Physician-Pharmacist collaboration in a pay for performance healthcare environment.

Science.gov (United States)

Farley, T M; Izakovic, M

2015-01-01

Healthcare is becoming more complex and costly in both European (Slovak) and American models. Healthcare in the United States (U.S.) is undergoing a particularly dramatic change. Physician and hospital reimbursement are becoming less procedure focused and increasingly outcome focused. Efforts at Mercy Hospital have shown promise in terms of collaborative team based care improving performance on glucose control outcome metrics, linked to reimbursement. Our performance on the Centers for Medicare and Medicaid Services (CMS) post-operative glucose control metric for cardiac surgery patients increased from a 63.6% pass rate to a 95.1% pass rate after implementing interventions involving physician-pharmacist team based care.Having a multidisciplinary team that is able to adapt quickly to changing expectations in the healthcare environment has aided our institution. As healthcare becomes increasingly saturated with technology, data and quality metrics, collaborative efforts resulting in increased quality and physician efficiency are desirable. Multidisciplinary collaboration (including physician-pharmacist collaboration) appears to be a viable route to improved performance in an outcome based healthcare system (Fig. 2, Ref. 12).

Design requirements for ubiquitous computing environments for healthcare professionals.

Science.gov (United States)

Bång, Magnus; Larsson, Anders; Eriksson, Henrik

2004-01-01

Ubiquitous computing environments can support clinical administrative routines in new ways. The aim of such computing approaches is to enhance routine physical work, thus it is important to identify specific design requirements. We studied healthcare professionals in an emergency room and developed the computer-augmented environment NOSTOS to support teamwork in that setting. NOSTOS uses digital pens and paper-based media as the primary input interface for data capture and as a means of controlling the system. NOSTOS also includes a digital desk, walk-up displays, and sensor technology that allow the system to track documents and activities in the workplace. We propose a set of requirements and discuss the value of tangible user interfaces for healthcare personnel. Our results suggest that the key requirements are flexibility in terms of system usage and seamless integration between digital and physical components. We also discuss how ubiquitous computing approaches like NOSTOS can be beneficial in the medical workplace.

A secure RFID authentication protocol for healthcare environments using elliptic curve cryptosystem.

Science.gov (United States)

Zhao, Zhenguo

2014-05-01

With the fast advancement of the wireless communication technology and the widespread use of medical systems, the radio frequency identification (RFID) technology has been widely used in healthcare environments. As the first important protocol for ensuring secure communication in healthcare environment, the RFID authentication protocols derive more and more attentions. Most of RFID authentication protocols are based on hash function or symmetