff underline their very high interest in interpersonal communication. They report a lack of VC inside their hospitals that cannot help patients to be self-oriented. Lost users can only ask information to the first doctor they see, taking staff time, which is already lacked. AVOHB: Powergrid shows that the positioning of the Aggregated Brand (RHS) and of each hospital analyzed are in the III quadrant. By a Corporate Communication point of view we can see that almost all companies reach a good level in terms of effective communication but none of them excel in all critical areas for an effective communication.

Communication between hospitals and isolated aboriginal community health clinics.

Science.gov (United States)

Mackenzie, G; Currie, B J

1999-04-01

This study described the communication dynamics, identified problems and recommended changes to improve patient follow-up and communication between Royal Darwin Hospital (RDH) and isolated Aboriginal community health clinics (CHC) in the Northern Territory (NT). In 1995, staff interviews were conducted and an audit of isolated Aboriginal patients' RDH discharge summaries (DS). Eighteen per cent of RDH DSs never arrived in CHCs. DSs were often prepared late and more likely to be in CHC records if written on time and if the referral source was specified. Interviews revealed discontent between CHCs and RDH regarding: communication, DS documentation, the supply of discharge medication, as well as different hospital and community perceptions of Aboriginies' reliability to carry a DS and CHC desire for patients to be given DSs at discharge. Aboriginal patients should be given a DS at discharge and resident medical officers should be educated as to the function and importance of the DS. In 18 months following this study, RDH appointed unit-based Aboriginal health workers and a policy was produced for written communication between hospital and CHCs, as well as a discharge planning manual for Aboriginal communities. Projects investigating communication between hospitals and isolated Aboriginal clinics and patient follow-up may result in significant policy changes concerning these processes.

Liberalization of the Flemish market for electricity and natural gas

International Nuclear Information System (INIS)

2002-01-01

In this first report of the Flemish Regulating Institute for the Electricity and Natural Gas Market (VREG) only attention is paid to the market for electricity. Every 3 months a state of the art will be given of the liberalization process of the energy market in Flanders [nl

Communication satisfaction of professional nurses working in public hospitals.

Science.gov (United States)

Wagner, J-D; Bezuidenhout, M C; Roos, J H

2015-11-01

This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. © 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd.

Improving nurse-patient communication with patients with communication impairments: hospital nurses' views on the feasibility of using mobile communication technologies.

Science.gov (United States)

Sharpe, Bridget; Hemsley, Bronwyn

2016-05-01

Nurses communicating with patients who are unable to speak often lack access to tools and technologies to support communication. Although mobile communication technologies are ubiquitous, it is not known whether their use to support communication is feasible on a busy hospital ward. The aim of this study was to determine the views of hospital nurses on the feasibility of using mobile communication technologies to support nurse-patient communication with individuals who have communication impairments. This study involved an online survey followed by a focus group, with findings analyzed across the two data sources. Nurses expected that mobile communication devices could benefit patient care but lacked access to these devices, encountered policies against use, and held concerns over privacy and confidentiality. The use of mobile communication technologies with patients who have communication difficulties is feasible and may lead to improvements in communication and care, provided environmental barriers are removed and facilitators enhanced. Copyright © 2015 Elsevier Inc. All rights reserved.

Doctor-pharmacist communication in hospitals: strategies, perceptions, limitations and opportunities.

Science.gov (United States)

Coomber, Peter; Clavarino, Alexandra; Ballard, Emma; Luetsch, Karen

2018-04-01

Background Effective communication between health professionals contributes to safe and efficient patient care, whereas communication breakdown can lead to adverse patient outcomes and increased healthcare expenditure. Information on how pharmacists and doctors communicate with each other in hospitals is limited. Objective To explore usage and perceptions of communication methods by doctors and pharmacists in hospital settings. Setting Four public hospitals in Australia. Method A mixed method study utilising a pilot questionnaire, semi-structured interviews, and electronic survey was designed. Frequentist statistics and logistic regression were used to analyse survey data. Thematic analysis was conducted to evaluate semi-structured interview data and free-text survey comments. Frequency of use of communication methods, perceptions of the convenience, time taken to use, accuracy and effectiveness of each method. Results More than 95% of doctors and pharmacists combined used face-to-face and phone calls to communicate with each other, 70% used a medication management plan, and 62% used progress notes. A preference for oral communication was confirmed with the expressed need for building professional rapport and receiving responses. Perceptions regarding effectiveness of oral communication methods were related to perceptions of their convenience and accuracy. Professional groups described differences in perceived ownership of various modes of communication. Conclusions Preferences for oral communication create potential issues with recall and comprehension. Integrating oral communication features into written communication methods, e.g. creating responses, conversations, building rapport, may change doctors' and pharmacists' perceptions of effectiveness. Communication receipt and response functionality in electronic medication and record management systems may improve communication.

In search of a unique angle: on the selection and framing decisions of Flemish newspaper reporters in an era of journalistic change

NARCIS (Netherlands)

Boesman, J.L.J.; d'Haenens, L.; Van Gorp, B.

2014-01-01

This paper investigates the way newspaper journalists in Flanders select and built their stories in precarious times. In recent years, the Flemish newspaper industry has known a progressive process of media concentration and growing synergies between newsrooms. Since June 2013, the Flemish newspaper

Mobility in the academic careers at the Flemish universities: Results from the Human Resources in Research database

Energy Technology Data Exchange (ETDEWEB)

Debacker, N.; Vandevelde, K.

2016-07-01

Worldwide mobility of researchers is generally correlated with an enhancement of the continuous interchange of ideas and is therefore highly stimulated. Flemish universities have occasionally been criticized for providing limited career opportunities for foreign researchers. However, presently no reliable data is available on researchers’ mobility in Flanders. For the five Flemish universities a full dataset is available at the ECOOM Centre for R&D Monitoring, containing all academic appointments and PhD’s awarded since 1990-1991. This dataset allows for prospective analyses within the Flemish university system as well as retrospective analyses and provides information on international and interuniversity recruitment and academic inbreeding. The present results confirm that the academic system in Flanders is indeed recognized by a tradition of internal recruitment. However specific differences between the universities and the scientific disciplines are observed calling for a more complex study of researchers’ mobility and of the relationship between mobility and research excellence. (Author)

Perceived barriers to communication between hospital and nursing home at time of patient transfer.

Science.gov (United States)

Shah, Faraaz; Burack, Orah; Boockvar, Kenneth S

2010-05-01

To identify perceived barriers to communication between hospital and nursing home at the time of patient transfer and examine associations between perceived barriers and hospital and nursing home characteristics. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Respondents rated the importance as a barrier to hospital-nursing home communication of (1) hospital providers' attitude, time, effort, training, payment, and familiarity with nursing home patients; (2) unplanned and off-hours transfers; (3) HIPAA privacy regulations; and (4) lost or failed information transmission. Associations were determined between barriers and the following organizational characteristics: (1) hospital-nursing home affiliations, pharmacy or laboratory agreements, cross-site staff visits, and cross-site physician care; (2) hospital size, teaching status, and frequency of geriatrics specialty care; (3) nursing home size, location, type, staffing, and Medicare quality indicators; and (4) hospital-to-nursing home communication, consistency of hospital care with health care goals, and communication quality improvement efforts. Of 647 questionnaires sent, 229 were returned (35.4%). The most frequently reported perceived barriers to communication were sudden or unplanned transfers (44.4%), transfers that occur at night or on the weekend (41.4%), and hospital providers' lack of effort (51.0%), lack of familiarity with patients (45.0%), and lack of time (43.5%). Increased hospital size, teaching hospitals, and urban nursing home location were associated with greater perceived importance of these barriers, and cross-site staff visits and hospital provision of laboratory and pharmacy services to the nursing home were associated with lower perceived importance of these barriers. Hospital and nursing home characteristics and interorganizational relationships were associated with nursing home

The Dutch-Flemish PROMIS Physical Function item bank exhibited strong psychometric properties in patients with chronic pain.

Science.gov (United States)

Crins, Martine H P; Terwee, Caroline B; Klausch, Thomas; Smits, Niels; de Vet, Henrica C W; Westhovens, Rene; Cella, David; Cook, Karon F; Revicki, Dennis A; van Leeuwen, Jaap; Boers, Maarten; Dekker, Joost; Roorda, Leo D

2017-07-01

The objective of this study was to assess the psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function item bank in Dutch patients with chronic pain. A bank of 121 items was administered to 1,247 Dutch patients with chronic pain. Unidimensionality was assessed by fitting a one-factor confirmatory factor analysis and evaluating resulting fit statistics. Items were calibrated with the graded response model and its fit was evaluated. Cross-cultural validity was assessed by testing items for differential item functioning (DIF) based on language (Dutch vs. English). Construct validity was evaluated by calculation correlations between scores on the Dutch-Flemish PROMIS Physical Function measure and scores on generic and disease-specific measures. Results supported the Dutch-Flemish PROMIS Physical Function item bank's unidimensionality (Comparative Fit Index = 0.976, Tucker Lewis Index = 0.976) and model fit. Item thresholds targeted a wide range of physical function construct (threshold-parameters range: -4.2 to 5.6). Cross-cultural validity was good as four items only showed DIF for language and their impact on item scores was minimal. Physical Function scores were strongly associated with scores on all other measures (all correlations ≤ -0.60 as expected). The Dutch-Flemish PROMIS Physical Function item bank exhibited good psychometric properties. Development of a computer adaptive test based on the large bank is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Tradesmen, Traitors, Pirates, and Prostitutes: Depictions of the Flemish in Later Medieval England

Science.gov (United States)

Schwamb, Sara M. B.

2010-01-01

This study examines the depictions of the Flemish in Chaucer's "The Canterbury Tales", Langland's "Piers Plowman", several historical chronicles including The Brut continuations, poetic works such as "The Libelle of Englysh Polycye", additional short poems dealing directly with events of the Hundred Years' War, and…

Flemish palliative care nurses' attitudes toward euthanasia: a quantitative study.

Science.gov (United States)

Gielen, Joris; van den Branden, Stef; van Iersel, Trudie; Broeckaert, Bert

2009-10-01

To adequately measure the attitudes of Flemish palliative care nurses toward euthanasia, and assess the relationship between these attitudes and demographic factors and the (perceived) influence of experience in palliative care on death anxiety. An anonymous questionnaire was sent to all nurses (n=589) employed in palliative care in Flanders, Belgium: 70.5% of the nurses (n=415) responded. A majority of the nurses supported the Belgian law regulating euthanasia but also believed that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care. Three clusters were discovered: staunch advocates of euthanasia (150 nurses, 41.1%); moderate advocates of euthanasia (135 nurses, 37%); and (moderate) opponents of euthanasia (80 nurses, 21.9%). An absolute opposition between advocates and opponents of euthanasia was not observed. A statistically significant relationship was found between the euthanasia clusters and years of experience in palliative care, and (perceived) influence of experience in palliative care on anxiety when a patient dies. Flemish palliative care nurses' attitudes toward euthanasia are nuanced and contextual. By indicating that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care, the nurses applied a 'palliative filter' a standard procedure in the case of a euthanasia request.

Non-Suicidal and Suicidal Self-Injurious Behavior among Flemish Adolescents : A Web-Survey

NARCIS (Netherlands)

Baetens, I.; Claes, L.; Muehlenkamp, J.; Grietens, Hans; Onghena, P.

2011-01-01

The present study investigated the prevalence of non-suicidal self-injury (NSSI) and suicidal self-injury (SSI) in a sample of 1,417 Flemish adolescents aged 12 to 18, as well as psychosocial differences between adolescents engaging in NSSI and adolescents engaging in SSI. Participants completed an

Modeling interdependencies between business and communication processes in hospitals.

Science.gov (United States)

Brigl, Birgit; Wendt, Thomas; Winter, Alfred

2003-01-01

The optimization and redesign of business processes in hospitals is an important challenge for the hospital information management who has to design and implement a suitable HIS architecture. Nevertheless, there are no tools available specializing in modeling information-driven business processes and the consequences on the communication between information processing, tools. Therefore, we will present an approach which facilitates the representation and analysis of business processes and resulting communication processes between application components and their interdependencies. This approach aims not only to visualize those processes, but to also to evaluate if there are weaknesses concerning the information processing infrastructure which hinder the smooth implementation of the business processes.

Dutch-Flemish translation of nine pediatric item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS)®.

Science.gov (United States)

Haverman, Lotte; Grootenhuis, Martha A; Raat, Hein; van Rossum, Marion A J; van Dulmen-den Broeder, Eline; Hoppenbrouwers, Karel; Correia, Helena; Cella, David; Roorda, Leo D; Terwee, Caroline B

2016-03-01

The Patient-Reported Outcomes Measurement Information System (PROMIS(®)) is a new, state-of-the-art assessment system for measuring patient-reported health and well-being of adults and children. It has the potential to be more valid, reliable, and responsive than existing PROMs. The items banks are designed to be self-reported and completed by children aged 8-18 years. The PROMIS items can be administered in short forms or through computerized adaptive testing. This paper describes the translation and cultural adaption of nine PROMIS item banks (151 items) for children in Dutch-Flemish. The translation was performed by FACITtrans using standardized PROMIS methodology and approved by the PROMIS Statistical Center. The translation included four forward translations, two back-translations, three independent reviews (at least two Dutch, one Flemish), and pretesting in 24 children from the Netherlands and Flanders. For some items, it was necessary to have separate translations for Dutch and Flemish: physical function-mobility (three items), anger (one item), pain interference (two items), and asthma impact (one item). Challenges faced in the translation process included scarcity or overabundance of possible translations, unclear item descriptions, constructs broader/smaller in the target language, difficulties in rank ordering items, differences in unit of measurement, irrelevant items, or differences in performance of activities. By addressing these challenges, acceptable translations were obtained for all items. The Dutch-Flemish PROMIS items are linguistically equivalent to the original USA version. Short forms are now available for use, and entire item banks are ready for cross-cultural validation in the Netherlands and Flanders.

[Communication prostheses and behavioral alignment in hospital leaflets].

Science.gov (United States)

Vasconcellos-Silva, Paulo Roberto; Rivera, Francisco Javier Uribe; Rozemberg, Brani

2003-08-01

Review was made of publications that describe experience with printed material distributed to the lay public in hospital institutions. From the 146 leaflets examined, those aimed at professionals or disabled people, thus leaving 75 papers that illustrate the present pattern for the rationality behind the production, use and evaluation of this type of resource. In a general manner, such leaflets invest in the power of "ideal printed information" to align behavior with the hospital's biomedical agenda. The underlying rationality that permeates them perceives the "perfect information package" as one that efficiently describes its technical content for the purpose of unidirectional persuasion, is up-to-date in relation to readability scales and embellished by graphic design, and emphasizes the priorities defined by the professionals. Such "communication prostheses" should be capable of electronic validation by means of software suitable for proportioning the "doses" to the subject matter. Information as a drug, cognitivism, the lack of research on message reception and the need for communicative action for the deconstruction of systems of closed thinking within the hospital environment have been discussed.

Socio-economic and lifestyle factors associated with overweight in Flemish adult men and women

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Duvigneaud Nathalie

2007-02-01

Full Text Available Abstract Background Changes in lifestyles and in the environment over the last decades are probably the most important cause of the overweight epidemic, but the findings are inconsistent among studies. The purpose of this study was to investigate the association of several socio-economic and lifestyle factors with overweight in Flemish adults, using BMI ≥ 25 kg/m2, waist circumference (WC ≥ 94 cm (men or ≥ 80 cm (women and the combination of BMI and WC for identifying overweight. Methods This cross-sectional epidemiological study was conducted by the Flemish Policy Research Centre Sport, Physical Activity and Health between October 2002 and February 2004 in 46 Flemish communities. A total of 4903 Flemish adults (2595 men and 2308 women, aged 18 to 75 years, from a population-based random sample were included in the analysis. Body weight, height and WC were measured, and socio-economic and lifestyle factors were reported by means of validated questionnaires. Results The results of the logistic regressions revealed that age is positively associated with overweight in both genders. Alcohol consumption is associated with overweight only in men. Men smoking in the past and watching TV >11 h/week have significantly higher OR's for overweight, while men who participate in health related sports >4 h/week have significantly lower OR's for overweight. In women, watching TV >9 h/week was positively associated with overweight. Women who are current smokers or participate in health related sports >2.5 h/week or with a higher educational level have significantly lower odds for overweight. Different results are observed between the first (BMI and the second model (WC in both genders. In men, the models differ for education and health related sports, while in women they differ for smoking status and leisure time physical activity. Conclusion The present study confirms the contention that overweight is a multifactorial problem. Age and TV viewing are

Effects of clinical communication interventions in hospitals: a systematic review of information and communication technology adoptions for improved communication between clinicians.

Science.gov (United States)

Wu, Robert C; Tran, Kim; Lo, Vivian; O'Leary, Kevin J; Morra, Dante; Quan, Sherman D; Perrier, Laure

2012-11-01

To conduct a systematic review of the literature to identify, describe and assess interventions of information and communication technology on the processes of communication and associated patient outcomes within hospital settings. Studies published from the years 1996 to 2010 were considered and were selected if they described an evaluation of information and communication technology interventions to improve clinical communication within hospitals. Two authors abstracted data from full text articles, and the quality of individual articles were appraised. Results of interventions were summarized by their effect. There were 18 identified studies that evaluated the use of interventions that included alphanumeric paging, hands-free communication devices, mobile phones, smartphones, task management systems and a display based paging system. Most quantitative studies used a before and after study design and were of lower quality. Of all the studies, there was only one prospective randomized study, but this study used only simulated communication events. Quantitative studies identified improved perceptions of communication and some improvement in communication metrics. Qualitative studies described improvements in efficiency of communication but also issues of loss of control and reliability. Despite the rapid advancement in information and communications technology over the last decade, there is limited evidence suggesting improvements in the ability of health professionals to communicate effectively. Given the critical nature of communication, we advocate further evaluation of information and communication technology designed to improve communication between clinicians. Outcome measures should include measures of patient-oriented outcomes and efficiency for clinicians. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Debating Futures in Flemish Deaf Parliament: Deaf Epistemologies, Participatory Citizenship, and Sustainable Development

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De Clerck, Goedele A.M.

2017-01-01

More than 350 deaf/sign language community members gathered at six local deaf clubs in Flanders in 2014 to share perspectives about the future and formulate proposals for policymaking. This initiative, Flemish Deaf Parliament, serves as a platform of deliberative democracy developed through cooperation between Ghent University and the Flemish…

Ancient deep-sea sponge grounds on the Flemish Cap and Grand Bank, northwest Atlantic.

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Murillo, F J; Kenchington, E; Lawson, J M; Li, G; Piper, D J W

Recent studies on deep-sea sponges have focused on mapping contemporary distributions while little work has been done to map historical distributions; historical distributions can provide valuable information on the time frame over which species have co-evolved and may provide insight into the reasons for their persistence or decline. Members of the sponge family Geodiidae are dominant members of deep-sea sponge assemblages in the northwestern Atlantic. They possess unique spicules called sterrasters, which undergo little transport in sediment and can therefore indicate the Geodiidae sponge historical presence when found in sediment cores. This study focuses on the slopes of Flemish Cap and Grand Bank, important fishing grounds off the coast of Newfoundland, Canada, in international waters. Sediment cores collected in 2009 and 2010 were visually inspected for sponge spicules. Cores containing spicules were sub-sampled and examined under a light microscope for the presence of sterrasters. These cores were also dated using X-radiographs and grouped into five time categories based on known sediment horizons, ranging from 17,000 years BP to the present. Chronological groupings identified Geodiidae sponges in four persistent sponge grounds. The oldest sterrasters were concentrated in the eastern region of the Flemish Cap and on the southeastern slope of the Grand Bank. Opportunistic sampling of a long core in the southeastern region of the Flemish Cap showed the continuous presence of sponge spicules to more than 130 ka BP. Our results indicate that the geodiids underwent a significant range expansion following deglaciation, and support a contemporary distribution that is not shaped by recent fishing activity.

An integrative review of communication between parents and nurses of hospitalized technology-dependent children.

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Giambra, Barbara K; Stiffler, Deborah; Broome, Marion E

2014-12-01

With advances in health care, the population of children who are technology-dependent is increasing and, therefore, the need for nurses to understand how best to engage in communication with the parents of these children is critical. Shared communication between the parents of hospitalized technology-dependent children and their nurses is essential to provide optimal care for the child. The components and behaviors of the parent-nurse communication process that improve mutual understanding of optimal care for the child had not previously been examined. Among parents of hospitalized technology-dependent children and their nurses, what communication behaviors, components, concepts, or processes improve mutual understanding of optimal care for the child? An integrative review of both qualitative and quantitative studies was conducted. Key words including communication, hospitalized, nurse, parent, pediatric, and technology-dependent were used to search databases such as Cumulative Index to Nursing and Allied Health and Medline for years 2000-2014. The data regarding the process of parent-nurse communication were extracted as they related to the mutual understanding of optimal care for the child. The data were grouped into themes and compared across studies, designs, populations, and settings. Six articles were identified that provided information regarding the processes of shared communication among the parents of hospitalized technology-dependent children and their nurses. Providing clear information, involving parents in care decisions, trust and respect for each other's expertise, caring attitudes, advocacy, and role negotiation were all found to be important factors in shared parent-nurse communication. The results of this integrative review inform our understanding of the parent-nurse communication process. The findings provide nurses with an understanding of strategies to better engage in respectful, engaging, and intentional communication with parents of

First TBEV serological screening in Flemish wild boar

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Sophie Roelandt

2016-04-01

Full Text Available In the frame of a Flemish wildlife surveillance in 2013, a serological screening was performed on sera from wild boar (Sus scrofa; n=238 in order to detect tick-borne encephalitis virus (TBEV-specific antibodies. Neutralising antibodies were titrated with a seroneutralisation test (SNT, using two cut-off titres (1/10–1/15. Seven wild boars were found TBEV-seropositive and showed moderate (>1/15 to high (>1/125 SNT-titres; three individuals had borderline results (1/10–1/15. This study demonstrated the presence of TBEV-specific antibodies in wild boar and highlighted potential TBEV-foci in Flanders. Additional surveillance including direct virus testing is now recommended.

Pending studies at hospital discharge: a pre-post analysis of an electronic medical record tool to improve communication at hospital discharge.

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Kantor, Molly A; Evans, Kambria H; Shieh, Lisa

2015-03-01

Achieving safe transitions of care at hospital discharge requires accurate and timely communication. Both the presence of and follow-up plan for diagnostic studies that are pending at hospital discharge are expected to be accurately conveyed during these transitions, but this remains a challenge. To determine the prevalence, characteristics, and communication of studies pending at hospital discharge before and after the implementation of an electronic medical record (EMR) tool that automatically generates a list of pending studies. Pre-post analysis. 260 consecutive patients discharged from inpatient general medicine services from July to August 2013. Development of an EMR-based tool that automatically generates a list of studies pending at discharge. The main outcomes were prevalence and characteristics of pending studies and communication of studies pending at hospital discharge. We also surveyed internal medicine house staff on their attitudes about communication of pending studies. Pre-intervention, 70% of patients had at least one pending study at discharge, but only 18% of these were communicated in the discharge summary. Most studies were microbiology cultures (68%), laboratory studies (16%), or microbiology serologies (10%). The majority of study results were ultimately normal (83%), but 9% were newly abnormal. Post-intervention, communication of studies pending increased to 43% (p pending studies, but in usual practice, the presence of these studies has rarely been communicated to outpatient providers in the discharge summary. Communication significantly increased with the implementation of an EMR-based tool that automatically generated a list of pending studies from the EMR and allowed users to import this list into the discharge summary. This is the first study to our knowledge to introduce an automated EMR-based tool to communicate pending studies.

Flemish Primary Teachers' Use of School Performance Feedback and the Relationship with School Characteristics

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Vanhoof, Jan; Verhaeghe, Goedele; Van Petegem, Peter; Valcke, Martin

2012-01-01

Background: Schools are increasingly confronted with the challenges that information about school performance brings with it. It is common for schools' use of performance feedback to be limited. Equally, however, there are documented cases in which school performance feedback is meaningfully used. Purpose: This study looks at how Flemish primary…

Omission of Dysphagia Therapies in Hospital Discharge Communications

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Kind, Amy; Anderson, Paul; Hind, Jacqueline; Robbins, JoAnne; Smith, Maureen

2009-01-01

Background Despite the wide implementation of dysphagia therapies, it is unclear whether these therapies are successfully communicated beyond the inpatient setting. Objective To examine the rate of dysphagia recommendation omissions in hospital discharge summaries for high-risk sub-acute care (i.e., skilled nursing facility, rehabilitation, long-term care) populations. Design Retrospective cohort study Subjects All stroke and hip fracture patients billed for inpatient dysphagia evaluations by speech-language pathologists (SLPs) and discharged to sub-acute care in 2003-2005 from a single large academic medical center (N=187). Measurements Dysphagia recommendations from final SLP hospital notes and from hospital (physician) discharge summaries were abstracted, coded, and compared for each patient. Recommendation categories included: dietary (food and liquid), postural/compensatory techniques (e.g., chin-tuck), rehabilitation (e.g., exercise), meal pacing (e.g., small bites), medication delivery (e.g., crush pills), and provider/supervision (e.g., 1-to-1 assist). Results 45% of discharge summaries omitted all SLP dysphagia recommendations. 47%(88/186) of patients with SLP dietary recommendations, 82%(93/114) with postural, 100%(16/16) with rehabilitation, 90%(69/77) with meal pacing, 95%(21/22) with medication, and 79%(96/122) with provider/supervision recommendations had these recommendations completely omitted from their discharge summaries. Conclusions Discharge summaries omitted all categories of SLP recommendations at notably high rates. Improved post-hospital communication strategies are needed for discharges to sub-acute care. PMID:20098999

Eliminating Social Inequality by Reinforcing Standard Language Ideology? Language Policy for Dutch in Flemish Schools

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Delarue, Steven; De Caluwe, Johan

2015-01-01

Flanders, the northern, Dutch-speaking part of Belgium, is experiencing growing intra- and interlingual diversity. On the intralingual level, Tussentaal ("in-between-language") has emerged as a cluster of intermediate varieties between the Flemish dialects and Standard Dutch, gradually becoming "the" colloquial language. At the…

Intergroup communication between hospital doctors: implications for quality of patient care.

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Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A

2009-12-01

Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

The evolution of a media image: newspaper attention to the Flemish far right 1987-2004

NARCIS (Netherlands)

Schafraad, P.; d'Haenens, L.; Scheepers, P.; Wester, F.

2012-01-01

This article investigates changes in attention to the far right in Flemish newspapers. Not only the volume of attention will be analysed but especially how newspapers pay attention to the far right, focusing on the portrayal of far-right actors (substantial attention), and on favourable and

Picture archiving and communication systems (PACS) for hospitals, a survey

International Nuclear Information System (INIS)

Haar Romeny, B.M. ter; Graaf, C.N. de; Waes, P.F.G.M. van; Rijk, P.P. van; Helder, J.C.; Valk, J.P.J. de

1985-01-01

In this article a survey is given for Picture Archiving and Communication Systems (PACS). Several aspects of PACS are treated, as image management, the introduction of the system, expenses etc. Special reference is made to the component parts of PACS: image stations, memory, network, software and coupling to the hospital information system. The introduction of PACS in Dutch hospitals is described. (Auth.)

Nurses' Perspectives on Interprofessional Communication in the Prevention of Functional Decline in Hospitalized Older People.

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Butler, Jeffrey I; Fox, Mary T

2018-03-22

Older people present with complex health issues on admission to hospital and are at high risk for functional decline and related complications. Thus, they require the services of diverse health-care professionals working in concert to support their functioning. Despite nurses' central role in caring for this patient population, and evidence indicating that interprofessional communication is a persistent challenge for nurses in acute-care settings, little is known about nurses' views on interprofessional communication in care preserving functioning in acutely admitted older people. To fill this knowledge gap, we gathered acute-care staff nurses' perspectives on interprofessional communication in a function-focused, interprofessional approach to hospital care for older adults. Thirteen focus groups were conducted with a purposeful, criterion-based sample of 57 nurses working in acute-care hospitals. Thematic analysis revealed two overarching themes capturing nurses' perspectives on key factors shaping interprofessional communication in a function-focused interprofessional approach to care (1) context of direct communication and (2) context of indirect communication. The first theme demonstrates that nurses preferred synchronous modes of communication, but some ascribed greater importance to unstructured forms of direct information-sharing, while others stressed structured direct communication, particularly interprofessional rounds. The second theme also documents divergence in nurses' views on asynchronous communication, with some emphasizing information technology and others analog tools. Perceptions of some modes of interprofessional communication were found to vary by practice setting. Theoretical and pragmatic conclusions are drawn that can be used to optimize interprofessional communication processes supporting hospitalized older people's functioning.

Subsidies and sustainable development. Case studies in the Flemish agricultural and housing policies; Subsidies en duurzame ontwikkeling. Casestudies in het Vlaamse landbouw- en woonbeleid

Energy Technology Data Exchange (ETDEWEB)

Bachus, K. [Onderzoeksinstituut voor Arbeid en Samenleving HIVA, KU Leuven, Leuven (Belgium)

2012-04-15

This paper is the 2nd research paper as part of the Centre for Sustainable Development project on the theme 'subsidies and sustainable development'. Attention is given to an application of the methodology to map subsidies. In the 1st paper the concept and method are discussed. The method was used for two Flemish subsidies: (1) the Flemish Renovation Incentive and Surcharge Rights in the Flemish agricultural sector [Dutch] Dit paper is het 2e onderzoekspaper in het kader van het Steunpunt Duurzame Ontwikkeling over het thema 'subsidies en duurzame ontwikkeling'. Aandacht wordt besteed aan een toepassing van de methodologie om subsidies in kaart te brengen. In het 1e paper werden de concepten en de methoden besproken. De methode werd toegepast op twee Vlaamse subsidies, namelijk de Vlaamse Renovatiepremie en de Toeslagrechten in de Vlaamse landbouw.

Mastery of Fundamental Movement Skills among 6-Year-Old Flemish Pre-School Children

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Vandaele, Bart; Cools, Wouter; de Decker, Steve; de Martelaer, Kristine

2011-01-01

The purpose of this study was to assess mastery of Fundamental Movement Skills (FMS) in 6- to 6.5-year-old Flemish pre-school children. The subjects were 236 6-year-old children (138 boys, 98 girls; mean age 6 years 2.4 months, SD 2.4). Children were individually assessed with the Motoriktest fur Vier- bis Sechsjahrige Kinder (MOT 4-6) in four…

[Instrumental, directive, and affective communication in hospital leaflets].

Science.gov (United States)

Vasconcellos-Silva, Paulo Roberto; Uribe Rivera, Francisco Javier; Castiel, Luis David

2003-01-01

This study focuses on the typical semantic systems extracted from hospital staff communicative resources which attempt to validate information as an "object" to be transferred to patients. We describe the models of textual communication in 58 patient information leaflets from five hospital units in Brazil, gathered from 1996 to 2002. Three categories were identified, based on the theory of speech acts (Austin, Searle, and Habermas): 1) cognitive-instrumental utterances: descriptions by means of technical terms validated by self-referred, incomplete, or inaccessible argumentation, with an implicit educational function; 2) technical-directive utterances: self-referred (to the context of the source domains), with a shifting of everyday acts to a technical terrain with a disciplinary function and impersonal features; and 3) expressive modulations: need for inter-subjective connections to strengthen bonds of trust and a tendency to use childish arguments. We conclude that the three categories displayed: fragmentary sources; assumption of univocal messages and invariable use of information (idealized motivations and interests, apart from individualized perspectives); and assumption of universal interests as generators of knowledge.

Outcomes In Two Massachusetts Hospital Systems Give Reason For Optimism About Communication-And-Resolution Programs.

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Mello, Michelle M; Kachalia, Allen; Roche, Stephanie; Niel, Melinda Van; Buchsbaum, Lisa; Dodson, Suzanne; Folcarelli, Patricia; Benjamin, Evan M; Sands, Kenneth E

2017-10-01

Through communication-and-resolution programs, hospitals and liability insurers communicate with patients when adverse events occur; investigate and explain what happened; and, where appropriate, apologize and proactively offer compensation. Using data recorded by program staff members and from surveys of involved clinicians, we examined case outcomes of a program used by two academic medical centers and two of their community hospitals in Massachusetts in the period 2013-15. The hospitals demonstrated good adherence to the program protocol. Ninety-one percent of the program events did not meet compensation eligibility criteria, and those events that did were not costly to resolve (the median payment was $75,000). Only 5 percent of events led to malpractice claims or lawsuits. Clinicians were supportive of the program but desired better communication about it from staff members. Our findings suggest that communication-and-resolution programs will not lead to higher liability costs when hospitals adhere to their commitment to offer compensation proactively. Project HOPE—The People-to-People Health Foundation, Inc.

Psychometric properties of the Flemish translation of the NEECHAM Confusion Scale

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Abraham Ivo L

2005-03-01

Full Text Available Abstract Background Determination of a patient's cognitive status by use of a valid and reliable screening instrument is of major importance as early recognition and accurate diagnosis of delirium is necessary for effective management. This study determined the reliability, validity and diagnostic value of the Flemish translation of the NEECHAM Confusion Scale. Methods A sample of 54 elderly hip fracture patients with a mean age of 80.9 years (SD = 7.85 were included. To test the psychometric properties of the NEECHAM Confusion Scale, performance on the NEECHAM was compared to the Confusion Assessment Method (CAM and the Mini-Mental State Examination (MMSE, by using aggregated data based on 5 data collection measurement points (repeated measures. The CAM and MMSE served as gold standards. Results The alpha coefficient for the total NEECHAM score was high (0.88. Principal components analysis yielded a two-component solution accounting for 70.8% of the total variance. High correlations were found between the total NEECHAM scores and total MMSE (0.75 and total CAM severity scores (-0.73, respectively. Diagnostic values using the CAM algorithm as gold standard showed 76.9% sensitivity, 64.6% specificity, 13.5% positive and 97.5% negative predictive values, respectively. Conclusion This validation of the Flemish version of the NEECHAM Confusion Scale adds to previous evidence suggesting that this scale holds promise as a valuable screening instrument for delirium in clinical practice. Further validation studies in diverse clinical populations; however, are needed.

Developing a model for the adequate description of electronic communication in hospitals.

Science.gov (United States)

Saboor, Samrend; Ammenwerth, Elske

2011-01-01

Adequate information and communication systems (ICT) can help to improve the communication in hospitals. Changes to the ICT-infrastructure of hospitals must be planed carefully. In order to support a comprehensive planning, we presented a classification of 81 common errors of the electronic communication on the MIE 2008 congress. Our objective now was to develop a data model that defines specific requirements for an adequate description of electronic communication processes We first applied the method of explicating qualitative content analysis on the error categorization in order to determine the essential process details. After this, we applied the method of subsuming qualitative content analysis on the results of the first step. A data model for the adequate description of electronic communication. This model comprises 61 entities and 91 relationships. The data model comprises and organizes all details that are necessary for the detection of the respective errors. It can be for either used to extend the capabilities of existing modeling methods or as a basis for the development of a new approach.

Evacuation of Hospitals during Disaster, Establishment of a Field Hospital, and Communication

OpenAIRE

Tekin, Erdal; Bayramoglu, Atif; Uzkeser, Mustafa; Cakir, Zeynep

2017-01-01

The buildings, working personnel, and patients and their relatives may directly or indirectly be affected by the disasters. Here we will discuss evacuation, establishing a field hospital, communication, the role of the media in disasters, and defending against sabotage. The affected individuals should be evacuated and transferred to secure zones safely and rapidly. How the decision for evacuation should be made and how the evacuation triage should be performed are important issues. Field hosp...

Analyzing Student Teachers' Academic Literacy Needs: A Qualitative Analysis of Flemish First-Year Teacher Trainees' Needs

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Van Houtven, Tine; Peters, Elke; Van den Branden, Kris

2013-01-01

In recent years, the student population enrolling in Flemish higher education has become increasingly diverse. Whereas teacher training institutes used to attract mainly students with a diploma of general secondary education, the proportion of students with a technical or vocational educational background has grown substantially over the past ten…

Information and communication technologies in hospital nursing care

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Luís Felipe Pissaia

2017-10-01

Full Text Available Justification and objective: This study has the objective check the use of Information and Communication Technologies (ICT in care processes of nursing through the methodology of Systematization of Nursing Assistance (SNA in a hospital in the interior of Rio Grande do Sul, Brasil. Methods: Descriptive and exploratory study with a qualitative approach carried out six nurses of a hospital service. Results: The lack of knowledge about the importance of ICT, the deficit in the provision of continuing education to professionals and cultural prejudice to new working methods were list as existing weaknesses. Contributions are relate to organizing and planning your activities, as well as an effective personnel management based on the principles of comprehensive care provided to the client. Conclusion: This study demonstrated that ICT help in the implementation of processes and implementation of SNA, promoting new models of work to nurses and encouraging compliance by the hospitals.

Perceptions of effective and ineffective nurse-physician communication in hospitals.

Science.gov (United States)

Robinson, F Patrick; Gorman, Geraldine; Slimmer, Lynda W; Yudkowsky, Rachel

2010-01-01

Nurse-physician communication affects patient safety. Such communication has been well studied using a variety of survey and observational methods; however, missing from the literature is an investigation of what constitutes effective and ineffective interprofessional communication from the perspective of the professionals involved. The purpose of this study was to explore nurse and physician perceptions of effective and ineffective communication between the two professions. Using focus group methodology, we asked nurses and physicians with at least 5 years' acute care hospital experience to reflect on effective and ineffective interprofessional communication and to provide examples. Three focus groups were held with 6 participants each (total sample 18). Sessions were audio recorded and transcribed verbatim. Transcripts were coded into categories of effective and ineffective communication. The following themes were found. For effective communication: clarity and precision of message that relies on verification, collaborative problem solving, calm and supportive demeanor under stress, maintenance of mutual respect, and authentic understanding of the unique role. For ineffective communication: making someone less than, dependence on electronic systems, and linguistic and cultural barriers. These themes may be useful in designing learning activities to promote effective interprofessional communication.

The effectiveness of the installation of a mobile voice communication system in a university hospital.

Science.gov (United States)

Hanada, Eisuke; Fujiki, Tadayoshi; Nakakuni, Hideaki; Sullivan, Corbet Vernon

2006-04-01

In large hospitals, collaborative clinical practice is currently emphasized, with members of various departments expected to work as a team. The importance of accurate communication among the team members is of utmost importance. To improve such communication, the introduction of mobile voice communication systems has received much attention in Japan. Shimane University Hospital also introduced a Personal Handy-phone System (PHS) for doctors. In the traditional setting, much time was wasted searching for doctors through multiple calls on fixed-line telephones. In order to measure the effectiveness of our system, the change in the number of calls made on fixed-line telephones before and after PHS installation was compared. The total number of calls was reduced by more than 35%, and the number of calls to the wards on weekdays was reduced by half. Mobile telecommunication systems with small output power, such as PHS, are known to cause little interference with medical devices which makes it possible to use mobile voice communication safely in hospitals. The improvement in communication by this systems resulted in an improvement in labor efficiency.

Task Manager: an innovative approach to improving hospital communication after hours.

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Seddon, Mary E; Hay, David

2010-10-15

To improve communication between doctors and nurses after hours, by developing a tool to display ward tasks, allowing staff to prioritise their work, without constant interruption from pagers (beepers). Middlemore Hospital, a large metropolitan 800-bed hospital in Auckland, New Zealand. Introduction of computerised system (Task Manager) to identify, allocate and complete after-hours tasks. In the first 6 months 21,000 tasks have been completed in Task Manager. Paging of junior doctors has decreased by over 30% and there is broad acceptance of the tool by both nursing and medical staff. Task Manager has collected real-time data on the type of after hours tasks (nearly 50% are phlebotomy-related tasks), busy times of the day (1600 hours to 2400 hours) and who is performing most of the tasks. Task Manager is a simple yet powerful tool for prioritising routine tasks after hours. It allows staff to quickly create tasks, and communicate effectively with other members of the team. It has reduced the frequency of junior doctors paging so that they can continue their work with fewer interruptions. Whilst it was introduced to improve effective communication after hours, it has become apparent that there are multiple 'tasks' that are ordered in a multitude of ways in our hospital and many could be served by Task Manager.

[Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

Science.gov (United States)

Alonso, E; Rubio, A; March, J C; Danet, A

2011-01-01

The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

From corporate governance to hospital governance. Authority, transparency and accountability of Belgian non-profit hospitals' board and management.

Science.gov (United States)

Eeckloo, Kristof; Van Herck, Gustaaf; Van Hulle, Cynthia; Vleugels, Arthur

2004-04-01

As a result of multiple developments in health care and health care policy, hospital administrators, policy makers and researchers are increasingly challenged to reflect on the meaning of good hospital governance and how they can implement it in the hospital organisations. The question arises whether and to what extent governance models that have been developed within the corporate world can be valuable for these reflections. Due to the unique societal position of hospitals--which involves a large diversity of stakeholders--the claim for autonomy of various highly professional groups and the lack of clear business objectives, principles of corporate governance cannot be translated into the hospital sector without specific adjustments. However, irrespective of these contextual differences, corporate governance can provide for a comprehensive 'frame of reference', to which the hospital sector will have to give its own interpretation. A multidisciplinary research unit of the university of Leuven has taken the initiative to develop a governance model for Belgian hospitals. As part of the preliminary research work a survey has been performed among 82 hospitals of the Flemish Community on their governance structure, the composition of the governance entities, the partition of competencies and the relationship between management and medical staff.

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

Science.gov (United States)

Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

2017-12-01

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

Preliminary Analysis of the (Process and Product) Quality of Physical Education in Flemish Secondary Schools: Implementation of IKLO

Science.gov (United States)

Huts, K.; Van Hoecke, J.; De Knop, P.; Theeboom, M.

2009-01-01

The purpose of the present study was twofold, namely implementing a multifunctional (self-) evaluation instrument for physical education in a sample of Flemish secondary schools (N=100), while simultaneously obtaining a preliminary picture of the subjects' product and process quality. Descriptive statistics revealed that P. E. teachers' engagement…

In search of the creation of news frames in Flemish newspapers: The case of the Belgian ‘Syria warriors’

NARCIS (Netherlands)

Boesman, J.L.J.; Berbers, A.; d'Haenens, L.; Van Gorp, B.

2014-01-01

This paper investigates the framing construction of Flemish newspaper journalists regarding the so-called ‘Syria-warriors’. When the Syrian conflict developed, the rebels against the Assad regim were joined by young muslims from Western European countries. Figures of the number of Belgian fighters

"We have made Europe, now we have to make Europeans." Researching European Identity Among Flemish Youths

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Petra Huyst

2008-12-01

Full Text Available After the rejection of the European Constitution in 2005, questions were raised about if and how European citizens feel connected to the European Union (EU. This article examines the image young, Flemish people have of the EU and whether they feel some sense of belonging in the EU. The research draws upon a qualitative study in which Flemish young people were asked how they felt towards the EU and how they perceived it. Using a social-constructionist perspective, the first part of the article concentrates on the concept of European identity and the theoretical divide between a civic and a cultural European political identity, as proposed by Bruter (2004. The second part of the article focuses on the results of a series of focus groups with young people (aged 17 to 19, held in spring 2007. The article argues that no strong European identity is yet present in the hearts and minds of these young people, although contexts and interactions might evoke a limited notion of European identity. This article offers an empirical account of a theoretical debate and presents a critical understanding of the dynamics at play in European identity construction.

Interspecialty communication supported by health information technology associated with lower hospitalization rates for ambulatory care-sensitive conditions.

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O'Malley, Ann S; Reschovsky, James D; Saiontz-Martinez, Cynthia

2015-01-01

Practice tools such as health information technology (HIT) have the potential to support care processes, such as communication between health care providers, and influence care for "ambulatory care-sensitive conditions" (ACSCs). ACSCs are conditions for which good outpatient care can potentially prevent the need for hospitalization. To date, associations between such primary care practice capabilities and hospitalizations for ambulatory care-sensitive conditions have been primarily limited to smaller, local studies or unique delivery systems rather than nationally representative studies of primary care physicians in the United States. We analyzed a nationally representative sample of 1,819 primary care physicians who responded to the Center for Studying Health System Change's Physician Survey. We linked 3 years of Medicare claims (2007 to 2009) with these primary care physician survey respondents. This linkage resulted in the identification of 123,760 beneficiaries with one or more of 4 ambulatory care-sensitive chronic conditions (diabetes, chronic obstructive pulmonary disease, asthma, and congestive heart failure) for whom these physicians served as the usual provider. Key independent variables of interest were physicians' practice capabilities, including communication with specialists, use of care managers, participation in quality and performance measurement, use of patient registries, and HIT use. The dependent variable was a summary measure of ambulatory care-sensitive hospitalizations for one or more of these 4 conditions. Higher provider-reported levels of communication between primary care and specialist physicians were associated with lower rates of potentially avoidable hospitalizations. While there was no significant main effect between HIT use and ACSC hospitalizations, the associations between interspecialty communication and ACSC hospitalizations were magnified in the presence of higher HIT use. For example, patients in practices with both the

Occupational therapist care in the introduction of Alternative Communication features in hospital environment

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Janaína Santos Nascimento

2017-03-01

Full Text Available Introduction: Alternative and Extended Communication (CAA is an area of assistive technology, and its introduction in the hospital environment has contributed decisively to the care and integration of patients with speech or writing difficulties. However, in order for the use of CAA resources to be effective in this environment, actions are essential to prevent and control Hospital Infections (HI. Objective: To describe the strategies related to the control of HI, used for the introduction of CAA resources on a in a university hospital. Method: It presents as methodological strategy the experience report, the descriptive and exploratory mode, based on the experience of five therapists occupational - four residents and a supervisor professor -, during the introductory work of CAA resource at a university hospital, from June 2012 to July 2014. Results: The main precautions adopted were: to laminate the printed boards; to wrap with plastic film computers, tablets, communicators, tablet pen, mouse and driver; protect with plastic bags support materials for activities such as table and inclined plane, and transport by means of a plastic cart. After the materials use, they were placed in plastic bags and sent for cleaning and disinfection the purge. Conclusion: The data showed the complexity of the use of CAA resources in the hospital environment by occupational therapists, and the need for training of professionals involved in actions by Hospital Infection Control Committees team (CCIH.

The Future of Religious Education on the Flemish School Curriculum: A Plea for Integrative Religious Education for All

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Franken, Leni; Loobuyck, Patrick

2013-01-01

After an elaboration of the paradigm shift concerning religious education in Europe, we will give a critical presentation of the Belgian and Flemish system of religious education. The article continues with a discussion of diverse proposals to change the religious education system in Flanders, and concludes that the introduction of an independent,…

Evaluating Midwives Communication Skills from the Perspective of Parturient Women Attending to Hospitals for Delivery

OpenAIRE

Maryam Sadat Katebi; Talat Khadivzadeh; Zohre Sepehri Shamloo; Habibolah Esmaily

2017-01-01

Background & aim: Communication is a fundamental human need. Medical students and healthcare professionals must be attuned to the needs of patients using effective communication skills. With regards to medical training, currently the focus is on theoretical matters and communication skills are taken for granted. This problem has caused miscommunication with patients referred to teaching hospitals. We conducted this study to assess communication skills of midwives from the perspective of partu...

A Customized Workflow-Driven Instant Messaging System Support Team Communication in the Hospital.

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Lee, Ying-Li; Chien, Tsai-Feng; Chen, Hsiu-Chin

2016-01-01

Effective communication among the healthcare team is a very important skill to support team resource management (TRM). However, we take too much effort to connect with other team members by using traditional telephone communication. In this study, we developed an instant messaging system embedded in the original hospital information system and evaluated the preliminary outcome and the usage of the system.

Installation of secure, always available wireless LAN systems as a component of the hospital communication infrastructure.

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Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku

2013-06-01

Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. In addition, insuring that the network is always available is important. Herein, we discuss security countermeasures and points to insure availability that must be taken to insure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at Shimane University Hospital. Security countermeasures differ according to their purpose, such as for preventing illegal use or insuring availability, both of which are discussed. It is our hope that this information will assist others in their efforts to insure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.

Assessing the effectiveness of voluntary solid waste reduction policies: Methodology and a Flemish case study

International Nuclear Information System (INIS)

Jaeger, Simon de; Eyckmans, Johan

2008-01-01

The purpose of this paper is to illustrate the use of statistical techniques to evaluate the effectiveness of voluntary policy instruments for waste management. The voluntary character of these instruments implies that latent characteristics, unobserved by the analyst, might influence the subscription decision and might lead to biased estimates of the effectiveness of the policy instrument if standard techniques are used. We propose an extension of the difference-in-differences (DiD) estimator to evaluate the effectiveness of voluntary policy instruments, which is termed the dynamic difference-in-differences (or DDD) estimator. We illustrate the technique by estimating the effectiveness of voluntary cooperation agreements between the Flemish environmental administration and individual municipalities aimed at curbing residential solid waste. Using a dataset covering all 308 Flemish municipalities for the period 2000-2005, our results indicate that municipalities subscribing to the agreement accomplished less reduction of their waste levels compared to what could be expected on the basis of their own performance prior to subscription and the performance of the non-subscribers. This result might be explained by the rising marginal cost of extra residential solid waste reduction policies. In addition, there are indications that subscribing municipalities refrain from additional reduction efforts once the target waste level of the program is achieved. The more complicated DDD methodology is shown to generate additional insight over the ordinary DiD analysis

Using Information and Communication Technologies in Hospital Classrooms: SAVEH Project

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Dolores Meneses

2011-03-01

Full Text Available Children suffering a serious illness, experience enormous changes in their daily lives. Not only does the direct consequences of the disease affect the child, but also the fact of being at a hospital, or at home and not being allowed to go to school. Frequently, connections with classmates, neighbors, and sometimes even some with his relatives are lost. Furthermore, the responsibility of the state, to continue his schooling process is much harder, since different communities (family, school teachers, hospital teachers, medical doctors, psychologists… have to be coordinated. Last but not least, entertainment and enjoyment should be provided to avoid boredom and to improve their affective state. At the same time, with the development of Information and Communication Technologies, a large number of solutions have arisen that allow people to enhance their communication, education and entertainment possibilities. These technologies seem perfectly suitable to be used to tackle the problems described above. In this article, some of the special necessities of children suffering from a serious illness are pointed out, technologies available to be facilitated are described and some initiatives taking place in Spain mentioned. The SAVEH project will be described in detail.

Civilization versus Commerce: On the Sociolinguistic Effects of the Deregulation of the TV Market on Flemish Public Service Broadcasting

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Van Hoof, Sarah

2018-01-01

In the globalized economy, old metadiscursive regimes have been challenged by new conditions which are often considered to be more favourable to heteroglossic practices. In Flemish Belgium, the liberalization of the TV market is said to have transformed the broadcaster VRT from a public service aiming at educating viewers into a competitive…

Examining the structural challenges to communication as experienced by nurse managers in two US hospital settings.

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Marx, Marcia

2014-11-01

This study examined the structural barriers to communication for first-line nurse managers with their staff nurses. The delivery of quality care depends on effective communication in hospital units. First-line nurse managers are central figures in networks whose responsibility is to communicate information from the senior management to staff nurses. The data were collected using face-to-face interviews with first-line managers at two US hospitals The interviews were transcribed and coded with limited use of the qualitative software atlas Interview questions focused on work experiences of managers with special emphases on communication. Structural barriers that influenced managers' communication included the amount of face-to-face interaction with nurses, the amount of information to communicate, levels of formalization, outreach to all nurses, time constraints and nurses' subcultural networks These factors compromised managers' ability to communicate effectively with nurses. Managers should carefully examine how structure affects communication recognizing that some dynamics of structure cannot be changed but that they can influence others, such as formalization and communication networks. Managers should examine their own positioning within nurses' networks and demonstrate to nurses that their expertise contributes to the collaborative capital upon which nursing practice depends. © 2013 John Wiley & Sons Ltd.

Evaluating Midwives Communication Skills from the Perspective of Parturient Women Attending to Hospitals for Delivery

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Maryam Sadat Katebi

2017-04-01

Full Text Available Background & aim: Communication is a fundamental human need. Medical students and healthcare professionals must be attuned to the needs of patients using effective communication skills. With regards to medical training, currently the focus is on theoretical matters and communication skills are taken for granted. This problem has caused miscommunication with patients referred to teaching hospitals. We conducted this study to assess communication skills of midwives from the perspective of parturient women. Methods: In this descriptive study, we evaluated 50 midwives working in maternity wards of Ghaem, Imam Reza, Omolbanin, and Hasheminejad hospitals in Mashhad, Iran. Three parturient women were selected per one midwife in a maternity ward. The parturient women participating in this study were in labor, delivery, admission or postpartum stages and completed the Interpersonal Communication Skills inventory by interview. To analyze the data, descriptive statistics, t-test, ANOVA, and Pearson product-moment correlation were performed, using SPSS 16. Results: The mean scores of communication behaviors of midwives with parturient in delivery, admission, and postpartum stages were 92.61±10.81, 93.31±10.59, and 94.19±8.26, respectively. Between the previous delivery of parturient, with communication behavior of midwives in the stage of admiss­ion or post-partum (P=0.015 and satisfaction of pregnancy with communication behavior of midwife in labor stage (P

Uncovering a Hidden Professional Agenda for Teacher Educators: A Mixed Method Study on Flemish Teacher Educators and Their Professional Development

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Tack, Hanne; Valcke, Martin; Rots, Isabel; Struyven, Katrien; Vanderlinde, Ruben

2018-01-01

Taking into account the pressing need to understand more about what teacher educators' professional development characterises, this article adopts a mixed method approach to explore Flemish (Dutch-speaking part of Belgium) teacher educators' professional development needs and opportunities. Analysis results of a large-scale survey study with 611…

The impact of the Family Communication Coordinator (FCC) Protocol on the role stress of hospital chaplains.

Science.gov (United States)

Dodd-McCue, Diane; Tartaglia, Alexander

2005-01-01

The Family Communication Coordinator (FCC) Protocol was implemented to provide early family intervention and to facilitate effective communications during potential organ donation cases. Previous studies found the Protocol associated with improved donor outcome measures and with reduced role stress for ICU nurses caring for potential donors. The present study examines the impact of the Protocol on the perceived role stress of hospital chaplains serving as FCCs. All hospital chaplains serving as FCCs at an academic teaching hospital were surveyed. Their perceptions of job dimensions, role stress, job satisfaction, and commitment were measured; interviews and secondary data supplemented the surveys. The findings demonstrate that the FCC Protocol is associated with improved role stress, specifically role ambiguity and role conflict, among hospital chaplains serving as FCCs. Additionally, the findings suggest that satisfaction with the Protocol may be associated with experience with the Protocol.

Descriptions of verbal communication errors between staff. An analysis of 84 root cause analysis-reports from Danish hospitals

DEFF Research Database (Denmark)

Rabøl, Louise Isager; Andersen, Mette Lehmann; Østergaard, Doris

2011-01-01

incidents. The objective of this study is to review RCA reports (RCAR) for characteristics of verbal communication errors between hospital staff in an organisational perspective. Method Two independent raters analysed 84 RCARs, conducted in six Danish hospitals between 2004 and 2006, for descriptions......Introduction Poor teamwork and communication between healthcare staff are correlated to patient safety incidents. However, the organisational factors responsible for these issues are unexplored. Root cause analyses (RCA) use human factors thinking to analyse the systems behind severe patient safety...... and characteristics of verbal communication errors such as handover errors and error during teamwork. Results Raters found description of verbal communication errors in 44 reports (52%). These included handover errors (35 (86%)), communication errors between different staff groups (19 (43%)), misunderstandings (13...

Implementing and evaluating e-communication to improve intersectoral cooperation between hospitals and local communities

DEFF Research Database (Denmark)

Nicolaisen, Anne; Qvist, Peter

2015-01-01

services for the patient. The Region of Southern Denmark has implemented e-communication to improve the cooperation across health care sectors. Communities and hospitals in the Region of Southern Denmark agreed to comply to specified quality standards for the content and timeliness of information exchange...... these will be presented at the conference. Keywords: e-communication, cooperation across health care sectors, audit, evaluation, practice...

Comunicación interna hospitalaria: una aproximación desde la creatividad/ Hospital internal communication : an approach from creativity

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Pablo Medina Aguerrebere

2015-07-01

Full Text Available La gestión profesional de la comunicación institucional se ha convertido en una iniciativa estratégica para aquellos hospitales que desean crear una marca sólida. Para ello, la definición de la arquitectura de marca (identidad, valores, misión, visión, cultura e imagen y su difusión entre los stakeholders internos resulta fundamental. El objetivo de este artículo es reflexionar sobre el impacto que tiene la creatividad publicitaria en las acciones de comunicación interna que realiza un hospital para crear marca. Para ello, se realiza una revisión bibliográfica sobre la comunicación institucional hospitalaria, la comunicación interna y la creatividad publicitaria. El artículo concluye que la creatividad contribuye positivamente a dinamizar la comunicación interna del hospital y a crear una marca hospitalaria sólida. The professional management of corporate communication has become a strategic initiative to those hospitals that wish to create a strong brand. To do this, the definition of brand architecture (identity, values, mission, vision, culture and image and its dissemination among internal stakeholders is essential. This paper aims to reflect on the impact of advertising creativity in internal communication actions that takes a hospital to create brand. For this, a literature review on hospital corporate communication, internal communication and advertising creativity is performed. This paper concludes that creativity contributes positively to energize the hospital internal communication and create a strong brand

Occupational therapist care in the introduction of Alternative Communication features in hospital environment

OpenAIRE

Janaína Santos Nascimento; Juliana Mannini; Miryam Bonadiu Pelosi; Mariana Mapelli de Paiva

2017-01-01

Introduction: Alternative and Extended Communication (CAA) is an area of assistive technology, and its introduction in the hospital environment has contributed decisively to the care and integration of patients with speech or writing difficulties. However, in order for the use of CAA resources to be effective in this environment, actions are essential to prevent and control Hospital Infections (HI). Objective: To describe the strategies related to the control of HI, used for the i...

The Impact of Interpersonal Communication toward Customer Satisfaction: The Case of Customer Service of Sari Asih Hospital

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Agung W. A. Novalia

2018-01-01

Full Text Available Customer Service has a considerable role. In order to retain the loyal customer, their attitude should be friendly, courteous, patient, and willing to listen to what customer said. Good Customer Service should create customer satisfaction for it is the presence of customer determines the existence of the company. This condition is also true for hospital as it is the case of Sari Asih Hospital in Ciledug, Indonesia. Sari Asih Hospital is a private hospital whose average patients are more than 700 patients monthly. This study assume that the interpersonal communication might be the cause. In constructing the argument, this paper will use the Humanistic Perspective Theory and the Theory of Value Expectancy. Quantitative approach will be the method and the survey will use the accident sampling among customers. It was found that the Impact of Interpersonal Communication Sari Asih Hospital toward Customer Satisfaction is has possitive effect.

Assessing Emotional and Behavioural Problems with the Child Behaviour Checklist: Exploring the Relevance of Adjusting the Norms for the Flemish Community

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Caroline Braet

2011-11-01

Full Text Available The Child Behaviour Checklist (CBCL is one of the most frequently used dimensional instruments for screening behavioural and emotional problems in children. In this study the psychometric properties of the CBCL 2001-version and the usefulness of existing US norms within a Flemish community sample were explored. Mothers of young children ('N' = 170 and school-aged children and adolescents ('N' = 718 completed the CBCL and the Strengths and Difficulties Questionnaire (SDQ. Reliability of both the CBCL/1½-5 and CBCL/6-18 was excellent. There were substantial correlations between the SDQ and CBCL scales, indicating a good concurrent validity. Significant differences were found when comparing the mean CBCL raw scores of the different subsamples (for different ages and gender groups with the US norms. Generally spoken, the mean CBCL raw scores as well as the clinical and borderline clinical cutpoints for Flemish children were mostly lower, specifically for the Total Problems score and the Externalising scales.

A Failure to Communicate? Doctors and Nurses in American Hospitals.

Science.gov (United States)

Michel, Lucie

2017-08-01

This article showcases the realities and challenges of teamwork in American hospitals based on the in situ comparison with France. Drawing on observation of nurse-physician interactions in hospitals in the two nations, this article highlights a troubling conflict between teamwork rhetoric and realities on the ward. Although the use of informatics systems such as electronic health records is supposed to increase cooperation, the observations presented here show that on the contrary, it inhibits communication that is becoming mainly virtual. While the nursing profession is more developed and provides stronger education in the United States, this story highlights the challenges in creating a shared environment of work and suggests the importance of balancing professional autonomy and effective teamwork. Copyright © 2017 by Duke University Press.

GP's consult and health behaviour change project. Developing a programme to train GPs in communication skills to achieve lifestyle improvements.

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Thijs, G A

2007-08-01

The European definition of General Practice states that GPs should use their core competence, amongst others, in their communication with patients. Their communication skills are particularly challenged in the field of lifestyle improvements. Most GPs feel they lack efficacy in achieving lifestyle changes. In November 2002 the Prevention Department of the Scientific Society of Flemish GPs (now Domus Medica) decided to start a project "consulting & behaviour change". Under this project, every Flemish GP should by the year 2007, have (amongst others things) a basic knowledge of the principles of lifestyle improvements and should be able to give a short advice to high risk patients. A literature search was conducted to make an inventory of models that could be used to train GPs. Experts at specific methods and topics were consulted to get acquainted with their specific approaches. Experts in the field of CME were gathered to discuss barriers and solutions to these barriers. During steering group meetings, several possible solutions were discussed. The Trans Theoretical Model (TTM-as theoretical framework) and brief motivational interviews (MI-as communication skill) were evaluated as offering the best opportunities for adapting the work situation of the GP. We promoted this approach to the GPs as an ABC concept (Anamnesis/Ask; Be the guide/Decision tree ("Beslissingsboom" in Dutch); Continuity) applied on different topics (smoke stop, alcohol, healthy food, physical activity). In our guidelines we pay more attention to brief motivational interviews for health behaviour changes. Recently we started developing an e-learning website as part of a larger learning project, this in cooperaion with different Flemish partners and disciplines. The Trans Theoretical Model and the brief motivational interviewing approach seem to be accepted by health care, educational and scientific organisations. The process of integrating this approach in the GP's daily practice has to be

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.

Science.gov (United States)

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2017-10-01

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication. To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling. This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling. Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s). The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies. Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches. Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

The ethnic prejudice of Flemish teachers: The role of ethnic school composition and of teachability.

Science.gov (United States)

Vervaet, Roselien; D'hondt, Fanny; Van Houtte, Mieke; Stevens, Peter A J

2016-10-01

The aim of this study is to investigate the association between ethnic composition in school and the ethnic prejudice of teachers, controlling for the individual characteristics of teachers and their perceptions of pupils' teachability. Multilevel analyses were carried out on data for 499 Flemish teachers in 44 Flemish (Belgian) secondary schools, collected through an online questionnaire. In this study, ethnic prejudice means a negative attitude to Moroccans, Turks, and Eastern Europeans. A scale was created by taking the mean scores for 18 items, with higher scores indicating greater ethnic prejudice (Quillian, 1995; Witte, 1999). Teachers with long-term higher education or a university diploma are shown to be less ethnically prejudiced than teachers with a lower level of education. Moreover, teachers who work at a school with a greater number of ethnic minority pupils, and at the same time evaluate their pupils as more teachable, are less ethnically prejudiced. These findings highlight the need for more research into the underlying processes, such as pupils' teachability, that influence the relationship between school characteristics and the ethnic prejudice of teachers. More knowledge about the context-specific factors and processes that mediate and/or moderate this relationship can increase the theoretical understanding of the development of ethnic prejudice. It can also highlight particular social characteristics, which can be the focus of social and organizational policy aimed at reducing ethnic prejudices. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

An integrative review of patient safety in studies on the care and safety of patients with communication disabilities in hospital.

Science.gov (United States)

Hemsley, Bronwyn; Georgiou, Andrew; Hill, Sophie; Rollo, Megan; Steel, Joanne; Balandin, Susan

2016-04-01

To review the research literature on the experiences of patients with communication disabilities in hospital according to the Generic Model of patient safety. In 2014 and 2015, we searched four scientific databases for studies with an aim or result relevant to safety of hospital patients with communication disabilities. The review included 27 studies. A range of adverse event types were outlined in qualitative research. Little detail was provided about contributing or protective factors for safety incidents in hospital for these patients or the impact of the incidents on the patient or organisations involved. Further research addressing the safety of patients with communication disabilities is needed. Sufficient detail is required to identify the nature, timing, and detection of incidents; factors that contribute to or prevent adverse events; and detail the impact of the adverse events. In order to provide safe and effective care to people with communication disabilities in hospital, a priority for health and disability services must be the design and evaluation of ecologically appropriate and evidence-based interventions to improve patient care, communication, and reduce the risk of costly and harmful patient safety incidents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Impact of digitalization of mammographic units on average glandular doses in the Flemish Breast Cancer Screening Program

OpenAIRE

De Hauwere, An; Thierens, Hubert

2012-01-01

The impact of digitalization on the average glandular doses in 49 mammographic units participating in the Flemish Breast Cancer Screening Program was studied. Screen-film was changed to direct digital radiography and computed radiography in 25 and 24 departments respectively. Average glandular doses were calculated before and after digitalization for different PMMA-phantom thicknesses and for groups of 50 successive patients. For the transition from screen-film to computed radiography both ph...

Lessons learned from a whole hospital PACS installation. Picture Archiving and Communication System.

Science.gov (United States)

Pilling, J R

2002-09-01

The Norfolk and Norwich University Hospital has incorporated a fully filmless Picture Archiving and Communication System (PACS) as part of a new hospital provision using PFI funding. The PACS project has been very successful and has met with unanimous acclaim from radiologists and clinicians. A project of this size cannot be achieved without learning some lessons from mistakes and recognising areas where attention to detail resulted in a successful implementation. This paper considers the successes and problems encountered in a large PACS installation.

Barriers to effective, safe communication and workflow between nurses and non-consultant hospital doctors during out-of-hours.

Science.gov (United States)

Brady, Anne-Marie; Byrne, Gobnait; Quirke, Mary Brigid; Lynch, Aine; Ennis, Shauna; Bhangu, Jaspreet; Prendergast, Meabh

2017-11-01

This study aimed to evaluate the nature and type of communication and workflow arrangements between nurses and doctors out-of-hours (OOH). Effective communication and workflow arrangements between nurses and doctors are essential to minimize risk in hospital settings, particularly in the out-of-hour's period. Timely patient flow is a priority for all healthcare organizations and the quality of communication and workflow arrangements influences patient safety. Qualitative descriptive design and data collection methods included focus groups and individual interviews. A 500 bed tertiary referral acute hospital in Ireland. Junior and senior Non-Consultant Hospital Doctors, staff nurses and nurse managers. Both nurses and doctors acknowledged the importance of good interdisciplinary communication and collaborative working, in sustaining effective workflow and enabling a supportive working environment and patient safety. Indeed, issues of safety and missed care OOH were found to be primarily due to difficulties of communication and workflow. Medical workflow OOH is often dependent on cues and communication to/from nursing. However, communication systems and, in particular the bleep system, considered central to the process of communication between doctors and nurses OOH, can contribute to workflow challenges and increased staff stress. It was reported as commonplace for routine work, that should be completed during normal hours, to fall into OOH when resources were most limited, further compounding risk to patient safety. Enhancement of communication strategies between nurses and doctors has the potential to remove barriers to effective decision-making and patient flow. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Psychometric Properties of the BIS/BAS Scales and the SPSRQ in Flemish Adolescents

Directory of Open Access Journals (Sweden)

Laura Vandeweghe

2016-12-01

Full Text Available Objective: Gray’s Reinforcement Sensitivity Theory (RST is a frequently used model of personality that is relevant to the period of adolescence. However, the psychometric properties of the most frequently used questionnaires to measure the RST-constructs, namely the Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS Scales and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ, are rarely examined in samples of adolescents. Therefore, the goal of the present study was to examine the two-factor structure, reliability and convergent validity of the BIS/BAS Scales and SPSRQ in a Flemish adolescent community sample.  Method: A sample of 579 adolescents (39.5% boys; 14–19 years was recruited. The proposed two-factor structure was assessed using Exploratory Structural Equation Modeling. Reliability was evaluated using internal consistency and construct validity was examined with the correlations between the two questionnaires and with the Temperament and Character Inventory–short form (TCI-SF.  Results: After the removal of problematic items, and the addition of correlated errors, all indices indicated a good fit for the two-factor structure of the modified BIS/BAS Scales. For the modified SPSRQ, three fit indices indicated a good model fit, while a fourth fit index was slightly below the cut-off score of an adequate model fit. Internal consistency of both questionnaires was sufficient. In general, the associations with scales of the TCI-SF were as expected, with positive correlations between BIS-related scales, and between BAS-related scales of all three instruments.  Discussion: In Flemish adolescents, the use of a two-factor model to analyze data gathered with the modified BIS/BAS Scales or modified SPSRQ seems appropriate.

Active listening: The key of successful communication in hospital managers.

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Jahromi, Vahid Kohpeima; Tabatabaee, Seyed Saeed; Abdar, Zahra Esmaeili; Rajabi, Mahboobeh

2016-03-01

One of the important causes of medical errors and unintentional harm to patients is ineffective communication. The important part of this skill, in case it has been forgotten, is listening. The objective of this study was to determine whether managers in hospitals listen actively. This study was conducted between May and June 2014 among three levels of managers at teaching hospitals in Kerman, Iran. Active Listening skill among hospital managers was measured by self-made Active Listening Skill Scale (ALSS), which consists of the key elements of active listening and has five subscales, i.e., Avoiding Interruption, Maintaining Interest, Postponing Evaluation, Organizing Information, and Showing Interest. The data were analyzed by IBM-SPSS software, version 20, and the Pearson product-moment correlation coefficient, the chi-squared test, and multiple linear regressions. The mean score of active listening in hospital managers was 2.32 out of 3.The highest score (2.27) was obtained by the first-level managers, and the top managers got the lowest score (2.16). Hospital mangers were best in showing interest and worst in avoiding interruptions. The area of employment was a significant predictor of avoiding interruption and the managers' gender was a strong predictor of skill in maintaining interest (p < 0.05). The type of management and education can predict postponing evaluation, and the length of employment can predict showing interest (p < 0.05). There is a necessity for the development of strategies to create more awareness among the hospital managers concerning their active listening skills.

A smartphone-enabled communication system to improve hospital communication: usage and perceptions of medical trainees and nurses on general internal medicine wards.

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Wu, Robert; Lo, Vivian; Morra, Dante; Appel, Eva; Arany, Teri; Curiale, Beth; Ryan, Joanne; Quan, Sherman

2015-02-01

There is increasing interest in the use of information and communication technologies to improve how clinicians communicate in hospital settings. We implemented a communication system with support for physician handover and secure messaging on 2 general internal medicine wards. We measured usage and surveyed physicians and nurses on perceptions of the system's effects on communication. Between May 2011 and August 2012, a clinical teaching team received, on average, 14.8 messages per day through the system. Messages were typically sent as urgent (69.1%) and requested a text reply (76.5%). For messages requesting a text reply, 8.6% did not receive a reply. For those messages that did receive a reply, the median response time was 2.3 minutes, and 84.5% of messages received a reply within 15 minutes. Of those who completed the survey, 95.3% were medical residents (82 of 86) and 81.7% were nurses (83 of 116). Medical trainees (82.8%) and nursing staff (78.3%) agreed or strongly agreed that the system helped to speed up their daily work tasks. Overall, 67.1% of the trainees and 73.2% of nurses agreed or strongly agreed that the system made them more accountable in their clinical roles. Only 35.8% of physicians and 26.3% of nurses agreed or strongly agreed that the system was useful for communicating complex issues. In summary, with a system designed to improve communication, we found that there was high uptake and that users perceived that the system improved efficiency and accountability but was not appropriate for communicating complex issues. © 2014 Society of Hospital Medicine.

Implementation of emergency department transfer communication measures in Minnesota critical access hospitals.

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Klingner, Jill; Moscovice, Ira; Casey, Michelle; McEllistrem Evenson, Alex

2015-01-01

Previously published findings based on field tests indicated that emergency department patient transfer communication measures are feasible and worthwhile to implement in rural hospitals. This study aims to expand those findings by focusing on the wide-scale implementation of these measures in the 79 Critical Access Hospitals (CAHs) in Minnesota from 2011 to 2013. Information was obtained from interviews with key informants involved in implementing the emergency department patient transfer communication measures in Minnesota as part of required statewide quality reporting. The first set of interviews targeted state-level organizations regarding their experiences working with providers. A second set of interviews targeted quality and administrative staff from CAHs regarding their experiences implementing measures. Implementing the measures in Minnesota CAHs proved to be successful in a number of respects, but informants also faced new challenges. Our recommendations, addressed to those seeking to successfully implement these measures in other states, take these challenges into account. Field-testing new quality measure implementations with volunteers may not be indicative of a full-scale implementation that requires facilities to participate. The implementation team's composition, communication efforts, prior relationships with facilities and providers, and experience with data collection and abstraction tools are critical factors in successfully implementing required reporting of quality measures on a wide scale. © 2014 National Rural Health Association.

Assessment of Midwives’ Communication Skills at the Maternity Wards of Teaching Hospitals in Mashhad in 2014

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Talate Khadivzadeh

2015-06-01

Full Text Available Background & aim:The quality of communication between midwives and parturient women is a determinant of maternal satisfaction with midwifery care. Therefore, this study was conducted to determine the communication skills of midwives at maternity wards of Mashhad teaching hospitals in 2014.   Methods:In this descriptive study, 49 midwives, working at Mashhad teaching hospitals, were randomly selected. All midwives worked rotating shifts at the wards. The midwives’ communication skills were assessed by the researcher, using the self-structured  observation checklist of communicative performance.   Results: The mean age of midwives was 39.11±9.66 years and their mean work experience was 15.9±8.77 years. In total, 68.3% of the participants experienced childbirth themselves. 66.7% of midwives were moderately  keen on midwifery as a profession. The mean score of the checklist obtained by midwives was 67.9±10.7. There was no relationship between midwives’ communication skills and work experience, childbirth experience, age or interest in midwifery. Conclusion:Considering the inadequacy of midwives’ communication skills, which could be the major cause of maternal dissatisfaction with delivery care, it is recommended that in-service training courses be held by applying new teaching methods. Moreover, the educational needs of midwives, including communication skills, should be considered in these training programs .

Technology and communication in hospital care for chronically ill patients from the Habermasian perspective

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Rich-Ruiz, Manuel; Martins, Maria-Manuela; Rodríguez-Borrego, María-Aurora

2014-01-01

The objectives of the study were to describe situations involving instrumental and communicative actions that take place in nursing and to explore the difficulties in communicative action. It was an ethnographic study conducted among nurses from two large hospitals in Spain and Portugal. Data collection took place through participant observation and semi-structured interviews. It was then followed up by a survey. A discourse analysis and quantitative analysis were performed (on the survey). T...

Exposure to arsenic in relation with DNA damage in adolescents of the 3rd Flemish environment and health study (2012-2014

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Carmen Franken

2015-06-01

Full Text Available Arsenic (As is a compound naturally present in the environment. Recent studies have shown detectable levels of As in rice, rice food products, and apple juice. As is a well known carcinogen and is related to multiple health effects, for example dermal and kidney toxicity. Recent epidemiological studies have shown that As exposure is also a risk factor for cardiovascular diseases. We evaluated the exposure to As in a sample of 408 adolescents that were recruited from the general population in Flanders as part of the third Flemish Environment and Health Study (FLEHS3. We tested whether the current levels of As exposure were associated with oxidative stress biomarkers or biomarkers for DNA damage. In this study, the individual exposure to As was estimated by measuring total As in whole blood and different toxic As metabolites in urine: As III, As V, mono-methylarsonous acid (MMA, dimethylarsinous acid (DMA, and the non-toxic, organic compound arsenobetaine. The sum of the toxic compounds was defined as toxic relevant As (TRA. DNA damage was measured using the alkaline comet assay and the micronucleus test in whole blood samples, and by an enzyme-linked immunosorbent assay (ELISA, Gentaur quantifying 8-hydroxy-2-deoxyguanosine (8-OHdG in urine. Multiple linear regression models were used to estimate the change of effect for an increase of the exposure from P25 to P75 (P25-P75. All models were adjusted for gender, age, smoking status and statistically significant (p<0.05 covariates. The exposure biomarker As III was categorised due to the large number values below the quantification limit (LOQ. The effect estimate was given for the group with the highest As III exposure versus the group with values below LOQ. Multiple regression analysis showed significant positive associations of urinary inorganic As III (iAsIII and MMA with DNA breaks measured by the comet assay (iAsIII: β=0.333, 95% CI=0.061-0.605; MMA: β=0.090, 95% CI=0.014-0.166. Urinary i

The impact of stakeholder involvement in hospital policy decision-making: a study of the hospital's business processes.

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Malfait, Simon; Van Hecke, Ann; Hellings, Johan; De Bodt, Griet; Eeckloo, Kristof

2017-02-01

In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance. To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes. A retrospective analysis of the decision processes was conducted in three hospitals that implemented a stakeholder committee. The analysis consisted of process and outcome evaluation. Fifteen themes were discussed in the stakeholder committees, whereof 11 resulted in a considerable change. None of these were on a strategic level. The theoretical model was not applied as initially developed, but was altered by each hospital. Consequentially, the decision processes differed between the hospitals. Despite alternation of the model, the stakeholder committee showed a meaningful impact in all hospitals on the operational level. As a result of the differences in decision processes, three factors could be identified as facilitators for success: (1) a close interaction with the board of executives, (2) the inclusion of themes with a more practical and patient-oriented nature, and (3) the elaboration of decisions on lower echelons of the organization. To effectively influence the organization's public accountability, hospitals should involve stakeholders in the decision-making process of the organization. The model of a stakeholder committee was not applied as initially developed and did not affect the strategic decision-making processes in the involved hospitals. Results show only impact at the operational level in the participating hospitals. More research is needed connecting stakeholder involvement with hospital governance.

Flemish consumer attitudes towards more sustainable food choices.

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Vanhonacker, Filiep; Van Loo, Ellen J; Gellynck, Xavier; Verbeke, Wim

2013-03-01

Intensive agricultural practices and current western consumption patterns are associated with increased ecological pressure. One way to reduce the ecological impact could be a shift to more sustainable food choices. This study investigates consumer opinions towards a series of food choices with a lower ecological impact. The investigated food choices range from well-known meat substitutes to alternatives which are more radical or innovative and that require an adaptation of food habits and cultural patterns. Results are obtained through a survey among 221 Flemish respondents in Spring 2011. Many consumers underestimate the ecological impact of animal production. Well-known alternatives such as organic meat, moderation of meat consumption and sustainable fish are accepted, although willingness to pay is clearly lower than willingness to consume. Consumers are more reluctant to alternatives that (partly) ban or replace meat in the meal. Opportunities of introducing insects currently appear to be non-existent. Five consumer segments were identified based on self-evaluated ecological footprint and personal relevance of the ecological footprint. The segments were termed Conscious, Active, Unwilling, Ignorant and Uncertain. A profile in terms of demographics, attitudinal and behavioral characteristics is developed for each segments, and conclusions with respect to opportunities for sustainable food choices are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Communication difficulties experienced by deaf male patients during their in-hospital stay: findings from a qualitative descriptive study.

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Sirch, Linda; Salvador, Linda; Palese, Alvisa

2017-06-01

Studies available have described several specific issues affecting healthcare accessibility by deaf people, but to date, no research has reported the experience of deaf patients with in-hospital communication. The aim of the study was to explore the communication experience of deaf patients with regard to their in-hospital stay. A purposeful sample of participants was selected. The data collection process was based on a focus group. The focus groups were conducted in Italian sign language and videorecorded; subsequently, the entire conversation was faithfully transcribed. A qualitative content analysis of the transcription was performed and the findings are reported using the Consolidated Criteria for Reporting Qualitative Research approach. Four themes have emerged: (a) experiencing a common vulnerability: the need for reciprocal understanding and sensitivity, (b) being outside the comfort zone: feeling discriminated against once again, (c) perceiving a lack of consonance between care and needs and (d) developing a sense of progressively disempowerment. The experience of deaf individuals during their in-hospital stay may be critical: they are exposed to protracted communication and interaction with healthcare providers and an environment that is not prepared and designed for these vulnerable patients. Two levels of strategies should be identified, implemented and developed to increase the quality of communication with deaf people during hospitalisation, both at the hospital/health system level and at the healthcare professional/clinical level. © 2016 Nordic College of Caring Science.

Economic and political foundations of local tax structures: an empirical investigation of the tax mix of Flemish municipalities

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Benny Geys; Federico Revelli

2011-01-01

This is the authors’ final, accepted and refereed manuscript to the article Building on the revenue structure theory developed by Hettich and Winer (1984, 1988, 1999), this paper is the first to investigate the economic and political determinants of local tax mix choices. We thereby use panel data on 289 municipalities in the Flemish region of Belgium (period 1995-2002), where local governments enjoy extensive fiscal autonomy and have a wide choice of available tax instruments. Estimating ...

A complete image management and communications network for the neuroradiology service at Georgetown University Hospital

International Nuclear Information System (INIS)

Horii, S.C.; Muraki, A.; Mun, S.K.; Clark, L.; Schellinger, M.D.; Mallon-Ingeholm, M.L.

1989-01-01

A complete image management and communications system has been installed at Georgetown University Hospital (GUH). The network is based on the AT ampersand T CommView System. In the Neuroradiology Division, this network supports a multiscreen workstation with access to multiple imaging modalities such as CT and MRI from both the hospital and a remote imaging center. In addition, the radiologist can access these images from various workstations located throughout the hospital as well as from remote sites such as the home. Among the radiology services supported by the network, neuroradiology has the greatest need for such a system with extensive daily requirements involving the remote imaging center and on-line consultation around the clock. By providing neuroradiology with all available communication links, the radiologist can monitor, diagnose, and consult. The efficiency and effectiveness of the system's capabilities with regard to remote and teleradiology (RVS) operations have been studied for the neuroradiology service. This paper discusses the current clinical acceptance and use, problems in implementation, and ways these difficulties are being surmounted

In-hospital fellow coverage reduces communication errors in the surgical intensive care unit.

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Williams, Mallory; Alban, Rodrigo F; Hardy, James P; Oxman, David A; Garcia, Edward R; Hevelone, Nathanael; Frendl, Gyorgy; Rogers, Selwyn O

2014-06-01

Staff coverage strategies of intensive care units (ICUs) impact clinical outcomes. High-intensity staff coverage strategies are associated with lower morbidity and mortality. Accessible clinical expertise, team work, and effective communication have all been attributed to the success of this coverage strategy. We evaluate the impact of in-hospital fellow coverage (IHFC) on improving communication of cardiorespiratory events. A prospective observational study performed in an academic tertiary care center with high-intensity staff coverage. The main outcome measure was resident to fellow communication of cardiorespiratory events during IHFC vs home coverage (HC) periods. Three hundred twelve cardiorespiratory events were collected in 114 surgical ICU patients in 134 study days. Complete data were available for 306 events. One hundred three communication errors occurred. IHFC was associated with significantly better communication of events compared to HC (Pcommunicated 89% of events during IHFC vs 51% of events during HC (PCommunication patterns of junior and midlevel residents were similar. Midlevel residents communicated 68% of all on-call events (87% IHFC vs 50% HC, Pcommunicated 66% of events (94% IHFC vs 52% HC, PCommunication errors were lower in all ICUs during IHFC (Pcommunication errors. Copyright © 2014 Elsevier Inc. All rights reserved.

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

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Hj.Indirawaty; Syamsuddin AB

2015-01-01

ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing re...

Participatory evaluation of regional light rail scenarios: A Flemish case on sustainable mobility and land-use

International Nuclear Information System (INIS)

Vermote, Levi; Macharis, Cathy; Hollevoet, Joachim; Putman, Koen

2014-01-01

Highlights: • We propose three light rail scenarios, each covering a specific landscape structure to curtail private vehicle-driven urban sprawl in the Flemish rhombus. • We used the participatory multi-actor multi-criteria analysis (MAMCA) to assess the social, economic and environmental impact of alternative light rail scenarios. • We discuss catalyst measures to comply with the identified drawbacks of the proposed scenarios. - Abstract: Rail transit is generally acknowledged as an alternative transport mode in contributing towards sustainable mobility. In addition to minimising negative externalities, rail transit has sustainable land-use opportunities to integrate transport- and spatial planning. The objective of this paper is to determine the impact of integrative light rail scenarios and their ability to curtail private vehicle driven urban sprawl in the Flemish rhombus. The paper proposes three light rail scenarios: an infrastructural scenario; tramification scenario; and spatial rail scenario, each covering a specific landscape structure to reorganise the dispersed spatial environment in Flanders in the long-term. We used the participatory multi-actor multi-criteria analysis (MAMCA) which incorporates the objectives of all involved stakeholders to assess the impact of the scenarios. The infrastructural alternative scenario gained most support among the involved stakeholders, on the grounds of improved multimodality, enhanced user amenities, reduced implementation costs, moderated greenhouse gas emissions and mitigated infrastructural barrier effects. Despite the merits of the infrastructural scenario in terms of stakeholder objectives, few possibilities are included to elaborate upon sustainable land-use development. In response to the low performance of this assessment criterion, catalyst measures are discussed to support the implementation

Flemish palliative-care nurses' attitudes to palliative sedation: a quantitative study.

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Gielen, Joris; Van den Branden, Stef; Van Iersel, Trudie; Broeckaert, Bert

2012-09-01

Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses' attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units.

Electronic discharge summary and prescription: improving communication between hospital and primary care.

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Murphy, S F; Lenihan, L; Orefuwa, F; Colohan, G; Hynes, I; Collins, C G

2017-05-01

The discharge letter is a key component of the communication pathway between the hospital and primary care. Accuracy and timeliness of delivery are crucial to ensure continuity of patient care. Electronic discharge summaries (EDS) and prescriptions have been shown to improve quality of discharge information for general practitioners (GPs). The aim of this study was to evaluate the effect of a new EDS on GP satisfaction levels and accuracy of discharge diagnosis. A GP survey was carried out whereby semi-structured interviews were conducted with 13 GPs from three primary care centres who receive a high volume of discharge letters from the hospital. A chart review was carried out on 90 charts to compare accuracy of ICD-10 coding of Non-Consultant Hospital Doctors (NCHDs) with that of trained Hopital In-Patient Enquiry (HIPE) coders. GP satisfaction levels were over 90 % with most aspects of the EDS, including amount of information (97 %), accuracy (95 %), GP information and follow-up (97 %) and medications (91 %). 70 % of GPs received the EDS within 2 weeks. ICD-10 coding of discharge diagnosis by NCHDs had an accuracy of 33 %, compared with 95.6 % when done by trained coders (p communication with primary care. It has led to a very high satisfaction rating with GPs. ICD-10 coding was found to be grossly inaccurate when carried out by NCHDs and it is more appropriate for this task to be carried out by trained coders.

Accreditation of Management Communication and Information Systems in Public Hospitals of Sabzevar City, Iran.

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Farzianpour, Fereshteh; Shojaei, Saeed; Arab, Mohammad; Foroushani, Abbas Rahimi

2016-04-01

Information systems are "computer systems that collect, store, process, retrieve, show, and provide timely information required in practice, education, management, and research". The purpose of these systems is to support hospital activities in practical, tactical, and strategic levels in order to provide better service to patients. This study aimed to evaluate the communication and information system (MCI) in public hospitals in Sabzevar city in 2014 from the perspective of human resources according to international standards of the Joint Commission Accreditation Hospital (JCAH). This study was a practical, descriptive, cross-sectional study. The study population consisted of Sabzevar nurses who used hospital information system. Sampling was done by classification method and in proportion to the number of nurses in each health care units in hospitals in 2014. The sample size was 200 and after referring to hospitals, 200 questionnaires were completed. Sample size was calculated by the formula n=Z(2)P (1-P)/d(2) with P=0.5, α=0.05, d=0.05, and Z=1.96. Data collection tool was the questionnaire of assessment of hospital information systems of JCAH, which has 124 specific questions, including 6 areas. To assess the effect of demographic variables with MCI standards of two questionnaires (feasibility and implementation), the following steps were taken. 1. Kolmogorov-Smirnov test was used to determine whether responses were normal or not. 2. In case of normal data, t-test was used for dual groups and one-way ANOVA test for groups of three or more. 3. If not normal, Mann-Whitney test was used for dual groups and Kruskal-Wallis test for groups of three or more. Research findings show the mean results of feasibility and implementation of all 6 areas of international standards MCI have feasibility in three hospitals in Sabzevar in 20 sections (H1=105.01±10.468), (H1=196.31±4.662), (H2=104.26±9.099), (H2=195.33±3.778) (H3=106.48±11.545) and (H3=197.57±4

Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.

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Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B

2018-01-29

Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings

Interprofessional Health Team Communication About Hospital Discharge: An Implementation Science Evaluation Study.

Science.gov (United States)

Bahr, Sarah J; Siclovan, Danielle M; Opper, Kristi; Beiler, Joseph; Bobay, Kathleen L; Weiss, Marianne E

The Consolidated Framework for Implementation Research guided formative evaluation of the implementation of a redesigned interprofessional team rounding process. The purpose of the redesigned process was to improve health team communication about hospital discharge. Themes emerging from interviews of patients, nurses, and providers revealed the inherent value and positive characteristics of the new process, but also workflow, team hierarchy, and process challenges to successful implementation. The evaluation identified actionable recommendations for modifying the implementation process.

Breast cancer patients' trust in physicians: the impact of patients' perception of physicians' communication behaviors and hospital organizational climate.

Science.gov (United States)

Kowalski, Christoph; Nitzsche, Anika; Scheibler, Fueloep; Steffen, Petra; Albert, Ute-Susann; Pfaff, Holger

2009-12-01

To examine whether patients' perception of a hospital's organizational climate has an impact on their trust in physicians after accounting for physicians' communication behaviors as perceived by the patients and patient characteristics. Patients undergoing treatment in breast centers in the German state of North Rhein-Westphalia in 2006 were asked to complete a standardized postal questionnaire. Disease characteristics were then added by the medical personnel. Multiple linear regressions were performed. 80.5% of the patients responded to the survey. 37% of the variance in patients' trust in physicians can be explained by the variables included in our final model (N=2226; R(2) adj.=0.372; porganizational climate. The impact of their perception of physicians' communication behaviors persists after introducing hospital organizational characteristics. Perceived physician accessibility shows the strongest association with trust. A trusting physician-patient relationship among breast cancer patients is associated with both the perceived quality of the hospital organizational climate and perceived physicians' communication behaviors. With regard to clinical organization, efforts should be put into improving the organizational climate and making physicians more accessible to patients.

Quality of communication about medicines in United States hospitals: A national retrospective study.

Science.gov (United States)

Mullings, Lauren; Sankaranarayanan, Jayashri

Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. To evaluate ComMed quality variations by hospital characteristics. In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys). After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality. One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

PERSONAL EMPIRICAL RESEARCH REGARDING DEVELOPMENT OF MORAL ATTITUDE OF ROMANIAN AND FLEMISH TEENAGERS

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Valentin Cosmin Blândul

2011-12-01

Full Text Available The adolescence represents one of the most complex and unpredictable period of human life. A teenager could be considered mature from physical, intellectual or moral point of view, but not from emotional one, because he is like a “sponge” able to absorb a lot of information, care and love. On the other hand, moral behaviour could be associated with social competence to establish a good relationship with others, to help them, to cooperate in a team and to have a positive attitude regarding general society. In the following paper, we will try to analyse the moral attitude of 182 Romanian teenagers and 210 Flemish ones regarding to different life’s situations. Our conclusions are that in spite of all intercultural differences, the majority of interviewed teenagers have an honest conduct and a respect form law and moral values.

Conflict and Stress in Hospital Nursing: Improving Communicative Responses to Enduring Professional Challenges.

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Moreland, Jennifer J; Apker, Julie

2016-07-01

Nurses function as central figures of health teams, coordinating direct care and communication between team members, patients, and their families. The importance of nurses to health care cannot be understated, but neither can the environmental struggles nurses routinely encounter in their jobs. Organizational communication and nursing scholarship show conflict and stress as two visible and ongoing challenges. This case study aims to (a) explore the ways conflict communication and communicative stress are experienced and endure in nursing and (b) understand how nurses discursively (mis)manage conflict and stress. Open-ended survey comments from nurses (N = 135) employed at a large teaching and research hospital were qualitatively analyzed. Weick's model of organizing, specifically his notion of communication cycles, emerged as a conceptual lens helpful for understanding cyclical conflict and stress. Results show that exclusionary communication, specifically nonparticipatory and unsupportive messages, contribute to nurse conflict and stress. Nurses tend to (mis)manage conflict and stress using respectful and disrespectful discourse. These communication patterns can facilitate or prohibit positive change. Metaphorically, nurse communicative conflict and stress can be depicted as fire. Relationships can go up in flames due to out-of-control fires in the form of destructive conflict. However, conflict and stress, like fire, can be harnessed for positive ends such as organizational decision making and innovation. Findings suggest conveying respect may help nurses manage and even avoid flames of conflict and stress. Solutions are offered to mitigate the effects of conflict and stress while developing respectful organizational cultures.

Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

Science.gov (United States)

Torke, Alexia M; Callahan, Christopher M; Sachs, Greg A; Wocial, Lucia D; Helft, Paul R; Monahan, Patrick O; Slaven, James E; Montz, Kianna; Burke, Emily S; Inger, Lev

2018-03-01

Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = -0.30, p = 0.003) and higher decision quality (β = -0.44, p post-traumatic stress (β = 0.23, p = 0.022) but also higher satisfaction (β = 0

[Communication, participation and leadership in the perception of the emotional climate in a university hospital in Andalusia, Spain].

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Danet, Alina; March, Joan Carles; Romera, Inmaculada García

2014-03-01

The aim of this study was to identify and analyze perceptions and opinions among health professionals in a university hospital in Andalusia, Spain, regarding the emotional climate, leadership style, quality of information, and internal communication. The study also aimed to collect health professionals' suggestions for improving these workplace characteristics. The study included 730 participants and used a quantitative and qualitative methodology. The results reflect a medium-to-low level of emotional climate, correlated with the leadership style and information and internal communication. Statistically significant differences appeared when comparing professional categories and hospital units. The health professionals provided a positive assessment of the administrators' work, although requiring more task-oriented, participative, and affiliative leadership skills.

Culture in Hospital Organizations and Cultural Policies for Coordinating Communication and Learning - DOI: 10.3395/reciis.v1i1.45en

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Elói Martins Senhoras

2007-06-01

Full Text Available This article deals with the importance of culture due to its dual strategic characteristics as both a process and a product of interaction, from the perspective of the management and planning of hospital organizations. The cultural changes within a hospital are analyzed through a review of theoretical and practical studies of health organizations, which are understood as relationships brokered by actors in a cultural system, who react to the introduction of mechanisms for participation and communication through mechanisms for learning. Through this discussion, arguments are provided to diversify and deepen the debate about administrative paths associated with communication which can lead to institutional efficiency, by suggesting the creation of communication mechanisms for building incentives in organizational learning and the operationalization of simple criteria for analyzing and revealing the cultures of a hospital organization.

[Mobile hospital -real time mobile telehealthcare system with ultrasound and CT van using high-speed satellite communication-].

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Takizawa, Masaomi; Miyashita, Toyohisa; Murase, Sumio; Kanda, Hirohito; Karaki, Yoshiaki; Yagi, Kazuo; Ohue, Toru

2003-01-01

A real-time telescreening system is developed to detect early diseases for rural area residents using two types of mobile vans with a portable satellite station. The system consists of a satellite communication system with 1.5Mbps of the JCSAT-1B satellite, a spiral CT van, an ultrasound imaging van with two video conference system, a DICOM server and a multicast communication unit. The video image and examination image data are transmitted from the van to hospitals and the university simultaneously. Physician in the hospital observes and interprets exam images from the van and watches the video images of the position of ultrasound transducer on screenee in the van. After the observation images, physician explains a results of the examination by the video conference system. Seventy lung CT screening and 203 ultrasound screening were done from March to June 2002. The trial of this real time screening suggested that rural residents are given better healthcare without visit to the hospital. And it will open the gateway to reduce the medical cost and medical divide between city area and rural area.

Communication of nursing students in listening to patients in a psychiatric hospital

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Albert Lengruber de Azevedo

2017-06-01

Full Text Available Abstract Qualitative exploratory and descriptive study with the aim of analyzing the communication of nursing students in the listening to patients in mental suffering admitted in a psychiatric hospital. The study was carried out from April to May 2013, with 23 nursing students regularly enrolled in a public higher education institution in the Southeast of Brazil. The data were collected based on artistic production and interviews, analyzed and categorized according to their thematic content. Proxemic nonverbal communication was unanimously indicated by the students based on personal-body position of face, neck, and, shoulders adopted in the listening to patients in mental suffering. The conscious use of proxemics favored clinical reasoning, improving interaction and listening in speech and thought disorders. Attentive, effective, and affective listening demands availability, control of fear, tension, anxiety, and insecurity.

Effective communication network structures for hospital infection prevention: a study protocol.

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Rangachari, Pavani

2013-01-01

Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implementation failure" in health care organizations. Several studies have used retrospective designs to examine the problem; however, there are few prospective studies examining communication dynamics underlying successful implementation of change (eg, evidence-based practices). This prospective study will be set in 2 intensive care units at an academic medical center. At baseline, both units have low compliance with CLB and higher-than-expected CRBSIs. Periodic quality improvement (QI) interventions will be conducted over a 52-week period to promote implementation of CLB in both units. Simultaneously, the following parameters will be examined: (1) Structure and content of communication related to CLB in both units through "communication logs" completed weekly by nurses, physicians, and managers; and (2) outcomes, that is, CLB adherence in both units through weekly chart review. Catheter utilization and CRBSI (infection) rates will serve as additional unit-level outcome measures. The aim is 2-fold: (1) to examine associations between QI interventions and structure and content of communication at the unit level; and (2) to examine associations between structure and content of communication and outcomes at the unit level. The periodic QI interventions are expected to increase CLB adherence and reduce CRBSIs through their influence on structure and content of communication. The prospective design would help examine dynamics in unit-level communication structure and content related to CLB, as well as unit-level outcomes. The study has potential to make significant contributions to theory and practice, particularly if interventions are found to be effective in

An iconographic study of the engraving of the Consecration, the Flemish artist Abraham van Diepenbeeck

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Juan Isaac Calvo Portela

2017-06-01

Full Text Available In this article we study a engraving from the workshop of flemish artist, Abraham van Diepenbeeck, who opened the engraver Mattheus Borrekens and published Martinus van den Enden the Elder, between the late 1640s and early 1650s. In the Courtland Institute of London is preserved a previus sketch of this engraving, which allows us to approach the analysis of the creative process of the engraving. In this engraving are expressed many of the doctrines that the Council of Trent established on the Eucharist is expressed, and at the same time, it tries to deal the position of Jansenism on the Sacramento and also it opposes to the idea of frequent Communion, idea that was defended among others the Jesuits.

A cross-cultural comparison of tonal synchrony and pitch imitation in the vocal dialogs of Belgian Flemish-speaking and Mexican Spanish-speaking mother-infant dyads.

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Van Puyvelde, Martine; Loots, Gerrit; Gillisjans, Lobcke; Pattyn, Nathalie; Quintana, Carmen

2015-08-01

This study reports a cross-cultural comparison of the vocal pitch patterns of 15 Mexican Spanish-speaking and 15 Belgian Flemish-speaking dyads, recorded during 5min of free-play in a laboratory setting. Both cultures have a tradition of dyadic face-to-face interaction but differ in language origins (i.e., Romanic versus Germanic). In total, 374 Mexican and 558 Flemish vocal exchanges were identified, analyzed and compared for their incidence of tonal synchrony (harmonic/pentatonic series), non-tonal synchrony (with/without imitations) and pitch and/or interval imitations. The main findings revealed that dyads in both cultures rely on tonal synchrony using similar pitch ratios and timing patterns. However, there were significant differences in the infants' vocal pitch imitation behavior. Additional video-analyzes on the contingency patterns involved in pitch imitation showed a cross-cultural difference in the maternal selective reinforcement of pitch imitation. The results are interpreted with regard to linguistic, developmental and cultural aspects and the 'musilanguage' model. Copyright © 2015 Elsevier Inc. All rights reserved.

Network Coded Cooperative Communication in a Real-Time Wireless Hospital Sensor Network.

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Prakash, R; Balaji Ganesh, A; Sivabalan, Somu

2017-05-01

The paper presents a network coded cooperative communication (NC-CC) enabled wireless hospital sensor network architecture for monitoring health as well as postural activities of a patient. A wearable device, referred as a smartband is interfaced with pulse rate, body temperature sensors and an accelerometer along with wireless protocol services, such as Bluetooth and Radio-Frequency transceiver and Wi-Fi. The energy efficiency of wearable device is improved by embedding a linear acceleration based transmission duty cycling algorithm (NC-DRDC). The real-time demonstration is carried-out in a hospital environment to evaluate the performance characteristics, such as power spectral density, energy consumption, signal to noise ratio, packet delivery ratio and transmission offset. The resource sharing and energy efficiency features of network coding technique are improved by proposing an algorithm referred as network coding based dynamic retransmit/rebroadcast decision control (LA-TDC). From the experimental results, it is observed that the proposed LA-TDC algorithm reduces network traffic and end-to-end delay by an average of 27.8% and 21.6%, respectively than traditional network coded wireless transmission. The wireless architecture is deployed in a hospital environment and results are then successfully validated.

Exposure to media predicts use of dietary supplements and anabolic-androgenic steroids among Flemish adolescent boys.

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Frison, Eline; Vandenbosch, Laura; Eggermont, Steven

2013-10-01

This study examined whether different types of media affect the use of dietary proteins and amino acid supplements, and intent to use anabolic-androgenic steroids. A random sample of 618 boys aged 11-18 years from eight schools in the Flemish part of Belgium completed standardized questionnaires as part of the Media and Adolescent Health Study. The survey measured exposure to sports media, appearance-focused media, fitness media, use of dietary supplements, and intent to use anabolic-androgenic steroids. Data were analyzed using logistic regressions and are presented as adjusted odds ratios (OR) and 95 % confidence intervals (CI); 8.6 % indicated to have used dietary proteins, 3.9 % indicated to have used amino acid supplements, and 11.8 % would consider using anabolic-androgenic steroids. After adjusting for fitness activity, exposure to fitness media was associated with the use of dietary proteins (OR = 7.24, CI = 2.25-23.28) and amino acid supplements (5.16, 1.21-21.92; 44.30, 8.25-238). Intent to use anabolic-androgenic steroids was associated with exposure to fitness media (2.38, 1.08-5.26; 8.07, 2.55-25.53) and appearance-focused media (6.02, 1.40-25.82; 8.94, 1.78-44.98). Sports media did not correlate with the use of dietary supplements and intent to use anabolic-androgenic steroids. Specific types of media are strong predictors of the use of supplements in adolescent boys. This provides an opportunity for intervention and prevention through the selection of fitness media as a communication channel. Health practitioners should also be aware that the contemporary body culture exerts pressure not only on girls but also on boys.

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

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Hj.Indirawaty

2015-08-01

Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

Improving communication between staff and disabled children in hospital wards: testing the feasibility of a training intervention developed through intervention mapping.

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Gumm, Rebecca; Thomas, Eleanor; Lloyd, Claire; Hambly, Helen; Tomlinson, Richard; Logan, Stuart; Morris, Christopher

2017-01-01

To develop and test the feasibility of a novel parent-inspired training intervention for hospital ward staff to improve communication with disabled children when inpatients. Training content and delivery strategies were informed by the iterative process of Intervention Mapping and developed in collaboration with parents of disabled children. UK University Hospital children's ward. 80 medical, nursing, allied health professionals, clerical and housekeeping staff on a children's ward. Themes identified in previous qualitative research formed the basis of the training. Learning objectives included prioritising communication, cultivating empathy, improving knowledge and developing confidence. Participant feedback was used to refine content and delivery. Intervention documentation adheres to the Template for Intervention Description and Replication checklist. Highlighting mandated National Health Service policies and involving the hospital Patient and Carer Experience Group facilitated management support for the training. Eighty staff participated in one of four 1-hour sessions. A paediatric registrar and nurse delivered sessions to mixed groups of staff. General feedback was very positive. The intervention, fully documented in a manual, includes videos of parent carers discussing hospital experiences, interactive tasks, small group discussion, personal reflection and intention planning. Generic and local resources were provided. It was feasible to deliver this new communication training to hospital ward staff and it was positively received. Early feedback was encouraging and indicates a commitment to behaviour change. Further piloting is required to establish the transferability of the intervention to other hospitals, followed by consideration of downstream markers to evaluate the effects on disabled children's inpatient experience. Organisational and cultural change is required to support individual behaviour change.

Perceived Nurse-Physician Communication in Patient Care and Associated Factors in Public Hospitals of Jimma Zone, South West Ethiopia: Cross Sectional Study.

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Fikadu Balcha Hailu

Full Text Available Nurse-physician communication has been shown to have a significant impact on the job satisfaction and retention of staff. In areas where it has been studied, communication failure between nurses and physicians was found to be one of the leading causes of preventable patient injuries, complications, death and medical malpractice claims.The objective of this study is to determine perception of nurses and physicians towards nurse-physician communication in patient care and associated factors in public hospitals of Jimma zone, southwest Ethiopia.Institution based cross-sectional survey was conducted from March 10 to April 16, 2014 among 341 nurses and 168 physicians working in public hospitals in Jimma zone. Data was collected using a pre-tested self-administered questionnaire; entered into EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS version 16.0 for analysis. Factor analysis was carried out. Descriptive statistics, independent sample t-test, linear regression and one way analysis of variance were used. Variables with P-value < 0.05 were considered as statistically significant.The response rate of the study was 91.55%. The mean perceived nurse-physician communication scores were 50.88±19.7% for perceived professional respect and satisfaction, and 48.52±19.7% for perceived openness and sharing of patient information on nurse-physician communication. Age, salary and organizational factors were statistically significant predictors for perceived respect and satisfaction. Whereas sex, working hospital, work attitude individual factors and organizational factors were significant predictors of perceived openness and sharing of patient information in nurse-physician communication during patient care.Perceived level of nurse-physician communication mean score was low among nurses than physicians and it is attention seeking gap. Hence, the finding of our study suggests the need for developing and implementing nurse

The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

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Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

2013-01-01

This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

The effect of subsidising firms on voting behaviour: Evidence from Flemish elections

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Caroline Buts

2012-06-01

Full Text Available Despite an international consensus on the importance to limit State aid spending, large amounts of resources are still devoted to a wide variety of subsidies to firms. A sizable literature studies the relationship between general government spending and the proximity of elections, mostly documenting a positive link. In addition, other studies verify whether this strategy of increasing government expenditure pays off in terms of number of votes. We focus on one type of government spending that can be quite vulnerable to becoming ‘targeted spending’, i.e. subsidies to firms. We empirically test the relationship between the amount of subsidies granted to firms at the local level and local support for incumbent parties in the regional government. To that end, we make use of subsidy data derived from financial statements on 2008 and Flemish election results of 2004 and 2009. We find that the total amount of subsidies as well as subsidies per capita granted in 2008 positively correlate to support for incumbent parties 2009, meaning that voters appear to reward subsidy granting politicians.

Knowledge, assessment, and management of adults with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type among Flemish physiotherapists.

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Rombaut, Lies; Deane, Janet; Simmonds, Jane; De Wandele, Inge; De Paepe, Anne; Malfait, Fransiska; Calders, Patrick

2015-03-01

Physiotherapy plays a fundamental role in managing adults with the joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT). However, it is a challenge for both the patient and the physiotherapist as the condition is poorly understood and treatment for JHS/EDS-HT is currently undefined. Insight into current practice is, therefore, necessary in order to establish baseline knowledge in this area and in the long term to improve the standard of patient care. Therefore, the purpose of this study was to evaluate current physiotherapists' knowledge of JHS/EDS-HT and to gain insight into current physiotherapy practice with emphasis on assessment, management, and treatment efficacy. Three hundred twenty-five Flemish physiotherapists participated in the study by filling out electronically a modified version of the "Hypermobility and Hypermobility Syndrome Questionnaire" (HHQ), which covered theoretical constructs such as general knowledge, assessment, management, and learning in relation to generalized joint hypermobility and JHS/EDS-HT. The results show that physiotherapists report a low level of confidence with regard to assessment and management of JHS/EDS-HT. Knowledge of hypermobility and JHS/EDS-HT is weak, especially regarding the features associated with JHS/EDS-HT. Many treatment approaches are used by physiotherapists with the majority showing preference for education, reassurance, muscle strengthening, proprioceptive and core stability training. Almost all approaches were perceived as being clinically effective by the physiotherapists, highlighting a lack of consensus. In conclusion, this study in Flemish physiotherapists confirms that JHS/EDS-HT is under-recognized, not well known and deemed difficult to treat. Further education is required and sought by the physiotherapists surveyed, and future research is needed. © 2015 Wiley Periodicals, Inc.

Seeing the soil through the net: an eye-opener on the soil map of the Flemish region (Belgium)

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Dondeyne, Stefaan; Vanierschot, Laura; Langohr, Roger; Van Ranst, Eric; Deckers, Jozef; Oorts, Katrien

2017-04-01

A systematic soil survey of Belgium was conducted from 1948 to 1991. Field surveys were done at the detailed scale of 1:5000 with the final maps published at a 1:20,000 scale. The legend of these detailed soil maps (scale 1:20,000) has been converted to the 3rd edition of the international soil classification system 'World Reference Base for Soil Resources' (WRB). Over the last years, the government of the Flemish region made great efforts to make these maps, along with other environmental data, available to the general audience through the internet. The soil maps are widely used and consulted by researchers, teachers, land-use planners, environmental consultancy agencies and archaeologists. The maps can be downloaded and consulted in the viewer 'Visual Soil Explorer' ('Bodemverkenner'). To increase the legibility of the maps, we assembled a collection of photographs from soil profiles representing 923 soil types and 413 photos of related landscape settings. By clicking on a specific location in the 'Visual Soil Explorer', pictures of the corresponding soil type and landscape appear in a pop-up window, with a brief explanation about the soil properties. The collection of photographs of soil profiles cover almost 80% of the total area of the Flemish region, and include the 100 most common soil types. Our own teaching experience shows that these information layers are particular valuable for teaching soil geography and earth sciences in general. Overall, such visual information layers should contribute to a better interpretation of the soil maps and legacy soil data by serving as an eye-opener on the soil map to the wider community.

The relationship between work engagement and psychological distress of hospital nurses and the perceived communication behaviors of their nurse managers: A cross-sectional survey.

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Kunie, Keiko; Kawakami, Norito; Shimazu, Akihito; Yonekura, Yuki; Miyamoto, Yuki

2017-06-01

Communication between nurse managers and nurses is important for mental health of hospital nurses. The aim of the present study was to investigate the relationship between managers' communication behaviors toward nurses, and work engagement and psychological distress among hospital nurses using a multilevel model. The present study was a cross-sectional questionnaire survey. The participants were nurses working at three hospitals in Japan. A total of 906 nurses from 38 units participated in the present study. The units with small staff sizes and participants with missing entries in the questionnaire were excluded. The data for 789 nurses from 36 questionnaire survey units were analyzed. A survey using a self-administered questionnaire was conducted. The questionnaire asked staff nurses about communication behaviors of their immediate manager and their own levels of work engagement, psychological distress, and other covariates. Three types of manager communication behaviors (i.e., direction-giving, empathetic, and meaning-making language) were assessed using the Motivating Language scale; and the scores of the respondents were averaged for each unit to calculate unit-level scores. Work engagement and psychological distress were measured using the Utrecht Work Engagement Scale and the K6 scale, respectively. The association of communication behaviors by unit-level managers with work engagement and psychological distress among nurses was analyzed using two-level hierarchical linear modeling. The unit-level scores for all three of the manager communication behaviors were significantly and positively associated with work engagement among nurses (pwork environment. The individual levels of all three of the manager communication behaviors were also significantly and positively associated with work engagement (p0.05). Motivating language by unit-level managers might be positively associated with work engagement among hospital nurses, which is mediated through the better

Online Education for Improving Communication and Documentation of Dietary Supplements Among Health Professionals Practicing in a Hospital Setting.

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Gardiner, Paula; Filippelli, Amanda C; Kabbara, Karim; Lin, Steven C; Sadikova, Ekaterina; Kaptchuk, Ted J; Kemper, Kathi

2015-10-01

Little is known about the feasibility of online education in improving communication and documentation of dietary supplements (DS) among clinicians. This prospective educational study included clinicians at an urban teaching hospital. The curriculum included video streams, didactics, and interactive case presentations to discuss (1) DS safety and effectiveness, (2) cultural competency, (3) managing DS in a hospital setting, and (4) DS adverse events. Participants were surveyed, at baseline and after training, about DS knowledge, confidence, communication, and documentation practices. Thirty-nine of 61 (64%) recruited clinicians completed all four patient cases and post-tests. Most (82%) were women and 59% were physicians. The mean DS knowledge test score increased after the curriculum (p online curriculum is an effective tool for presenting DS education to clinicians with the goal of improving clinicians' knowledge, confidence, and documentation practices about DS.

Nurses' Use and Perception of an Information and Communication Technology System for Improving Coordination During Hospital Discharges: A Survey in Swedish Primary Healthcare.

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Christiansen, Line; Fagerström, Cecilia; Nilsson, Lina

2017-07-01

To facilitate communications between care levels and improve coordination during hospital discharges, there is great potential in using information and communication technology systems, because they can significantly help to deter unnecessary readmissions. However, there is still a lack of knowledge about how often nurses use information and communication technology and the indicators related to its use. The aims of this study were to describe the indicators related to nurses' use of an information and communication technology system for collaboration between care levels and to estimate whether the level of use can be related to nurses' perceptions of the information and communication technology system's contribution to improve coordination during hospital discharges. A quantitative survey of 37 nurses from 11 primary healthcare centers was performed in a county in southern Sweden. The data were analyzed using descriptive and comparative analyses. The results showed that perceptions concerning the information and communication technology system's usability and time consumption differed between nurses who used the system and those who did not. Simultaneously, the nurses were rather unaware of the ability of the information and communication technology system to improve coordination during patient discharges.

International and national initiatives in biobanking.

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Ectors, N

2011-01-01

Translational research and biobanking are "in", also in Flanders and in Belgium. In Flanders the Advice report 120 from the Flemish Council for Science and innovation, entitled "Extension of translational research in Flanders" paved the way for the Center for Medical Innovation. The Center for Medical Innovation aims at promoting collaboration between Flemish Universities, university hospitals, pharma and biotech industry and the Flemish Government specifically in the domain of translational research. The Initiative # 27 of the Cancer plan from the Federal Government aims at financing a virtual interuniversity tumor bank in order to promote "cancer" translational research in a collaborative network between academic structures, general hospitals en different industrial partners (pharmacy, biotechnology, diagnostics, ...) active in research in Belgium. However, the scientific interest in the human tissues is not new, at all. This text aims at giving an overview of the development and evolutions of "biobanking" initiatives.

The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

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Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

2013-01-01

Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

Use of a Hands Free, Instantaneous, Closed-Loop Communication Device Improves Perception of Communication and Workflow Integration in an Academic Teaching Hospital: A Pilot Study.

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Fang, Daniel Z; Patil, Teja; Belitskaya-Levy, Ilana; Yeung, Marianne; Posley, Keith; Allaudeen, Nazima

2017-11-17

Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service. We conducted a prospective, observational, survey-based study over twenty-four weeks in an academic tertiary care center with attending physicians and residents. Our intervention involved the implementation of an HFCD alongside the existing paging system. Fifty-six pre and post surveys evaluated the perception of improvement in communication and the integration of the HFCD into existing workflow. We saw significant improvements in the ability of an HFCD to help physicians communicate thoughts clearly, communicate thoughts effectively, reach team members, reach ancillary staff, and stay informed about patients. Physicians also reported better workflow integration during admissions, rounds, discharge, and teaching sessions. Qualitative data from post surveys demonstrated that the greatest strengths of the HFCD included the ability to reach colleagues and staff quickly, provide instant access to individuals of the care team, and improve overall communication. Integration of an instantaneous, hands free, closed loop communication system alongside the existing pager system can provide improvements in the perceptions of communication and workflow integration in an academic medicine service. Future studies are needed to correlate these subjective findings with objective measures of quality and safety.

Short communication: risk factors for methicillin-resistant Staphylococcus aureus colonization among HIV patients at hospital admission.

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Lee, Linda K; Win, Mar Kyaw; Veeraraghavan, Meyyur A; Wong, Chia Siong; Chow, Angela L; Leo, Yee-Sin

2013-05-01

Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen that has become increasingly prominent in hospitals and the community. HIV-positive patients may be one of the most MRSA-susceptible populations because of their immunocompromised status. At the Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, we implemented a universal MRSA screening program and performed a case-control study to identify risk factors for MRSA colonization among 294 HIV patients at admission from January 2009 to January 2010. Among 54 HIV-positive patients who were MRSA positive at hospital admission, 16 (29.6%) were positive at the nares/axilla/groin (NAG; one combined swab), 14 (25.9%) were NAG and perianal positive, 3 (5.6%) were NAG and throat positive, 10 (18.5%) were NAG, perianal, and throat positive, 6 (11.1%) were throat positive, and 5 (9.3%) were perianal positive. Upon multivariate analysis, we found that age [odds ratio (OR)=1.04, 95% confidence interval (CI): 1.01-1.07, p=0.006] and CD4 count hospital admission.

High susceptibility prevalence for F4+ and F18+Escherichia coli in Flemish pigs.

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Nguyen, Ut V; Coddens, Annelies; Melkebeek, Vesna; Devriendt, Bert; Goetstouwers, Tiphanie; Poucke, Mario Van; Peelman, Luc; Cox, Eric

2017-04-01

F4 and/or F18 enterotoxigenic Escherichia coli (F4 + /F18 + ETEC) are responsible for diarrhea while F18 + verotoxigenic E. coli (F18 + VTEC) cause edema disease in pigs. Both infections can result in severe economic losses, which are mainly the result of the medication, growth retardation and mortality. The susceptibility of piglets to these pathogens is determined by the presence of F4 and F18 receptors (F4R and F18R). Understanding the composition of the susceptibility phenotypes of pigs is useful for animal health and breeding management. This study aimed to determine the prevalence of the F4 ETEC susceptibility phenotypes and F18 + E. coli susceptibility among Flemish pig breeds by using the in vitro villous adhesion assay. In this study, seven F4 ETEC susceptibility phenotypes were found, namely A (F4 ab R + , ac R + , ad R + ; 59.16%), B (F4 ab R + , ac R + , ad R - ; 6.28%), C (F4 ab R + , ac R - , ad R + ; 2.62%), D (F4 ab R - , ac R - , ad R + ; 6.28%), E (F4 ab R - , ac R - , ad R - ; 24.08%), F (F4 ab R + , ac R - , ad R - ; 1.05%) and G (F4 ab R - , ac R + , ad R - ; 0.52%). F4ab and F4ac E. coli showed a stronger degree of adhesion to the intestinal villi (53.40% and 52.88% strong adhesion, respectively), compared to F4ad E. coli (43.46% strong adhesion). Furthermore, the correlation between F4ac and F4ab adhesion was higher (r=0.78) than between F4ac and F4ad adhesion (r=0.41) and between F4ab and F4ad adhesion (r=0.57). For F18 + E. coli susceptibility, seven out of 82 pigs were F18R negative (8.54%), but only two of these seven pigs (2.44%) were also negative for F4R. As such, the chance to identify a pig that is positive for a F4 ETEC variant or F18 + E. coli is 97.56%. Therefore, significant economic losses will arise due to F4 + and/or F18 + E. coli infections in the Flemish pig population due to the high susceptibility prevalence. Copyright © 2016 Elsevier B.V. All rights reserved.

The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of tabriz, iran.

Science.gov (United States)

Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

2013-03-01

Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education.

A Model for QoS - Aware Wireless Communication in Hospitals.

Science.gov (United States)

Alavikia, Zahra; Khadivi, Pejman; Hashemi, Masoud Reza

2012-01-01

In the recent decade, research regarding wireless applications in electronic health (e-Health) services has been increasing. The main benefits of using wireless technologies in e-Health applications are simple communications, fast delivery of medical information, reducing treatment cost and also reducing the medical workers' error rate. However, using wireless communications in sensitive healthcare environment raises electromagnetic interference (EMI). One of the most effective methods to avoid the EMI problem is power management. To this end, some of methods have been proposed in the literature to reduce EMI effects in health care environments. However, using these methods may result in nonaccurate interference avoidance and also may increase network complexity. To overcome these problems, we introduce two approaches based on per-user location and hospital sectoring for power management in sensitive healthcare environments. Although reducing transmission power could avoid EMI, it causes a number of successful message deliveries to the access point to decrease and, hence, the quality of service requirements cannot be meet. In this paper, we propose the use of relays for decreasing the probability of outage in the aforementioned scenario. Relay placement is the main factor to enjoy the usefulness of relay station benefits in the network and, therefore, we use the genetic algorithm to compute the optimum positions of a fixed number of relays. We have considered delay and maximum blind point coverage as two main criteria in relay station problem. The performance of the proposed method in outage reduction is investigated through simulations.

Electronic Cigarettes on Hospital Campuses

Directory of Open Access Journals (Sweden)

Clare Meernik

2015-12-01

Full Text Available Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121 to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62% completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.

Electronic Cigarettes on Hospital Campuses.

Science.gov (United States)

Meernik, Clare; Baker, Hannah M; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O

2015-12-29

Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.

Exploring Integrated Marketing Communications, Brand Awareness, and Brand Image in Hospitality Marketing: A Cross-Cultural Approach

OpenAIRE

Maja Šerić; Irene Gil Saura; Josip Mikulić

2016-01-01

Purpose – The purpose of this paper is to assess customer perceptions of integration of marketing communications, brand awareness, and brand image in hospitality. Moreover, cross-cultural differences are considered when evaluating all the concepts, since national culture can have a considerable impact on customer behavior. Design/Methodology/Approach – After a literature review of the examined concepts, the results of an empirical study are presented and discussed. The empirical investigat...

[Communication center in public health].

Science.gov (United States)

George, W; Grimminger, F; Krause, B

2002-06-01

The Communications Center's portfolio covers areas such as marketing, contacts, distribution of information, sales activities and collection of bills by telephone (encashment). A special emphasis is Customer Care Management (Customer Relationship Management) to the patient and his caregivers (relatives), the customers, especially the physicians who send their patients to the hospital and the hospital doctor. By providing communication centers, the hospital would be able to improve the communication with the G.P.s, and identify the wishes and requirements more accurately and easily from the beginning. Dealing effectively with information and communication is already also of special importance for hospital doctors today. One can assume that the demands on doctors in this respect will become even more complex in the future. Doctors who are involved in scientific research are of course fully aware of the growing importance of the Internet with its new information and communication channels. Therefore analysing the current situation, the demands on a future information management system can be formulated: A system that will help doctors to avoid dealing with little goal-oriented information and thus setting up effective communication channels; an information system which is multi-media oriented towards the interests and needs of the patients and patient's relatives and which is further developed continually and directly by those involved.

Communicating with the business community. A hospital launches two outreach efforts to educate community leaders.

Science.gov (United States)

Lofgren, C; Schieffer, T

1994-10-01

Several years ago the management of Saint Francis Medical Center in Peoria, IL, decided that, with healthcare issues becoming increasingly complex, the hospital needed to find ways to share information with its community. Saint Francis's outreach effort began in 1991 with the launching of a Leadership Roundtable. Under its auspices, local leaders in business, finance, government, education, religion, and the media gather once a month to hear hospital staff members outline some aspect of healthcare or healthcare reform. A question-and-answer period follows. In 1993 James Moore, a Saint Francis administrator, began writing a monthly column on healthcare reform for a business publication that serves central Illinois. Moore's column explains to businesspeople how various healthcare reform proposals could affect them. With the column, as with the Leadership Roundtable, Saint Francis has strengthened its communication with the community.

Evaluation of barriers contributing in the demonstration of an effective nurse-patient communication in educational hospitals of Jahrom, 2014.

Science.gov (United States)

Kargar Jahromi, Marzieh; Ramezanli, Somayeh

2014-06-30

Establishing an effective communication with patients is an essential aspect of nursing care. Nurse-patient communication has a key role in improving nursing care and increasing patient's satisfaction of health care system. The study aimed at evaluation of barriers contributing in the demonstration of an effective nurse-patient communication from their viewpoint. This was cross-sectional study, carried out in 2014, with a sample of 200 nurses and patients drawn from two educational hospitals in jahrom city. Data were collected by using two questionnaire structured by the researchers. Data were analyzed using SPSS software (version 16). The results of this study showed that the greatest barriers of nurse-patient communication were characteristics of nursing job with an average score of 71.05 ± 10.18. The most communication barriers from patients viewpoint including: heavy work load of the nurses, age , sex and language difference between patient and nurse and the spicy morality of nurses. It is concluded that overcome barriers to communication and support are needed to enable nurses to communicate therapeutically with patients in order to achieve care that is effective and responsive to their needs.

Total picture archiving communication system for medical use at medium-sized hospitals

International Nuclear Information System (INIS)

Kabata, Shun; Goto, Kazuhiko; Yamada, Kazumi; Okaniwa, Hiroshi.

1991-01-01

An increasingly widespread use of diagnostic imaging systems has seen a concomitant rise in the number of medical images. Picture archiving and communication system (PACS) allows filmless storage by digitizing images to record and store into the optical disk, and allows the rapid data retrieval and transmission. It is anticipated that PACS may be a promising approach to the medical routine practice. In January 1991, Hitachi PACS was introduced in Tokyo Hitachi Hospital. In this paper, the experience with PACS in the clinical setting is presented. The process of improvement in PACS is given in terms of the following: the flow of images, image deletion in the image workstation, and the number of sequential images to be observed. (N.K.)

AIDS knowledge and sexual activity among Flemish secondary school students: a multilevel analysis of the effects of type of education.

Science.gov (United States)

Van Rossem, Ronan; Berten, Hans; Van Tuyckom, Charlotte

2010-01-21

The behavior of adolescents puts them at an increased risk for HIV and other STIs, and their knowledge about HIV/AIDS is often inadequate. An understanding of how AIDS knowledge and sexual activity co-vary among Flemish secondary school students and of how education type, specifically, affects these students is limited. This study addresses the question of whether the effects of education type on HIV/AIDS knowledge and sexual activity are independent of the socio-demographic characteristics of the students. Data from the Flemish Educational Assessment survey, which collected data from a large representative sample of third- and fifth-grade high school students (N = 11,872), were used. Data were analyzed using multilevel logistic and Poisson regression techniques. There is an indication that type of education affects both an adolescent's sexual activity and his/her AIDS knowledge; these effects prove robust for differences in socio-economic backgrounds. Students in lower status education types are more likely to be sexually active and to have poorer AIDS knowledge. The relationship between AIDS knowledge and sexual activity is, however, more complex. Although students in education types with poorer AIDS knowledge are more sexually active, within each of these groups the sexually active have better AIDS knowledge than the non-sexually active. There is also evidence of active information seeking by sexually active students, which leads to improved AIDS knowledge. These findings are consistent with the literature on the role of the educational system in the reproduction of social inequalities. Students from lower status education types are at increased sexual risk compared to those from higher status types. There is also evidence of active information seeking by sexually active students, which leads to improved AIDS knowledge.

Low-Frequency Oceanographic Variability Near Flemish Cap and Sackville Spur

Science.gov (United States)

Layton, Chantelle; Greenan, Blair J. W.; Hebert, Dave; Kelley, Dan E.

2018-03-01

To address a need for science-based advice on issues of resource exploration, two oceanographic moorings were placed on the abyssal slope of northwest Flemish Cap from July 2013 to July 2014. These yielded some of the first long-term moored measurements of velocity, temperature, and salinity in the region. Hydrographic and lowered-ADCP measurements made during mooring deployment and recovery reveal that the deep Labrador Current flows approximately along isobaths between water depths of 1,200 and 2,200 m. However, these snapshots differ significantly, with stronger currents observed during the deployment survey. The mooring data, obtained near the 1,500 m isobath, reveal a complex temporal variation of the current. The velocity spectrum is dominated by a peak at a period of approximately 21 days, with power increasing with depth in the water column and varying through the year. In other boundary-current studies, variations in the several-week band have been attributed to baroclinic topographic Rossby waves, but with just two widely spaced moorings, we cannot infer the wave number and test for such waves using the dispersion relationship. However, an indirect estimate of wave number can be made by examining the variation of spectral power with depth, and doing this yields results that are reasonably consistent with a linear theory of baroclinic topographic Rossby waves for water of constant stratification over a planar slope. This agreement is somewhat surprising, given the simplicity of the theory and the complexity of the domain, but it appears to offer a clear indication of the importance of baroclinic vorticity dynamics in this region.

Homophobic Violence, Coping Styles, Visibility Management, and Mental Health: A Survey of Flemish Lesbian, Gay, and Bisexual Individuals.

Science.gov (United States)

D'haese, Lies; Dewaele, Alexis; Houtte, Mieke Van

2016-09-01

The understanding of how lesbians, gays, and bisexuals cope with homophobic violence is limited. Therefore, on the one hand, this study focuses on avoidance, problem-oriented, and emotion-oriented coping as general coping styles. On the other hand, special attention is paid to visibility management as a coping strategy that can be applied in a heteronormative context. Moreover, the moderating role of general coping styles and visibility management in the relationship between homophobic violence and negative mental health outcomes is studied. Data were collected from 1,402 Flemish lesbians, gays, and bisexuals. Stepwise regression analyses shows that coping styles and visibility management have a direct effect on mental health; however, no evidence for a moderating effect is found. Additionally, visibility management and emotion-oriented coping are found to exert a combined effect on mental health.

Shall I call, text, post it online or just tell it face-to-face? How and why Flemish adolescents choose to share their emotions on- or offline

OpenAIRE

Vermeulen, Anne; Vandebosch, Heidi; Heirman, Wannes

2017-01-01

Abstract: Social sharing of emotions is a frequently used emotion regulation strategy. This study adds to the emotion regulation literature and the affordances of technologies perspective by providing a better understanding of with whom adolescents share emotions on- and offline, how they do this and why they use certain modes. In-depth interviews with 22 Flemish adolescents (aged 1418) show that these youngsters share almost all experienced emotions, often with multiple recipients and using ...

Resident physicians' attitudes and confidence in communicating with patients: a pilot study at a Japanese university hospital.

Science.gov (United States)

Ishikawa, Hirono; Eto, Masato; Kitamura, Kiyoshi; Kiuchi, Takahiro

2014-09-01

This study aimed to explore the relationships among physicians' confidence in conducting medical interviews, their attitudes toward the patient-physician relationship, and undergraduate training in communication skills among resident physicians in Japan. Participants were 63 first-year resident physicians at a university hospital in Tokyo. The Physician Confidence in the Medical Interview scale (PCMI) was constructed based on the framework of the Calgary-Cambridge Guide. Additionally, participants' attitudes toward the patient-physician relationship (Patient-Practitioner Orientation Scale; PPOS), undergraduate experience of communication skills training, and demographic characteristics were assessed through a self-reported questionnaire. The internal consistency of the PCMI and PPOS scales were adequate. As expected from the undergraduate curriculum for medical interviews in Japan, residents had relatively higher confidence in their communication skills with respect to gathering information and building the relationship, whereas less confident about sharing information and planning treatment. The PCMI was associated with a more patient-centered attitude as measured by the PPOS. These scales could be useful tools to measure physicians' confidence and attitudes in communicating with patients and to explore their changes through medical education. Residency programs should consider including systematic training and assessment in communication skills related to sharing information and planning treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Do hospital physicians really want to go digital? Acceptance of a picture archiving and communication system in a university hospital

International Nuclear Information System (INIS)

Duyck, P.; Pynoo, B.; Devolder, P.; Voet, T.; Adang, L.; Vercruysse, J.

2008-01-01

Purpose: radiology departments are making the transition from analog film to digital images by means of PACS (Picture Archiving and Communication System). It is critical for the hospital that its physicians adopt and accept the new digital work method regarding radiological information. The aim of this study is to investigate hospital physicians' acceptance of PACS using questionnaires pre- and post-implementation and to identify main influencing factors. Materials and methods: the study was conducted in an 1169 bed university hospital. The UTAUT (Unified Theory of Acceptance and Use of Technology) questionnaire was administered at two times: one month pre-implementation (T1) and 1.5 years post-implementation (T2) of PACS, targeting all hospital physicians with the exemption of radiologists. The UTAUT scales (Behavioral Intention BI; Facilitating Conditions FC; Effort Expectancy EE; Performance Expectancy PE; Anxiety ANX; Social Influence SI; System Use USE; Attitude toward technology ATT; Self-Efficacy SE) were used to assess questions regarding: (a) PACS' usefulness, (b) PACS' ease of learning/using, (c) PACS support availability, (d) the perceived pressure to use PACS, (e) physicians' attitude towards PACS and (f) physicians' intention to use and actual use of PACS. Results: at T1 scale ratings were positive toward the PACS implementation. The ratings on all scales with the exception of self-efficacy improved at T2. Regression analysis revealed that the key factor for intention to use PACS at T1 was the usefulness of PACS, while the availability and awareness of support was its most important predictor at T2. Overall, PE was the best predictor of BI, but all four UTAUT-determinants (PE, FC, EE and SI) were salient for its prediction. Variance explained in BI ranged from 31 to 37% while variance explained in USE was very low (3%). (orig.)

Communicating with Professionals

Medline Plus

Full Text Available ... rushed than you (or your professionals) want. Simple communication skills can help you get what you need – ... at the hospital or during office visits. Good communication skills help you get better results from the ...

Communicating with Professionals

Medline Plus

Full Text Available ... than you (or your professionals) want. Simple communication skills can help you get what you need – over ... the hospital or during office visits. Good communication skills help you get better results from the time ...

A multiple linear regression analysis of factors affecting the simulated Basic Life Support (BLS) performance with Automated External Defibrillator (AED) in Flemish lifeguards.

Science.gov (United States)

Iserbyt, Peter; Schouppe, Gilles; Charlier, Nathalie

2015-04-01

Research investigating lifeguards' performance of Basic Life Support (BLS) with Automated External Defibrillator (AED) is limited. Assessing simulated BLS/AED performance in Flemish lifeguards and identifying factors affecting this performance. Six hundred and sixteen (217 female and 399 male) certified Flemish lifeguards (aged 16-71 years) performed BLS with an AED on a Laerdal ResusciAnne manikin simulating an adult victim of drowning. Stepwise multiple linear regression analysis was conducted with BLS/AED performance as outcome variable and demographic data as explanatory variables. Mean BLS/AED performance for all lifeguards was 66.5%. Compression rate and depth adhered closely to ERC 2010 guidelines. Ventilation volume and flow rate exceeded the guidelines. A significant regression model, F(6, 415)=25.61, p<.001, ES=.38, explained 27% of the variance in BLS performance (R2=.27). Significant predictors were age (beta=-.31, p<.001), years of certification (beta=-.41, p<.001), time on duty per year (beta=-.25, p<.001), practising BLS skills (beta=.11, p=.011), and being a professional lifeguard (beta=-.13, p=.029). 71% of lifeguards reported not practising BLS/AED. Being young, recently certified, few days of employment per year, practising BLS skills and not being a professional lifeguard are factors associated with higher BLS/AED performance. Measures should be taken to prevent BLS/AED performances from decaying with age and longer certification. Refresher courses could include a formal skills test and lifeguards should be encouraged to practise their BLS/AED skills. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[The Health Department of Sicily "Regional recommendations for hospital discharge and communication with patients after admission due to a cardiologic event" decree].

Science.gov (United States)

Abrignani, Maurizio Giuseppe; De Luca, Giovanni; Gabriele, Michele; Tourkmani, Nidal

2014-06-01

Mortality and rehospitalizations still remain high after discharge for an acute cardiologic event. In this context, hospital discharge represents a potential pitfall for heart disease patients. In the setting of care transitions, the discharge letter is the main instrument of communication between hospital and primary care. Communication, besides, is an integral part of high-quality, patient-centered interventions aimed at improving the discharge process. Inadequate information at discharge significantly affects the quality of treatment compliance and the adoption of lifestyle modifications for an effective secondary prevention. The Health Department of Sicily, in 2013, established a task force with the aim to elaborate "Regional recommendations for hospital discharge and communication with patients after admission due to a cardiologic event", inviting to participate GICR-IACPR and many other scientific societies of cardiology and primary care, as discharge letter and communication are fundamental junctions of care transitions in cardiology. These recommendations have been published as a specific decree and contain: a structured model of discharge letter, which includes all of the parameters characterizing patients at high clinical risk, high thrombotic risk and low risk according to the Consensus document ANMCO/GICR-IACPR/GISE; is thus possible to identify these patients, choosing consequently the most appropriate follow-up pathways. A particular attention has been given to the "Medication Reconciliation" and to the identification of therapeutic targets; an educational Kit, with different forms on cardiac diseases, risk factors, drugs and lifestyle; a check-list about information given to the patient and caregivers. The "Recommendations" represent, in conclusion, the practical realization of the fruitful cooperation between scientific societies and political-administrative institutions that has been realized in Sicily in the last years.

Het Gebruik van Internet Door Kleuters. [Flemish preschoolers online - A mixed-method approach to explore online use, preferences and the role of parents and siblings.

OpenAIRE

Teuwen, Jolien; De Grooff, Dirk; Zaman, Bieke

2012-01-01

Today'€™s children are growing up surrounded by digital media. However, there has been relatively little research on the media use and preferences of preschoolers. This paper reports upon a mixed-method study in which an online survey (n=451) was combined with in-home interviews with parents and show-and-tell observations with children (n=12 families). The aim of this study was to explore the Internet use of Flemish-speaking (Belgian) preschoolers aged two to six years old, who ha...

Relationship between communication manners of head nurses with job satisfaction of nurses under their supervision in educational hospitals of Isfahan University of Medical Sciences in 2006.

Science.gov (United States)

Dehaghani, Abdollah Rezaei; Hosseini, Habibollah; Tavakol, Khosrow; Bakhtiyari, Soheila

2010-01-01

Interpersonal communication is considered as an important and effective factor of job satisfaction and efficiency and has special significance in nursing career because of the face to face relationship with patients. This study aimed to determine the association between head nurses' interpersonal communication and job satisfaction of nurses under their supervision. The study was conducted in educational hospitals of Isfahan University of Medical Sciences in 2006. This was a descriptive and analytical study on 203 nursing personnel working in educational hospitals of Isfahan University of Medical Sciences in 2006. Data were collected using Job Descriptive Index (JDI) developed by Smith and Kendall and interpersonal communication was measured using a researcher-made questionnaire. Data were analyzed using SPSS software and Pearson's test and presented in tables and diagrams. The majority of the participants (148 subjects, 73%) believed that head nurses' interpersonal communication was excellent and in general Pearson's test showed a significant association between head nurses' interpersonal communication and their personnel's job satisfaction (p interpersonal communication of the head nurses and job satisfaction of their personnel, we can improve the job satisfaction of nursing personnel as well as patients' satisfactory and level of services by developing educational courses and workshops on importance and effectiveness of interpersonal communication for head nurses.

Clinical communication in diagnostic imaging studies: mixed-method study of pre- and post-implementation of a hospital information system.

Science.gov (United States)

Pirnejad, H; Niazkhani, Z; Bal, R

2013-01-01

To examine how and why the quality of clinical communication between radiologists and referring physicians was changed in the inpatient imaging process after implementation of a hospital information system (HIS). A mixed-method study of the chest X-ray (CXR) requests and reports, and their involved processes within a pre- and post-HIS implementation setting. Documentation of patient age, patient ward, and name and signature of requesting physician decreased significantly in post-HIS CXR requests (Pcommunication loop between physicians and radiologists after the implementation resulted in extra steps in the workflow and more workload for them. To cope with the new workload, they adopted different workarounds that could explain the results seen in the quantitative study. The HIS improved communication of administrative and identification information but did not improve communication of clinically relevant information. The reason was traced to the complications that the inappropriate implementation of the system brought to clinical workflow and communication loop.

Hospital Dermatology, Introduction.

Science.gov (United States)

Fox, Lindy P

2017-03-01

Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.

Evaluation of communication between physicians and patients in Astana City Hospital №1

Directory of Open Access Journals (Sweden)

Anara Zhumadilova

2014-01-01

Full Text Available Introduction: Communication between patients and health care providers is important for the effective functioning of health care systems. Miscommunication often stems from discrepancies in expectations of both healthcare professionals and patients due to cultural and historical influences. We investigated the degree to which health care providers (doctors and nurses and patients in Kazakhstan believe that interaction between doctors and patients should be doctor- or patient-oriented. Material and methods: We conducted a cross-sectional study of 163 patients and 176 health care providers (71 doctors and 105 nurses in a general hospital in Astana, Kazakhstan. The subjects completed a structured questionnaire containing the Patient-Practitioner Orientation Scale (PPOS, and scales assessing life and job satisfaction, effort-reward balance of healthcare professionals, and the patients’ perceptions of communication practices. Results: An overwhelming majority of doctors (81.7%, nurses (88.1%, and patients (92.3% were doctor-oriented. Among health care providers, PPOS was not associated with age, sex, life and job satisfaction, or effort-reward imbalance. Among patients, PPOS was not associated with age, sex, or specialty of health care provider. However, higher PPOS among patients (indicating preference for patient-oriented interaction was associated with higher satisfaction with communication with health care providers and, less strongly, with their life satisfaction. Conclusion: The main finding of this study is the very small proportion of doctors, nurses and patients who believe that interaction should be patient-oriented. These results highlight the necessity of improvement of communication among health care providers towards patient-oriented approach in order to decrease miscommunication with patients. The fact that most patients prefer doctor-oriented interaction may reflect historical stereotypes; educational/information interventions among

Hospitality lighting solutions communication framework

NARCIS (Netherlands)

Blanch, Anna

2014-01-01

Hospitality customers are looking for systems that involve more than just turning the light on and off. They want lighting solutions that are energy-efficient, flexible and that will help enhance the guest experience. Based on on-going research about the impact that light can have in different

Communicating with Professionals

Medline Plus

Full Text Available ... rushed than you (or your professionals) want. Simple communication skills can help you get what you need – over ... at the hospital or during office visits. Good communication skills help you get better results from the time ...

Smoking patterns, depression, and sociodemographic variables among Flemish women during pregnancy and the postpartum period.

Science.gov (United States)

De Wilde, Katrien S; Trommelmans, Leen C; Laevens, Hans H; Maes, Lea R; Temmerman, Marleen; Boudrez, Hedwig L

2013-01-01

Relationships among feelings of depression, smoking behavior, and educational level during pregnancy have been documented. Feelings of depression may contribute to persistent smoking during pregnancy. No longitudinal studies assessing feelings of depression in women with different antepartum and postpartum smoking patterns are available. The aim was to determine relationships between depressive symptoms, sociodemographic characteristics, and smoking pattern during and after pregnancy. An observational, prospective, noninterventional study was conducted. Data were collected during two stages of pregnancy (T0: postpartum (T2: >6 weeks) in 523 Flemish women. Feelings of depression (measured using the Beck Depression Inventory [BDI]), smoking behavior, and sociodemographic variables were analyzed using a general linear mixed model implemented in SAS Proc MIXED. Smokers and initial smokers reported significantly more depressive symptoms at all time points compared with recent ex-smokers, nonsmokers, and initial nonsmokers (p postpartum. Smoking patterns were associated with depression and showed complex interactions with educational level. Assessment and intervention for both smoking and depression are needed throughout the perinatal period to support the health of mothers, their infants, and families.

Access, use and preferences of information and communication technologies by physicians in a general hospital in Peru

OpenAIRE

Vásquez-Silva, Luis; Facultad de Medicina. Universidad Peruana Cayetano Heredia. Lima, Perú. Hospital Nacional Cayetano Heredia. Lima, Perú.; Ticse, Ray; Facultad de Medicina. Universidad Peruana Cayetano Heredia. Lima, Perú. Hospital Nacional Cayetano Heredia. Lima, Perú.; Alfaro-Carballido, Luz; Hospital Nacional Cayetano Heredia. Lima, Perú.; Guerra-Castañon, Felix; Facultad de Medicina. Universidad Peruana Cayetano Heredia. Lima, Perú. Hospital Nacional Cayetano Heredia. Lima, Perú.

2015-01-01

We assessed the access, use and preferences of information and communication technology (ICT) by physicians who practice at Cayetano Heredia National Hospital. The questionnaire explored the availability and skills of ICT, time, educational activities, search engines and technological applications most used as well as ICT preferences in education.211 physicians were surveyed; laptop use was 93%, tablet and smartphone use was 66% and 88%.68% havemobile Internet. Differences were evident in the...

Food recommendations, tradition and change in a Flemish cookbook: Ons Kookboek, 1920-2000.

Science.gov (United States)

Segers, Yves

2005-08-01

The first edition of Ons Kookboek (Our Cookbook), also known as 'the culinary bible of Flanders', was published in 1927 by the Belgian Women Farmers' Union. By 2000, an estimated 2.3 million copies had been sold. This exceptionally successful and long-running series of cookbooks represents a unique source of the history of Flemish cuisine and food culture. The aim of this article is to analyse how the food recommendations in Ons Kookboek changed during the past decades, parallel with the shrinking importance of the Belgian agricultural sector. Initially, the main goal of the editors was to overcome and to alter the monotonous nature of the rural menu through the giving of information about healthy, simple and inexpensive cooking, in which own produce occupied a central place. From the mid 1960s onwards, with the growing purchasing power and internationalisation of cooking, the content changed. Ons Kookboek was no longer only a basic cookbook with strictly didactic advice. The reader was given greater freedom and was encouraged to choose from a large culinary range, which resulted in contradictory recommendations. But notwithstanding all innovations, the link with the farming sector remained as the attitude towards a vegetarian or low-meat diet clearly demonstrates.

Predictors of Satisfaction With Doctor and Nurse Communication: A National Study.

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McFarland, Daniel C; Johnson Shen, Megan; Holcombe, Randall F

2017-10-01

Prior research indicates that effective communication between medical providers and patients is associated with a number of positive patient outcomes, yet little research has examined how ecological factors (e.g., hospital size, local demographics) influence patients' reported satisfaction with doctor and nurse communication. Given the current emphasis on improving patient satisfaction in hospitals across the United States, understanding these factors is critical to interpreting patient satisfaction and improving patient-centered communication, particularly in diverse and dense populations. As such, this study examined county-level data including population density, population diversity, and hospital structural factors as predictors of patient satisfaction with doctor and nurse communication. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), U.S. Census data, and number of hospital beds were obtained from publicly available Hospital Compare, U.S. Census, and American Hospital Directory websites, respectively. Multivariate regression modeling was performed for the individual dimensions of HCAHPS scores assessing doctor and nurse communication. Standardized partial regression coefficients were used to assess strengths of county-level predictors. County-level factors accounted for 30% and 16% of variability in patient satisfaction with doctor and nurse communication, respectively. College education (β = 0.45) and White ethnicity (β = 0.25) most strongly predicted a favorable rating of doctor and nurse communication, respectively. Primary language (non-English speaking; β = -0.50) most strongly predicted an unfavorable rating of doctor communication, while number of hospital beds (β = -0.16) and foreign-born (β = -0.16) most strongly predicted an unfavorable rating of nurse communication. County-level predictors should be considered when interpreting patient satisfaction with doctor and nurse communication and designing

Mobile Display of Information about Aggregated Antibiotic Resistance in the Hospital Setting Supported by Near Field Communication.

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Meng, Philipp; Fehre, Karsten; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

2014-01-01

Antibiotic resistance is a heterogeneous phenomenon. It does not only differ between countries or states, but also between wards of hospitals, where different resistance patterns have been found. To support clinicians in administering empiric antibiotic therapy, we developed software to present information about antibiotic resistance using a mobile concept. A pre-existing infrastructure was deployed as the server component. The systems analyze and aggregate data from laboratory information systems, generating statistical data on antibiotic resistance. The information is presented to the Android client using a Representational State Transfer (REST) interface. Geographical localization is performed using near field communication (NFC) tags. The prototype provides tabulated data concerning antibiotic resistance patterns in the wards of a hospital. Using Android, NFC, and data caching, the usability of the system is estimated to be high. We hypothesize that antibiotic stewardship in hospitals can be supported by this software, thus improving medical monitoring of antibiotic resistance. Future studies in a productive environment are needed to measure the impact of the system on the outcome of patient care.

Self-reported "communication technology" usage in patients attending a cardiology outpatient clinic in a remote regional hospital.

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Gandiya, Tariro; Dua, Anahita; King, Gerry; Mazzocco, Thomas; Hussain, Amir; Leslie, Stephen J

2012-04-01

This study assessed the perceived usage of, and attitudes toward, communication technologies (mobile phone and texting, e-mail, and the World Wide Web) in patients attending a cardiology clinic with a view to guiding future health service redesign. This was performed in a remote regional hospital serving both urban and rural populations. A self-completion questionnaire was completed by a convenience sample of 221 patients attending a general cardiology clinic. The questions asked about patients' access to and use of technology at home. Data collected also included age, gender, travel time to the clinic, mode of travel, and whether the respondent was accompanied to the clinic. Appropriate statistical tests were used with significance taken at the 0.05 level. Age was the strongest predictor of use of communication technologies, with younger patients more likely to use e-mail, Web, mobile phone, and texting. However, frequency of use of e-mail was not related to age. It is encouraging that over 99% of patients used at least one communication technology. This study has highlighted that there may be several potential barriers to the widespread implementation of communication technologies in general cardiology patients. Cognizance should be taken of these findings when attempting service redesign.

Diffuse emissions of PCDD/F and dioxin-like PCB from industrial sources in the Flemish region (Belgium)

Energy Technology Data Exchange (ETDEWEB)

Francois, F.; Blondeel, M.; Bernaert, P.; Baert, R. [Ministry of the Flemish Community - Environmental Inspection Section, Brussels (Belgium)

2004-09-15

In Belgium, and especially in the Flemish region, the contamination of the environment and food chain with PCDD/F and PCB has been a major public concern during the past decade. The largest point sources of PCDD/F emissions have been monitored and tackled by the Environment Inspection Section (EIS) since 1993. This has caused a very significant emission reduction, which in its turn had a considerable impact on lowering the environmental and food PCDD/F levels, both in the immediate surroundings of the sources and on a regional scale. However, at a few measurement locations, levels of PCDD/F in deposition samples and in cow's milk remained increased despite the stack emission reduction of nearby sources. Recently, also increased dioxinlike PCB levels were found at some locations. This has led to an investigation of the contribution of diffuse emission sources, revealing the importance of such sources at particular plants, mainly in the non-ferrous metal and scrap metal sectors.

A Model for QoS – Aware Wireless Communication in Hospitals

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Alavikia, Zahra; Khadivi, Pejman; Hashemi, Masoud Reza

2012-01-01

In the recent decade, research regarding wireless applications in electronic health (e-Health) services has been increasing. The main benefits of using wireless technologies in e-Health applications are simple communications, fast delivery of medical information, reducing treatment cost and also reducing the medical workers’ error rate. However, using wireless communications in sensitive healthcare environment raises electromagnetic interference (EMI). One of the most effective methods to avoid the EMI problem is power management. To this end, some of methods have been proposed in the literature to reduce EMI effects in health care environments. However, using these methods may result in nonaccurate interference avoidance and also may increase network complexity. To overcome these problems, we introduce two approaches based on per-user location and hospital sectoring for power management in sensitive healthcare environments. Although reducing transmission power could avoid EMI, it causes a number of successful message deliveries to the access point to decrease and, hence, the quality of service requirements cannot be meet. In this paper, we propose the use of relays for decreasing the probability of outage in the aforementioned scenario. Relay placement is the main factor to enjoy the usefulness of relay station benefits in the network and, therefore, we use the genetic algorithm to compute the optimum positions of a fixed number of relays. We have considered delay and maximum blind point coverage as two main criteria in relay station problem. The performance of the proposed method in outage reduction is investigated through simulations. PMID:23493832

Unsettled teamwork: communication and learning in the operating theatres of an urban hospital.

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Bezemer, Jeff; Korkiakangas, Terhi; Weldon, Sharon-Marie; Kress, Gunther; Kneebone, Roger

2016-02-01

To explore the unsettling effects of increased mobility of nurses, surgeons and other healthcare professionals on communication and learning in the operating theatre. Increasingly, healthcare professionals step in and out of newly formed transient teams and work with colleagues they have not met before, unsettling previously relatively stable team work based on shared, local knowledge accumulated over significant periods of close collaboration. An ethnographic case study was conducted of the operating theatre department of a major teaching hospital in London. Video recordings were made of 20 operations, involving different teams. The recordings were systematically reviewed and coded. Instances where difficulties arose in the communication between scrub nurse and surgeons were identified and subjected to detailed, interactional analysis. Instrument requests frequently prompted clarification from the scrub nurse (e.g. 'Sorry, what did you want?'). Such requests were either followed by a relatively elaborate clarification, designed to maximize learning opportunities, or a by a relatively minimal clarification, designed to achieve the immediate task at hand. Significant variation exists in the degree of support given to scrub nurses requesting clarification. Some surgeons experience such requests as disruptions, while others treat them as opportunities to build shared knowledge. © 2015 John Wiley & Sons Ltd.

Comparative Effectiveness of Disease Management With Information Communication Technology for Preventing Hospitalization and Readmission in Adults With Chronic Congestive Heart Failure.

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Aronow, Wilbert S; Shamliyan, Tatyana A

2018-06-01

Critical appraisal of all available evidence regarding the role of noninvasive communication technology for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). Systematic literature review and grading of the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach. Four databases were searched in March 2018 to find 2 high-quality meta-analyses and published and unpublished data from 58 randomized controlled trials (RCTs) that compared noninvasive communication technology with usual care in community-dwelling adults with HF. Direct meta-analysis of aggregate data with random effects models. Moderate-quality evidence suggests that there are no differences in all-cause mortality between telemonitoring and usual care, whereas complex telemonitoring that includes transmission of patient parameters and analysis by health care professionals decreases all-cause mortality (relative risk [RR] 0.78, 95% confidence interval [CI] 0.62, 0.99; 2885 people in 12 RCTs). Moderate-quality evidence suggests that telemonitoring prevents HF-related hospitalizations (RR 0.74; 95% CI 0.62, 0.88; 4001 people in 11 RCTs). Moderate-quality evidence suggests that structured telephone support decreases all-cause mortality (RR 0.86; 95% CI 0.77, 0.97; 9535 people in 24 RCTs) and HF-related hospitalizations (RR 0.83; 95% CI 0.73, 0.94; 7030 people in 16 RCTs). Use of a mobile personal digital assistant prevents HF-related hospitalizations (RR 0.58; 95% CI 0.44, 0.77; 674 people in 3 RCTs). The evidence regarding the comparative effectiveness of specific telecommunication devices is insufficient. The results from many completed studies are not available. Clinicians should offer noninvasive monitoring with communication technology applications to all HF patients. Future research should examine comparative effectiveness of technology applications in patient subpopulations

Episodic Sediment Failure in Northern Flemish Pass, Eastern Canadian Margin: Interplay of Seismicity, Contour Current Winnowing, and Excess Pore Pressures

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Piper, D.

2015-12-01

Episodic sediment failures are recognised on continental slopes around Flemish Pass and Orphan Basin from multibeam bathymetry, seismic reflection profiles and piston cores. Seismic stratigraphy is tied to published long cores with O-isotope data back to before MIS 6 and carbonate rich Heinrich layers in places produce marker reflections in high-resolution sparker profiles. Heinrich layers, radiocarbon dates and peaks in diatom abundance provide core chronology. Slope sedimentation was strongly influenced by the Labrador Current and the silty muds show architecture characteristic of contourites. Variation in Labrador Current strength is known from the sortable silt proxy over the past 125 ka. Large slope failures were mapped from seismic reflection profiles and their age estimated from seismic stratigraphy (3-5 ka resolution) and in some cases refined from cores (1-3 ka resolution). Large slope failures occurred apparently synchronously over margin lengths of 50-350 km. Such failures were earthquake triggered: other mechanisms for producing laterally extensive synchronous failure do not apply. Triaxial shear measurements show a Su/σ' ratio of typical slope sediment of 0.48, implying considerable stability. However, some silty muds have Atterberg limits that suggest susceptibility to liquefaction under cyclic loading, particularly in Holocene deposits and by analogy those of past full interglacials. Basal failure planes of some large failures correspond with either the last interglacial or the MIS 6 glacial maximum. Comparison with seismological models suggests that the observed slope failures represent earthquakes ranging from Mw ~5.6 to ~7.6. Mean recurrence interval of M = 7 earthquakes at any point on the margin is estimated at 30 ka from seismological models and 40 ka from the sediment failure record. In northern Flemish Pass, a spatial cluster of several failures over 30 ka preceded by a long interval with no failures suggests that some other mechanism has

Predictive factors of mother-child communication patterns in the mothers referred to Khorramabad Shahid Madani hospital in 2012

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khatereh Anbari

2014-03-01

Full Text Available Background : The quality of mother-child relationship play an important role in personality shaping, social functioning and mental health of children in the future . This study was designed to evaluate the prognostic factors of mother - child relationship patterns.   Materials and Methods: In this cross sectional study 110 mothers admitted to children's hospital of Khorramabad selected by consecutive sampling method. Data gathering tool was Mother - Child Relationship Evaluation (MCRE questionnaire. At first the view points of the mothers about four communication patterns including: over protection, child rejection, overneglignce and child acceptance were examined, then according to each pattern cut off, the type of communication pattern was determined. Fisher's exact test and linear regression were used for data analysis.   Results: The mean age of participants was 28.6±6.46. Communication pattern in 66.4% of the mothers was over protection and 19.1% of them had overneglence pattern. Also communication pattern in 12.8% of the participants was child acceptance and 1.8% followed from child rejectoin communication pattern. A significant statistical relation was seen between age, education level, marital status, mothers residence and pregnancy status with the pattern of their relationship (P <0.05. In linear regression analysis, most important factors in predicting the communication pattern were single parent and unplanned pregnancy.   Conclusion: Raising awareness of mothers through workshops can increase proper child skills and led to the development of social skills and reducing child behavior problems in the future.

[Access, use and preferences of Information and Communication Technologies by physicians in a general hospital in Peru].

Science.gov (United States)

Vásquez-Silva, Luis; Ticse, Ray; Alfaro-Carballido, Luz; Guerra-Castañon, Felix

2015-01-01

We assessed the access, use and preferences of information and communication technology (ICT) by physicians who practice at Cayetano Heredia National Hospital. The questionnaire explored the availability and skills of ICT, time, educational activities, search engines and technological applications most used as well as ICT preferences in education.211 physicians were surveyed; laptop use was 93%, tablet and smartphone use was 66% and 88%.68% have mobile Internet. Differences were evident in the frequency of use of ICT in 25-34 year old age group as well as a higher level of skills (pWhatsApp as a means of exchanging images and data related to health, 50% participated in medical blogs, online courses or videoconferences. The use and access of ICT is common among doctors in this hospital and there is positive interest in its use in education.

Exploring strategies to improve the health promotion orientation of Flemish sports clubs.

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Meganck, Jeroen; Seghers, Jan; Scheerder, Jeroen

2017-08-01

Sports clubs are increasingly recognized as an innovative setting for health promotion, as exemplified by the health promoting sports club concept. This study aims to assess the health promotion orientation of both youth sports clubs (YSC) and adult sports clubs (ASC) in Flanders and to identify the motives and barriers as reported by their representatives as a basis for proposing intervention strategies to improve the health promotion orientation in sports clubs. A total of 253 Flemish sports clubs, consisting of 156 YSC and of 97 ASC, completed the online questionnaire, covering club characteristics (e.g. finances, human resources), perceived motives and barriers for health promotion and the health promoting sports club index. Even though YSC were more health promoting than ASC, the results indicated that all sports clubs could improve their health promotion orientation. The most consistent predictors of health promotion orientation are perceived motives index for YSC and perceived lack of resources for ASC. Based on these results, interventions to enhance the health promoting orientation need to tackle the lack of resources such as lack of expertise regarding health promotion. Interventions aimed specifically at YSC should emphasize the direct benefits, for example by demonstrating how health promotion helps clubs to improve the provision of high quality sports participation and by awarding a health promotion quality label. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assessing the effectiveness of interpersonal communication skills training on job satisfaction among nurses in Al-Zahra Hospital of Isfahan, Iran.

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Dehaghani, Abdollah Rezaei; Akhormeh, Kobra Ahmadi; Mehrabi, Tayyebeh

2012-05-01

The worldwide nursing shortage is threatening the quality of healthcare. The two most common causes in maintaining nurses are job satisfaction, a positive working environment, and good relationships among staff. This study aimed to determine the effect of interpersonal communication skills training on job satisfaction among the nurses working in Al-Zahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in 2011. This study was a quasi-experimental research with two groups and two phases, and was carried out on 70 nurses from Al-Zahra University Hospital. Only nurses who had been employed for more than one year were accepted into the study. There were 35 nurses in the test group and 35 nurses in the control group. The study questionnaire included personal details and job satisfaction scale by Smith and Kendall. Sampling was done randomly and nurses were divided into test and control groups. In the test group, the communication skills training program was done in 6 sessions, twice a week and each session was held for 2 hours. The questionnaire was completed in two stages; before, and two months after the study. Data were analyzed by descriptive and inferential statistics through SPSS Software version 18. Findings showed that pre-intervention mean score of job satisfaction of nurses in both groups had no significant difference (p = 0.92). After the communication skills training program in the experimental group, mean score of job satisfaction increased and it was significant compared to the control group (p interpersonal communication skills training program increased the mean score of job satisfaction in the test group. Therefore, it seems necessary that nursing managers design training programs for them.

The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol.

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Newell, Stephanie; Jordan, Zoe

2015-01-01

care. However, current methods used to collect and use information from patients about their care is often retrospective, provides inadequate real time data and is not effective in creating action to produce change at the individual patient level. Methods which focus on including the patient and their information in real-time are considered by many to be crucial to the advancement of improved health outcomes and the reduced costs that are required of health care to be sustainable. One such method is patient-centered communication.The nurse-patient interaction is a core component of nursing science and high quality nursing care. Fleisher et al. contend that 'the main intention of communication and interaction, in the health setting, is to influence the patient's health status or state of well-being'. As a profession, nursing predominately requires communicating with, and relating to, patients at the individual level. In the hospital setting nurses undertake many of their patient related duties in a face-to-face manner with the patient at the bedside and these moments can facilitate effective interaction to occur between the nurse and the patient, which is patient-centered. McCabe et al. state that patient-centered communication as "defined by Langewitz et al. as 'communication that invites and encourages the patient to participate and negotiate in decision-making regarding their own care'.''However, qualitative studies by McCabe and Wellard et al, highlighted that nurses interact with patients only when performing administrative or functional activities and nursing 'practice was predominately task-orientated'. The outcome of these studies are supported by Maurer et al. in their report on the tools and strategies available to support patient and family engagement in the hospital setting. Maurer et al. identified that current strategies 'are not attuned to patient and family member experiences of hospitalization' and that most tools and strategies were 'more reflective of

The lived experiences of flemish midwifery students undertaking an internship in Suriname: A phenomenological study.

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Hilde, Curinckx; Marion, Welsh; Marianne, Nieuwenhuijze

2018-05-01

The aim of this study is to explore the lived experience of Flemish midwifery students undertaking an internship in Suriname. Hermeneutic phenomenological method as described by van Manen. Seven midwifery students from one University College were selected purposefully for an in-depth interview during their internship abroad within the period October-November 2014. All interviews were audio-taped, transcribed verbatim and analysed thematically. The study revealed five overarching themes: (1) A time to reconsider the time, (2) a time of connection and disconnection, (3) spatiality for thought and rethinking, (4) a body to undergo or a body to respond and (5) the other(s) among the others. The experience of an internship in Suriname presents itself in each individual as: 'A process of awareness from the self with a main focus on the professional'. Meaning that it was a process of 'disconnection' from their own culture towards 'connection' with another culture. Both, the 'rethinking' of their role as a midwife, as well as, balancing between guarding one's own authenticity by 'responding' or being the friendly stranger through 'undergoing', was noticeably striking. Copyright © 2018 Elsevier Ltd. All rights reserved.

Short Communication - Hospital-Based Mortality in Federal Capital ...

African Journals Online (AJOL)

Background: Cause-specific mortality data are important to monitor trends in mortality over time. Medical records provide reliable documentation of the causes of deaths occurring in hospitals. This study describes all causes of mortality reported at hospitals in the Federal Capital Territory (FCT) of Nigeria. Methods: Deaths ...

Barriers and strategies for improving communication between inpatient and outpatient mental health clinicians.

Science.gov (United States)

Stockdale, Susan E; Sherin, Jonathan E; Chan, Jeffrey A; Hermann, Richard C

2011-11-01

To explore hospital leaders' perceptions of organisational factors as barriers and/or facilitators in improving inpatient-outpatient (IP-OP) communication. Semistructured in-person interviews. Constant comparative method of qualitative data. Inpatient psychiatry units in 33 general medical/surgical and specialty psychiatric hospitals in California and Massachusetts (USA). Psychiatry chair/chief, service director or medical director. Importance to leadership, resources, organisational structure and culture. A majority of hospital leaders rated the IP-OP communication objective as highly or moderately important. Hospitals with good IP-OP communication had structures in place to support communication or had changed/implemented new procedures to enhance communication, and anticipated clinicians would 'buy in' to the goal of improved communication. Hospitals reporting no improvement efforts were less likely to have structures supporting IP-OP communication, anticipated resistance among clinicians and reported a need for technological resources such as electronic health records, integrated IT and secure online communication. Most leaders reported a need for additional staff time and information, knowledge or data. For many hospitals, successfully improving communication will require overcoming organisational barriers such as cultures not conducive to change and lack of resources and infrastructure. Creating a culture that values communication at discharge may help improve outcomes following hospitalisation, but changes in healthcare delivery in the past few decades may necessitate new strategies or changes at the systems level to address barriers to effective communication.

We need to talk: an observational study of the impact of electronic medical record implementation on hospital communication.

Science.gov (United States)

Taylor, Stephanie Parks; Ledford, Robert; Palmer, Victoria; Abel, Erika

2014-07-01

Increasing attention is being given to the importance of communication in the delivery of high-quality healthcare. We sought to determine whether communication improved in a hospital setting following the introduction of an electronic medical record (EMR). This pre-post cohort design enrolled 75 patient-nurse-physician triads prior to the introduction of EMR, and 123 triads after the introduction of EMR. Nurses and patients reported whether they communicated with the physician that day. Patients, nurses and physicians answered several questions about the plan of care for the day. Responses were scored for degree of agreement and compared between pre-EMR and post-EMR cohorts. The primary outcome was Total Agreement Score, calculated as the sum of the agreement responses. Chart review was performed to determine patients' actual length of stay. Although there was no difference between the frequency of nurses reporting communication with physicians before and after EMR, face-to-face communication was significantly reduced (67% vs 51%, p=0.03). Total Agreement Score was significantly lower after the implementation of EMR (p=0.03). Additionally, fewer patients accurately predicted their expected length of stay after EMR (34% vs 26%, p=0.001). The implementation of EMR was associated with a decrease in face-to-face communication between physicians and nurses, and worsened overall agreement about the plan of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Integration of Parent and Nurse Perspectives of Communication to Plan Care for Technology Dependent Children: The Theory of Shared Communication.

Science.gov (United States)

Giambra, Barbara K; Broome, Marion E; Sabourin, Teresa; Buelow, Janice; Stiffler, Deborah

The purpose of this qualitative research study was to expand our understanding of the process of communication between parents of hospitalized technology dependent children and their nurses originally detailed in the Theory of Shared Communication (TSC). This grounded theory study was conducted with five parents of technology dependent children hospitalized in a large Midwestern children's hospital and nine nurses who care for technology dependent children admitted to the same hospital during July and August 2013. Semi-structured interviews and journals (parents only), field notes and a demographic survey were used to collect data which was analyzed using constant comparative analysis. Parents verified the concepts of the TSC and relationships among them. Nurses' perceptions of communication with parents reflected the same parent identified and verified concepts upon which the TSC was originally grounded including respect for own and other's expertise, asking, listening, explaining, advocating, verifying understanding and negotiating roles to achieve mutual understanding of the child's plan of care. The nurses' perceptions differed stylistically but not categorically from those of the parents. The addition of the nurse's perspectives to the verified TSC expands our understanding of this process of communication. With the integration of nurse and parent perspectives, the TSC can be used to enhance communication and care for hospitalized technology dependent children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

Post-divorce custody arrangements and binuclear family structures of Flemish adolescents

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An Katrien Sodermans

2013-03-01

Full Text Available BACKGROUND Because of the tendency towards equal parental rights in post-divorce custody decisions, the number of children living partially in two households after divorce has increased. Because of this evolution, traditional family typologies have been challenged. OBJECTIVE In this study, we want to describe the post-divorce custody arrangements and family configurations of Flemish adolescents (between 12 and 18 years old. METHODS We use four waves of the Leuven Adolescents and Families Study, a yearly survey in which adolescents are questioned at school about their family life, family relationships and various dimensions of their wellbeing. Our research sample consists of 1525 adolescents who experienced a parental break-up. First, we present information on the proportion of adolescents in different custody arrangements, according to divorce cohort, age and sex. Next, we describe post-divorce family configurations, according to the custody arrangement and different criteria of co-residence between children and step-parents. RESULTS We observe a higher proportion of adolescents spending at least 33Š of time in both parental households (shared residence for more recent divorce cohorts. A large proportion of adolescents is living with a new partner of the mother or father, but there are important differences, according to the criteria used to define stepfamily configurations. CONCLUSIONS The relatively high incidence figures of children in shared residence challenge the current dichotomous post-divorce family concept in terms of single parent families and stepfamilies. Family typologies applying a binuclear perspective are therefore increasingly meaningful and necessary. In addition, shared residence increases the chance of co-residence with at least one step-parent, and increases the proportion of children with a part-time residential stepmother.

THE INFORMATION AND COMMUNICATION TECHNOLOGY – IMPACT ON THE HOSPITALITY INDUSTRY IN ROMANIA

Directory of Open Access Journals (Sweden)

Daniela FIROIU

2015-02-01

Full Text Available In the context of an increasingly dynamic society, globalization has become one of the key issues, causing important changes in the evolution of all economic sectors and especially in the development of the tourism industry, an industry that depends heavily on the free movement of people and unhindered access to information. Although the implications of the globalization phenomenon on tourism are extremely diverse and profound, sometimes difficult to commensurate, the evolution of the information and communication technology is currently outlining the main directions of the global economy through the accelerated pace of innovation. The hospitality industry requires a high level of adaptability to the demands of the tourist market, and the information and communication technology represents an efficient tool for increasing the degree of correlation between tourist supply and clients' demands, thus turning into a real progress bond. Improving the efficiency of this sector's activity becomes one of the primary issues on an increasingly dynamic global market, the changes regarding the distribution channel, the marketing services and the customer relationship management representing the key elements in this respect. In this context, the hotel market in Romania acquires new dimensions, its performance depending on the strong influence that the implementation of the newest informational technologies has on it, determining important changes at both the management and the operational level.

Keeping primary care "in the loop": General practitioners want better communication with specialists and hospitals when caring for people diagnosed with cancer.

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Lizama, Natalia; Johnson, Claire E; Ghosh, Manonita; Garg, Neeraj; Emery, Jonathan D; Saunders, Christobel

2015-06-01

To investigate general practitioners' (GP) perceptions about communication when providing cancer care. A self-report survey, which included an open response section, was mailed to a random sample of 1969 eligible Australian GPs. Content analysis of open response comments pertaining to communication was undertaken in order to ascertain GPs' views about communication issues in the provision of cancer care. Of the 648 GPs who completed the survey, 68 (10%) included open response comments about interprofessional communication. Participants who commented on communication were a median age of 50 years and worked 33 h/week; 28% were male and 59% practiced in the metropolitan area. Comments pertaining to communication were coded using five non-mutually exclusive categories: being kept in the loop; continuity of care; relationships with specialists; positive communication experiences; and strategies for improving communication.GPs repeatedly noted the importance of receiving detailed and timely communication from specialists and hospitals, particularly in relation to patients' treatment regimes and follow-up care. Several GPs remarked that they were left out of "the information loop" and that patients were "lost" or "dumped" after referral. While many GPs are currently involved in some aspects of cancer management, detailed and timely communication between specialists and GPs is imperative to support shared care and ensure optimal patient outcomes. This research highlights the need for established channels of communication between specialist and primary care medicine to support greater involvement by GPs in cancer care. © 2015 Wiley Publishing Asia Pty Ltd.

A Novel Survey to Examine the Relationship Between Health IT Adoption and Nurse-Physician Communication

Science.gov (United States)

Pfeifer, Eric; Manojlovich, Milisa; Adler-Milstein, Julia

2016-01-01

Summary Background As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are theoretically available to facilitate physician-nurse communication, but we know little about the adoption rate of specific technologies or the impact of their use. Objectives To measure adoption of hardware, software, and telephony relevant to nurse-physician communication in US hospitals. To assess the relationship between non-IT communication practices and hardware, software, and telephony adoption. To identify hospital characteristics associated with greater adoption of hardware, software, telephony, and non-IT communication practices. Methods We conducted a survey of 105 hospitals in the National Nursing Practice Network. The survey captured adoption of hardware, software, and telephony to support nurse-physician communication, along with non-IT communication practices. We calculated descriptive statistics and then created four indices, one for each category, by scoring degree of adoption of technologies or practices within each category. Next, we examined correlations between the three technology indices and the non-IT communication practices index. We used multivariate OLS regression to assess whether certain types of hospitals had higher index scores. Results The majority of hospitals surveyed have a range of hardware, software, and telephony tools available to support nurse-physician communication; we found substantial heterogeneity across hospitals in non-IT communication practices. More intensive non-IT communication was associated with greater adoption of software (r=0.31, p=0.01), but was not correlated with hardware or telephony. Medium-sized hospitals had lower adoption of software (r =-1.14,p=0.04) in comparison to small hospitals, while federally-owned hospitals had lower software (r=-2.57, p=0.02) and hardware adoption (r=-1.63, p=0.01). Conclusions The positive relationship between non-IT communication and level of software adoption suggests that

Effect of interaction with clowns on vital signs and non-verbal communication of hospitalized children.

Science.gov (United States)

Alcântara, Pauline Lima; Wogel, Ariane Zonho; Rossi, Maria Isabela Lobo; Neves, Isabela Rodrigues; Sabates, Ana Llonch; Puggina, Ana Cláudia

2016-12-01

Compare the non-verbal communication of children before and during interaction with clowns and compare their vital signs before and after this interaction. Uncontrolled, intervention, cross-sectional, quantitative study with children admitted to a public university hospital. The intervention was performed by medical students dressed as clowns and included magic tricks, juggling, singing with the children, making soap bubbles and comedic performances. The intervention time was 20minutes. Vital signs were assessed in two measurements with an interval of one minute immediately before and after the interaction. Non-verbal communication was observed before and during the interaction using the Non-Verbal Communication Template Chart, a tool in which nonverbal behaviors are assessed as effective or ineffective in the interactions. The sample consisted of 41 children with a mean age of 7.6±2.7 years; most were aged 7 to 11 years (n=23; 56%) and were males (n=26; 63.4%). There was a statistically significant difference in systolic and diastolic blood pressure, pain and non-verbal behavior of children with the intervention. Systolic and diastolic blood pressure increased and pain scales showed decreased scores. The playful interaction with clowns can be a therapeutic resource to minimize the effects of the stressing environment during the intervention, improve the children's emotional state and reduce the perception of pain. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

A hospital-wide picture archiving and communication system (PACS): the views of users and providers of the radiology service at Hammersmith Hospital

International Nuclear Information System (INIS)

Watkins, Jessamy

1999-01-01

Objective: To obtain users' views of the new picture archiving and communication system (PACS) from clinical and radiological staff at Hammersmith Hospital, UK. Methods: Semi-structured interviews were used to ascertain the views of staff, following an interview schedule which covered aspects of: (1) their use of PACS, (2) facilities available, (3) the perceived quality of images, (4) reporting, (5) image availability, (6) image accessibility, (7) training, and (8) ease of use of PACS. Results: Interviews were carried out with 34 key users and providers of the radiological service at Hammersmith Hospital. Overall, staff were very satisfied with PACS particularly in terms of image availability. All staff said that they preferred PACS to the previous, conventional radiology service. Conclusions: The key implications of issues raised by staff were: the impact of 'down-time' and the importance of an efficient back-up system, the requirement for sufficient short-term storage to prevent images being off-line during clinical situations, the usefulness of the folder system for management of the images, the need to access images for teaching purposes, the advantage of having a default display protocol to facilitate radiological reporting, and the requirement for flexible, yet effective, training to ensure that the system is utilised to its full potential by users

Communication that heals: mindful communication practices from palliative care leaders.

Science.gov (United States)

Omilion-Hodges, Leah M; Swords, Nathan M

2016-01-01

Though research has begun to highlight the centrality of communication in palliative care, studies have yet to focus on the use of mindful communication. Mindful communication is associated with increases in patient care and decreases in physician burnout. Through in-depth, semi-structured interviews the authors sought mindful communication practices from palliative care leaders in American Hospital Association Circle of Life® award-wining units. Four key mindful communication practices emerged: Know your audience, ask questions, discard scripts, and recognize your role. The discussion articulates how key mindful communication practices may be used as a stage model, where key practices may be used individually or in concert, by sole practitioners or within interdisciplinary teams and by new and seasoned clinicians. Theoretical contributions and areas for future inquiry are also discussed.

Exploring Integrated Marketing Communications, Brand Awareness, and Brand Image in Hospitality Marketing: A Cross-Cultural Approach

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Maja Šerić

2016-12-01

Full Text Available Purpose – The purpose of this paper is to assess customer perceptions of integration of marketing communications, brand awareness, and brand image in hospitality. Moreover, cross-cultural differences are considered when evaluating all the concepts, since national culture can have a considerable impact on customer behavior. Design/Methodology/Approach – After a literature review of the examined concepts, the results of an empirical study are presented and discussed. The empirical investigation was carried out by approaching 475 guests of upscale Croatian hotels. The SPSS software was employed for data analysis. Findings and implications – The results indicate that hotel guests assessed integrated marketing communications fairly highly. Brand image also reached relatively high scores, while the level of awareness of the brand was more moderate. Significant differences in perceptions among three delimited groups according to their national culture were found. The findings suggest that hotel managers should increase brand awareness and consider cross-cultural differences when implementing their business strategies. Limitations – A greater number of hotel guests according to their national culture should be approached to obtain more representative subsamples. Originality – The contribution of this work lies in examining three key marketing variables from the consumer point of view and under a cross-cultural approach. In particular, there has been little empirical evidence on IMC perceptions from the consumer perspective and hardly any considering the cultural background of the respondents. The contribution is also made to the hotel environment, as the variables were examined from the cross-cultural perspective, an issue that was completely neglected in the literature on hospitality marketing to date.

Use of foreign-educated nurses and patient satisfaction in U.S. hospitals.

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Mazurenko, Olena; Menachemi, Nir

2016-01-01

In the context of value-based purchasing, this study examines the association between the utilization of foreign-educated registered nurses (RNs) and patient satisfaction among U.S. acute care hospitals. We utilized data from the Hospital Consumer Assessment of Healthcare Providers and Systems to measure patient satisfaction and data from the American Hospital Association regarding the utilization of foreign-educated RNs in 2012. In this study, a cross-sectional design with propensity score adjustment to examine the relationship between use of foreign-educated nurses and 10 patient satisfaction outcome measures. Control variables include hospital size, ownership, geographic location, teaching status, system membership, a high-technology index, and U.S. region based on census categories. The utilization of foreign-educated RNs was negatively and significantly related to six patient satisfaction measures. Specifically, hospitals with foreign-educated RNs scored, on average, lower on measures related to nurse communication (β = -0.649, p = .01), doctor's communication (β = -0.837, p ≤ .001), communication about administered drugs (β = -0.539, p = .81), and communication about what to do during their recovery at home (β = -0.571, p = .01). Moreover, hospitals utilizing foreign-educated RNs scored, on average, lower on overall satisfaction measures including rating the hospital as 9 or 10 overall (β = -1.20, p = .005), and patients would definitely recommend the hospital (β = -1.32, p = .006). Utilization of foreign-educated RNs is negatively associated with measures of patient satisfaction pertaining to communication and overall perceptions of care. Hospitals that utilize foreign-educated RNs should consider strategies that enhance communication competency and aid improving perception of care among patients.

Implantação de um mini-pacs (sistema de arquivamento e distribuição de imagens em hospital universitário Mini-PACS (picture archiving and communication system implementation at a university hospital

Directory of Open Access Journals (Sweden)

Paulo Mazzoncini de Azevedo-Marques

2001-08-01

Full Text Available Este trabalho apresenta a implementação de um mini-PACS (sistema de arquivamento e comunicação de imagens que está sendo estruturado junto ao Serviço de Radiodiagnóstico do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, como parte do projeto de um serviço de radiologia digital ("filmless".This paper describes the implementation of a mini-PACS (picture archiving and communication system at a university hospital ("Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo", as a component of a project for a filmless radiology facility.

Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study.

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Mehta, Rajnikant L; Baxendale, Bryn; Roth, Katie; Caswell, Victoria; Le Jeune, Ivan; Hawkins, Jack; Zedan, Haya; Avery, Anthony J

2017-09-05

Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p communication.

A hospital-level cost-effectiveness analysis model for toxigenic Clostridium difficile detection algorithms.

Science.gov (United States)

Verhoye, E; Vandecandelaere, P; De Beenhouwer, H; Coppens, G; Cartuyvels, R; Van den Abeele, A; Frans, J; Laffut, W

2015-10-01

Despite thorough analyses of the analytical performance of Clostridium difficile tests and test algorithms, the financial impact at hospital level has not been well described. Such a model should take institution-specific variables into account, such as incidence, request behaviour and infection control policies. To calculate the total hospital costs of different test algorithms, accounting for days on which infected patients with toxigenic strains were not isolated and therefore posed an infectious risk for new/secondary nosocomial infections. A mathematical algorithm was developed to gather the above parameters using data from seven Flemish hospital laboratories (Bilulu Microbiology Study Group) (number of tests, local prevalence and hospital hygiene measures). Measures of sensitivity and specificity for the evaluated tests were taken from the literature. List prices and costs of assays were provided by the manufacturer or the institutions. The calculated cost included reagent costs, personnel costs and the financial burden following due and undue isolations and antibiotic therapies. Five different test algorithms were compared. A dynamic calculation model was constructed to evaluate the cost:benefit ratio of each algorithm for a set of institution- and time-dependent inputted variables (prevalence, cost fluctuations and test performances), making it possible to choose the most advantageous algorithm for its setting. A two-step test algorithm with concomitant glutamate dehydrogenase and toxin testing, followed by a rapid molecular assay was found to be the most cost-effective algorithm. This enabled resolution of almost all cases on the day of arrival, minimizing the number of unnecessary or missing isolations. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Paintings on copper by the Flemish artist Frans Francken II: PIXE characterization by external microbeam

International Nuclear Information System (INIS)

Corregidor, V.; Oliveira, A.R.; Rodrigues, P.A.; Alves, L.C.

2015-01-01

Resorting to an external proton microbeam, PIXE analyses of three oil paintings on copper support dated from the XVII century and attributed to the Flemish artist Frans Francken II, were undertaken. The present work aims to contribute to the compositional study of the painting materials employed by XVII century artists that exploited copper as a support for oil painting, and specifically the materials used by Francken’s workshop, particularly copper plates. Because of the low thickness of the pictorial layers of this type of paintings and its non-destructive character, PIXE is the ideal technique to study the elemental composition of the paintings. Several spots in each painting were chosen for analysis in order to cover almost all the pigments used in the colour palette. Lead and calcium were detected in practically every analysed regions, probably related to the presence of lead white and chalk, usually used as ground layer on copper paintings. Small quantities of gold were also detected, which is present in many of this artist’s works to embellish some details of the representations. Also this work reports the first application of the external proton microbeam set-up available at CTN/IST in Portugal for the characterization of oil paintings

Nonprofit Communications from a Corporate Communications Viewpoint

Science.gov (United States)

Cross, Ava

2006-01-01

Nonprofit organizations, such as social service agencies, charities, and hospitals, plan and prepare communications that are vital to their missions. Although not corporations, these organizations produce news releases, newsletters, and annual reports that are similar to those created in the corporate sector. In this research project for a course…

Scrutinized with inadequate control and support: Interns' experiences communicating with and writing referrals to hospital radiology departments – A qualitative study

International Nuclear Information System (INIS)

Kruse, J.; Lehto, N.; Riklund, K.; Tegner, Y.; Engström, Å.

2016-01-01

Introduction: Interns' experiences communicating with and writing referrals to hospital radiology departments are important for patient safety, image quality, and decision-making in the diagnostic process. Understanding roles within the department and in the diagnostic process is important for communication. This study aimed to describe interns' experiences communicating with and writing referrals to their hospital's radiology department. Method: A qualitative study design was used. Data was collected from focus discussions with ten interns in three focus groups in Northern Sweden during 2012. The data were subjected to qualitative content analysis. Results: One theme, “a feeling of being scrutinized and lacking control”, was identified in the final categories. The interns experienced that the radiology department placed high demands on them and desired more diagnostic skills training, resources and feedback. The interns suggested the following improvements: enhanced dialogue and feedback, improved education, handy guidelines, and practice writing referrals. Conclusion: Interns need more feedback from, and dialogue with, members of the Department of Radiology. They also need more knowledge of referral guidelines, appropriateness criteria and more practice to develop their knowledge and skill for writing referrals. They describe feelings of inadequate support and feel scrutinized in demanding work conditions and need more collaboration. They also need more time and more control of radiology outcomes, and they are eager to learn. - Highlights: • Interns' experiences of writing referrals are important in the diagnostic process. • Communication between referents and radiology staff influences patient safety. • Medical interns experience insufficient diagnostic skills. • Interns need more feedback from, and dialogue with radiology staff. • The learning process could benefit from knowledge of the referrers perspective.

Hyper Hospital on the satellite multi-media network.

Science.gov (United States)

Yamaguchi, T

1997-01-01

We have been developing the Hyper Hospital, a network based VR mediated medical care system. The Hyper Hospital is composed of two seamlessly integrated environments, that is, the virtual and the real worlds. Of them, its virtual environment expands the conventional medical care system using the virtual reality technology as a principal human interface and a collaboration tool, in the present study, an attempt to extend the Hyper Hospital system to various modalities of communication network is reported. A satellite communication based multi-media network using Internet protocols with the WWW interface is used. Data transmission rate and other performances were measured under various conditions and the satellite network was shown to be suitable to the Hyper Hospital network.

The mission of the well-managed community hospital.

Science.gov (United States)

Griffith, J R

1988-07-01

The well-managed community hospital as an organization is in dynamic equilibrium with its geographic community and with other communities providing finance, physicians, nurses, other professionals and resources necessary to meet local health care needs. The hospital is "well-managed" when it develops an equilibrium that permits all of its various constituencies to be satisfied. Growth in market share results from good management. The hospital's ability to attract and satisfy the needs of health care professionals while simultaneously meeting the needs of patients and their families at competitive prices allows it to flourish. Its financial success allows it to reward its medical staff and employees in ways that attract the best of each work group. A central problem in achieving good management is communication. Hospitals must communicate their goals convincingly to a large number of doctors and employees. "The Well-Managed Community Hospital," winner of the James A. Hamilton Hospital Administration Book Award, argues that a well-structured mission statement is the essential first step in the communications process. According to the book, final responsibility for the mission statement lies with the governing board and is one of five non-delegable functions of the board. The nature of the mission setting function as described in the book follows.

Does pre-hospital telephone communication with a clinician result in more appropriate medication administration by parents during childhood asthma exacerbations?

Science.gov (United States)

Garro, A C; Fearon, D; Koinis-Mitchell, D; McQuaid, E L

2009-11-01

The National Heart, Lung and Blood Institute asthma guidelines recommend that parents communicate with a clinician during childhood asthma exacerbations when symptoms worsen or do not improve with initial therapy. This study tested the hypothesis that communication by parents with a clinician before an Emergency Department visit was associated with more appropriate medication administration for children with asthma exacerbations. This was a retrospective cohort study using data gathered from parents of children presenting with an asthma exacerbation to the emergency department. The communicating cohort included parents who communicated by telephone with a clinician during the exacerbation and the non-communicating cohort included parents who did not. Multivariate logistic regression models were used to test three hypotheses; communication with a clinician is associated with (1) administration of short-acting beta-agonists (SABAs), (2) increased dosing frequency of SABAs, and (3) administration of an oral corticosteroid. A total of 199 subjects were enrolled, with 104 (52.3%) in the communicating and 95 (47.7%) in the non-communicating cohort. There was an association between communication and provider practice type, with children who received routine care from a private practice provider more likely to communicate with the clinician than children in hospital-based clinics or community health centers (Adjusted OR 1.9, 95% CI 1.0-3.7). Impoverished children and children insured by Medicaid were less likely to communicate with a clinician (controlling for provider type). Parents who communicated with a clinician were more likely to administer a SABA (adjusted OR 3.6, 95% CI 1.3-9.4) and an oral corticosteroid (adjusted OR 3.3, 95% CI 1.3-8.4) but were not more likely to administer a SABA with increased dosing frequency (adjusted OR 0.9, 95% CI 0.5-1.6). Parents of children with asthma exacerbations who communicated with clinicians were more likely to administer SABAs

Communicating with Professionals

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Full Text Available ... communication skills can help you get what you need – over the phone, at the hospital or during ... complies with the HONcode standard for trustworthy health information: verify here.

Nurses' communication and patient satisfaction in a tertiary hospital ...

African Journals Online (AJOL)

Chi-square results of the respondents profile and satisfaction with communication of nursing care provision by sex was significant (p< 0.0076). The study recommended among others, that nurses' acquisition of relevant communication skills will be helpful in interactions between nurses and the patients during the period of ...

The structured communication tool SBAR (Situation, Background, Assessment and Recommendation) improves communication in neonatology.

Science.gov (United States)

Raymond, M; Harrison, M C

2014-12-01

Effective communication, co-operation and teamwork have been identified as key determinants of patient safety. SBAR (Situation, Background, Assessment and Recommendation) is a communication tool recommended by the World Health Organization and the UK National Health Service. SBAR is a structured method for communicating critical information that requires immediate attention and action, contributing to effective escalation of management and increased patient safety. To our knowledge, this is the first study showing use of SBAR in South Africa (SA). To determine the effectiveness of adopting the SBAR communication tool in an acute clinical setting in SA. In the first phase of this study, neonatal nurses and doctors at Groote Schuur Hospital, Cape Town, were gathered in a focus group and given a questionnaire asking about communication in the neonatal department. Neonatal nurses and doctors were then trained to use SBAR. A telephone audit demonstrated an increase in SBAR use by registrars from 29% to 70% when calling consultants for help. After training, the majority of staff agreed that SBAR had helped with communication, confidence, and quality of patient care. There was qualitative evidence that SBAR led to greater promptness in care of acutely ill patients. Adopting SBAR was associated with perceived improvement in communication between professionals and in the quality and safety of patient care. It is suggested that this simple tool be introduced to many other hospitals in SA.

Promoters and barriers in hospital team communication

DEFF Research Database (Denmark)

Rabøl, Louise Isager; McPhail, Mette Arnsfelt; Østergaard, Doris

2012-01-01

on teamwork and communication promote safe information exchange. Lack of standard assignments and procedures, a flat hierarchy that leaves responsibility unclear, different agendas for the treatment of the patient, interruptions, and multimultitasking, inhibit safe information exchange. Conclusion: Power...

Smart use of data, information and communication: the INFORM-ed Best Local Practice Project--Grafton Base Hospital.

Science.gov (United States)

Lloyd, Sheree; Collie, Jean; McInnes, Alastair; King, Kevin; Lollback, Alison; Garland, Angie

This paper describes current progress for an information management project in a medium-sized rural hospital after the first four months of the one-year project. In particular, the article examines some of the project outcomes to date as these relate to the National Hospitals and Health Reform recommendations for the smart use of data, information and communication. The paper identifies a number of important challenges and issues that have been addressed by the project and proposes that the project findings may be used to inform similar projects in other settings. These findings relate to clinician requirements for reports, investment in human resources, development, and time for information management activities. An understanding of data collected, information systems, and presentation of clinician data are also important. The benefits of information sharing in assisting quality improvement activities are particularly relevant but, more importantly, they can engage and involve clinicians in the use of information. The importance of local data, information, and knowledge is described. Finally, issues for the health information management profession, such as working collegially and sharing knowledge and expertise, are outlined.

Sociodemographic profile and hospitalization process of elderly assisted at a emergency hospital

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Maria Luciene Nobre Coutinho

2015-12-01

Full Text Available Objectives: to investigate the sociodemographic profile and the process of hospitalization of elderly assisted in an emergency hospital. Methods: descriptive epidemiological study conducted at an emergency hospital with 300 elderly patients using a form with hospitalization process and sociodemographic variables. Results: there was a predominance of females (56.0%, between 80 and 89 years old (45.4%, illiterate or with elementary education (86.7%, married or living in stable union (42.6%, with non-communicable chronic disease (54.7% and regular use of medications. The main reason for hospitalization was fall (54.7% at home and in the morning hours (42.4%, with admission in the afternoon, transported by ambulance. Conclusion: the findings contribute to the development of strategies directed to assist and care of the healthy elderly and in vulnerable situations.

Communication Skills Training in the Medical Curriculum

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Branet Partric

2013-01-01

Full Text Available Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. Communication is more than history taking; it includes all methods of interaction with patients, patient's relatives, members of the health care team, and the public. Many studies stressed that the main complaints of patients are related to communication problems and not to clinical competency. This has contributed to an increase in the number of law suits, non-adherence to medical regimens, and the tendency of patients to keep changing physicians and hospitals. Also, it has been shown that health outcome is positively affected by proper communication. This includes patient's satisfaction and cooperation, decrease in treatment duration, decrease in painkillers requirements, and decrease in hospital stay. Also, it has been shown that communication skills can be taught and important changes in physician's behavior and in their communication skills have been demonstrated after courses of communication skills. Thus, many medical colleges in the world are including communication skills courses in their undergraduate and graduate curricula

Dietary Sources of Fiber Intake and Its Association with Socio-Economic Factors among Flemish Preschool Children

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Inge Huybrechts

2011-03-01

Full Text Available The objectives were to assess total dietary fiber intake, identify the major sources of dietary fiber, and examine its association with socio-economic factors among Flemish preschoolers. Three-day estimated dietary records were collected from a representative sample of preschoolers 2.5–6.5 years old (n = 661; 338 boys, 323 girls. The mean dietary fiber intake (13.4 g/d was lower than the intake level recommended by the Belgian Superior Health Council (70% boys and 81% girls below the guidelines. The most important contributor was the group of bread and cereals (29.5%, followed by fruits (17.8%, potatoes and grains (16.0%, energy-dense, low-nutritious foods (12.4%, and vegetables (11.8%. Multiple linear regression analyses showed that total fiber intake was associated with maternal education and parents’ employment. Overall, fiber intakes from high-nutritious foods (vegetables and fruits were higher in preschoolers of higher educated mothers and those with one or both parents being employed. In conclusion, the majority of the preschoolers had dietary fiber intakes below the recommended level. Hence, dietary fiber should be promoted among parents of preschoolers and low socio-economic status families should be addressed in particular.

Communicating with Professionals

Medline Plus

Full Text Available ... concerns, asking questions and getting the facts. Usually, office visits and phone calls are shorter and more ... over the phone, at the hospital or during office visits. Good communication skills help you get better ...

Peri-operative communication patterns and media usage--implications for systems design.

Science.gov (United States)

Karlsen, Ero S; Toussaint, Pieter Jelle

2010-01-01

Inter-hospital communication amounts for a great deal of clinicians' work time. While communication is essential to coordinate care, it can also be time consuming and interruptive, and breakdown in communication is an important source of medical errors. One contributor to the interruptive nature of communication is the use of synchronous media, and there is clearly a potential for novel technologies. To assess communication patterns and media usage we performed an ethnographic field study in the peri-operative environment at a Norwegian hospital, as well as interviews with nurses. We analyze the results with regards to choice of media, characteristics of the conversations taking place and meta-messages, and account for addressing, obtrusiveness and information richness in the message exchanges. We find a relative high degree of interruptiveness in communication, and ascribe it to 1) a lack of situational awareness between locations in the peri-operative domain, as well as 2) use of synchronous media. This suggests that design of novel technology for intra-hospital communication should aim at supporting sender-receiver awareness and signaling of availability.

Hospital pharmacists' and patients' views about what constitutes effective communication between pharmacists and patients.

Science.gov (United States)

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William N

2017-12-06

The study's objective was to explore hospital pharmacists' and patients' views about what constitutes effective communication exchanges between pharmacists and patients. This was a novel theory-based qualitative study using semi-structured interviews to elicit patients' and pharmacists' perspectives. Pharmacists providing clinical pharmacy services in either inpatient or outpatient settings were recruited first. Eligible patients had been admitted to a study pharmacist's practice area and were prescribed three or more medications to manage a chronic disease(s). Following each pharmacist-patient medication counselling session, semi-structured interviews were held separately with patients and pharmacists. Participants were asked questions intended to explore their views about what constitutes an effective pharmacist-patient conversation. Audio recordings were transcribed verbatim, analysed using a process of inductive thematic analysis and then mapped to Communication Accommodation Theory strategies. Observational notes and reflexive note taking were conducted throughout. Twelve pharmacists each engaged four individual patients for a total of 48 pharmacist-patient conversations (resulting in 48 separate interviews with pharmacists and patients). An overall shared goal was the assurance of patients' confidence in managing their medications at home. Themes included shared colloquialisms/slang, well-explained information, engagement, established rapport and empowerment. Participants provided rich exemplars for each of the themes. Pharmacists and patients provided valuable insights about what makes pharmacist-patient interactions effective. Patient-identified preferences for pharmacist-patient exchanges may help guide pharmacy students and practitioners to engage patients in effective conversations. © 2017 Royal Pharmaceutical Society.

Working together for the children. New Children’s Hospital 2017 fundraising campaign on Facebook and the communication of charity work.

OpenAIRE

Uoti, Jaakko

2016-01-01

This thesis aims to examine the communication of charity work on social media. The thesis takes on the fundraising efforts of Finnish charity organization New Children’s Hospital 2017 (Uusi Lastensairaala 2017) and its Facebook Page posts over the course of twelve months. The research problem is to look at what kinds of charity work ULS 2017 Facebook Page promotes and what discourses of responsibility and solidarity can be seen as inscribed into these forms of charity work. The subject matter...

How Differences Between Manager and Clinician Perceptions of Safety Culture Impact Hospital Processes of Care.

Science.gov (United States)

Richter, Jason; Mazurenko, Olena; Kazley, Abby Swanson; Ford, Eric W

2017-11-04

Evidenced-based processes of care improve patient outcomes, yet universal compliance is lacking, and perceptions of the quality of care are highly variable. The purpose of this study is to examine how differences in clinician and management perceptions on teamwork and communication relate to adherence to hospital processes of care. Hospitals submitted identifiable data for the 2012 Hospital Survey on Patient Safety Culture and the Centers for Medicare and Medicaid Services' Hospital Compare. The dependent variable was a composite, developed from the scores on adherence to acute myocardial infarction, heart failure, and pneumonia process of care measures. The primary independent variables reflected 4 safety culture domains: communication openness, feedback about errors, teamwork within units, and teamwork between units. We assigned each hospital into one of 4 groups based on agreement between managers and clinicians on each domain. Each hospital was categorized as "high" (above the median) or "low" (below) for clinicians and managers in communication and teamwork. We found a positive relationship between perceived teamwork and communication climate and processes of care measures. If managers and clinicians perceived the communication openness as high, the hospital was more likely to adhere with processes of care. Similarly, if clinicians perceived teamwork across units as high, the hospital was more likely to adhere to processes of care. Manager and staff perceptions about teamwork and communications impact adherence to processes of care. Policies should recognize the importance of perceptions of both clinicians and managers on teamwork and communication and seek to improve organizational climate and practices. Clinician perceptions of teamwork across units are more closely linked to processes of care, so managers should be cognizant and try to improve their perceptions.

Attempt to promote hospital management by IM Public Platform

Directory of Open Access Journals (Sweden)

Hui CHEN

2014-06-01

Full Text Available Thisarticle has analyzed the contribution of modern IT to hospital management: using public platform of IM (instant message/communication will make it more convenient and efficient to conduct communication with (prior to the treatment, conduct treatment, and provide post-treatment service for patients and their family; withthe set-up of a smooth and efficient information channel set up, the relationship between patients and doctors will be greatly improved ,thus reputation and credibility of the hospital and its doctors will be promoted; when the public has better received the hospital and its doctors, social harmony will be achieved. 

Communication Matters: Exploring the Intersection of Family and Practitioner End of Life Communication

Directory of Open Access Journals (Sweden)

Leah M. Omilion-Hodges

2017-03-01

Full Text Available After establishing a baseline understanding of some of the factors that influence and shape family end of life communication, empirical research centered on the communication tendencies of nationally-recognized palliative care clinicians is presented. Because death is no longer confined to the bedroom and individuals are increasingly turning to hospitals and health care institutes to assist with end of life, the role of palliative care practitioners is vital. To that end, common communication-rooted issues that may transpire among various medical personnel are explored. Focus on a shared underlying tension—care vs. cure—links the findings between family and palliative care clinician communication regarding end of life. Practical communication solutions and suggestions are offered to facilitate productive and mindful end of life communication between and among family members and health care practitioners.

Family communication coordination: a program to increase organ donation.

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Linyear, A S; Tartaglia, A

1999-09-01

To improve organ donation performance, the Medical College of Virginia Hospitals implemented a comprehensive family support and communication program, consisting of a standard family communications protocol, a hospital-based team from the Department of Pastoral Care, targeted staff education, and an ongoing quality assurance measuring and monitoring system. The 3 best-demonstrated request practices, private setting, "decoupling," and collaboration in the request between the organ procurement organization and hospital staff, were incorporated into the program. Improvement in the consent and donation rate was evident in the second calendar year of the program; the consent rate was 72% and the donation rate was 50%. During the second year, there was also a positive correlation between "decoupling," appropriate requestor, and the consent rate. Implementation of a hospital-based team and a standard protocol facilitated the clarification of roles and responsibilities toward clearer and more consistent family communication and support. Data suggest that staff experience is a major contributor to a positive donation outcome.

Inter-hospital communications and transport: turning one-way funnels into two-way networks.

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Rokos, Ivan C; Sanddal, Nels D; Pancioli, Arthur M; Wolff, Catherine; Gaieski, David F

2010-12-01

The Inter-hospital Communications and Transport workgroup was charged with exploring the current status, barriers, and data necessary to optimize the initial destination and subsequent transfer of patients between and among acute care settings. The subtitle, "Turning Funnels Into Two-way Networks," is descriptive of the approach that the workgroup took by exploring how and when smaller facilities in suburban, rural, and frontier areas can contribute to the daily business of caring for emergency patients across the lower-acuity spectrum-in some instances with consultant support from academic medical centers. It also focused on the need to identify high-acuity patients and expedite triage and transfer of those patients to facilities with specialty resources. Draft research recommendations were developed through an iterative writing process and presented to a breakout session of Academic Emergency Medicine's 2010 consensus conference, "Beyond Regionalization: Integrated Networks of Emergency Care." Priority research areas were determined by informal consensus of the breakout group. A subsequent iterative writing process was undertaken to complete this article. A number of broad research questions are presented. 2010 by the Society for Academic Emergency Medicine.

Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

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Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

2018-05-04

The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

Change management in Iranian hospitals: social factors model

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B. Delgoshaei

2012-02-01

Full Text Available Background: Continuous change in the complex health care environments is a major challenge for administrative managers. This study aimed to design a change model to facilitate change implementation in the Iranian hospitals. Methods: This is a descriptive and comparative study. The data were collected through library search and in-depth interview with 15 hospital managers. Nine well-established change theories developed by Lewin, Action Research, Kotter, Ackerman- Anderson and Anderson, Prosci , Kilman, Beer, Continuum, and Gelicher were compared. Common denominators of the theories were identified and tabulated. Experienced hospital managers’ suggestions about social factors were acquired. The initial model was designed and validated using the Delphi Technique. Results: The majority of the selected change models emphasize the significance of social factors in change implementation such as effective communication, organizational climate and culture, and leadership. The results from the interviews indicate that low readiness to change, lack of confidence (or trust for change, and autocratic leadership style ,and poor communication could hinder the change process. Conclusion: Based on the model developed in the study, effective communication, readiness of employees, and a contingency leadership/management combined could lead to successful implementation of change in the hospital.

Do HCAHPS Doctor Communication Scores Reflect the Communication Skills of the Attending on Record? A Cautionary Tale from a Tertiary-Care Medical Service.

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Velez, Vicente J; Kaw, Roop; Hu, Bo; Frankel, Richard M; Windover, Amy K; Bokar, Dan; Rish, Julie M; Rothberg, Michael B

2017-06-01

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient satisfaction with hospital care. It is not known if these reflect the communication skills of the attending physician on record. The Four Habits Coding Scheme (4HCS) is a validated instrument that measures bedside physician communication skills according to 4 habits, namely: investing in the beginning, eliciting the patient's perspective, demonstrating empathy, and investing in the end. To investigate whether the 4HCS correlates with provider HCAHPS scores. Using a cross-sectional design, consenting hospitalist physicians (n = 28), were observed on inpatient rounds during 3 separate encounters. We compared hospitalists' 4HCS scores with their doctor communication HCAHPS scores to assess the degree to which these correlated with inpatient physician communication skills. We performed sensitivity analysis excluding scores returned by patients cared for by more than 1 hospitalist. A total of 1003 HCAHPS survey responses were available. Pearson correlation between 4HCS and doctor communication scores was not significant, at 0.098 (-0.285, 0.455; P = 0.619). Also, no significant correlations were found between each habit and HCAHPS. When including only scores attributable to 1 hospitalist, Pearson correlation between the empathy habit and the HCAHPS respect score was 0.515 (0.176, 0.745; P = 0.005). Between empathy and overall doctor communication, it was 0.442 (0.082, 0.7; P = 0.019). Attending-of-record HCAHPS scores do not correlate with 4HCS. After excluding patients cared for by more than 1 hospitalist, demonstrating empathy did correlate with the doctor communication and respect HCAHPS scores. Journal of Hospital Medicine 2017;12:421-427. © 2017 Society of Hospital Medicine

Framework for near-field-communication-based geo-localization and personalization for Android-based smartphones--application in hospital environments.

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Meng, Philipp; Fehre, Karsten; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

2014-01-01

Various applications using near field communication (NFC) have been developed for the medical sector. As a method of short-range wireless contact-driven data transfer, NFC is a useful tool in medicine. It can be used to transfer data such as blood pressure, control adherence to medication, or transmit in vivo data. The first proposed general framework uses NFC as a mechanism for indoor geo-localization in hospitals. NFC geo-localization is economical compared to classical concepts using indoor GPS or WLAN triangulation, and the granularity of location retrieval can be defined at a tag level. Using this framework, we facilitate the development of medical applications that require exact indoor geo-localization. Multi-user Android systems are addressed in the second framework. Using private NFC tags, users are able to carry on their personal settings for enabled applications. This eliminates the need for multiple user accounts on common Android devices, improves usability, and eases technical administration. Based on the prototypes presented here, we show a novel concept of using NFC-enabled Android devices in hospital environments.

How to Improve Patient Safety Culture in Croatian Hospitals?

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Šklebar, Ivan; Mustajbegović, Jadranka; Šklebar, Duška; Cesarik, Marijan; Milošević, Milan; Brborović, Hana; Šporčić, Krunoslav; Petrić, Petar; Husedžinović, Ino

2016-09-01

Patient safety culture (PCS) has a crucial impact on the safety practices of healthcare delivery systems. The purpose of this study was to assess the state of PSC in Croatian hospitals and compare it with hospitals in the United States. The study was conducted in three public general hospitals in Croatia using the Croatian translation of the Hospital Survey of Patient Safety Culture (HSOPSC). A comparison of the results from Croatian and American hospitals was performed using a T-square test. We found statistically significant differences in all 12 PSC dimensions. Croatian responses were more positive in the two dimensions of Handoff s and Transitions and Overall Perceptions of Patient Safety. In the remaining ten dimensions, Croatian responses were less positive than in US hospitals, with the most prominent areas being Nonpunitive Response to Error, Frequency of Events Reported, Communication Openness, Teamwork within Units, Feedback & Communication about Error, Management Support for Patient Safety, and Staffing. Our findings show that PSC is significantly lower in Croatian than in American hospitals, particularly in the areas of Nonpunitive Response to Error, Leadership, Teamwork, Communication Openness and Staffing. This suggests that a more comprehensive system for the improvement of patient safety within the framework of the Croatian healthcare system needs to be developed. Our findings also help confirm that HSOPSC is a useful and appropriate tool for the assessment of PSC. HSOPSC highlights the PSC components in need of improvement and should be considered for use in national and international benchmarking.

Do families after early postnatal discharge need new ways to communicate with the hospital? A feasibilility study.

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Danbjørg, Dorthe Boe; Wagner, Lis; Clemensen, Jane

2014-06-01

the length of the postnatal hospital stay in Denmark as well as globally has been radically reduced over the past 10-20 years and this raises the challenge of finding new ways of providing observation and support to families discharged early, that they otherwise would be provided as inpatients. this study is to identify the nursing support needs of new parents and their infants during the first seven days post partum, by drawing on the experiences of all stakeholders' in early postnatal discharge from hospital, and thereby gaining new knowledge to investigate further whether telemedicine is a viable option in providing the required support. this article describes the first phase of a participatory design process. A qualitative approach guided the research process and the data analysis. Data were collected from participant observation, qualitative interviews with the new parents, focus groups interviews and a workshop attended by the new parents and health-care professionals. the total number of participants in this study was 37; nineteen parents and 18 health-care professionals from one hospital and three municipalities in Denmark. the investigation findings highlighted, amongst other aspects, the importance of individualised postnatal follow-up in which families have increased access to the health-care professionals and are provided with timely information tailored to their specific needs. the present study underscored that the families experiencing early discharge were not provided with seamless individualised follow-up support. They requested more availability from the health-care system to respond to their concerns and questions during the postnatal period. They experienced a barrier in attempting to contact health-care professionals following hospital discharge and they asked for new ways to communicate that would eliminate that barrier and meet their needs for more individualised and timely information and guidance. Copyright © 2013 Elsevier Ltd. All rights

Development and testing of emergency department patient transfer communication measures.

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Klingner, Jill; Moscovice, Ira

2012-01-01

Communication problems are a major contributing factor to adverse events in hospitals.(1) The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality measurement of interfacility patient transfer communication. Input from existing measures, measurement and health care delivery experts, as well as hospital frontline staff was used to design and modify ED quality measures. Three field tests were conducted to determine the feasibility of data collection and the effectiveness of different training methods and types of partnerships. Measures were evaluated based on their prevalence, ease of data collection, and usefulness for internal and external improvement. It is feasible to collect ED quality measure data. Different data sources, data collection, and data entry methods, training and partners can be used to examine hospital ED quality. There is significant room for improvement in the communication of patient information between health care facilities. Current health care reform efforts highlight the importance of clear communication between organizations held accountable for patient safety and outcomes. The patient transfer communication measures have been tested in a wide range of rural settings and have been vetted nationally. They have been endorsed by the National Quality Forum, are included in the National Quality Measurement Clearinghouse supported by the Agency for Health Care Research and Quality (AHRQ), and are under consideration by the Centers for Medicare and Medicaid Services for future payment determinations beginning in calendar year 2013. © 2011 National Rural Health Association.

Why should I talk about emotion? Communication patterns associated with physician discussion of patient expressions of negative emotion in hospital admission encounters.

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Adams, Kristen; Cimino, Jenica E W; Arnold, Robert M; Anderson, Wendy G

2012-10-01

To describe hospital-based physicians' responses to patients' verbal expressions of negative emotion and identify patterns of further communication associated with different responses. Qualitative analysis of physician-patient admission encounters audio-recorded between August 2008 and March 2009 at two hospitals within a university system. A codebook was iteratively developed to identify patients' verbal expressions of negative emotion. We categorized physicians' responses by their immediate effect on further discussion of emotion - focused away (away), focused neither toward nor away (neutral), and focused toward (toward) - and examined further communication patterns following each response type. In 79 patients' encounters with 27 physicians, the median expression of negative emotion was 1, range 0-14. Physician responses were 25% away, 43% neutral, and 32% toward. Neutral and toward responses elicited patient perspectives, concerns, social and spiritual issues, and goals for care. Toward responses demonstrated physicians' support, contributing to physician-patient alignment and agreement about treatment. Responding to expressions of negative emotion neutrally or with statements that focus toward emotion elicits clinically relevant information and is associated with positive physician-patient relationship and care outcomes. Providers should respond to expressions of negative emotion with statements that allow for or explicitly encourage further discussion of emotion. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Clinician user involvement in the real world: Designing an electronic tool to improve interprofessional communication and collaboration in a hospital setting.

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Tang, Terence; Lim, Morgan E; Mansfield, Elizabeth; McLachlan, Alexander; Quan, Sherman D

2018-02-01

User involvement is vital to the success of health information technology implementation. However, involving clinician users effectively and meaningfully in complex healthcare organizations remains challenging. The objective of this paper is to share our real-world experience of applying a variety of user involvement methods in the design and implementation of a clinical communication and collaboration platform aimed at facilitating care of complex hospitalized patients by an interprofessional team of clinicians. We designed and implemented an electronic clinical communication and collaboration platform in a large community teaching hospital. The design team consisted of both technical and healthcare professionals. Agile software development methodology was used to facilitate rapid iterative design and user input. We involved clinician users at all stages of the development lifecycle using a variety of user-centered, user co-design, and participatory design methods. Thirty-six software releases were delivered over 24 months. User involvement has resulted in improvement in user interface design, identification of software defects, creation of new modules that facilitated workflow, and identification of necessary changes to the scope of the project early on. A variety of user involvement methods were complementary and benefited the design and implementation of a complex health IT solution. Combining these methods with agile software development methodology can turn designs into functioning clinical system to support iterative improvement. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Nutritional quality evaluation of rabbit meat (Flemish Giant breed corelated with fatty acids content

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Gabriela Frunză

2016-10-01

Full Text Available The aim of this study was to assess the nutritional quality of rabbit meat (Flemish Giant breed in terms of content of fatty acids. The biological material consisted of 42 rabbits (17 females and 15 males from which were collected Longissimus dorsi, Semimembranosus and Triceps Brachii muscles immediately after slaughter. The samples were vacuum packaged, frozen at -80 0C, and immediately after thawing have been minced and freeze-dried at -110 0C (using lyophilizer CoolSafe Scanvac. The content in fatty acids was followed through NIRS methodology, using FOSS 6500 spectrophotometer, by gender. Was determined: the saturated fatty acids: C14:0 (Myristic acid, C15: 0 (Pentadecanoic acid, C16: 0 (Palmitic acid, C17: 0 (Heptadecanoic acid and C18: 0 (Stearic acid; monounsaturated fatty acids: Palmitoleic acid (C16: 1n-7, Vaccenic acid, cis-isomer of oleic acid (C18: 1n-7 and oleic acid (C18: 1n-9 and the polyunsaturated fatty acids (ω3 and ω6: C18: 2n-6 (linoleic acid, C18: 3n-3 (Linolenic acid, C20: 2n-6 (Eicosadienoic acid, C20: 3n-6 (Eicosatrienoic acid, C20: 4n-6 (arachidonic acid, C20: 5n-3 (Eicosapentaenoic acid, C22: 4n-6 (Docosatetraenoic acid, C22: 5n-3 (Docosopentaenoic acid and C22: 6n- 3 (docosahexaenoic acid. The results were statistically analyzed, including analysis of variance (ANOVA and was observed significant differences between gender.

Determinants of Hospital Pharmacists’ Job Satisfaction in Romanian Hospitals

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Magdalena Iorga

2017-12-01

Full Text Available Aim: The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods: Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results: The analyses of the data revealed a low level of satisfaction regarding the pay–promotion subscale, a high level of satisfaction with the management–interpersonal relationship dimension, and a high level of satisfaction regarding the organization–communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions: These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.

Determinants of Hospital Pharmacists' Job Satisfaction in Romanian Hospitals.

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Iorga, Magdalena; Dondaș, Corina; Soponaru, Camelia; Antofie, Ioan

2017-12-11

Aim : The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods : Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results : The analyses of the data revealed a low level of satisfaction regarding the pay-promotion subscale, a high level of satisfaction with the management-interpersonal relationship dimension, and a high level of satisfaction regarding the organization-communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions : These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.

Communication competencies of oncology nurses in Malaysia.

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Maskor, Nor Aida; Krauss, Steven Eric; Muhamad, Mazanah; Nik Mahmood, Nik Hasnaa

2013-01-01

This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.

The influence of dairy consumption and physical activity on ultrasound bone measurements in Flemish children.

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De Smet, Stephanie; Michels, Nathalie; Polfliet, Carolien; D'Haese, Sara; Roggen, Inge; De Henauw, Stefaan; Sioen, Isabelle

2015-03-01

The study's aim was to analyse whether children's bone status, assessed by calcaneal ultrasound measurements, is influenced by dairy consumption and objectively measured physical activity (PA). Moreover, the interaction between dairy consumption and PA on bone mass was studied. Participants of this cross-sectional study were 306 Flemish children (6-12 years). Body composition was measured with air displacement plethysmography (BodPod), dairy consumption with a Food Frequency Questionnaire, PA with an accelerometer (only in 234 of the 306 children) and bone mass with quantitative ultrasound, quantifying speed of sound (SOS), broadband ultrasound attenuation (BUA) and Stiffness Index (SI). Regression analyses were used to study the associations between dairy consumption, PA, SOS, BUA and SI. Total dairy consumption and non-cheese dairy consumption were positively associated with SOS and SI, but no significant association could be demonstrated with BUA. In contrast, milk consumption, disregarding other dairy products, had no significant effect on calcaneal bone measurements. PA [vigorous PA, moderate to vigorous physical activity (MVPA) and counts per minute] was positively associated and sedentary time was negatively associated with BUA and SI, but no significant influence on SOS could be detected. Dairy consumption and PA (sedentary time and MVPA) did not show any interaction influencing bone measurements. In conclusion, even at young age, PA and dairy consumption positively influence bone mass. Promoting PA and dairy consumption in young children may, therefore, maximize peak bone mass, an important protective factor against osteoporosis later in life.

Networks in the radiology department and the hospital

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Pelikan, E.; Timmermann, U. [Hospital Computer Center, University Hospital Freiburg (Germany); Kotter, E. [Freiburg Univ. (Germany). Radiologische Universitaetsklinik

2001-02-01

Data networks are a basic technology with regard to an appropriate design of the information technology (IT) infrastructure for the hospital. Due to the distributed workflow within the hospital, an integrated Hospital Information System (HIS) is based mostly on a set of network applications facing specific items. Medical communication standards, i. e., HL 7, DICOM, and in the near future the migration towards XML, support the interoperability between the IT subsystems and pave the way to patient information systems with access to unified and complete electronic medical records (EMR). Furthermore, with standardized communication techniques, such as CORBAmed, an object-oriented design of Healthcare applications will be possible in the near future. The intent of this paper is to give an overview of which basic technologies are suitable for building comprehensive, flexible, and reliable hospital networks and which also meet the special demands of the radiology department. (orig.)

Networks in the radiology department and the hospital

International Nuclear Information System (INIS)

Pelikan, E.; Timmermann, U.; Kotter, E.

2001-01-01

Data networks are a basic technology with regard to an appropriate design of the information technology (IT) infrastructure for the hospital. Due to the distributed workflow within the hospital, an integrated Hospital Information System (HIS) is based mostly on a set of network applications facing specific items. Medical communication standards, i. e., HL 7, DICOM, and in the near future the migration towards XML, support the interoperability between the IT subsystems and pave the way to patient information systems with access to unified and complete electronic medical records (EMR). Furthermore, with standardized communication techniques, such as CORBAmed, an object-oriented design of Healthcare applications will be possible in the near future. The intent of this paper is to give an overview of which basic technologies are suitable for building comprehensive, flexible, and reliable hospital networks and which also meet the special demands of the radiology department. (orig.)

Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

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Haroon, Muhammad; Yasin, Faiza; Eckel, Rachael; Walker, Frank

2010-10-01

Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of ≥ 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication. Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

Trends in genome-wide and region-specific genetic diversity in the Dutch-Flemish Holstein-Friesian breeding program from 1986 to 2015.

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Doekes, Harmen P; Veerkamp, Roel F; Bijma, Piter; Hiemstra, Sipke J; Windig, Jack J

2018-04-11

In recent decades, Holstein-Friesian (HF) selection schemes have undergone profound changes, including the introduction of optimal contribution selection (OCS; around 2000), a major shift in breeding goal composition (around 2000) and the implementation of genomic selection (GS; around 2010). These changes are expected to have influenced genetic diversity trends. Our aim was to evaluate genome-wide and region-specific diversity in HF artificial insemination (AI) bulls in the Dutch-Flemish breeding program from 1986 to 2015. Pedigree and genotype data (~ 75.5 k) of 6280 AI-bulls were used to estimate rates of genome-wide inbreeding and kinship and corresponding effective population sizes. Region-specific inbreeding trends were evaluated using regions of homozygosity (ROH). Changes in observed allele frequencies were compared to those expected under pure drift to identify putative regions under selection. We also investigated the direction of changes in allele frequency over time. Effective population size estimates for the 1986-2015 period ranged from 69 to 102. Two major breakpoints were observed in genome-wide inbreeding and kinship trends. Around 2000, inbreeding and kinship levels temporarily dropped. From 2010 onwards, they steeply increased, with pedigree-based, ROH-based and marker-based inbreeding rates as high as 1.8, 2.1 and 2.8% per generation, respectively. Accumulation of inbreeding varied substantially across the genome. A considerable fraction of markers showed changes in allele frequency that were greater than expected under pure drift. Putative selected regions harboured many quantitative trait loci (QTL) associated to a wide range of traits. In consecutive 5-year periods, allele frequencies changed more often in the same direction than in opposite directions, except when comparing the 1996-2000 and 2001-2005 periods. Genome-wide and region-specific diversity trends reflect major changes in the Dutch-Flemish HF breeding program. Introduction of

An Insiders’ Outside Perspective on the Flemish-Walloon Conflict: The Role of Identification and Disidentification for the German-Speaking Minority

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Frank Asbrock

2017-11-01

Full Text Available In this study we analyzed the opinions of citizens of the German-speaking minority in Belgium on the linguistic conflict between the Walloons and the Flemish, as well as their attitudes towards these linguistic communities. We were especially interested in the effects of identification with the local community and disidentification with Belgium. We distributed a survey questionnaire in Eupen, the capital of the German-speaking community, and received replies from 129 inhabitants. Results showed that identification with the German-speaking community was associated with positive attitudes towards the German-speaking community and with demands for more autonomy of the community within the federal Belgian state. Disidentification with Belgium was not positively correlated with these constructive and positive outcomes, but with negative perceptions of all three Belgian communities, the perception of strong conflicts among these communities, and demands for the separation of the Belgian federal state into independent regions. The results are in line with previous research on these processes and point to unique, positive aspects of a strong local identity.

Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework.

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Kerstenetzky, Luiza; Birschbach, Matthew J; Beach, Katherine F; Hager, David R; Kennelty, Korey A

2018-02-01

Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of

Use of social media by Western European hospitals: longitudinal study.

OpenAIRE

Belt, T.H. van de; Berben, S.A.A.; Samsom, M.; Engelen, L.J.; Schoonhoven, L.

2012-01-01

BACKGROUND: Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals inc...

Telecommunications in Israeli field hospitals deployed to three crisis zones.

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Finestone, Aharon S; Levy, Gadi; Bar-Dayan, Yaron

2014-10-01

A field hospital overseas requires various types of communication equipment. This study presents the communications equipment used by three Israeli field hospital delegations to earthquake sites at Adapazari, Turkey, in 1999, Port-au-Prince, Haiti, in 2010 and Minamisanriku, Japan, in 2011. The delegations to Turkey and Haiti were relatively large (105-230 personnel) and were on the site early (three to four days after each event). The 55-person delegation to Japan arrived later and was established as an outpatient community hospital. Standard military VHF radios were the only effective tool up to 5 km, until cellular coverage was regained (1-2 weeks after each event). International communication was good. While short-wave communication (telephone and Internet) was used in Turkey, a direct satellite channel was set up in Haiti. In Japan, BGAN Inmarsat provided efficient Wi-Fi for all needs. Motorola walkie talkies were not efficient beyond the immediate vicinity. This paper recommends continued use of military-specification equipment alongside newer modalities, particularly in situations where infrastructure is damaged. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting.

Science.gov (United States)

Liu, Wei; Gerdtz, Marie; Manias, Elizabeth

2016-10-01

This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication

Assessing written communication during interhospital transfers of emergency general surgery patients.

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Harl, Felicity N R; Saucke, Megan C; Greenberg, Caprice C; Ingraham, Angela M

2017-06-15

Poor communication causes fragmented care. Studies of transitions of care within a hospital and on discharge suggest significant communication deficits. Communication during transfers between hospitals has not been well studied. We assessed the written communication provided during interhospital transfers of emergency general surgery patients. We hypothesized that patients are transferred with incomplete documentation from referring facilities. We performed a retrospective review of written communication provided during interhospital transfers to our emergency department (ED) from referring EDs for emergency general surgical evaluation between January 1, 2014 and January 1, 2016. Elements of written communication were abstracted from referring facility documents scanned into the medical record using a standardized abstraction protocol. Descriptive statistics summarized the information communicated. A total of 129 patients met inclusion criteria. 87.6% (n = 113) of charts contained referring hospital documents. 42.5% (n = 48) were missing history and physicals. Diagnoses were missing in 9.7% (n = 11). Ninety-one computed tomography scans were performed; among 70 with reads, final reads were absent for 70.0% (n = 49). 45 ultrasounds and x-rays were performed; among 27 with reads, final reads were missing for 80.0% (n = 36). Reasons for transfer were missing in 18.6% (n = 21). Referring hospital physicians outside the ED were consulted in 32.7% (n = 37); consultants' notes were absent in 89.2% (n = 33). In 12.4% (n = 14), referring documents arrived after the patient's ED arrival and were not part of the original documentation provided. This study documents that information important to patient care is often missing in the written communication provided during interhospital transfers. This gap affords a foundation for standardizing provider communication during interhospital transfers. Copyright © 2017 Elsevier Inc. All rights reserved.

Doing worse but knowing better: an exploration of the relationship between HIV/AIDS knowledge and sexual behavior among adolescents in Flemish secondary schools.

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Berten, Hans; Van Rossem, Ronan

2009-10-01

Most studies on sexual behavior have approached the relationship between AIDS knowledge and sexual behavior unidirectionally. This paper sets out to examine a reciprocal relationship between AIDS knowledge and sexual behavior, in which it is possible that adolescents who enter into sexuality may start to actively seek out information on sex. Additionally, the effects of various sources for AIDS-related information and condom use are analyzed. Data from the Flemish Educational Assessment project, which surveyed a sample of adolescents from the 3rd and 5th years of secondary school, were used. Results indicate that the relationship between AIDS knowledge and sexual behavior is quite complex. On one hand, we find that better knowledge leads to a later onset of sexuality and more consistent condom use; on the other hand, we find that adolescents who start sex earlier and use condoms inconsistently tend to be more knowledgeable about AIDS.

Measuring and Communicating Emotions Through Game Design

DEFF Research Database (Denmark)

Knutz, Eva; Markussen, Thomas

2010-01-01

digital narrative and game play as means for self-report. In so doing it integrate play, communication and measurement in one and the same device. First it gives 4-6 year old hospitalized children an opportunity to learn how to cope with their own emotional reactions to medical treatment through game play......This paper explores how emotion research may inform the design of a playful interactive tool for emotion measurement and communication, called Child Patient Game (CPgame) that has been developed for paediatric patients at a Danish hospital. The CPgame differs from other instruments in that it uses...

Evaluation and improvement of doctor–patient communication competence for emergency neurosurgeons: a standardized family model

Directory of Open Access Journals (Sweden)

Wu X

2014-06-01

Full Text Available Xi Wu,1 Zhinong Wang,2 Bo Hong,1 Shengjuan Shen,3 Yan Guo,4 Qinghai Huang,1 Jianmin Liu1 1Department of Neurosurgery, Changhai Hospital, Shanghai, People’s Republic of China; 2Department of Surgical Education, Changhai Hospital, Changzheng Hospital, Shanghai, People’s Republic of China; 3Department of Medical Education, The Second Military Medical University, Shanghai, People’s Republic of China; 4Department of Internal Medicine, Changhai Hospital, Shanghai, People’s Republic of China Abstract: Disease treatments have been significantly influenced by the communications between patients, their families, and doctors the lack of which may lead to malpractice allegations and complaints. In particular, inadequate communication may delay diagnosis and treatment. Therefore, for doctors communication and interpersonal skills, are as important as clinical skills and medical knowledge. In this study we intended to develop two detailed communication content checklists and a modified interpersonal skills inventory, aiming to evaluate their integrity in the midst of communication skills assessments, to provide feedback for some participants, and to observe their communication competence in both aspects Keywords: standardized patient, communication skill, training, medical education, neurosurgeon

The Role of ICT in Early Childhood Education: Scale Development and Research on ICT Use and Influencing Factors

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Kerckaert, Stephanie; Vanderlinde, Ruben; van Braak, Johan

2015-01-01

Nowadays, more and more authors are convinced that ICT (information and communication technology) in early childhood education provides multiple possibilities for young children. The current study, conducted in Flanders, aims to get a clearer picture of ICT use in Flemish preschools. For this purpose, a questionnaire was composed consisting of…

Exploring communication difficulties in pediatric hematology: oncology nurses.

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Citak, Ebru Akgun; Toruner, Ebru Kilicarslan; Gunes, Nebahat Bora

2013-01-01

Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.

All-Round Marketing Increases Hospital Popularity.

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Ziqi, Tao

2015-06-01

Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

LENUS (Irish Health Repository)

Haroon, Muhammad

2012-02-01

OBJECTIVES: Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. METHODS: This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. RESULTS: At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of >\\/= 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.Conclusions: Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

Safety and cost savings of reducing adult dengue hospitalization in a tertiary care hospital in Singapore.

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Lee, Linda K; Earnest, Arul; Carrasco, Luis R; Thein, Tun L; Gan, Victor C; Lee, Vernon J; Lye, David C; Leo, Yee-Sin

2013-01-01

Previously, most dengue cases in Singapore were hospitalized despite low incidence of dengue hemorrhagic fever (DHF) or death. To minimize hospitalization, the Communicable Disease Centre at Tan Tock Seng Hospital (TTSH) in Singapore implemented new admission criteria which included clinical, laboratory, and DHF predictive parameters in 2007. All laboratory-confirmed dengue patients seen at TTSH during 2006-2008 were retrospectively reviewed for clinical data. Disease outcome and clinical parameters were compared over the 3 years. There was a 33.0% mean decrease in inpatients after the new criteria were implemented compared with the period before (p hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

Linguistic barriers at a Malawian referral hospital | Kamwendo ...

African Journals Online (AJOL)

The paper discusses a small segment of the findings of a sociolinguistic study that was conducted at a Republic of China-funded referral hospital located in the predominantly Chitumbuka-speaking Northern Malawi. The main objective of the study was to identify linguistic barriers to communication that existed at the hospital ...

Towards a More Sustainable Building Stock: Optimizing a Flemish Dwelling Using a Life Cycle Approach

Directory of Open Access Journals (Sweden)

Matthias Buyle

2015-05-01

Full Text Available Over the past decades, the construction sector has focused strongly on reducing operational energy consumption. Other types of environmental impact that occur during the life span of construction works, however, have to be taken into account as well. This case study focuses on developing scenarios to improve the environmental profile of new buildings in the Flemish/Belgian context. The study takes into account current energy regulation and investigates the influence of energy scenarios and building type on the environmental profile. A life cycle energy assessment (LCEA and a life cycle impact assessment (LCIA were carried out for all scenarios, supplemented by a screening life cycle costing (LCC. The results indicate the importance of the compactness of a building, with the best results identified for the terraced scenario. The results are due to the reduced use of materials and, to a smaller extent, a reduction in energy consumption (smaller exposed surface. The results of the energy scenarios show a discrepancy between the LCEA and LCIA. According to the LCEA, passive scenarios are always preferable, but the LCIA results suggest two ways to reach a similar environmental profile. Firstly, by providing a level of insulation based on current regulations complemented with advanced technical services, and, alternatively, by increasing the level of insulation along with standard services. The results of the LCC show a similar trend to those of the LCIA. The results therefore suggest that there are multiple ways to improve the environmental profile of new buildings. Nevertheless, the choice of impact assessment method can have a strong influence on the results.

The challenges of emerging HISs in bridging the communication gaps among physicians and nurses in China: an interview study.

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Wen, Dong; Zhang, Xingting; Wan, Jie; Fu, Jing; Lei, Jianbo

2017-06-12

To explore the current situation, existing problems and possible causes of said problems with regards to physician-nurse communication under an environment of increasingly widespread usage of Hospital Information Systems and to seek out new potential strategies in information technology to improve physician-nurse communication. Semi-structured interviews were conducted with 20 physicians and nurses in five leading tertiary grade A hospitals in Beijing, China (two physicians and two nurses in each hospital). The interviews primarily included three aspects comprising the current situation and problems of clinical physician-nurse communication, the application and problems of Hospital Information Systems, and assessments on the improvement of physician-nurse communication through the usage of information technology. The inductive conventional content analysis approach was employed. (1) Physicians and nurses are generally quite satisfied with the current situation of communication. However, the information needs of nurses are prone to being overlooked, and the communication methods are primarily synchronous communication such as face-to-face and phone communication. (2) Hospital Information Systems are gradually being used for physician-nurse communication; in the meantime, physicians and nurses face challenges with regards to the improvement of physician-nurse communication through the usage of information technology. Challenges differ based on the different stages of using the system and the different levels of understanding of physicians and nurses towards information technology. Their dissatisfaction mainly deals with system errors and the level of convenience in using the system. (3) In-depth interviews found that in general, physicians and nurses have a strong interest and trust in improving physician-nurse communication through appropriate information technology, e.g., communication methods such as information reminders for physicians and nurses through mobile

Inter-organisation communication for end of life care.

Science.gov (United States)

Thomas, Paul

2009-01-01

Background Poor communication between in-hours and out-of-hours (OoH) general practitioners (GPs) causes unwanted admissions to hospital of patients who want to die at home Setting A GP OoH service in West London (London Central and West Unscheduled Care Service) used by 159 general practices from four primary care trusts Question What helps to avoid hospital admission of patients who want to die at home when a crisis occurs in the OoH period? Methods Whole system participatory action research, with four stages: 1. engage stakeholders; 2. understand the initial situation; 3. re-design the system; 4. action for change Results The following help to avoid undesirable hospital admission of a dying person who has a crisis in the OoH period: 1. a register of vulnerable adults; 2. records at home; 3. key worker(s); 4. home interventions; 5. day-time practitioner communication; 6. a development and governance group; 7. speedy discharge from hospital; 8. decision support for OoH GPs. Discussion This project revealed a useful set of policies to help avoid unnecessary OoH admission to hospital, especially improved communication between day-time GPs and OoH GPs. The approach combined whole system participatory action research with systems modelling and this helped the issues to be revealed quickly and cheaply. Furthermore, including leaders from partner organisations at each stage of the inquiry has encouraged shared purpose and produced champions to move forward the project recommendations. Some changes have already happened.

32nd Annual Conference of the Gesellschaft für Klassifikation e.V., Joint Conference with the British Classification Society (BCS) and the Dutch/Flemish Classification Society (VOC), Helmut-Schmidt-University

CERN Document Server

Lausen, Berthold; Seidel, Wilfried; Ultsch, Alfred

2010-01-01

Data Analysis, Data Handling and Business Intelligence are research areas at the intersection of computer science, artificial intelligence, mathematics, and statistics. They cover general methods and techniques that can be applied to a vast set of applications such as in marketing, finance, economics, engineering, linguistics, archaeology, musicology, medical science, and biology. This volume contains the revised versions of selected papers presented during the 32nd Annual Conference of the German Classification Society (Gesellschaft für Klassifikation, GfKl). The conference, which was organized in cooperation with the British Classification Society (BCS) and the Dutch/Flemish Classification Society (VOC), was hosted by Helmut-Schmidt-University, Hamburg, Germany, in July 2008.

Understanding the occupational and organizational boundaries to safe hospital discharge.

Science.gov (United States)

Waring, Justin; Marshall, Fiona; Bishop, Simon

2015-01-01

Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Intercultural doctor-patient communication in daily outpatient care: relevant communication skills.

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Paternotte, Emma; Scheele, Fedde; Seeleman, Conny M; Bank, Lindsay; Scherpbier, Albert J J A; van Dulmen, Sandra

2016-10-01

Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical consultations. Doctor-patient consultations of Dutch doctors with non-Dutch patients were videotaped in a multi-ethnic hospital in the Netherlands. The consultations were analyzed using the validated MAAS-Global assessment list in combination with factors influencing ICC, as described in the literature. In total, 39 videotaped consultations were analyzed. The doctors proved to be capable of practising many communication skills, such as listening and empathic communication behaviour. Other skills were not practised, such as being culturally aware and checking the patient's language ability. We showed that doctors did practice some but not all the relevant ICC skills and that the ICC style of the doctors was mainly biomedically centred. Furthermore, we discussed the possible overlap between intercultural and patient-centred communication. Implications for practice could be to implement the relevant ICC skills in the existing communication training or develop a communication training with a patient-centred approach including ICC skills.

The usefulness of information and communication technologies in crisis response.

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Paul, Sharoda A; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher; Deflitch, Christopher J

2008-11-06

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams.

The Usefulness of Information and Communication Technologies in Crisis Response

Science.gov (United States)

Paul, Sharoda A.; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher

2008-01-01

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams. PMID:18998898

Measuring hospital medical staff organizational structure.

Science.gov (United States)

Shortell, S M; Getzen, T E

1979-01-01

Based on organization theory and the work of Roemer and Friedman, seven dimensions of hospital medical staff organization structure are proposed and examined. The data are based on a 1973 nationwide survey of hospital medical staffs conducted by the American Hospital Association. Factor analysis yielded six relatively independent dimensions supporting a multidimensional view of medical staff organization structure. The six dimensions include 1) Resource Capability, 2) Generalist Physician Contractual Orientation, 3) Communication/Control, 4) Local Staff Orientation, 5) Participation in Decision Making, and 6) Hospital-Based Physician Contractual Orientation. It is suggested that these dimensions can be used to develop an empirical typology of hospital medical staff organization structure and to investigate the relationship between medical staff organization and public policy issues related to cost containment and quality assurance. PMID:511580

CAUSES FOR INEFFECTIVE COMMUNICATION BETWEEN MEDICAL SPECIALISTS

Directory of Open Access Journals (Sweden)

Stayko I. Spiridonov

2017-07-01

Full Text Available Purpose: In the resent years the healthcare system has moved to inter-professional, cross-disciplinary, multi-person approach where the communications are very important for ensuring patient safety. Communication in health organisations needs to be studied and analysed deeply and comprehensively because the future of an organisation often depends on good communication. The purpose of this study is to investigate and analyse the reasons for ineffective communication between medical specialists in the teams they work in. Materials and Methods: A questionnaire method is used. Through a survey over a period of 12 months (from 01. 12. 2014 to 01. 12. 2015 at the Escullap Hospital in Pazardzhik, DCC 18 - Sofia, St. Mina Hospital in Plovdiv, MHAT – Plovdiv, DCC 1 in Haskovo, UMHAT in Stara Zagora, DCC 3 in Varna and MHAT – Parvomay, was studied and analyzed the opinion of medical specialists on the effectiveness of communication within the team they work in. The survey includes 477 medical specialists. Results and conclusions: According to 41.1% of the respondents, the communication in the team they work in is insufficiently effective. Most of the respondents (39.8% find their colleagues responsible for the ineffective communication, followed by those who seek the cause for poor communication in the management of the health care facility (27.6%. The leading cause of poor communication in the team according to the study participants is the inequality between the characters of the colleagues (41.9%. According to the majority of respondents (28.3%, improvements in facilities and wage increases (27.3% would be essential to improve communication within the team they work in. Recommendations have been formulated to improve communication among medical specialists.

Improving the communication between teams managing boarded patients on a surgical specialty ward.

Science.gov (United States)

Puvaneswaralingam, Shobitha; Ross, Daniella

2016-01-01

Transferring patients from the ward of their specialty or consultant is described as boarding. 1 Boarding patients is becoming increasingly prevalent due to greater pressure on hospital capacity. This practice compromises patient safety through delayed investigations, prolonged hospital stays, and increased risk of hospital-acquired infections. 1 2 We evaluated how regularly boarded patients were reviewed, and how effectively information regarding their management was communicated from their primary specialty to ward staff. We aimed to improve the frequency of patient reviews by ensuring that each patient was reviewed every weekday and increase communication between primary specialty, and medical and nursing teams by 20% from baseline during the data collection period. The project was based in the Otolaryngology ward in Ninewells Hospital, Dundee, where there was a high prevalence of boarded patients. Baseline data showed a clear deficit in communication between the primary specialty and ward staff with only 31% of patient reviews being communicated to ward doctors. We designed and implemented a communication tool, in the form of a sticker, to be inserted into patients' medical notes for use by the primary specialty. Implementation of the sticker improved communication between teams as stickers were completed in 93% of instances. In 88% of patient reviews, the junior doctor was informed of the management plan, showing a large increase from baseline. Through PDSA cycles, we aimed to increase the sustainability and reliability of the sticker; however, we faced challenges with sustainability of sticker insertion. We aim to engage more stakeholders to raise awareness of the problem, brainstorm solutions together, and review the production and implementation of stickers with senior hospital management to discuss the potential use of this tool within practice. There is potentially a large scope for utilisation of this communication tool on a local level, which we hope

Hospital branding in Italy: A pilot study based on the case method.

Science.gov (United States)

Esposito, Annamaria

2017-01-01

The article investigates if, and in affirmative case how, Italian hospitals are managing corporate brand communication. Thanks to results of qualitative research, this article offers insights on Italian hospital branding. The pilot study based in the case method is to be considered a starting point for wider investigations on this topic, and it is useful for managers and practitioners who want to understand the role of corporate brand in hospital communication management and to connect health care professionals with the audience in a meaningful way in those countries in which the health care system is a mix of both public and private institutions.

The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol.

Science.gov (United States)

Manojlovich, Milisa; Adler-Milstein, Julia; Harrod, Molly; Sales, Anne; Hofer, Timothy P; Saint, Sanjay; Krein, Sarah L

2015-06-11

Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians. The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication. This 4-year study uses a sequential mixed-methods design, beginning with a

[From the medieval hospitals hospices to modern National public Health Institutes].

Science.gov (United States)

de Micheli, Alfredo

2016-01-01

Since the most ancient times, hospital constructions and progresses in the clinical practice advanced pari passu. We can find exampless of this statement in Greek regions as well as in Greek citie overseas. Thus, during the renaissance, great figures ot that time converged in Italy: The genius Leonardo da Vinci (1452-1519) and Leon Battista Alberti (1404-1472), a humanist and innovator of architecture. Michelangelo Buonarroti (1475-1564) and his contemporany artists performed anatomical dissection to perfect their art by studying the human body. Anatomical studies flourished at the University of Padua, driven by the Flemish Master. Based on the rigorous study of the anatomical substrate, the studies on the function of the already known organic structures excelled in the xvii century. That century started with the revelation of the major blood circulation by the British physician William Harvey, alumni of the University of Padua, and continued with the description of the minior or pulmonary circulation by ancient or contemporany authors and of the peripheral connections between the arterial and the venous system (Marcelo Malpighi, 1661). All these researchers, and others, were membres of the University of Padua, were the beneficial influence of the teachings of Galileo persisted. In the following centuries, together with the embryological and normal anatomy, the pathological anatomy, systematized by G.B. Morgani, became the cornerstone of the clinical practice. The model of the ancient hospitals evolved to ward the National Institutes of Health in Mexico fostered by Dr. Ignacio Chávez. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology.

Science.gov (United States)

Ahmadi, Maryam; Mehrabi, Nahid; Sheikhtaheri, Abbas; Sadeghi, Mojtaba

2017-09-01

The picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users' acceptance of PACS in the military hospitals of Tehran. In this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach's alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data. Expected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user's behavioral intentions to use PACS technology. Performance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services' quality.

Feeling Heard & Understood in the Hospital Environment: Benchmarking Communication Quality Among Patients with Advanced Cancer Before and After Palliative Care Consultation.

Science.gov (United States)

Ingersoll, Luke T; Saeed, Fahad; Ladwig, Susan; Norton, Sally A; Anderson, Wendy; Alexander, Stewart C; Gramling, Robert

2018-05-02

Maximizing value in palliative care requires continued development and standardization of communication quality indicators. To describe the basic epidemiology of a newly-adopted patient-centered communication quality indicator for hospitalized palliative care patie9nts with advanced cancer. Cross-sectional analysis of 207 advanced cancer patients who received palliative care consultation at two medical centers in the United States. Participants completed the Heard & Understood quality indicator immediately before and the day following the initial palliative care consultation: "Over the past two days ["24 hours" for the post-consultation version], how much have you felt heard and understood by the doctors, nurses and hospital staff? Completely/Quite a Bit/Moderately/Slightly/Not at All". We categorized "Completely" as indicating ideal quality. Approximately one-third indicated ideal Heard & Understood quality before palliative care consultation. Age, financial security, emotional distress, preferences for comfort-longevity tradeoffs at end-of-life, and prognosis expectations were associated with pre-consultation quality. Among those with less-than-ideal quality at baseline, 56% rated feeling more Heard & Understood the day following palliative care consultation. The greatest pre-post improvement was among people who had unformed end-of-life treatment preferences or who reported having "no idea" about their prognosis at baseline. Most patients felt incompletely heard and understood at the time of referral to palliative care consultation and more than half improved following consultation. Feeling heard and understood is an important quality indicator sensitive to interventions to improve care and key variations in the patient experience. Copyright © 2018. Published by Elsevier Inc.

Improving communication between emergency department staff.

Science.gov (United States)

Moore, Kate

2014-05-01

During redevelopment of the emergency department at the Royal Sussex County Hospital, Brighton, it was deemed vital that its internal communication system should be as effective as possible. An audit of staff perceptions of the existing communication system and a relevant literature review were undertaken, therefore, to inform a proposal for the development of a new online system. This article describes the development and implementation of the system.

Doctor-patient communication in Southeast Asia: a different culture?

Science.gov (United States)

Claramita, Mora; Nugraheni, Mubarika D F; van Dalen, Jan; van der Vleuten, Cees

2013-03-01

Studies of doctor-patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative study based on principles of grounded theory. Twenty residents and specialists and 20 patients of a low or high educational level were interviewed in internal medicine outpatient clinics of an Indonesian teaching hospital and two affiliated hospitals. During 26 weeks we engaged in an iterative interview and coding process to identify emergent factors. Patients were generally dissatisfied with doctors' communication style. The doctors indicated that they did not deliberately use a one-way style. Communication style appeared to be associated with characteristics of Southeast Asian culture, the health care setting and medical education. Doctor-patient communication appeared to be affected by cultural characteristics which fell into two broad categories representing key features of Southeast Asian culture, "social distance" and "closeness of relationships", and to characteristics categorized as "specific clinical context". Consideration of these characteristics could be helpful in promoting the use of a partnership communication style.

Advances in Telemedicine Using Mobile Communications

National Research Council Canada - National Science Library

Istepanian, Robert S. H

2001-01-01

Future telemedicine systems will exploit mobile communications technology so that patients who are free to move around at home or at work, or in emergency medical situations, can be monitored in a hospital...

Care team identification in the electronic health record: A critical first step for patient-centered communication.

Science.gov (United States)

Dalal, Anuj K; Schnipper, Jeffrey L

2016-05-01

Patient-centered communication is essential to coordinate care and safely progress patients from admission through discharge. Hospitals struggle with improving the complex and increasingly electronic conversation patterns among care team members, patients, and caregivers to achieve effective patient-centered communication across settings. Accurate and reliable identification of all care team members is a precursor to effective patient-centered communication and ideally should be facilitated by the electronic health record. However, the process of identifying care team members is challenging, and team lists in the electronic health record are typically neither accurate nor reliable. Based on the literature and on experience from 2 initiatives at our institution, we outline strategies to improve care team identification in the electronic health record and discuss potential implications for patient-centered communication. Journal of Hospital Medicine 2016;11:381-385. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Mandatory communication training of all employees with patient contact.

Science.gov (United States)

Ammentorp, Jette; Graugaard, Lars Toke; Lau, Marianne Engelbrecht; Andersen, Troels Præst; Waidtløw, Karin; Kofoed, Poul-Erik

2014-06-01

In 2010 a communication program that included mandatory communication skills training for all employees with patient contact was developed and launched at a large regional hospital in Denmark. We describe the communication program, the implementation process, and the initial assessment of the process to date. The cornerstone of the program is a communication course based on the Calgary Cambridge Guide and on the experiences of several efficacy and effectiveness studies conducted at the same hospital. The specific elements of the program are described in steps and a preliminary assessment based on feedback from the departments will be presented. The elements of the communication program are as follows: (1) education of trainers; (2) courses for health professionals employed in clinical departments; (3) education of new staff; (4) courses for health professionals in service departments; and (5) maintenance of communication skills. Thus far, 70 of 86 staff have become certified trainers and 17 of 18 departments have been included in the program. Even though the communication program is resource-intensive and competes with several other development projects in the clinical departments, the experiences of the staff and the managers are positive and the program continues as planned. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Hospitality Language In Tourism Field: Facework

Directory of Open Access Journals (Sweden)

Yohanes Kristianto

2017-01-01

Full Text Available This study aims to uncover, analyze, and interpret the reality of hospitality language in tourism from the perspective of the duality. The underlying assumption that language is an action  in social practices. This is shown by the practice of the English language in the service interaction. The structure of the English language is like  schemata of principles for service interaction and at the same time empowering service  provider to perform service interaction To uncover and interpret  hospitality language practice, the theory of structuration is applied. Theory of pragmatics is  used to analyze the linguistic phenomena. Based on the frame of structuration, this  research is identified in four issues, namely (1 the structure of hospitality language, (2 the system of  hospitality language, and (3 hospitality language as a representation facework. Problem (1 and (2 are analyzed by ethnography of communication. Problem (3 is analyzed using speech act theory and politeness theory. This study is a qualitative research, due to explore, pattern, interpreting the language practices, so it does not use statistical analysis to generalize the results. Population is not  in large quantities, but using purposive sample to determine the number of informants based on the criteria and representativeness in service encounter. In addition, language behavior in general is homogeneous. Data collected by the ethnography of communication methods, observation, and recording. The data selected are English due to English as the main foreign language in the service interaction. The findings of this study are: (1 the structure of the hospitality language, namely (a the structure of significance in the form of setting or scene of service encounter, (b the structure of domination, namely participants (tourism practitioners and tourists, (2 the system of  hospitality language in the form of (a the schemata interpretation of act sequences and keys, (b the schemata

Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme

Energy Technology Data Exchange (ETDEWEB)

Timmermans, Lore; Hauwere, An de; Bacher, Klaus; Thierens, Hubert [Ghent University, Department of Basic Medical Sciences, QCC-Gent, Ghent (Belgium); Bosmans, Hilde; Lemmens, Kim; Steen, Andre van [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Bleyen, Luc; Mortier, Griet; Herck, Koen van [Ghent University, Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent (Belgium); Limbergen, Erik van [Leuvens Universitair Centrum voor Kankerpreventie, Leuven (Belgium); Martens, Patrick [Vroegtijdige Opsporing van Borstklierkanker vzw, Bruges (Belgium)

2014-08-15

To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30 % in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. (orig.)

Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme

International Nuclear Information System (INIS)

Timmermans, Lore; Hauwere, An de; Bacher, Klaus; Thierens, Hubert; Bosmans, Hilde; Lemmens, Kim; Steen, Andre van; Bleyen, Luc; Mortier, Griet; Herck, Koen van; Limbergen, Erik van; Martens, Patrick

2014-01-01

To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30 % in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. (orig.)

Screen-detected versus interval cancers: Effect of imaging modality and breast density in the Flemish Breast Cancer Screening Programme

Energy Technology Data Exchange (ETDEWEB)

Timmermans, Lore; Bacher, Klaus; Thierens, Hubert [Ghent University, Department of Basic Medical Sciences, QCC-Gent, Ghent (Belgium); Bleyen, Luc; Herck, Koen van [Ghent University, Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent (Belgium); Lemmens, Kim; Ongeval, Chantal van; Steen, Andre van [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Martens, Patrick [Centrum voor Kankeropsporing, Bruges (Belgium); Brabander, Isabel de [Belgian Cancer Registry, Brussels (Belgium); Goossens, Mathieu [UZ Brussel, Dienst Kankerpreventie, Brussels (Belgium)

2017-09-15

To investigate if direct radiography (DR) performs better than screen-film mammography (SF) and computed radiography (CR) in dense breasts in a decentralized organised Breast Cancer Screening Programme. To this end, screen-detected versus interval cancers were studied in different BI-RADS density classes for these imaging modalities. The study cohort consisted of 351,532 women who participated in the Flemish Breast Cancer Screening Programme in 2009 and 2010. Information on screen-detected and interval cancers, breast density scores of radiologist second readers, and imaging modality was obtained by linkage of the databases of the Centre of Cancer Detection and the Belgian Cancer Registry. Overall, 67% of occurring breast cancers are screen detected and 33% are interval cancers, with DR performing better than SF and CR. The interval cancer rate increases gradually with breast density, regardless of modality. In the high-density class, the interval cancer rate exceeds the cancer detection rate for SF and CR, but not for DR. DR is superior to SF and CR with respect to cancer detection rates for high-density breasts. To reduce the high interval cancer rate in dense breasts, use of an additional imaging technique in screening can be taken into consideration. (orig.)

Screen-detected versus interval cancers: Effect of imaging modality and breast density in the Flemish Breast Cancer Screening Programme

International Nuclear Information System (INIS)

Timmermans, Lore; Bacher, Klaus; Thierens, Hubert; Bleyen, Luc; Herck, Koen van; Lemmens, Kim; Ongeval, Chantal van; Steen, Andre van; Martens, Patrick; Brabander, Isabel de; Goossens, Mathieu

2017-01-01

To investigate if direct radiography (DR) performs better than screen-film mammography (SF) and computed radiography (CR) in dense breasts in a decentralized organised Breast Cancer Screening Programme. To this end, screen-detected versus interval cancers were studied in different BI-RADS density classes for these imaging modalities. The study cohort consisted of 351,532 women who participated in the Flemish Breast Cancer Screening Programme in 2009 and 2010. Information on screen-detected and interval cancers, breast density scores of radiologist second readers, and imaging modality was obtained by linkage of the databases of the Centre of Cancer Detection and the Belgian Cancer Registry. Overall, 67% of occurring breast cancers are screen detected and 33% are interval cancers, with DR performing better than SF and CR. The interval cancer rate increases gradually with breast density, regardless of modality. In the high-density class, the interval cancer rate exceeds the cancer detection rate for SF and CR, but not for DR. DR is superior to SF and CR with respect to cancer detection rates for high-density breasts. To reduce the high interval cancer rate in dense breasts, use of an additional imaging technique in screening can be taken into consideration. (orig.)

Study on Students' Impression Data in Practical Training Using Text Mining Method-Analysis of Considerable Communication.

Science.gov (United States)

Teramachi, Hitomi; Sugita, Ikuto; Ino, Yoko; Hayashi, Yuta; Yoshida, Aki; Otsubo, Manami; Ueno, Anri; Katsuno, Hayato; Noguchi, Yoshihiro; Iguchi, Kazuhiro; Tachi, Tomoya

2017-09-01

We analyzed impression data and the scale of communication skills of students using text mining method to clarify which area a student was conscious of in communication in practical training. The results revealed that students tended to be conscious of the difference between practical hospital training and practical pharmacy training. In practical hospital training, specific expressions denoting relationships were "patient-visit", "counseling-conduct", "patient-counseling", and "patient-talk". In practical pharmacy training, specific expressions denoting relationships were "patient counseling-conduct", "story-listen", "patient-many", and "patient-visit". In practical hospital training, the word "patient" was connected to many words suggesting that students were conscious of a patient-centered communication. In practical pharmacy training, words such as "patient counseling", "patient", and "explanation" were placed in center and connected with many other words and there was an independent relationship between "communication" and "accept". In conclusion, it was suggested that students attempted active patient-centered communication in practical hospital training, while they were conscious of listening closely in patient counseling in practical pharmacy training.

Collaboration between Hospital and Community Pharmacists to Improve Medication Management from Hospital to Home

Directory of Open Access Journals (Sweden)

Judith Kristeller

2017-05-01

Full Text Available Objective: The objective of this study is to determine if a model for patient-centered care that integrates medication management between hospital and community pharmacists is feasible and can improve medication adherence. Design: This was a randomized, non-blinded, interventional study of 69 patients discharged from a hospital to home. Process measures include the number and type of medication-related discrepancies or problems identified, patient willingness to participate, the quality and quantity of interactions with community pharmacists, hospital readmissions, and medication adherence. Setting: A 214-bed acute care hospital in Northeastern Pennsylvania and seventeen regional community pharmacies. Patients: Enrolled patients were hospitalized with a primary or secondary diagnosis of heart failure or COPD, had a planned discharge to home, and agreed to speak to one of seventeen community pharmacists within the study network (i.e., a network community pharmacist following hospital discharge. Intervention: Information about a comprehensive medication review completed by the hospital pharmacist was communicated with the network community pharmacist to assist with providing medication therapy management following hospital discharge. Results: Of 180 patients eligible for the study, 111 declined to participate. Many patients were reluctant to talk to an additional pharmacist, however if the patient’s pharmacist was already within the network of 17 pharmacies, they usually agreed to participate. The study enrolled 35 patients in the intervention group and 34 in the control group. An average of 6 medication-related problems per patient were communicated to the patient’s network community pharmacist after discharge. In the treatment group, 44% of patients had at least one conversation with the network community pharmacist following hospital discharge. There was no difference in post-discharge adherence between the groups (Proportion of Days

Clinical handover as an interactive event: informational and interactional communication strategies in effective shift-change handovers.

Science.gov (United States)

Eggins, Suzanne; Slade, Diana

2012-01-01

Clinical handover -- the transfer between clinicians of responsibility and accountability for patients and their care (AMA 2006) -- is a pivotal and high-risk communicative event in hospital practice. Studies focusing on critical incidents, mortality, risk and patient harm in hospitals have highlighted ineffective communication -- including incomplete and unstructured clinical handovers -- as a major contributing factor (NSW Health 2005; ACSQHC 2010). In Australia, as internationally, Health Departments and hospital management have responded by introducing standardised handover communication protocols. This paper problematises one such protocol - the ISBAR tool - and argues that the narrow understanding of communication on which such protocols are based may seriously constrain their ability to shape effective handovers. Based on analysis of audio-recorded shift-change clinical handovers between medical staff we argue that handover communication must be conceptualised as inherently interactive and that attempts to describe, model and teach handover practice must recognise both informational and interactive communication strategies. By comparing the communicative performance of participants in authentic handover events we identify communication strategies that are more and less likely to lead to an effective handover and demonstrate the importance of focusing close up on communication to improve the quality and safety of healthcare interactions.

A qualitative study of caregivers' expectations and communication desires during medical consultation for sick children in Uganda.

Science.gov (United States)

Kiguli, Sarah; Mafigiri, David; Nakigudde, Janet; van Dalen, Jan; van der Vleuten, Cees

2011-08-01

Little data exist on patients' expectations and communication desires during medical consultation in Non-Western settings. We conducted a qualitative study to compare expectations and communication desires of sick children's caregivers at Mulago Hospital, Uganda, to those of patients in Western countries. Three Focus Group Interviews and three Key Informant Interviews were conducted with 24 caregivers of sick children in Mulago Hospital Kampala, Uganda. An interview guide adapted from the Calgary-Cambridge Guide was used to conduct focus group and Key Informant Interviews. Two investigators worked independently to review transcripts and analyse them for content and emerging themes. Caregivers of sick children in Mulago Hospital expect attending doctors to build a relationship with them, by demonstrating the verbal and nonverbal skills outlined in the CCG including maintaining eye contact, using appropriate gestures and voice during communication, and being nonjudgmental. The communication needs and expectations of caregivers of sick children in Mulago Hospital are similar to those of patients and caregivers in Western countries. The CCG can be used as a training guide to enhance the communication skills of current and future doctors in Mulago Hospital. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Instant messaging at the hospital: supporting articulation work?

Science.gov (United States)

Iversen, Tobias Buschmann; Melby, Line; Toussaint, Pieter

2013-09-01

Clinical work is increasingly fragmented and requires extensive articulation and coordination. Computer systems may support such work. In this study, we investigate how instant messaging functions as a tool for supporting articulation work at the hospital. This paper aims to describe the characteristics of instant messaging communication in terms of number and length of messages, distribution over time, and the number of participants included in conversations. We also aim to determine what kind of articulation work is supported by analysing message content. Analysis of one month's worth of instant messages sent through the perioperative coordination and communication system at a Danish hospital. Instant messaging was found to be used extensively for articulation work, mostly through short, simple conversational exchanges. It is used particularly often for communication concerning the patient, specifically, the coordination and logistics of patient care. Instant messaging is used by all actors involved in the perioperative domain. Articulation work and clinical work are hard to separate in a real clinical setting. Predefined messages and strict workflow design do not suffice when supporting communication in the context of collaborative clinical work. Flexibility is of vital importance, and this needs to be reflected in the design of supportive communication systems. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Social capital and social inequality in adolescents' health in 601 Flemish communities: a multilevel analysis.

Science.gov (United States)

De Clercq, B; Vyncke, V; Hublet, A; Elgar, F J; Ravens-Sieberer, U; Currie, C; Hooghe, M; Ieven, A; Maes, L

2012-01-01

Although it is widely acknowledged that community social capital plays an important role in young people's health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005-2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents' perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

Bridging the gap: linking a legacy hospital information system with a filmless radiology picture archiving and communications system within a nonhomogeneous environment.

Science.gov (United States)

Rubin, R K; Henri, C J; Cox, R D

1999-05-01

A health level 7 (HL7)-conformant data link to exchange information between the mainframe hospital information system (HIS) of our hospital and our home-grown picture archiving and communications system (PACS) is a result of a collaborative effort between the HIS department and the PACS development team. Based of the ability to link examination requisitions and image studies, applications have been generated to optimise workflow and to improve the reliability and distribution of radiology information. Now, images can be routed to individual radiologists and clinicians; worklists facilitate radiology reporting; applications exist to create, edit, and view reports and images via the internet; and automated quality control now limits the incidence of "lost" cases and errors in image routing. By following the HL7 standard to develop the gateway to the legacy system, the development of a radiology information system for booking, reading, reporting, and billing remains universal and does not preclude the option to integrate off-the-shelf commercial products.

Implementation and evaluation of health passport communication tools in emergency departments.

Science.gov (United States)

Heifetz, Marina; Lunsky, Yona

2018-01-01

People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Media and message strategies: consumer input for hospital advertising.

Science.gov (United States)

Flexner, W A; Berkowitz, E N

1981-01-01

In summary, the results of the study suggest that a potentially large segment of consumers views advertising as an appropriate way to communicate about hospital services and rates. These consumers are unique not by traditional measures of audience/patient sociodemographic characteristics, but rather by their values and outlook toward hospitals and health care providers. Effective hospital advertising should recognize this segment's perspective in the message that are part of overall advertising strategy.

Logistics in hospitals: a case study of some Singapore hospitals.

Science.gov (United States)

Pan, Zhi Xiong; Pokharel, Shaligram

2007-01-01

The purpose of this paper is to investigate logistics activities in Singapore hospitals. It defines various types of activities handled by a logistics division. Inventory management policy and the use of information and communication technologies (ICT) for logistics purposes are also discussed. The study identifies the nature of strategic alliances in Singapore's health care industry. This study was conducted by utilizing a framework for data collection, pre-testing the questionnaire and conducting interviews. Various relevant literature was reviewed to design the questionnaire. This study finds that logistics division carry out many related activities and some of them also provide engineering services. The hospitals make use of ICT. The hospitals are clustered under various groups to minimize the cost of operation, including the logistics related costs. However, hospitals do not see alliances with suppliers as a strategic option; rather they focus on outsourcing of logistics services. The findings also show that Singapore hospitals have a good stocking policy for both medical and non-medical items so that changes in patient mix can be easily handled. Singapore is continuously improving its health care industry and therefore, the findings will help hospitals in other regions to adopt some of the practices, like concentrating on local vendors, outsourcing, clustering, and maximum use of information technology as competitive factors that can improve the service and reduce the cost of operation. The paper suggests motivators and barriers to the use of ICT in logistics in the health care industry.

Positioning and change in a hospital ward

DEFF Research Database (Denmark)

Kjærbeck, Susanne

2017-01-01

Purpose This paper focuses on communication about hygiene in a hospital ward and with the relevant infection control organization. The purpose of this paper is to examine the function of the hygiene coordinator as a key change agent and the communicative challenges and role conflicts implied in her...... practice. The author suggests strategies for improving communication on hygiene on ward level. Design/methodology/approach The empirical material consists of interviews and recordings of communicative events in relation to a breakout of dangerous bacteria in the ward. Change communication is used...... as a contextualizing frame of understanding, and positioning theory and analysis are applied to shed light upon the core challenges of communicating as a change agent when the coordinator's professional position and collegial relations do not support it. Findings It is shown how these challenges are connected...

Health Literacy and Communication Quality in Health Care Organizations

Science.gov (United States)

Wynia, Matthew K.; Osborn, Chandra Y.

2011-01-01

The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

Centralized vs. Decentralized Nursing Stations: An Evaluation of the Implications of Communication Technologies in Healthcare.

Science.gov (United States)

Bayramzadeh, Sara; Alkazemi, Mariam F

2014-01-01

This study aims to explore the relationship between the nursing station design and use of communication technologies by comparing centralized and decentralized nursing stations. The rapid changes in communication technologies in healthcare are inevitable. Communication methods can change the way occupants use a space. In the meantime, decentralized nursing stations are emerging as a replacement for the traditional centralized nursing stations; however, not much research has been done on how the design of nursing stations can impact the use of communication technologies. A cross sectional study was conducted using an Internet-based survey among registered nurses in a Southeastern hospital in the United States. Two units with centralized nursing stations and two units with decentralized nursing stations were compared in terms of the application of communication technologies. A total of 70 registered nurses completed the survey in a 2-week period. The results revealed no significant differences between centralized and decentralized nursing stations in terms of frequency of communication technologies used. However, a difference was found between perception of nurses toward communication technologies and perceptions of the use of communication technologies in decentralized nursing stations. Although the study was limited to one hospital, the results indicate that nurses hold positive attitudes toward communication technologies. The results also reveal the strengths and weaknesses of each nursing station design with regard to communication technologies. Hospital, interdisciplinary, nursing, technology, work environment.

Watch the lights. A visual communication system.

Science.gov (United States)

Rahtz, S K

1989-01-01

The trend for hospitals to market their emergency care services results in a greater demand on radiology departments, states Ms. Rahtz. Radiology must provide efficient service to both departments, even when it is difficult to predict patient flow in the emergency care center. Improved communication is the key, and a light system installed at Morton Plant Hospital is one alternative for solving the problem.

Surgeon-patient communication during awake procedures.

Science.gov (United States)

Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander

2017-06-01

Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

TYPES OF COMMUNICATION AND THEIR ROLE IN THE COMPANY

OpenAIRE

Gudriniks, Dainis; Arbidāne, Iluta

2017-01-01

The author reviewed information in EBSCO databases on communication between managment and employee in commercial enterprises, hospitals, educational institutions, in crisis situations and everyday life. The problem identified iclude a weak communications structure and poor managment skills deteriorating quality of work in nowadays. The article dealt with Brian Weberg comunication structure, which is divided into two types. To learn how to improve communication in the organization, it was inve...

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members.

Science.gov (United States)

Wauben, L S G L; Dekker-van Doorn, C M; van Wijngaarden, J D H; Goossens, R H M; Huijsman, R; Klein, J; Lange, J F

2011-04-01

To assess surgical team members' differences in perception of non-technical skills. Questionnaire design. Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT. Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

Patient-reported Communication Quality and Perceived Discrimination in Maternity Care.

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Attanasio, Laura; Kozhimannil, Katy B

2015-10-01

High-quality communication and a positive patient-provider relationship are aspects of patient-centered care, a crucial component of quality. We assessed racial/ethnic disparities in patient-reported communication problems and perceived discrimination in maternity care among women nationally and measured racial/ethnic variation in the correlates of these outcomes. Data for this analysis came from the Listening to Mothers III survey, a national sample of women who gave birth to a singleton baby in a US hospital in 2011-2012. Outcomes were reluctance to ask questions and barriers to open discussion in prenatal care, and perceived discrimination during the birth hospitalization, assessed using multinomial and logistic regression. We also estimated models stratified by race/ethnicity. Over 40% of women reported communication problems in prenatal care, and 24% perceived discrimination during their hospitalization for birth. Having hypertension or diabetes was associated with higher levels of reluctance to ask questions and higher odds of reporting each type of perceived discrimination. Black and Hispanic (vs. white) women had higher odds of perceived discrimination due to race/ethnicity. Higher education was associated with more reported communication problems among black women only. Although having diabetes was associated with perceptions of discrimination among all women, associations were stronger for black women. Race/ethnicity was associated with perceived racial discrimination, but diabetes and hypertension were consistent predictors of communication problems and perceptions of discrimination. Efforts to improve communication and reduce perceived discrimination are an important area of focus for improving patient-centered care in maternity services.

Communication Adaptations for a Diverse International Patient Population.

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Ghosh, Aditya; Joshi, Shashank; Ghosh, Amit K

2017-11-01

We live in an age of hyper connectivity, people from around the world are looking outside their own national borders to receive medical care. As more people are learning about the quality that the elite Indian hospitals provide at a competitive, and often more affordable, price compared to other institutions around the world, they are becoming increasingly interested in receiving their medical care in Indian hospitals. It is for this exact reason that it is very important to learn the importance of communicating effectively with people from a diverse background. Over the next decade, the number of international patients that Indian hospitals will provide care for is set to dramatically increase. In this new age of medicine in India, it is imperative that doctors are adequately equipped with the communication skills to appropriately connect with patients coming from very different cultural backgrounds. The interaction with an international patient can be tremendously deepened through effective communication that adheres to the cultural beliefs of the patient. In this article, we detail how to effectively communicate with people from different backgrounds. We explore how to speak with patients and connect on a deeper level and respect the cultural differences that exist. We will also discuss how to avoid offending your patients or miscommunicating your plans to them. Overall, improved awareness of cultural differences will ensure higher patient satisfaction as well as an improved doctor patient interaction. © Journal of the Association of Physicians of India 2011.

Implementation of the Vocera Communication System in a Quaternary Perioperative Environment.

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Friend, Tynan H; Jennings, Samantha J; Copenhaver, Martin S; Levine, Wilton C

2017-01-01

In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment. Overall, the system increased the speed of information flow and eased communication between coworkers yet was perceived to have raised the overall noise level in and around the operating rooms (ORs). The perceived increase in noise was outweighed by the closed-loop communication between clinicians. Further education of the system's features in regard to speech recognition and privacy along with expected conversation protocol are necessary to ensure hassle-free communication for all staff.

Communication and well-being outcomes of a hybrid service delivery model of intensive impairment-based treatment for aphasia in the hospital setting: a pilot study.

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Wenke, Rachel; Cardell, Elizabeth; Lawrie, Melissa; Gunning, Dana

2018-06-01

This pilot study aimed to evaluate the effects of an intensive hybrid service delivery model (i.e., combining face-to-face individual, computer and group therapy) on communication and well-being for people with aphasia (PWA) in the hospital setting. The study explored two different intensities of the hybrid model, 4 h/week (Hybrid-4) and 8 h/week (Hybrid-8) both for 8 weeks. Participants ranging from 1 month to 5 years post-onset were allocated using matched-pair randomisation to receive either Hybrid-4 (n = 5) or Hybrid-8 (n = 4) and assessed using a comprehensive language battery by a blinded assessor, as well as selected activity, participation and well-being measures before, immediately after and 4-week post-treatment. All participants in Hybrid-4 and three out of four participants in Hybrid-8 demonstrated clinically significant improvement to measures of language impairment immediately post-treatment, with the majority also demonstrating maintenance effects 4-week post-treatment. Clinically significant improvements to activity, participation and well-being measures were also observed across participants in both groups. Findings support the potential benefit of employing an intensive hybrid service model and suggest that both 4 and 8 h per week of impairment-based treatment for 8 weeks may result in improvements in communication and well-being for some PWA across different stages of recovery. Implications for rehabilitation The present findings help bridge the gap between what evidence suggests is effective intensity of rehabilitation for aphasia and what can be practically delivered in real-world hospital settings. Findings support the potential clinical value of employing a hybrid service model (using computer, group and individual therapy) to deliver intensive rehabilitation to people with aphasia in the hospital setting, and suggest that clinically significant improvements to communication and well-being can result when the model is

Ensuring the security and availability of a hospital wireless LAN system.

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Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku

2013-01-01

Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. Herein we discuss security countermeasures that must be taken and issues concerning availability that must be considered to ensure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at a university hospital. Security countermeasures differ according to their purpose, such as preventing illegal use or ensuring availability, both of which are discussed. The main focus of the availability discussion is on signal reach, electromagnetic noise elimination, and maintaining power supply to the network apparatus. It is our hope that this information will assist others in their efforts to ensure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.

Effect of Filmless Imaging on Utilization of Radiologic Services with a Two-stage, Hospital-Wide Implementation of a Picture Archiving and Communication System: Initial Experience of a Fee-for-Service Model

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Yu-Ting Kuo

2003-02-01

Full Text Available A medium-sized general hospital using a fee-for-service model implemented a hospital-wide picture archiving and communication system (PACS in two stages. This study evaluated the reporting time with filmless operation and the effect of filmless imaging on referring physicians' use of the radiologic service before and after completion of the second stage of PACS implementation. The relationship between the total number of hospital patients and the number of radiologic department patients was also evaluated. All sample images were retrieved from the PACS. All corresponding reports except for one for a computerized tomography study were available. The median reporting time for different studies performed during working hours was less than 2 hours. There was a significantly positive and linear relationship (p < 0.01 between the total number of hospital patients and the number of radiologic department patients after hospital-wide implementation of PACS. We conclude that the fee-for-service model had no negative impact on referring physicians' use of radiologic services in a filmless hospital.

The role of technology in clinician-to-clinician communication.

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McElroy, Lisa M; Ladner, Daniela P; Holl, Jane L

2013-12-01

Incomplete, fragmented and poorly organised communications contribute to more than half the errors that lead to adverse and sentinel events. Meanwhile, communication software and devices with expanding capabilities are rapidly proliferating and being introduced into the healthcare setting. Clinicians face a large communication burden, which has been exacerbated by the additional challenge of selecting a mode of communication. In addition to specific communication devices, some hospitals have implemented advanced technological systems to assist with communication. However, few studies have provided empirical evidence of the specific advantages and disadvantages of the different devices used for communication. Given the increasing quantities of information transmitted to and by clinicians, evaluations of how communication methods and devices can improve the quality, safety and outcomes of healthcare are needed.

Communication disorders in Nigerian children.

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Somefun, O A; Lesi, F E A; Danfulani, M A; Olusanya, B O

2006-04-01

Communication disorders have been acknowledged as a major public health issue because they compromise early childhood development, restrict vocational attainment and undermine the economic well being of the society. The aim of this study is to determine the pattern of communication disorders among children in a developing country and the requisite intervention services. This prospective study was conducted in Lagos University Teaching Hospital, Lagos between January 2002 and June 2003 among children aged 6 months to 15 years that presented in the audiology clinic of the hospital with communication disorders. All the patients had neurological, otolaryngological, audiological and speech evaluations. A total of 184 patients were seen during the period out of whom 136 (74%) were between the ages of 6-47 months. Hearing impairment was documented in 120 (65.2%) children, speech disorders in 56 (30.4%), rhinolalia 2.2% and stuttering 2.2%. Of those with hearing impairment, 70% had delayed speech and language. Among children with speech disorders 78.6% had specific language impairment (SLI). Aetiological factors recorded for the communication disorders were seizures 10.9%, measles 8.7% meningitis 8.7%, birth asphyxia 6.5%, otitis media with effusion (OME) 4.3%, kernicterus 4.3%, congenital deformity 4.3%, ototoxicity 2.2%, cerebral palsy 2.2%, and undetermined causes 47.9%. Hearing impairment is the commonest communication disorder. Early detection and appropriate follow up is recommended for all children in their first year of life. The role of parents and caregivers in seeking early help should be strengthened while capacity building for the training of more audiologists and speech therapists should be pursued rapidly.

Workplace Learning Strategies and Professional Competencies in Innovation Contexts in Brazilian Hospitals

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Antonio Isidro-Filho

2013-04-01

Full Text Available Competencies mobilized by service providers form an element of hospital services insofar as scientific and technological procedures that are part of the service become tangible. In view of the fact that hospitals have adopted Information and Communication Technologies (ICT, it would be logical to assume that learning contributes towards acquiring competencies related to changes in hospitals resulting from the adoption of new technologies. This paper aims to analyze relationships between workplace learning strategies and professional competencies after the adoption of innovations supported ICT in hospitals. Eleven interviews were carried out with professionals from three different hospitals and identifying the professional competencies resulting from innovations supported by ICT. This was followed by a cross-sectional survey involving 425 employees at the hospitals surveyed. The data analysis was undertaken by means of structural equation modeling (SEM. The results confirm the hypothesis and indicate that the performance of professional competences based on new ICT is determined by the way the respondents think, change and apply their knowledge, skills and attitudes in the workplace by use of new information and communication technologies.

Improved perception of communication and compliance with a revised, intensive care unit-specific bedside communication sheet.

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Aponte-Patel, Linda; Sen, Anita

2015-01-01

Although many pediatric intensive care units (PICUs) use beside communication sheets (BCSs) to highlight daily goals, the optimal format is unknown. A site-specific BCS could improve both PICU communication and compliance completing the BCS. Via written survey, PICU staff at an academic children's hospital provided recommendations for improving and revising an existing BCS. Pre- and post-BCS revision, PICU staff were polled regarding PICU communication and BCS effectiveness, and daily compliance for completing the BCS was monitored. After implementation of the revised BCS, staff reporting "excellent" or "very good" day-to-day communication within the PICU increased from 57% to 77% (P = .02). Compliance for completing the BCS also increased significantly (75% vs 83%, P = .03). Introduction of a focused and concise BCS tailored to a specific PICU leads to improved perceptions of communication by PICU staff and increased compliance completing the daily BCS. © The Author(s) 2014.

Risk communication and crisis communication in infectious disease outbreaks in Germany: what is being done, and what needs to be done.

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Dickmann, Petra; Biedenkopf, Nadine; Keeping, Sam; Eickmann, Markus; Becker, Stephan

2014-06-01

Risk communication plays a central role in the management of infectious disease. The World Health Organization's 2005 International Health Regulations have highlighted the need for countries to strengthen their capacities in this area to ensure effective responses to public health emergencies. We surveyed laboratories, hospitals, and public health institutions in Germany to detail the current situation regarding risk communication and crisis management and to identify which areas require further development. A mixed methods approach was adopted. An initial questionnaire was distributed to relevant persons in laboratories and hospitals, and semistructured interviews were conducted with selected participants. Representatives from state public health authorities, federal agencies, and media also were interviewed to add additional contextual information to the questionnaire responses. Based on the responses received, the universal sense among key stakeholders was that risk communication and crisis communication measures must be improved. Collaborative working was a consistent theme, with participants suggesting that a partnering strategy could help to improve performance. This approach could be achieved through better coordination between groups, for example, through a knowledge-sharing policy. More research is needed on how such collaboration might be implemented, along with a general conceptual framework for risk communication to underpin the overall strategy.

EFFECTIVE LEADERSHIP AND WORK MOTIVATION IN THE APLICATION OF NURSE THERAPEUTIC COMMUNICATION

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Farida Farida

2017-04-01

Full Text Available Introduction: The objective of this study was to identify effective leadership and the work motivation with the implementation of therapeutic communication, Method: Design used in this study was descriptive design of the correlation with the approach cross sectional study. The population of this study was all of the practising nurse in the in-patient (hospitalized ward at the Dr. Iskak Tulungagung hospital. All datas were taken by using the method of total population of the 98 practising nurses. Result: The result of this study showed that the big proportion of the practising nurses whose ages are less than 30 years old, graduated from Diploma, status are single (unmarried, duration of work was less or same as 6 years, generally never followed a training of communication, whereas effective leadership was in the good category and the category of work motivation wasn’t better. Analysis using chi-square with alpha 0,05 showed that there was relations between the age, old the work, effective leadership and the work motivation and the implementation of therapeutic communication. The marital status and training had not relationship with the implementation of therapeutic communication. Discussion: It is suggested that hospital should encoverage nurse manager to promote therapeutic communication among nurses.

Evaluation of a novel individualised communication-skills training intervention to improve doctors' confidence and skills in end-of-life communication.

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Clayton, Josephine M; Butow, Phyllis N; Waters, Amy; Laidsaar-Powell, Rebekah C; O'Brien, Angela; Boyle, Frances; Back, Anthony L; Arnold, Robert M; Tulsky, James A; Tattersall, Martin H N

2013-03-01

We developed a novel individualised training program regarding end-of-life communication, designed to be time effective for busy junior-doctors working in hospital settings. We aimed to pilot this brief individualised training program with junior-doctors to explore its acceptability, feasibility and effect on the doctors' confidence, communication skills, attitudes towards psychosocial care and burnout. The content of the training intervention was informed by a systematic literature review and evidence-based clinical practice guidelines regarding end-of-life communication. The intervention was based on sound educational principles and involved three one-hour teaching sessions over a three-week period, including two individual sessions with an expert facilitator and simulated patient/caregiver. In addition, participants received written and audiovisual take-home learning materials. PARTICIPANTS were videotaped consulting with a simulated patient/caregiver pre/post training to assess the impact of the course on their communication behaviours. PARTICIPANTS completed de-identified questionnaires pre/post training, including self-assessed confidence, attitudes to psychosocial care, and the Maslach Burnout inventory. PARTICIPANTS included 22 junior-doctors from a large teaching hospital in Sydney, Australia. All participants reported that the training was useful, had been helpful for their communication with patients and that they would recommend the training to others. Significant improvements were found in participants' communication skills (in seven out of 21 specific and all three global communication behaviours assessed, range P=0.02 to confidence in communicating about relevant topics (P<0.001), attitudes towards psychosocial care (P=0.03) and sense of personal accomplishment (P=0.043). There were no overall differences in participants' burnout levels. This intervention shows promise and warrants further formal evaluation.

A Step Toward High Reliability: Implementation of a Daily Safety Brief in a Children's Hospital.

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Saysana, Michele; McCaskey, Marjorie; Cox, Elaine; Thompson, Rachel; Tuttle, Lora K; Haut, Paul R

2017-09-01

Health care is a high-risk industry. To improve communication about daily events and begin the journey toward a high reliability organization, the Riley Hospital for Children at Indiana University Health implemented a daily safety brief. Various departments in our children's hospital were asked to participate in a daily safety brief, reporting daily events and unexpected outcomes within their scope of responsibility. Participants were surveyed before and after implementation of the safety brief about communication and awareness of events in the hospital. The length of the brief and percentage of departments reporting unexpected outcomes were measured. The analysis of the presurvey and the postsurvey showed a statistically significant improvement in the questions related to the awareness of daily events as well as communication and relationships between departments. The monthly mean length of time for the brief was 15 minutes or less. Unexpected outcomes were reported by 50% of the departments for 8 months. A daily safety brief can be successfully implemented in a children's hospital. Communication between departments and awareness of daily events were improved. Implementation of a daily safety brief is a step toward becoming a high reliability organization.

Effective communication with primary care providers.

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Smith, Karen

2014-08-01

Effective communication requires direct interaction between the hospitalist and the primary care provider using a standardized method of information exchange with the opportunity to ask questions and assign accountability for follow-up roles. The discharge summary is part of the process but does not provide the important aspects of handoff, such as closed loop communication and role assignments. Hospital discharge is a significant safety risk for patients, with more than half of discharged patients experiencing at least one error. Hospitalist and primary care providers need to collaborate to develop a standardized system to communicate about shared patients that meets handoff requirements. Copyright © 2014 Elsevier Inc. All rights reserved.

Intelligent energy efficiency control in hospitals

Energy Technology Data Exchange (ETDEWEB)

Nykaenen, E., Email: esa.nykanen@vtt.fi

2012-06-15

The concern of European society for the well-being of its residents and the sustainability of the environment has led to the consciousness that energy savings need to be at the top of the political agenda. Until recently, the focus of energy reduction has been on schools and offices. Hospitals, however, also use large amounts of energy. Therefore, the project will address specifically the hospital domain. HosPilot will address the two main technology areas Lighting and HVAC (Heating, Ventilation and Air Conditioning), thus covering the largest part of the energy-consuming areas. By adding intelligence, ICT (Information and Communication Technology) will play a vital role to achieve significant energy reduction in the complex environment of a hospital. (orig.)

Conduits to care: call lights and patients’ perceptions of communication

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Montie M

2017-09-01

Full Text Available Mary Montie,1 Clayton Shuman,1 Jose Galinato,1 Lance Patak,2 Christine A Anderson,1 Marita G Titler1 1Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, 2Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA, USA Background: Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods: Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated. Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results: Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”. Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion: Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. Keywords: nurse–patient communication, medical technology, quality of care, qualitative research

The impact of medical tourism on Thai private hospital management: informing hospital policy.

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James, Paul T J

2012-01-01

The purpose of this paper is to help consolidate and understand management perceptions and experiences of a targeted group (n=7) of Vice-Presidents of international Private Thai hospitals in Bangkok regarding medical tourism impacts. The method adopted uses a small-scale qualitative inquiry. Examines the on-going development and service management factors which contribute to the establishment and strengthening of relationships between international patients and hospital medical services provision. Develops a qualitative model that attempts to conceptualize the findings from a diverse range of management views into a framework of main (8) - Hospital Management; Hospital Processes; Hospital Technology; Quality Related; Communications; Personnel; Financial; and Patients; and consequent sub-themes (22). Outcomes from small-scale qualitative inquiries cannot by design be taken outside of its topical arena. This inevitably indicates that more research of this kind needs to be carried out to understand this field more effectively. The evidence suggests that Private Thai hospital management have established views about what constitutes the impact of medical tourism on hospital policies and practices when hospital staff interact with international patients. As the private health service sector in Thailand continues to grow, future research is needed to help hospitals provide appropriate service patterns and appropriate medical products/services that meet international patient needs and aspirations. Highlights the increasing importance of the international consumer in Thailand's health industry. This study provides insights of private health service providers in Bangkok by helping to understand more effectively health service quality environments, subsequent service provision, and the integrated development and impacts of new medical technology.

Emergency Response of Iranian Hospitals Against Disasters: A Practical Framework for Improvement.

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Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah

2018-04-01

Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).

A conceptual model of the role of communication in surrogate decision making for hospitalized adults.

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Torke, Alexia M; Petronio, Sandra; Sachs, Greg A; Helft, Paul R; Purnell, Christianna

2012-04-01

To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model. The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model. Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Endocrine actions of pesticides measured in the Flemish environment and health studies (FLEHS I and II).

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Croes, K; Den Hond, E; Bruckers, L; Govarts, E; Schoeters, G; Covaci, A; Loots, I; Morrens, B; Nelen, V; Sioen, I; Van Larebeke, N; Baeyens, W

2015-10-01

Within the Flemish Environment and Health studies (FLEHS I, 2002-2006, and FLEHS II, 2007-2012), pesticide exposure, hormone levels and degree of sexual maturation were measured in 14-15-year-old adolescents residing in Flanders (Belgium). In FLEHS II, geometric mean concentrations (with 95 % confidence interval (CI)) of 307 (277-341) and 36.5 ng L(-1) (34.0-39.2) were found for p,p'-dichlorophenyldichloroethylene (p,p'-DDE) and hexachlorobenzene (HCB). These values were respectively 26 and 60 % lower than levels in FLEHS I, 5 years earlier. Metabolites of organophosphorus pesticides (OPPs) and of para-dichlorobenzene were measured for the first time in FLEHS II, yielding concentrations of 11.4, 3.27 and 1.57 μg L(-1) for the sum of dimethyl- and diethyl phosphate metabolites and 2,5-dichlorophenol (2,5-DCP), respectively. Data on internal exposure of HCB showed a positive correlation with sexual maturation, testosterone and the aromatase index for boys and with free thyroxine (fT4) and thyroid stimulating hormone (TSH) (both boys and girls). For both p,p'-DDE and HCB, a negative association with sexual development in girls was found. The OPP metabolites were negatively associated with sex hormone levels in the blood of boys and with sexual maturation (both boys and girls). The pesticide metabolite 2,5-DCP was negatively correlated with free T4, while a positive association with TSH was reported (boys and girls). These results show that even exposure to relatively low concentrations of pesticides can have significant influences on hormone levels and the degree of sexual maturation in 14-15-year-old adolescents.

Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

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YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

2010-01-01

Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

Role of communication systems in coordinating supervising anesthesiologists' activities outside of operating rooms.

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Smallman, Bettina; Dexter, Franklin; Masursky, Danielle; Li, Fenghua; Gorji, Reza; George, Dave; Epstein, Richard H

2013-04-01

Theoretically, communication systems have the potential to increase the productivity of anesthesiologists supervising anesthesia providers. We evaluated the maximal potential of communication systems to increase the productivity of anesthesia care by enhancing anesthesiologists' coordination of care (activities) among operating rooms (ORs). At hospital A, data for 13,368 pages were obtained from files recorded in the internal alphanumeric text paging system. Pages from the postanesthesia care unit were processed through a numeric paging system and thus not included. At hospital B, in a different US state, 3 of the authors categorized each of 898 calls received using the internal wireless audio system (Vocera(®)). Lower and upper 95% confidence limits for percentages are the values reported. At least 45% of pages originated from outside the ORs (e.g., 20% from holding area) at hospital A and at least 56% of calls (e.g., 30% administrative) at hospital B. In contrast, requests from ORs for urgent presence of the anesthesiologist were at most 0.2% of pages at hospital A and 1.8% of calls at hospital B. Approximately half of messages to supervising anesthesiologists are for activity originating outside the ORs being supervised. To use communication tools to increase anesthesia productivity on the day of surgery, their use should include a focus on care coordination outside ORs (e.g., holding area) and among ORs (e.g., at the control desk).

[Communication between nursing students and patients with Aids].

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de Lima, Ivana Cristina Vieira; Galvão, Marli Teresinha Gimeniz; Costa, Enia; Freitas, Julyana Gomes; Freitag, Lorita Marlena

2011-04-01

This study was performed with the purpose to analyze the communication between nursing students and patients with AIDS during peripheral venous puncture. Video recordings were made of six pairs (student-patient) while performing the venous puncture procedure in May 2009 at a day-hospital in Fortaleza-Ceará. As a group, four judges evaluated the interactions established between the pairs. The analyses were categorized in: Valuing technique over communication; Mask: a barriers to communication; Private space invasion; Interference of the environment in the communication. It was concluded that different factors increase the difficulty establishing an effective communication, especially the need for students to be trained about the importance of establishing communication during care, so as to promote humanized and individual care, in which sensitivity and empathy overlap fear and insecurity.

Mass casualty drill in a local hospital | Ardill | Nigerian Journal of ...

African Journals Online (AJOL)

The stated goals of the mass casualty drill were as follows: evaluate the performance of the hospital staff at every cadre, the communication systems, the adequacy of hospital supplies and equipment and provide immediate feedback to the staff for their educational benefit and improved future performance. The Consultant ...

Associations between communication climate and the frequency of medical error reporting among pharmacists within an inpatient setting.

Science.gov (United States)

Patterson, Mark E; Pace, Heather A; Fincham, Jack E

2013-09-01

Although error-reporting systems enable hospitals to accurately track safety climate through the identification of adverse events, these systems may be underused within a work climate of poor communication. The objective of this analysis is to identify the extent to which perceived communication climate among hospital pharmacists impacts medical error reporting rates. This cross-sectional study used survey responses from more than 5000 pharmacists responding to the 2010 Hospital Survey on Patient Safety Culture (HSOPSC). Two composite scores were constructed for "communication openness" and "feedback and about error," respectively. Error reporting frequency was defined from the survey question, "In the past 12 months, how many event reports have you filled out and submitted?" Multivariable logistic regressions were used to estimate the likelihood of medical error reporting conditional upon communication openness or feedback levels, controlling for pharmacist years of experience, hospital geographic region, and ownership status. Pharmacists with higher communication openness scores compared with lower scores were 40% more likely to have filed or submitted a medical error report in the past 12 months (OR, 1.4; 95% CI, 1.1-1.7; P = 0.004). In contrast, pharmacists with higher communication feedback scores were not any more likely than those with lower scores to have filed or submitted a medical report in the past 12 months (OR, 1.0; 95% CI, 0.8-1.3; P = 0.97). Hospital work climates that encourage pharmacists to freely communicate about problems related to patient safety is conducive to medical error reporting. The presence of feedback infrastructures about error may not be sufficient to induce error-reporting behavior.

Three-tiered integration of PACS and HIS toward next generation total hospital information system.

Science.gov (United States)

Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

1998-01-01

The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

Quality Communication in Hospitality: Language Skills or Culture Transfer?

Science.gov (United States)

Leung, Peggy; Lo, Terence

This paper focuses on English language teaching for the hospitality industry in Hong Kong, presenting a brief statement on the concept of transfer and its relevance to teaching English as a Foreign Language (EFL) for the world of work. The observable changes in the nature of language in the world of work in a service-oriented economy are…

The VOICE study - A before and after study of a dementia communication skills training course.

Science.gov (United States)

O'Brien, Rebecca; Goldberg, Sarah E; Pilnick, Alison; Beeke, Suzanne; Schneider, Justine; Sartain, Kate; Thomson, Louise; Murray, Megan; Baxendale, Bryn; Harwood, Rowan H

2018-01-01

A quarter of acute hospital beds are occupied by persons living with dementia, many of whom have communication problems. Healthcare professionals lack confidence in dementia communication skills, but there are no evidence-based communication skills training approaches appropriate for professionals working in this context. We aimed to develop and pilot a dementia communication skills training course that was acceptable and useful to healthcare professionals, hospital patients and their relatives. The course was developed using conversation analytic findings from video recordings of healthcare professionals talking to patients living with dementia in the acute hospital, together with systematic review evidence of dementia communication skills training and taking account of expert and service-user opinion. The two-day course was based on experiential learning theory, and included simulation and video workshops, reflective diaries and didactic teaching. Actors were trained to portray patients living with dementia for the simulation exercises. Six courses were run between January and May 2017. 44/45 healthcare professionals attended both days of the course. Evaluation entailed: questionnaires on confidence in dementia communication; a dementia communication knowledge test; and participants' satisfaction. Video-recorded, simulated assessments were used to measure changes in communication behaviour. Healthcare professionals increased their knowledge of dementia communication (mean improvement 1.5/10; 95% confidence interval 1.0-2.0; pskills learned in clinical practice. Blind-ratings of simulated patient encounters demonstrated behaviour change in taught communication behaviours to close an encounter, consistent with the training, but not in requesting behaviours. We have developed an innovative, evidence-based dementia communication skills training course which healthcare professionals found useful and after which they demonstrated improved dementia communication

Performance Measurement in Belgian Hospitals : a state-of-the-art

OpenAIRE

Van Caillie, Didier; Rouhana, Rima; Santin, Sarah

2007-01-01

This communication proposes a global state-of-the-art around the central question : "How is performance measured and controlled in Belgian hospitals. As a first step in a global research project dedicated to the use of Balanced ScoreCard in publics hospitals around the world, it is essentially focused on global economic aspects and on major macroeconomic statistics.

We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record.

Science.gov (United States)

Sheu, Leslie; Fung, Kelly; Mourad, Michelle; Ranji, Sumant; Wu, Ethel

2015-05-01

Poor communication between hospitalists and outpatient physicians can contribute to adverse events after discharge. Electronic medical records (EMRs) shared by inpatient and outpatient clinicians offer primary care providers (PCPs) better access to information surrounding a patient's hospitalization. However, the PCP experience and subsequent expectations for discharge communication within a shared EMR are unknown. We surveyed PCPs 1 year after a shared EMR was implemented at our institution to assess PCP satisfaction with current discharge communication practices and identify areas for improvement. Seventy-five of 124 (60%) clinicians completed the survey. Although most PCPs reported receiving automated discharge notifications (71%), only 39% felt that notifications plus discharge summaries were adequate for safe transitions of care. PCPs expressed that complex hospitalizations necessitated additional communication via e-mail or telephone; only 31% reported receiving such communication. The content most important in additional communication included medication changes, follow-up actions, and active medical issues. Despite optimized access to information provided by a shared EMR, only 52% of PCPs were satisfied with current discharge communication. PCPs express a continued need for high-touch communication for safe transitions of care. Further standardization of discharge communication practices is necessary. © 2015 Society of Hospital Medicine.

Multidisciplinary in-hospital teams improve patient outcomes: A review.

Science.gov (United States)

Epstein, Nancy E

2014-01-01

The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses' aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient "staff" satisfaction. Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers' performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.

Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria

Directory of Open Access Journals (Sweden)

A Ibrahim

2011-01-01

Full Text Available Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for training in communication skills as a basis for developing an effective education programme. Method A survey of patient care - related communication skills among surgery residents and assessment of competence, rating the importance and perceived need for training in communication skills. Results Most residents rated their skills as either fairly or extremely competent in all areas except in providing bereavement counseling. They found all skills important and indicated a need for training in them. Senior registrars rated their competence and the importance higher in skills relating to breaking bad news, educating and preparing patients and families for surgery and encouraging them to express their anxieties. (p 0.05. Conclusion Residents face difficult communication challenges with patients and their families. There is a dire need for improved education in communication skills. Understanding the surgical trainees perceptions of patient care related communication skills is the first step in designing an effective education programme.

[The effect of a scenario-based simulation communication course on improving the communication skills of nurses].

Science.gov (United States)

Huang, Ya-Hsuan; Hsieh, Suh-Ing; Hsu, Li-Ling

2014-04-01

Limited disease knowledge is frequently the cause of disease-related anxiety in myocardial infarction patients. The ability to communicate effectively serves multiple purposes in the professional nursing practice. By communicating effectively with myocardial infarction patients, nurses may help reduce their anxiety by keeping them well informed about their disease and teaching them self-care strategies. This research evaluates the communication skills of nurses following scenario-based simulation education in the context of communication with myocardial infarction patients. This study used an experimental design and an educational intervention. The target population comprised nurses of medicine (clinical qualified level N to N2 for nursing) working at a municipal hospital in Taipei City, Taiwan. A total 122 participants were enrolled. Stratified block randomization divided participants into an experimental group and a control group. The experimental group received clinical scenario-based simulation education for communication. The control group received traditional class-based education for communication. Both groups received a pre-test and a Communication Skills Checklist post-test assessment. Results were analyzed using SPSS 17.0 for Windows software. A t-test showed significant increases in communication skills (p skills following the education intervention. The results indicate that clinical scenario-based simulation education for communication is significantly more effective than traditional class-based education in enhancing the ability of nurses to communicate effectively with myocardial infarction patients.

Developing hospital identity manuals: a reference tool for illustrators.

Science.gov (United States)

Schaffer, J A; Zimmerman, S B

1990-01-01

Because of an increase in hospital marketing efforts, medical illustrators may be asked to assist in developing and implementing hospital identity manuals, which specify the graphic standards for visual communications media. A checklist survey of existing identity manuals and a literature review were conducted by one of the authors, a medical illustrator, to help her to develop a manual for her hospital employer. This article documents the literature review, the study, and the identity manual development, and presents recommendations to help other medical illustrators who might become involved in similar assignments.

First-grade retention in the Flemish educational context: Effects on children's academic growth, psychosocial growth, and school career throughout primary education.

Science.gov (United States)

Goos, Mieke; Van Damme, Jan; Onghena, Patrick; Petry, Katja; de Bilde, Jerissa

2013-06-01

This study examined the effects of first-grade retention on children's academic growth, psychosocial growth, and future school career by following a cohort of first graders until the start of secondary school. The study took place in the Flemish educational context where primary school students are taught in uniform curricular year groups; the same curricular goals are set for all students, irrespective of ability; and grade retention is used as the main way to cater for students not reaching these goals. Propensity score stratification was used to deal with selection bias. Three-level curvilinear growth curve models, encompassing both grade and age comparisons, were used to model children's growth in math skills, reading fluency skills, and psychosocial skills. Two-level logistic regression models were used to model children's likelihood of repeating any grade between Grades 2 and 6, transitioning to a special education primary school, moving to another primary school, and transitioning to the A (versus B) track in secondary education. Overall, results showed that first-grade retention was less helpful for struggling students than generally thought by parents and educators. Limitations of the study and further research suggestions are provided, and practical implications are discussed. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Physicians interrupted by mobile devices in hospitals: understanding the interaction between devices, roles, and duties.

Science.gov (United States)

Solvoll, Terje; Scholl, Jeremiah; Hartvigsen, Gunnar

2013-03-07

A common denominator of modern hospitals is a variety of communication problems. In particular, interruptions from mobile communication devices are a cause of great concern for many physicians. To characterize how interruptions from mobile devices disturb physicians in their daily work. The gathered knowledge will be subsequently used as input for the design and development of a context-sensitive communication system for mobile communications suitable for hospitals. This study adheres to an ethnographic and interpretive field research approach. The data gathering consisted of participant observations, non-structured and mostly ad hoc interviews, and open-ended discussions with a selected group of physicians. Eleven physicians were observed for a total of 135 hours during May and June 2009. The study demonstrates to what degree physicians are interrupted by mobile devices in their daily work and in which situations they are interrupted, such as surgery, examinations, and during patients/relatives high-importance level conversations. The participants in the study expected, and also indicated, that wireless phones probably led to more interruptions immediately after their introduction in a clinic, when compared to a pager, but this changed after a short while. The unpleasant feeling experienced by the caller when interrupting someone by calling them differs compared to sending a page message, which leaves it up to the receiver when to return the call. Mobile devices, which frequently interrupt physicians in hospitals, are a problem for both physicians and patients. The results from this study contribute to knowledge being used as input for designing and developing a prototype for a context-sensitive communication system for mobile communication suitable for hospitals. We combined these findings with results from earlier studies and also involved actual users to develop the prototype, CallMeSmart. This system intends to reduce such interruptions and at the same time

Doctors' traits perceived by Japanese nurses as communication barriers: a questionnaire survey.

Science.gov (United States)

Morinaga, Kyoko; Ohtsubo, Yohsuke; Yamauchi, Keiko; Shimada, Yasuhiro

2008-05-01

Studies addressing nurses' traits to improve the quality of nurse-physician communication exist, whereas only a few studies exploring physicians' traits as communication barriers are conducted. The purpose of this research is to determine what types of physicians do nurses find difficult to communicate with. To this end, we conducted a pilot study, consisting of semi-structured interviews, with nine nurses. A questionnaire survey was then conducted to test the generalizability of the interviewees' opinions about physician traits that impede effective nurse-physician communication. A within-respondent factorial design was employed. Each respondent answered questions about two physicians whom she or he has found most difficult or easiest to communicate with. The order of physician type (easy vs. difficult) was counterbalanced. The main study, a questionnaire survey, was administered at four Japanese hospitals. Participants were 310 nurses. The questionnaires were mailed to the person in charge of each hospital. The questionnaires were handed to the nurses by the person in charge. Three out of the four hospitals reported that a majority of their nurses answered the questionnaires. The questionnaire asked respondents to evaluate how well various statements (e.g., Is the doctor moody?) fit a particular physician whom she or he has found most difficult or easiest to communicate with. A series of repeated-measures ANOVAs revealed that every statement was judged as fitting the description of doctors they found difficult better than that of doctors they found easy to talk to. An exploratory cluster analysis was conducted and it revealed that difficult characteristics of physicians can be divided into three subtypes. The questionnaire survey confirmed that opinions provided by interviewees in the pilot study were widely shared by other Japanese nurses. The study revealed that communication barriers between nurses and physicians are caused by the physicians' reluctance to

Drug shortage management in Alabama hospital pharmacies

Directory of Open Access Journals (Sweden)

Oliver W. Holmes, III

2013-01-01

Full Text Available Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages. Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory. The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used. Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals. Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.   Type: Original Research

Drug shortage management in Alabama hospital pharmacies

Directory of Open Access Journals (Sweden)

Oliver W. Holmes III, Pharm.D. Candidate 2013

2013-01-01

Full Text Available Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages.Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory. The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used.Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals.Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.

Packaging Patients and Handing Them Over: Communication Context and Persuasion in the Emergency Department.

Science.gov (United States)

Nugus, Peter; McCarthy, Sally; Holdgate, Anna; Braithwaite, Jeffrey; Schoenmakers, Anne; Wagner, Cordula

2017-02-01

Communication is commonly understood by health professional researchers to consist of relatively isolated exchanges of information. The social and organizational context is given limited credit. This article examines the significance of the environmental complexity of the emergency department (ED) in influencing communication strategies and makes the case for adopting a richer understanding of organizational communication. This study draws on approximately 12 months (1,600 hours) of ethnographic observations, yielding approximately 4,500 interactions across 260 clinicians and staff in the EDs of 2 metropolitan public teaching hospitals in Sydney, Australia. The study identifies 5 communication competencies of increasing complexity that emergency clinicians need to accomplish. Furthermore, it identifies several factors-hierarchy, formally imposed organizational boundaries and roles, power, and education-that contribute to the collective function of ensuring smooth patient transfer through and out of the ED. These factors are expressed by and shape external communication with clinicians from other hospital departments. This study shows that handoff of patients from the ED to other hospital departments is a complex communication process that involves more than a series of "checklistable" information exchanges. Clinicians must learn to use both negotiation and persuasion to achieve objectives. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

A Therapeutic Communication Study of Families with Children Suffering from Cancer

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Devie Rahmawati

2017-12-01

Full Text Available Therapeutic communication is a relatively new area of research in Indonesia. It is widely known that the success of therapeutic communication is largely influenced by the medical providers’ communication effectiveness when dealing with their clients. This paper reports on research that aimed to explore the connection between therapeutic communication and satisfaction and dissatisfaction as experienced by families of child cancer patients. It used a quantitative approach with a cross-sectional design. The sample was the families of child cancer patients who were acccompanying the patients during hospital stay treatment at an Indonesian public hospital in Jakarta over the period December of   2014 – March 2015. There were 23 respondents for the research. The statistical test used was chi-square with an 0.05 level of significance. The result indicated that 56.5% of the respondents were satisfied with the therapeutic communication provided by nursing staff and that those who praticed therapeutic communication well, were 22 times more likely to provide a satisfactory level to the families  of   child  cancer  patients  compared  with  those who  did not  apply good therapeutic communication  (the value of p=0.003 and Odds ratio= 22. Thus, the research indicated that the medical providers’ communication effectiveness was associated with the patients’ satisfaction. We suggest that medical providers be given workshops on how to improve their communication skills to make their clients more satisfied with the medical services.

The communication atmosphere between physician colleagues: competitive perfectionism or supportive dialogue? A Norwegian study.

Science.gov (United States)

Akre, V; Falkum, E; Hoftvedt, B O; Aasland, O G

1997-02-01

Open and supportive communication is probably one of the most important promotors of learning, coping and satisfaction at the workplace. The aim of this paper is to describe and predict the communication atmosphere between Norwegian physicians. Twenty statements describing communication, as perceived by the physicians themselves, were presented to a random sample of the members of the Norwegian Medical Association of which more than 90% of the physicians in the country are members (N = 2628). In general, this investigation indicates that the communication atmosphere among Norwegian physicians is characterised by support and mutual respect. More than half of the respondents fully agreed that communication between colleagues in the workplace is marked by solidarity, and that experienced colleagues show respect for the less experienced in both personal and professional matters. Physicians working in hospitals described the communication atmosphere as substantially more selfish and competitive than non-hospital physicians, whilst general practitioners considered the atmosphere between colleagues to be more supportive than non-specialists. In addition, high perceived stress was associated with the perception of a less supportive atmosphere. However, the strongest predictor of the communication atmosphere was clearly the physician's perceived autonomy. The comprehensive retrenchment programmes implemented in Norwegian hospitals during recent years have increased stress and restricted professional autonomy among both physicians and other occupational groups. Our findings indicate that the communication atmosphere necessary to secure continuity of knowledge within the medical profession may have been jeopardised by this process. In the long term, this may prove hazardous to the quality of medical care.

Kenya Hospices and Palliative Care Association: integrating palliative care in public hospitals in Kenya

OpenAIRE

Ali, Zipporah

2016-01-01

Background In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable...

Radiation decontamination unit for the community hospital

International Nuclear Information System (INIS)

Waldron, R.L. II; Danielson, R.A.; Shultz, H.E.; Eckert, D.E.; Hendricks, K.O.

1981-01-01

Freestanding radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstrution. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Rige Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important

The Relational Responding Task: Toward a New Implicit Measure of Beliefs

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Jan eDe Houwer

2015-03-01

Full Text Available We introduce the Relational Responding Task (RRT as a tool for capturing beliefs at the implicit level. Flemish participants were asked to respond as if they believed that Flemish people are more intelligent than immigrants (e.g., respond true to the statement Flemish people are wiser than immigrants or to respond as if they believed that immigrants are more intelligent than Flemish people (e.g., respond true to the statement Flemish people are dumber than immigrants. The difference in performance between these two tasks correlated with ratings of the extent to which participants explicitly endorsed the belief that Flemish people are more intelligent than immigrants and with questionnaire measures of subtle and blatant racism. The current study provides a first step towards validating RRT effects as a viable measure of implicit beliefs.

St Joseph's Community Hospital, Stranorlar, Donegal.

LENUS (Irish Health Repository)

Nuzum, D

2017-02-01

Communicating bad news in obstetrics is challenging. This study explores the impact of how bad news was communicated to parents following a diagnosis of stillbirth. Qualitative in-depth interviews were conducted with 12 mothers and 5 fathers, bereaved following stillbirth at a tertiary maternity hospital where the perinatal mortality rate is 5.2\\/1000. Data were analysed using Interpretative Phenomenological Analysis. How the diagnosis of stillbirth was communicated had a profound and lasting impact on parents. Dominant superordinate themes were Language used, Sensitivity and Diversionary techniques. Parents recalled in detail where and how bad news was broken and language used. Diversionary techniques created a sense of mistrust especially when parents felt information was being withheld. Bereaved parents valued privacy at the time of diagnosis of stillbirth.This study highlights the importance of language, sensitivity and environment where clinicians can learn from the experiences of bereaved parents who value open, sensitive and honest communication. The results of this study highlight the importance of patient-focused communication training for clinicians.

Investigating the effect of nurse-team communication on nurse turnover: relationships among communication processes, identification, and intent to leave.

Science.gov (United States)

Apker, Julie; Propp, Kathleen M; Ford, Wendy S Zabava

2009-03-01

Enhanced team communication may strengthen nurses' attachment to their organizations and teams and improve nurse retention. This study examines the relationships among nurse-team communication, identification (organizational and team), and intent to leave. Hospital nurses (N = 201) completed surveys measuring 3 nurse-team communication processes: promoting team synergy, ensuring quality decisions, and individualizing communication. Hierarchical regression analyses revealed that promoting team synergy was a significant predictor of intent to leave, whereas ensuring quality decisions and individualizing communication did not account for significant additional variance in intent to leave. Separate analyses showed that the relationship between promoting team synergy and intent to leave was partially mediated by team identification or by organizational identification. Further analyses were conducted on the 7 communication practices for promoting team synergy. Mentoring emerged as the only significant predictor of intent to leave; however, its relationship to intent to leave was fully mediated by organizational identification or partially mediated by team identification. Pragmatic suggestions are offered to improve nurse identification and reduce turnover.

Happy crisis tests hospitals' PR plan. Septuplets' arrival swamps Iowa hospitals with national, international media. Blank Children's Hospital, Iowa Methodist Medical Center, Des Moines.

Science.gov (United States)

1998-01-01

The public relations staff believed the birth of healthy septuplets would become a human interest story for local media. But the staff was stunned at the outpouring of international and national media knocking at their front doors. The staff of both Iowa Methodist Medical Center and Blank Children's Hospital in Des Moines, Iowa, organized a communications plan for 14 official press conferences, constant updates to the media and a website to handle ongoing inquiries from the public. As a result, the story of the McCaughey septuplets was shown in more than 10,000 television stories around the world. The hospitals received more than 36,000 magazine and newspaper articles. The public relations staff not only fielded more than 2,000 phone calls in the days following the Nov. 19 birth, but more than 15 major networks parked their vehicles and satellite dishes in front of the hospital.

Cost comparison between private and public collection of residual household waste: multiple case studies in the Flemish region of Belgium.

Science.gov (United States)

Jacobsen, R; Buysse, J; Gellynck, X

2013-01-01

The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticed in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private. Copyright © 2012 Elsevier Ltd. All rights reserved.

Knowledge, information and communication among cancer patients

International Nuclear Information System (INIS)

Parvez, T.; Saeed, N.; Pervaiz, K.

2001-01-01

Objective: Knowledge, information and communication, within oncology, are a core clinical strength for the out-come of the disease and inadequate communication, can cause distress for the patient and their families. Design: A senior doctor conducted this study by filling in the performa after interviewing the subject of the study. Place and duration of study: This study was done in Oncology Department of Service Hospital, Lahore and was completed in four months. Subjects and Method: One hundred cancer patients were interviewed regarding their knowledge about their disease, its causes, prognosis, and information supplied by the health-care providers. They were also asked about their satisfaction regarding this information, deficiencies and pitfalls in this information, need for more information, which should supply the information from among the hospital team or their relative, attitude of the family and their communication regarding the disease. Results: Study revealed that the knowledge about the disease and its causes was present in 53% and 7% respectively. The patients (59%) wanted more information. Majority perceived that the information was not adequate and needed more information and 68% thought that more information would reduce their anxiety. The attitude of family was found encouraging in 87% of patients and 42% were communicating with other family members regarding their diseases. Conclusion: Knowledge about the disease and its cause should be increasingly supplied by the doctors, as it will reduce the anxiety and have a good effect on health. Communication among the family members needs to be improved. (author)

Communication Channels as Implementation Determinants of Performance Management Framework in Kenya

Science.gov (United States)

Sang, Jane

2016-01-01

The purpose of this study to assess communication channels as implementation determinants of performance management framework In Kenya at Moi Teaching and Referral Hospital (MTRH). The communication theory was used to inform the study. This study adopted an explanatory design. The target sampled 510 respondents through simple random and stratified…

Survey alerts hospital to needs of consumers.

Science.gov (United States)

Schoenfeldt, R C; Seale, W B; Hale, A W

1987-09-01

Because of rapidly changing developments in the healthcare field, more emphasis is being placed on marketing of hospital services. A hospital's success will depend more and more on strategic planning based on timely and accurate information. In light of this, Lourdes Hospital, Paducah, KY, undertook a survey to evaluate its current performance and to determine a path for the future. The survey found, among other discoveries, that patients want more voice in determining their own treatment; they prefer outpatient treatment when possible, even if it is not covered by insurance; and stress management and health assessment clinics are the most popular extra services a hospital could offer. Physicians surveyed said they wanted more input into the evaluation of new services and equipment at the hospital. The survey also found that most patients either select a hospital in conjunction with their physician or have their physician choose the hospital. The findings led to some major changes at the hospital, including a restructuring of the planning process to get physicians more involved, a new marketing strategy to enhance communication with consumers, and increased outpatient services. The results have given direction to the hospital administration, helped shape advertising, and provided support for certificate-of-need requests.

Improving Interdisciplinary Provider Communication Through a Unified Paging System.

Science.gov (United States)

Heidemann, Lauren; Petrilli, Christopher; Gupta, Ashwin; Campbell, Ian; Thompson, Maureen; Cinti, Sandro; Stewart, David A

2016-06-01

Interdisciplinary communication at a Veterans Affairs (VA) academic teaching hospital is largely dependent on alphanumeric paging, which has limitations as a result of one-way communication and lack of reliable physician identification. Adverse patient outcomes related to difficulty contacting the correct consulting provider in a timely manner have been reported. House officers were surveyed on the level of satisfaction with the current VA communication system and the rate of perceived adverse patient outcomes caused by potential delays within this system. Respondents were then asked to identify the ideal paging system. These results were used to develop and deploy a new Web site. A postimplementation survey was repeated 1 year later. This study was conducted as a quality improvement project. House officer satisfaction with the preintervention system was 3%. The majority used more than four modalities to identify consultants, with 59% stating that word of mouth was a typical source. The preferred mode of paging was the university hospital paging system, a Web-based program that is used at the partnering academic institution. Following integration of VA consulting services within the university hospital paging system, the level of satisfaction improved to 87%. Significant decreases were seen in perceived adverse patient outcomes (from 16% to 2%), delays in patient care (from 90% to 16%), and extended hospitalizations (from 46% to 4%). Our study demonstrates significant improvement in physician satisfaction with a newly implemented paging system that was associated with a decreased perceived number of adverse patient events and delays in care.

Hospital planning for weapons of mass destruction incidents

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Perry Ronald

2006-01-01

Full Text Available As terrorists attacks increase in frequency, hospital disaster plans need to be scrutinized to ensure that they take into account issues unique to weapons of mass destruction. This paper reports a review of the literature addressing hospital experiences with such incidents and the planning lessons thus learned. Construction of hospital disaster plans is examined as an ongoing process guided by the disaster planning committee. Hospitals are conceived as one of the components of a larger community disaster planning efforts, with specific attention devoted to defining important linkages among response organizations. This includes the public health authorities, political authorities, prehospital care agencies, and emergency management agencies. A review is completed of six special elements of weapons of mass destruction incidents that should be addressed in hospital disaster plans: incident command, hospital security, patient surge, decontamination, mental health consequences, and communications. The paper closes with a discussion of the importance of training and exercises in maintaining and improving the disaster plan.

Conduits to care: call lights and patients’ perceptions of communication

Science.gov (United States)

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Background Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. PMID:29075125

Conduits to care: call lights and patients' perceptions of communication.

Science.gov (United States)

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

Time and flow study results before and after installation of a hospital information system and radiology information system and before clinical use of a picture archiving and communication system.

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Inamura, K; Umeda, T; Harauchi, H; Kondoh, H; Hasegawa, T; Kozuka, T; Takeda, H; Inoue, M

1997-02-01

The effectiveness of a hospital information system (HIS) and a radiological information system (RIS) was evaluated to optimize preparation for the planned full clinical operation of a picture archiving and communication system (PACS), which is now linked experimentally to the HIS and the RIS. One thousand IC (integrated circuit) cards were used for time studies and flow studies in the hospital. Measurements were performed on image examination order entry, image examination, reporting, and image delivery times. Even though after the HIS and the RIS operation only a small amount of time savings were realized in each time fraction component, such as in the patient movement time, examination time, and film delivery time, the total turn-around time was shortened markedly, by more than 23 hours on average. It was verified that the HIS and the RIS was beneficial in the outpatient clinics of the orthopedic department. Our method of measurement employing IC cards before and after HIS and RIS operations can be applied in other hospitals.

Post eLetter Solutions: Healthy Results for Improving Patient Communication Processes at the Royal Hobart Hospital.

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Boulter, Rhonda

2009-06-01

The primary objective of the Australia Post eLetter project 1 was to determine the feasibility of using the eLetter service with the Patient Administration System Appointment Scheduling Module to provide a fully automated mailing function that would eliminate the need for manual processing of mail delivery. Issues with timely delivery of letters throughout all outpatient sites at the Royal Hobart Hospital (RHH) have been identified as being mainly due to limited human resources being available to perform mailing duties and the like. This new desktop service enables staff to transmit data electronically in conjunction with the appointment software for large quantity mail postings to Australia Post via a secure line. Australia Post then validates the address, appends a barcode, prints the letter, envelopes it and inserts it into the mail distribution network in the state of the recipient. This article depicts the process that has eliminated the manual processing of a letter via the traditional Microsoft application, Wordmate, a system at RHH that was always difficult to use. With the introduction of eLetter, the RHH's Specialist Clinics have significantly improved the timeliness and quality of communication with patients as well as reducing administration tasks for staff.

Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme.

Science.gov (United States)

Timmermans, Lore; De Hauwere, An; Bacher, Klaus; Bosmans, Hilde; Lemmens, Kim; Bleyen, Luc; Van Limbergen, Erik; Martens, Patrick; Van Steen, Andre; Mortier, Griet; Van Herck, Koen; Thierens, Hubert

2014-08-01

To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30% in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. • Performance parameters showed no major differences after digitalisation to CR or DR. • Transition from SFM to CR results in a higher mean glandular dose. • Transition from SFM to DR results in a lower mean glandular dose.

Four minutes for a patient, twenty seconds for a relative - an observational study at a university hospital

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Xander Carola J

2010-04-01

Full Text Available Abstract Background In the modern hospital environment, increasing possibilities in medical examination techniques and increasing documentation tasks claim the physicians' energy and encroach on their time spent with patients. This study aimed to investigate how much time physicians at hospital wards spend on communication with patients and their families and how much time they spend on other specific work tasks. Methods A non-participatory, observational study was conducted in thirty-six wards at the University Medical Center Freiburg, a 1700-bed academic hospital in Germany. All wards belonging to the clinics of internal medicine, surgery, radiology, neurology, and to the clinic for gynaecology took part in the study. Thirty-four ward doctors from fifteen different medical departments were observed during a randomly chosen complete work day. The Physicians' time for communication with patients and relatives and time spent on different working tasks during one day of work were assessed. Results 374 working hours were analysed. On average, a physician's workday on a university hospital ward added up to 658.91 minutes (10 hrs 58 min; range 490 - 848 min. Looking at single items of time consumption on the evaluation sheet, discussions with colleagues ranked first with 150 minutes on average. Documentation and administrative requirements took an average time of 148 minutes per day and ranked second. Total time for communication with patients and their relatives was 85 minutes per physician and day. Consequently, the available time for communication was 4 minutes and 17 seconds for each patient on the ward and 20 seconds for his or her relatives. Physicians assessed themselves to communicate twice as long with patients and sevenfold with relatives than they did according to this study. Conclusions Workload and time pressure for physicians working on hospital wards are high. To offer excellent medical treatment combined with patient centred care and

Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria

OpenAIRE

A Ibrahim; Z I Delia; M E Asuku; T Dahiru

2011-01-01

Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for ...

Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records.

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Bardach, Shoshana H; Real, Kevin; Bardach, David R

2017-05-01

Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.

Mitigation and Compensation under EU Nature Conservation Law in the Flemish Region: Beyond the Deadlock for Development Projects?

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Hendrik Schoukens

2014-05-01

Full Text Available For years, the predicament of many of the European protected habitats and species in the Flemish Region, as in many other Member States, passed relatively unnoticed. The lack of proper rules and clear implementation rules fuelled the impression amongst project developers and planning authorities that the impacts of project developments on biodiversity did not really warrant closer assessment. However, in the past ten years, strict national case law has significantly altered this view. Faced with tighter judicial scrutiny, the Habitats and Birds Directives were seen as an important obstacle to project development. Hence mitigation and compensation have now come up as novel approaches to better align spatial aspirations with the conservation of nature. In reality, mitigation was often used as a cover-up for projects that would not fit the strict requirements enshrined in the derogatory clauses. Interestingly, the Belgian Council of State showed itself quite cautious in reasserting the lax view of some planning authorities on mitigation and compensation. In reviewing the legality of several new approaches to mitigation and compensation, the Belgian Council of State, which was initially very cautious in quashing decisions that would actually jeopardise major infrastructure developments, has rendered some compelling rulings on the specific application of mitigation and compensatory measures in a spatial planning context. By letting the objectives of EU nature conservation law prevail in the face of economic interests, the recent case law of the Belgian Council of State can be seen as a remarkable example of judicial environmental activism.

Use of social media by Western European hospitals: longitudinal study.

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Van de Belt, Tom H; Berben, Sivera A A; Samsom, Melvin; Engelen, Lucien J L P G; Schoonhoven, Lisette

2012-05-01

Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals increasingly use social media, but it is unknown whether and how Western European hospitals use social media. To identify to what extent Western European hospitals use social media. In this longitudinal study, we explored the use of social media by hospitals in 12 Western European countries through an Internet search. We collected data for each country during the following three time periods: April to August 2009, August to December 2010, and April to July 2011. We included 873 hospitals from 12 Western European countries, of which 732 were general hospitals and 141 were university hospitals. The number of included hospitals per country ranged from 6 in Luxembourg to 347 in Germany. We found hospitals using social media in all countries. The use of social media increased significantly over time, especially for YouTube (n = 19, 2% to n = 172, 19.7%), LinkedIn (n =179, 20.5% to n = 278, 31.8%), and Facebook (n = 85, 10% to n = 585, 67.0%). Differences in social media usage between the included countries were significant. Social media awareness in Western European hospitals is growing, as well as its use. Social media usage differs significantly between countries. Except for the Netherlands and the United Kingdom, the group of hospitals that is using social media remains small. Usage of LinkedIn for recruitment shows the awareness of the potential of social media. Future research is needed to investigate how social media lead to improved health care.

Implementation of Online Veterinary Hospital on Cloud Platform.

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Chen, Tzer-Shyong; Chen, Tzer-Long; Chung, Yu-Fang; Huang, Yao-Min; Chen, Tao-Chieh; Wang, Huihui; Wei, Wei

2016-06-01

Pet markets involve in great commercial possibilities, which boost thriving development of veterinary hospital businesses. The service tends to intensive competition and diversified channel environment. Information technology is integrated for developing the veterinary hospital cloud service platform. The platform contains not only pet medical services but veterinary hospital management and services. In the study, QR Code andcloud technology are applied to establish the veterinary hospital cloud service platform for pet search by labeling a pet's identification with QR Code. This technology can break the restriction on veterinary hospital inspection in different areas and allows veterinary hospitals receiving the medical records and information through the exclusive QR Code for more effective inspection. As an interactive platform, the veterinary hospital cloud service platform allows pet owners gaining the knowledge of pet diseases and healthcare. Moreover, pet owners can enquire and communicate with veterinarians through the platform. Also, veterinary hospitals can periodically send reminders of relevant points and introduce exclusive marketing information with the platform for promoting the service items and establishing individualized marketing. Consequently, veterinary hospitals can increase the profits by information share and create the best solution in such a competitive veterinary market with industry alliance.

Making hospital advertisements more readable and more effective.

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Costello, M M; Bednarz, J A

1994-01-01

Hospitals and other health care organizations make continuing use of newspaper and magazine advertising as part of their marketing programs. However, many institutions have questioned the effectiveness of advertising because they have not achieved the results they had hoped for. Part of the problem may lie in the fact that many hospital advertisements violate the principles of good copywriting. Well written advertisements will draw larger readership, and should subsequently prove more effective in helping the institution achieve its communications objectives.

Improving operating room coordination: communication pattern assessment.

Science.gov (United States)

Moss, Jacqueline; Xiao, Yan

2004-02-01

To capture communication patterns in operating room (OR) management to characterize the information needs of OR coordination. Technological applications can be used to change system processes to improve communication and information access, thereby decreasing errors and adverse events. The successful design of such applications relies on an understanding of communication patterns among healthcare professionals. Charge nurse communication was observed and documented at four OR suites at three tertiary hospitals. The data collection tool allowed rapid coding of communication patterns in terms of duration, mode, target person, and the purpose of each communication episode. Most (69.24%) of the 2074 communication episodes observed occurred face to face. Coordinating equipment was the most frequently occurring purpose of communication (38.7%) in all suites. The frequency of other purposes in decreasing order were coordinating patient preparedness (25.7%), staffing (18.8%), room assignment (10.7%), and scheduling and rescheduling surgery (6.2%). The results of this study suggest that automating aspects of preparing patients for surgery and surgical equipment management has the potential to reduce information exchange, decreasing interruptions to clinicians and diminishing the possibility of adverse events in the clinical setting.

Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

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Shafazand Masoud

2012-03-01

Full Text Available Abstract Background Chronic heart failure (CHF is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. To characterise patients with CHF who seek an emergency department (ED because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital. Method Patients (n = 2,648 seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF. Results Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.

Integrated Patient Education on U.S. Hospital Web Sites.

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Huang, Edgar; Wu, Kerong; Edwards, Kelsey

2016-01-01

Based on a census of the 2015 Most Wired Hospitals, this content analysis aimed to find out how patient education has been integrated on these best IT hospitals' Web sites to serve the purposes of marketing and meeting online visitors' needs. This study will help hospitals to understand where the weaknesses are in their interactive patient education implementation and come up with a smart integration strategy. The study found that 70% of these hospitals had adopted interactive patient education contents, 76.6% of such contents were from a third-party developer, and only 20% of the hospitals linked their patient education contents to one or more of the hospital's resources while 26% cross-references such contents. The authors concluded that more hospitals should take advantage of modern information communication technology to cross-reference their patient education contents and to integrate such contents into their overall online marketing strategy to benefit patients and themselves.

Is the Australian hospital system adequately prepared for terrorism?

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Rosenfeld, Jeffrey V; Fitzgerald, Mark; Kossmann, Thomas; Pearce, Andrew; Joseph, Anthony; Joseph, Andrew; Tan, Gim; Gardner, Michele; Shapira, Shmuel

Australian hospitals need to be prepared to deal with mass casualties from terrorist strikes, including bomb blasts and chemical, biological and radiation injury. Injuries from bomb explosions are more severe than those commonly seen in Australian hospitals. In disasters involving mass casualties in urban areas, many of the injured make their own way to hospital, often arriving before the more seriously injured casualties. Major hospitals in Australia should plan for large numbers of undifferentiated and potentially contaminated casualties arriving with minimal warning. It is critical that experienced and trained senior medical officers perform the triage of casualties in emergency departments, with frequent reassessment to detect missed injuries (especially pulmonary blast injury). Hospitals require well developed standard operating procedures for mass casualty events, reinforced by regular drills. Preparing for a major event includes training staff in major incident management, setting up an operational/control unit, nominating key personnel, ensuring there is an efficient intra-hospital communication system, and enhancing links with other emergency services and hospitals.

Effectiveness of Selected Communication Media on Tourism ...

African Journals Online (AJOL)

waterfalls, historical relics, captivating beaches, rock out-crops, rolling lulls coupled with hospitable and culturally active people that are capable of making tourism a delight in Nigeria. The study therefore assessed the effectiveness of selected communication media on awareness creation towards tourism for rural ...

Physicians lead the way at America's top hospitals.

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Weber, D O

2001-01-01

The 100 Top hospitals are selected annually based on seven critical parameters for each of the 6,200-plus U.S. hospitals with 25 or more beds. They include the previous year's risk-adjusted patient mortality and complication rates, severity-adjusted average patient lengths of stay, expenses, profitability, proportional outpatient revenue, and asset turnover ratio (a measure of facility and technological pace-keeping ability). The winners are selected from five comparable size groupings--small, medium, large community, teaching, and large academic hospitals. Conspicuous among the winners at every level are physician-led organizations. Even in the majority of hospitals headed by non-physician administrators, however, the managerial capabilities of medical directors are the key to success. The most common characteristic of these award-winning hospitals is that the leadership is working together and communicating the institution's goals effectively to all levels of the organization.

Mobile emergency, an emergency support system for hospitals in mobile devices: pilot study.

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Bellini, Pierfrancesco; Boncinelli, Sergio; Grossi, Francesco; Mangini, Marco; Nesi, Paolo; Sequi, Leonardo

2013-05-23

Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed

Pending laboratory tests and the hospital discharge summary in patients discharged to sub-acute care.

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Walz, Stacy E; Smith, Maureen; Cox, Elizabeth; Sattin, Justin; Kind, Amy J H

2011-04-01

Previous studies have noted a high (41%) prevalence and poor discharge summary communication of pending laboratory (lab) tests at the time of hospital discharge for general medical patients. However, the prevalence and communication of pending labs within a high-risk population, specifically those patients discharged to sub-acute care (i.e., skilled nursing, rehabilitation, long-term care), remains unknown. To determine the prevalence and nature of lab tests pending at hospital discharge and their inclusion within hospital discharge summaries, for common sub-acute care populations. Retrospective cohort study. Stroke, hip fracture, and cancer patients discharged from a single large academic medical center to sub-acute care, 2003-2005 (N = 564) Pending lab tests were abstracted from the laboratory information system (LIS) and from each patient's discharge summary, then grouped into 14 categories and compared. Microbiology tests were sub-divided by culture type and number of days pending prior to discharge. Of sub-acute care patients, 32% (181/564) were discharged with pending lab tests per the LIS; however, only 11% (20/181) of discharge summaries documented these. Patients most often left the hospital with pending microbiology tests (83% [150/181]), particularly blood and urine cultures, and reference lab tests (17% [30/181]). However, 82% (61/74) of patients' pending urine cultures did not have 24-hour preliminary results, and 19% (13/70) of patients' pending blood cultures did not have 48-hour preliminary results available at the time of hospital discharge. Approximately one-third of the sub-acute care patients in this study had labs pending at discharge, but few were documented within hospital discharge summaries. Even after considering the availability of preliminary microbiology results, these omissions remain common. Future studies should focus on improving the communication of pending lab tests at discharge and evaluating the impact that this improved

Increasing communication in the intensive care unit: is blogging the answer?

Science.gov (United States)

Curry, Kimberly

2012-01-01

Effective communication is a key factor to success in intensive care nursing. At Allegheny General Hospital in Pittsburgh, Pennsylvania, a cardiac intensive care unit (ICU) incorporated blogging as one of its primary means of communication. In the health care clinical environment, blogging can help to promote 2-way communication among nursing staff and leadership. Blogging can serve as a valuable method of relaying important updates, changes in practice, and educational resources. Incorporating a blog into the ICU environment involves a cultural shift and some potential barriers. Lack of a technological understanding of social media, outdated software systems, and limited hospital policies may pose issues when incorporating a blog into the health care setting. The benefits though are impressive. Blogging is a form of rapid, real-time communication for which any person may post or comment on an important thought or message. Blogging can help to increase compliance with quality measures, update staff on need to know information such as changes in policies and procedures, and provide up-to-date educational resources at any time, from anywhere.

THE IMPORTANCE OF PLAY DURING HOSPITALIZATION OF CHILDREN

Science.gov (United States)

Koukourikos, Konstantinos; Tzeha, Laila; Pantelidou, Parthenopi; Tsaloglidou, Areti

2015-01-01

Introduction: Play constitutes an essential parameter of the normal psychosomatic development of children, as well as their statutory right. It is also an important means of communication in childhood. Objective: To review, detect and highlight all data cited regarding the role of play during the hospitalization of children. Methodology: Literature review was achieved by searching the databases Scopus, PubMed, Cinhal in English, using the following key words: therapeutic play, play therapy, hospitalized child, therapist. Results: During hospitalization, play either in the form of therapeutic play, or as in the form of play therapy, is proven to be of high therapeutic value for ill children, thus contributing to both their physical and emotional well-being and to their recovery. It helps to investigate issues related to the child’s experiences in the hospital and reduce the intensity of negative feelings accompanying a child’s admission to hospital and hospitalization. Play is widely used in pre-operative preparation and invasive procedures, while its use among children hospitalized for cancer is beneficial. Conclusion: The use of play in hospital may become a tool in the hands of healthcare professionals, in order to provide substantial assistance to hospitalized children, as long as they have appropriate training, patience, and will to apply it during hospitalization. PMID:26889107

Communication training as a part of medical education: a pilot project

Directory of Open Access Journals (Sweden)

Petersen, Corinna

2005-01-01

Full Text Available Within the last years, the importance of communication skills regarding the doctor-patient-relationship received more attention. Medical school curricula for future physicians must include teaching of communication skills as well. A pilot project for training communicative basic skills at the University Hospital Hamburg-Eppendorf will be presented. The content of teaching was generated by employees of the Institute and Policlinics of Medical Psychology. Contents of the course will be described and experiences discussed.

TEAM ATTITUDE EVALUATION: AN EVALUATION IN HOSPITAL COMMITTEES.

Science.gov (United States)

Hekmat, Somayeh Noori; Dehnavieh, Reza; Rahimisadegh, Rohaneh; Kohpeima, Vahid; Jahromi, Jahromi Kohpeima

2015-12-01

Patients' health and safety is not only a function of complex treatments and advanced therapeutic technologies but also a function of a degree based on which health care professionals fulfill their duties effectively as a team. The aim of this study was to determine the attitude of hospital committee members about teamwork in Kerman hospitals. This study was conducted in 2014 on 171 members of clinical teams and committees of four educational hospitals in Kerman University of Medical Sciences. To collect data, the standard "team attitude evaluation" questionnaire was used. This questionnaire consisted of five domains which evaluated the team attitude in areas related to the team structure, leadership, situation monitoring, mutual support, and communication in the form of a 5-point Likert type scale. To analyze data, descriptive statistical tests, T-test, ANOVA, and linear regression were used. The average score of team attitude for hospital committee members was 3.9 out of 5. The findings showed that leadership had the highest score among the subscales of team work attitude, while mutual support had the lowest score. We could also observe that responsibility was an important factor in participants' team work attitude (β = -0.184, p = 0.024). Comparing data in different subgroups revealed that employment, marital status, and responsibility were the variables affecting the participants' attitudes in the team structure domain. Marital status played a role in leadership; responsibility had a role in situation monitoring; and work experience played a role in domains of communication and mutual support. Hospital committee members had a positive attitude towards teamwork. Training hospital staff and paying particular attention to key elements of effectiveness in a health care team can have a pivotal role in promoting the team culture.

Hospital Job Skills Enhancement Program: A Workplace Literacy Project. Final Evaluation Report.

Science.gov (United States)

Nurss, Joanne R.

A workplace literacy program was designed to improve the literacy skills of entry-level workers in the housekeeping, food service, and laundry departments of Grady Memorial Hospital in Atlanta. Classes were held twice per week for 36 weeks at the hospital on job time. Literacy was defined as reading, writing, oral communication, and problem…

Ethics policies on euthanasia in nursing homes: a survey in Flanders, Belgium.

Science.gov (United States)

Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Verbeke, Geert; Van Craen, Katleen; Schotsmans, Paul; Gastmans, Chris

2008-01-01

In many European countries there is a public debate about the acceptability and regulation of euthanasia. In 2002, Belgium became the second country after the Netherlands to enact a law on euthanasia. Although euthanasia rarely occurs, the complexity of the clinical-ethical decision making surrounding euthanasia requests and the need for adequate support reported by caregivers, means that healthcare institutions increasingly need to consider how to responsibly handle euthanasia requests. The development of written ethics policies on euthanasia may be important to guarantee and maintain the quality of care for patients requesting euthanasia. The aim of this study was to determine the prevalence, development, position, and communication of written ethics policies on euthanasia in Flemish nursing homes. Data were obtained through a cross-sectional mail survey of general directors of all Catholic nursing homes in Flanders, Belgium. Of the 737 nursing homes invited to participate, 612 (83%) completed the questionnaire. Of these, only 15% had a written ethics policy on euthanasia. Presence of an ethics committee and membership of an umbrella organization were independent predictors of whether a nursing home had such a written ethics policy. The Act on Euthanasia and euthanasia guidelines advanced by professional organizations were the most frequent reasons (76% and 56%, respectively) and reference sources (92% and 64%, respectively) for developing ethics policies on euthanasia. Development of ethics policies occurred within a multidisciplinary context. In general, Flemish nursing homes applied the Act on Euthanasia restrictively by introducing palliative procedures in addition to legal due care criteria. The policy was communicated to the consulting general practitioner and nurses in 74% and 89% of nursing homes, respectively. Although the overall prevalence of ethics policies on euthanasia was low in Flemish nursing homes, institution administrators displayed growing

[Patient safety culture in hospitals: experiences in planning, organising and conducting a survey among hospital staff].

Science.gov (United States)

van Vegten, Amanda; Pfeiffer, Yvonne; Giuliani, Francesca; Manser, Tanja

2011-01-01

This article presents the first hospital-wide survey on patient safety climate, involving all staff (medical and non-medical), in the German-speaking area. Its aim is to share our experiences with planning, organising and conducting this survey. The study was performed at the university hospital in Zurich and had a response rate of 46.8% (2,897 valid questionnaires). The survey instrument ("Patientensicherheitsklimainventar") was based on the Hospital Survey on Patient Safety Culture (AHRQ). Primarily it allowed for assessing the current patient safety climate as well as identifying specific areas for improvement and creating a hospital-wide awareness and acceptance for patient safety issues and interventions (e.g., the introduction of a Critical Incident Reporting System [CIRS]). We discuss the basic principles and the feedback concept guiding the organisation of the overall project. Critical to the success of this project were the guaranteed anonymity of the respondents, adequate communication through well-established channels within the organisation and the commitment of the management across all project phases. Copyright © 2011. Published by Elsevier GmbH.

Communication Patterns in the Perioperative Environment During Epic Electronic Health Record System Implementation.

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Friend, Tynan H; Jennings, Samantha J; Levine, Wilton C

2017-02-01

In April 2016, Massachusetts General Hospital (MGH) went live with the Epic electronic health records (EHR) system, replacing a variety of EHRs that previously existed in different departments throughout the hospital. At the time of implementation, the Vocera® Badge Communication System, a wireless hands-free communication device distributed to perioperative team members, had increased perioperative communication flow and efficiency. As a quality improvement effort to better understand communication patterns during an EHR go-live, we monitored our Vocera call volume and user volume before, during and after our go-live. We noticed that call volume and user volume significantly increased during our immediate go-live period and quickly returned to baseline levels. We also noticed that call volume increased during periods of unplanned EHR downtime long after our immediate go-live period. When planning the implementation of a new EHR, leadership must plan for and support this critical communication need at the time of the go-live and must also be aware of these needs during unplanned downtime.

Próteses de comunicação e alinhamento comportamental sobre impressos hospitalares Communication prostheses and behavioral alignment in hospital leaflets

Directory of Open Access Journals (Sweden)

Paulo Roberto Vasconcellos-Silva

2003-08-01

graphic design, and emphasizes the priorities defined by the professionals. Such "communication prostheses" should be capable of electronic validation by means of software suitable for proportioning the "doses" to the subject matter. Information as a drug, cognitivism, the lack of research on message reception and the need for communicative action for the deconstruction of systems of closed thinking within the hospital environment have been discussed.

[Professional communication in long term health care quality].

Science.gov (United States)

Martín Padilla, E; Sarmiento Medina, P; Ramírez Jaramillo, A

2014-01-01

To Identify aspects of professional communication that affect the quality of long-term care for patients with chronic illness or disabilities and their families, in the experience of health professionals, as input for the development of an assessment tool. Descriptive qualitative.The data was processed by performing an interpretative analysis from grounded theory. The participants included 12 health professionals (three doctors, three nurses, three therapists and three psychologists), who work at the Hospital of the Universidad de La Sabana, Chia, and other institutions in Bogota, Colombia,with more than five years experience in programs treating chronic disease or disability in hospital therapeutic contexts. Semi-structured interviews and a Delphi survey were used. Validation strategies included, theoretical sampling, script evaluation by judges, triangulation of data collection techniques, and interviewers. We defined specific aspects of professional communication that could optimize the quality of health care, in information management as well as in the relationships with patients and families. From these aspects, an explanatory matrix was designed with axes, categories, and codes as a support for the construction of tools. Health communication, in order to become a therapeutic support element, requires professional training in communication skills to give information in an understandable way, with emotional support and coping possibilities. It should include and involve the family in decision making. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Communication skills training in orthopaedics.

Science.gov (United States)

Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

2008-06-01

Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

Implementation and quality monitoring of e-communication across Health care sectors

DEFF Research Database (Denmark)

Nicolaisen, Anne; Qvist, Peter

will identify challenges in e-communication across health care sectors and provide knowledge of the implementation and quality of the Sam:Bo e-communication. Points for discussion: How to improve quality of care using e-communication in general practice in the handover of patients and how to measure it? What......Background: There has been an increased focus on how to improve the quality of care for patients that receives services from more than one sector in the health care system. Continuity in and coordination of patient pathways in the health care system are included in accreditation standards both...... for general practice and hospitals. An important factor for patient-perceived quality of care is the cooperation between the health care sectors that provides services for the patient. In 2009 the Region of Southern Denmark launched a collaboration agreement called Sam:Bo between general practice, hospitals...

Structuring communication relationships for interprofessional teamwork (SCRIPT: a cluster randomized controlled trial

Directory of Open Access Journals (Sweden)

Kenaszchuk Chris

2007-09-01

Full Text Available Abstract Background Despite a burgeoning interest in using interprofessional approaches to promote effective collaboration in health care, systematic reviews find scant evidence of benefit. This protocol describes the first cluster randomized controlled trial (RCT to design and evaluate an intervention intended to improve interprofessional collaborative communication and patient-centred care. Objectives The objective is to evaluate the effects of a four-component, hospital-based staff communication protocol designed to promote collaborative communication between healthcare professionals and enhance patient-centred care. Methods The study is a multi-centre mixed-methods cluster randomized controlled trial involving twenty clinical teaching teams (CTTs in general internal medicine (GIM divisions of five Toronto tertiary-care hospitals. CTTs will be randomly assigned either to receive an intervention designed to improve interprofessional collaborative communication, or to continue usual communication practices. Non-participant naturalistic observation, shadowing, and semi-structured, qualitative interviews were conducted to explore existing patterns of interprofessional collaboration in the CTTs, and to support intervention development. Interviews and shadowing will continue during intervention delivery in order to document interactions between the intervention settings and adopters, and changes in interprofessional communication. The primary outcome is the rate of unplanned hospital readmission. Secondary outcomes are length of stay (LOS; adherence to evidence-based prescription drug therapy; patients' satisfaction with care; self-report surveys of CTT staff perceptions of interprofessional collaboration; and frequency of calls to paging devices. Outcomes will be compared on an intention-to-treat basis using adjustment methods appropriate for data from a cluster randomized design. Discussion Pre-intervention qualitative analysis revealed that a

Identifying the key factors in increasing recycling and reducing residual household waste: a case study of the Flemish region of Belgium.

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Gellynck, X; Jacobsen, R; Verhelst, P

2011-10-01

The competent waste authority in the Flemish region of Belgium created the 'Implementation plan household waste 2003-2007' and the 'Implementation plan sustainable management 2010-2015' to comply with EU regulation. It incorporates European and regional requirements and describes strategies, goals, actions and instruments for the collection and treatment of household waste. The central mandatory goal is to reduce and maintain the amount of residual household waste to 150 kg per capita per year between 2010-2015. In literature, a reasonable body of information has been published on the effectiveness and efficiency of a variety of policy instruments, but the information is complex, often contradictory and difficult to interpret. The objective of this paper is to identify, through the development of a binary logistic regression model, those variables of the waste collection scheme that help municipalities to reach the mandatory 150 kg goal. The model covers a number of variables for household characteristics, provision of recycling services, frequency of waste collection and charging for waste services. This paper, however, is not about waste prevention and reuse. The dataset originates from 2003. Four out of 12 variables in the model contributed significantly: income per capita, cost of residual waste collection, collection frequency and separate curbside collection of organic waste. Copyright © 2011 Elsevier Ltd. All rights reserved.

Labor and Management Build Skills in the Hospitality Industry.

Science.gov (United States)

Moy, Debbie

1998-01-01

The San Francisco Hotels Partnership is a consortium of hotel operators and unions that addresses skill-development needs in the hospitality industry. Participating workers were very satisfied with the opportunity to learn communication, problem solving, and teamwork skills. (SK)

Introducing Namaste Care to the hospital environment: a pilot study.

Science.gov (United States)

St John, Kimberley; Koffman, Jonathan

2017-10-01

The rising prevalence of dementia is impacting on acute hospitals and placing increased expectations on health and social care professionals to improve the support and services they are delivering. It has been recommended that good practice in dementia care relies on adopting a palliative approach to care and meeting people's physical, psychological, social and spiritual needs. Increased dementia training for staff that includes initiatives that promote dignity; enhancing communication skills and recognizing that a person with dementia may be approaching the end of their lives are needed. Our study aim was to explore whether Namaste Care is an acceptable and effective service for people with advanced dementia being cared for on an acute hospital ward. This was an exploratory qualitative interview, pilot study. Individual, semi-structured, face-to-face interviews were conducted with hospital healthcare staff working in an area of the hospital where Namaste Care had been implemented. Data were analysed using the framework approach. Eight interviews were completed with members of the multidisciplinary ward team. Two themes were identified: (I) difficulties establishing relationships with people with dementia in hospital (subthemes: lack of time and resources, lack of confidence leading to fear and anxiety); (II) the benefits of a Namaste Care service in an acute hospital setting (subthemes: a reduction in agitated behavior; connecting and communicating with patients with dementia using the senses; a way of showing people with dementia they are cared for and valued). This small-scale study indicates that Namaste Case has the potential to improve the quality of life of people with advanced dementia being cared for in an acute hospital setting. However, further research is required to explore more specifically its benefits in terms of improved symptom management and wellbeing of people with dementia on acute hospitals wards.

Heterosexual assumptions in verbal and non-verbal communication in nursing.

Science.gov (United States)

Röndahl, Gerd; Innala, Sune; Carlsson, Marianne

2006-11-01

This paper reports a study of what lesbian women and gay men had to say, as patients and as partners, about their experiences of nursing in hospital care, and what they regarded as important to communicate about homosexuality and nursing. The social life of heterosexual cultures is based on the assumption that all people are heterosexual, thereby making homosexuality socially invisible. Nurses may assume that all patients and significant others are heterosexual, and these heteronormative assumptions may lead to poor communication that affects nursing quality by leading nurses to ask the wrong questions and make incorrect judgements. A qualitative interview study was carried out in the spring of 2004. Seventeen women and 10 men ranging in age from 23 to 65 years from different parts of Sweden participated. They described 46 experiences as patients and 31 as partners. Heteronormativity was communicated in waiting rooms, in patient documents and when registering for admission, and nursing staff sometimes showed perplexity when an informant deviated from this heteronormative assumption. Informants had often met nursing staff who showed fear of behaving incorrectly, which could lead to a sense of insecurity, thereby impeding further communication. As partners of gay patients, informants felt that they had to deal with heterosexual assumptions more than they did when they were patients, and the consequences were feelings of not being accepted as a 'true' relative, of exclusion and neglect. Almost all participants offered recommendations about how nursing staff could facilitate communication. Heterosexual norms communicated unconsciously by nursing staff contribute to ambivalent attitudes and feelings of insecurity that prevent communication and easily lead to misconceptions. Educational and management interventions, as well as increased communication, could make gay people more visible and thereby encourage openness and awareness by hospital staff of the norms that they

A taxonomy and cultural analysis of intra-hospital patient transfers.

Science.gov (United States)

Rosenberg, Alana; Campbell Britton, Meredith; Feder, Shelli; Minges, Karl; Hodshon, Beth; Chaudhry, Sarwat I; Jenq, Grace Y; Emerson, Beth L

2018-05-02

Existing research on intra-hospital patient transitions focuses chiefly on handoffs, or exchanges of information, between clinicians. Less is known about patient transfers within hospitals, which include but extend beyond the exchange of information. Using participant observations and interviews at a 1,541-bed, academic, tertiary medical center, we explored the ways in which staff define and understand patient transfers between units. We conducted observations of staff (n = 16) working in four hospital departments and interviewed staff (n = 29) involved in transfers to general medicine floors from either the Emergency Department or the Medical Intensive Care Unit between February and September 2015. The collected data allowed us to understand transfers in the context of several hospital cultural microsystems. Decisions were made through the lens of the specific unit identity to which staff felt they belonged; staff actively strategized to manage workload; and empty beds were treated as a scarce commodity. Staff concepts informed the development of a taxonomy of intra-hospital transfers that includes five categories of activity: disposition, or determining the right floor and bed for the patient; notification to sending and receiving staff of patient assignment, departure and arrival; preparation to send and receive the patient; communication between sending and receiving units; and coordination to ensure that transfer components occur in a timely and seamless manner. This taxonomy widens the study of intra-hospital patient transfers from a communication activity to a complex cultural phenomenon with several categories of activity and views them as part of multidimensional hospital culture, as constructed and understood by staff. © 2018 Wiley Periodicals, Inc.

Nurses' perception of how an e-message system influences cross-sectoral communication

DEFF Research Database (Denmark)

Petersen, Helle V; Foged, Signe; Madsen, Annette L

2018-01-01

AIM: To investigate hospital and home care nurses' experiences on how an e-message system influences cross-sectoral communication 2 years after introduction. BACKGROUND: Cross-sectoral communication is identified as the main barrier for high quality in transitional care. An e-message system......-message system was used in both sectors but did not promote cross-sectoral dialogue. The home care nurses expressed distrust in the information from the hospital. The hospital nurses' intention was to provide relevant and accurate information but their main focus was to fulfil the standards within the system...... rather than the quality of the information exchanged. CONCLUSIONS: The e-message system supports a one-way information flow, rather than the intended loop of information exchange and dialogue. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognise that although an e-message system is being...

A 37-year-old man trying to choose a high-quality hospital: review of hospital quality indicators.

Science.gov (United States)

Howell, Michael D

2009-12-02

Mr A, a previously healthy 37-year-old man, was diagnosed as having Prinzmetal angina and a hypercoagulable state 3 years ago after an ST-elevation myocardial infarction. Now, his cardiologist is moving and Mr A must select a new physician and health system. Geographic relocation, insurance changes, and other events force millions in the United States to change physicians and hospitals every year. Mr A should begin by choosing a primary care physician, since continuity and coordination of care improves outcomes. Evidence for evaluating specific physicians is less robust, though a variety of sources are available. A broad range of detailed quality information, such as Medicare's Hospital Compare (http://www.hospitalcompare.hhs.gov/), is available for selecting a hospital. However, the relationship of these metrics to patient outcomes is variable, and different Web sites provide meaningfully different rankings and data interpretations. For Mr A in particular, a warfarin management team, the hospital's location, and a cardiologist with whom he feels comfortable and who can communicate with his primary care physician are important factors. Nevertheless, hospital quality information and metrics are an important component of the strategy Mr A should take to solve this challenging problem.

Interfacility Transfers to General Pediatric Floors: A Qualitative Study Exploring the Role of Communication.

Science.gov (United States)

Rosenthal, Jennifer L; Okumura, Megumi J; Hernandez, Lenore; Li, Su-Ting T; Rehm, Roberta S

2016-01-01

Children with special health care needs often require health services that are only provided at subspecialty centers. Such children who present to nonspecialty hospitals might require a hospital-to-hospital transfer. When transitioning between medical settings, communication is an integral aspect that can affect the quality of patient care. The objectives of the study were to identify barriers and facilitators to effective interfacility pediatric transfer communication to general pediatric floors from the perspectives of referring and accepting physicians, and then develop a conceptual model for effective interfacility transfer communication. This was a single-center qualitative study using grounded theory methodology. Referring and accepting physicians of children with special health care needs were interviewed. Four researchers coded the data using ATLAS.ti (version 7, Scientific Software Development GMBH, Berlin, Germany), using a 2-step process of open coding, followed by focused coding until no new codes emerged. The research team reached consensus on the final major categories and subsequently developed a conceptual model. Eight referring and 9 accepting physicians were interviewed. Theoretical coding resulted in 3 major categories: streamlined transfer process, quality handoff and 2-way communication, and positive relationships between physicians across facilities. The conceptual model unites these categories and shows how these categories contribute to effective interfacility transfer communication. Proposed interventions involved standardizing the communication process and incorporating technology such as telemedicine during transfers. Communication is perceived to be an integral component of interfacility transfers. We recommend that transfer systems be re-engineered to make the process more streamlined, to improve the quality of the handoff and 2-way communication, and to facilitate positive relationships between physicians across facilities. Copyright �

Assessment of safety culture in isfahan hospitals (2010).

Science.gov (United States)

Raeisi, Ahmed Reza; Nazari, Maryam; Bahmanziari, Najme

2013-01-01

Many internal and external risk factors in health care organizations make safety important and it has caused the management to consider safety in their mission statement. One of the most important tools is to establish the appropriate organizational structure and safety culture. The goal of this research is to inform managers and staff about current safety culture status in hospitals in order to improve the efficiency and effectiveness of health services. This is a descriptive-survey research. The research population was selected hospitals of Isfahan, Iran. Research tool was a questionnaire (Cronbach alpha 0.75). The questionnaire including 93 questions (Likert scale) classified in 12 categories: Demographic questions, Individual attitude, management attitude, Safety Training, Induced stress, pressure and emotional conditions during work, Consultation and participation, Communications, Monitoring and control, work environment, Reporting, safety Rules, procedures and work instructions that distributed among 45 technicians, 208 Nurses and 62 Physicians. All data collected from the serve was analysis with statistical package of social science (SPSS). In this survey Friedman test, Spearman correlation, analysis of variance (ANOVA) and factor analysis have been used for data analyzing. The score of safety culture dimensions was 2.90 for Individual attitude, 3.12 for management attitude, 3.32 for Safety Training, 3.14 for Induced stress, pressure and emotional conditions during work, 3.31 for Consultation and participation, 2.93 for Communications, 3.28 for Monitoring and control, 3.19 for work environment, 3.36 for Reporting, 3.59 safety Rules, procedures and work instructions that Communication and individual attitude were in bad condition. Safety culture among different hospitals: governmental and educational, governmental and non-educational and non-governmental and different functional groups (physicians, nurses, diagnostic) of studied hospitals showed no

'The singing hospital'--integrated group therapy in the Black mentally ill.

Science.gov (United States)

Benjamin, B

1983-06-04

Integrated group therapy was originally introduced at Sterkfontein Hospital in 1957, and reintroduced 6 years ago in an effort to overcome difficulties in communication with approximately 100 Black male and female mental hospital patients. This therapy consisted mainly of song and dance activation, sociodrama, psychodrama and behavioural modification methods. These techniques are flexible, and can be carried out by proxy therapists working with doctors and psychologists.

The Modern Marketing Communications of Hotel Enterprises

Directory of Open Access Journals (Sweden)

Vlashchenko Nataliia M.

2017-06-01

Full Text Available The article is aimed at studying the features of marketing communications in the hotel industry and developing scientific-practical recommendations to activate their use at the level of domestic hotel enterprises. A classification of the communications of hotel enterprises, with defining the place for marketing therein, has been compiled. A complex of marketing communications of hotel enterprises has been developed, taking account of the current marketing instrumentarium. Objectives for the staff of hotel enterprises in terms of activities in the social networks have been formulated. Recommendations to activate the development of Internet marketing in the sphere of hospitality have been developed. It has been concluded that the special feature of promoting services of a hotel enterprise is the development of personalized relationships with customers.

Role of pacs in an integrated communication system

International Nuclear Information System (INIS)

Thompson, B.G.; Creasy, J.L.; Johnston, R.E.; Parrish, D.; Scatliff, J.H.

1986-01-01

An integrated computer-based communications system uses multiple computers for the high speed transmission, storage, enhancement and display for medical information. Interconnected by a network such as coaxial and fiberoptic cables or microwave stations, the system would provide integrated communications throughout a satellite medical environment. As the availability of proven PACS components becomes a commercial reality, migratory expansion of PACS within the radiology clinical, educational and research areas will be possible. When the PACS is integrated with hospital, radiology and medical school information systems it provides the image component of a total medical information system. Current PACS efforts are on a research basis including the development of prototype systems. This paper provides an overview of implementation strategies. Issues to be discussed include PACS research objectives, typical implementation methods, and a review of interactions between PACS and radiology information systems (RIS) and hospital information systems

Consistent codling moth population decline by two years of mating disruption in apple: a Flemish case study.

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Bangels, E; Beliën, T

2012-01-01

Codling moth (Cydia pomonella) is one of the most important pests in apple and pear. In 2010 mating disruption became a key pest management tactic in Flemish pip fruit orchards, largely due to a government subsidy and demonstrating projects aiming to widen the area treated by pheromones as large as possible. As a consequence, the mating disruption strategy was applied at approximately 7.500 ha, or half of the pip fruit area, in 2010 and 2011. The sudden large-scale implementation of this technique changed the codling moth management landscape. Here we present a case study of a commercially managed orchard that suffered from high codling moth pressures for many years, as did the surrounding area. The RAK3 mating disruption system was introduced at this location in 2010, and was continued in 2011. Systematic detailed codling moth flight data for this location are available for many years. In addition, comprehensive data on damage levels of chemically untreated windows spread all over the test orchard in a randomized block design were obtained in successive years, enabling us to thoroughly evaluate the effect of the changed codling moth management strategy. Data from 2011 included damage levels in chemically treated windows when the entire orchard was applied once at the flight peak of Cydia pomonella. In 2009, before introduction of mating disruption, a mean of 8.25 +/- 5.54% of the fruits were infested at harvest when assessed in completely untreated windows. After two years of mating disruption, supported with a full chemical support in 2010, except for the untreated assessment windows, and only one application on the flight peak of 2011, damage was reduced to less than 0.03% at harvest. This is a valuable case study to demonstrate the benefits of the mating disruption approach.

Reason for hospital admission: a pilot study comparing patient statements with chart reports.

Science.gov (United States)

Berger, Zackary; Dembitzer, Anne; Beach, Mary Catherine

2013-01-01

Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients on the medical wards of an urban academic medical center. We asked subjects to state the reason why their doctors admitted them to the hospital, and then compared their statement with the reason in the medical record. We defined concordance on reported reason for hospitalization as agreement between the patient's report and the reason abstracted from the chart. We interviewed and abstracted chart data from a total of 46 subjects. Concordance on reported reason for hospitalization was present in 24 (52%) and discordance in 17 (37%); 5 patients (11%) could not give any reason for their hospitalization. Among the 17 patients whose report was discordant with their chart, 12 (71%) reported a different organ system than was recorded in the chart. A significant proportion of medical inpatients could not state their physicians' reason for admission. In addition, patients who identify a different reason for hospitalization than the chart often give a different organ system altogether. Providers should explore patient understanding of the reason for their hospitalization to facilitate communication and shared decision making.

Communication at the interface between hospitals and primary care - a general practice audit of hospital discharge summaries.

Science.gov (United States)

Belleli, Esther; Naccarella, Lucio; Pirotta, Marie

2013-12-01

Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. We audited receipt rates, timeliness and the quality of discharge summaries for 49 admissions among 38 patients in an urban general practice. For missing discharge summaries, a hospital medical record search was performed. Discharge summaries were received for 92% of identified admissions; 73% were received within three days and 55% before the first post-discharge visit to the general practitioner (GP). Administrative information and clinical content, including diagnosis, treatment and follow-up plans, were well reported. However, information regarding tests, referrals and discharge medication was often missing; 57% of summaries were entirely typed and 13% had legibility issues. Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.

Video conferencing versus telephone calls for team work across hospitals: a qualitative study on simulated emergencies

Directory of Open Access Journals (Sweden)

Hagen Oddvar

2009-11-01

Full Text Available Abstract Background Teamwork is important for patient care and outcome in emergencies. In rural areas, efficient communication between rural hospitals and regional trauma centers optimise decisions and treatment of trauma patients. Little is known on potentials and effects of virtual team to team cooperation between rural and regional trauma teams. Methods We adapted a video conferencing (VC system to the work process between multidisciplinary teams responsible for trauma as well as medical emergencies between one rural and one regional (university hospital. We studied how the teams cooperated during simulated critical scenarios, and compared VC with standard telephone communication. We used qualitative observations and interviews to evaluate results. Results The team members found VC to be a useful tool during emergencies and for building "virtual emergency teams" across distant hospitals. Visual communication combined with visual patient information is superior to information gained during ordinary telephone calls, but VC may also cause interruptions in the local teamwork. Conclusion VC can improve clinical cooperation and decision processes in virtual teams during critical patient care. Such team interaction requires thoughtful organisation, training, and new rules for communication.

Screen-detected versus interval cancers: Effect of imaging modality and breast density in the Flemish Breast Cancer Screening Programme.

Science.gov (United States)

Timmermans, Lore; Bleyen, Luc; Bacher, Klaus; Van Herck, Koen; Lemmens, Kim; Van Ongeval, Chantal; Van Steen, Andre; Martens, Patrick; De Brabander, Isabel; Goossens, Mathieu; Thierens, Hubert

2017-09-01

To investigate if direct radiography (DR) performs better than screen-film mammography (SF) and computed radiography (CR) in dense breasts in a decentralized organised Breast Cancer Screening Programme. To this end, screen-detected versus interval cancers were studied in different BI-RADS density classes for these imaging modalities. The study cohort consisted of 351,532 women who participated in the Flemish Breast Cancer Screening Programme in 2009 and 2010. Information on screen-detected and interval cancers, breast density scores of radiologist second readers, and imaging modality was obtained by linkage of the databases of the Centre of Cancer Detection and the Belgian Cancer Registry. Overall, 67% of occurring breast cancers are screen detected and 33% are interval cancers, with DR performing better than SF and CR. The interval cancer rate increases gradually with breast density, regardless of modality. In the high-density class, the interval cancer rate exceeds the cancer detection rate for SF and CR, but not for DR. DR is superior to SF and CR with respect to cancer detection rates for high-density breasts. To reduce the high interval cancer rate in dense breasts, use of an additional imaging technique in screening can be taken into consideration. • Interval cancer rate increases gradually with breast density, regardless of modality. • Cancer detection rate in high-density breasts is superior in DR. • IC rate exceeds CDR for SF and CR in high-density breasts. • DR performs better in high-density breasts for third readings and false-positives.

Evaluations of children who have disclosed sexual abuse via facilitated communication.

Science.gov (United States)

Botash, A S; Babuts, D; Mitchell, N; O'Hara, M; Lynch, L; Manuel, J

1994-12-01

To review the findings of interdisciplinary team evaluations of children who disclosed sexual abuse via facilitated communication. Case series. Tertiary care hospital outpatient child sexual abuse program in central New York. Between January 1990 and March 1993, 13 children who disclosed sexual abuse via facilitated communication and were referred to a university hospital child abuse referral and evaluation center. The range of previously determined developmental diagnosis included mental retardation, speech delay, and autism. None. Medical records were reviewed for (1) disclosure, (2) physical evidence, (3) child's behavioral and medical history, (4) disclosures by siblings, (5) perpetrator's confession, (6) child protective services determinations, and (7) court findings. Four children had evidence of sexual abuse: two had physical findings consistent with sexual abuse, one also disclosed the allegation verbally, and one perpetrator confessed. These results neither support nor refute validation of facilitated communication. However, many children had other evidence of sexual abuse, suggesting that each child's case should be evaluated without bias.

2015-2016 Travel and Hospitality Expense Reports for Joanne ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ruxandra Staicu

Montreal, Toronto, Vancouver. Airfare: $968.74. Other. Transportation: $248.71. Accommodation: $461.37. Meals and. Incidentals: $302.96. Other: $0.00. Total: $1,981.78. Comments: 2015-2016 Travel and Hospitality Expense. Reports for Joanne Charette, Vice-President,. Corporate Strategy and Communications.

Parents' Perceived Satisfaction of Care, Communication and Environment of the Pediatric Intensive Care Units at a Tertiary Children's Hospital.

Science.gov (United States)

Abuqamar, Maram; Arabiat, Diana H; Holmes, Sandra

2016-01-01

This study aims to identify parental perceptions on pediatric intensive care-related satisfaction within three domains: environment, child's care provided and communication. In addition, it aims to identify whether parent's socio-demographics and child's clinical variables predict parents' perceived satisfaction. In this study, a total of 123 parents whose child received care in the PICU of a tertiary children's hospital in Amman completed the Arabic version of the parents satisfaction survey (PSS). A cross-sectional, descriptive-correlational design was used to collect data. All data were collected between June and October of 2013. Central tendency measures and percentages of replies for each domain revealed that at least 7 items were rated poorly satisfied. More than half of the parents were not satisfied with the noise level of the PICU, the time nurses spent at the child's bedside, as well as the way the healthcare team prepare them for the child's admission. Almost 90% of the parents believed that the nurses ignored their child's needs by not listening to parents and by responding slowly to child's needs. Stepwise regression analysis showed that that the number of hospital admissions, health insurance and the severity of illness was the main predictor of parents' satisfaction. In conclusion, the availability of health care professionals, the support and the information they share with the child's parents are all significant to parent's satisfaction and hence to better quality of care. Targeting the domains of low satisfaction reported by the parents could increase parent's satisfaction and achieve quality improvement required for this population. Copyright © 2016 Elsevier Inc. All rights reserved.

The Role of the Built Environment: How Decentralized Nurse Stations Shape Communication, Patient Care Processes, and Patient Outcomes.

Science.gov (United States)

Real, Kevin; Bardach, Shoshana H; Bardach, David R

2017-12-01

Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.

Innovation on a Hospital Perinatal Unit: Cell Phone Use by Nurses

National Research Council Canada - National Science Library

Petrilak, Thomas

2002-01-01

.... This study evaluates the impact and effect of cell phone communication technology on reducing nurse task frequency and time spent on activities that could more appropriately be accomplished by hospital support staff...

Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding.

Science.gov (United States)

Bao, Yuhua; Fan, Guanrong; Zou, Dongdong; Wang, Tong; Xue, Di

2017-01-01

Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care. To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments. Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals. 7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014. Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week) and hospital outpatient volume in the first half of 2014. Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only. Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience.

Leader communication approaches and patient safety: An integrated model.

Science.gov (United States)

Mattson, Malin; Hellgren, Johnny; Göransson, Sara

2015-06-01

Leader communication is known to influence a number of employee behaviors. When it comes to the relationship between leader communication and safety, the evidence is more scarce and ambiguous. The aim of the present study is to investigate whether and in what way leader communication relates to safety outcomes. The study examines two leader communication approaches: leader safety priority communication and feedback to subordinates. These approaches were assumed to affect safety outcomes via different employee behaviors. Questionnaire data, collected from 221 employees at two hospital wards, were analyzed using structural equation modeling. The two examined communication approaches were both positively related to safety outcomes, although leader safety priority communication was mediated by employee compliance and feedback communication by organizational citizenship behaviors. The findings suggest that leader communication plays a vital role in improving organizational and patient safety and that different communication approaches seem to positively affect different but equally essential employee safety behaviors. The results highlights the necessity for leaders to engage in one-way communication of safety values as well as in more relational feedback communication with their subordinates in order to enhance patient safety. Copyright © 2015 Elsevier Ltd. and National Safety Council. Published by Elsevier Ltd. All rights reserved.

Physician communication in the operating room: expanding application of face-negotiation theory to the health communication context.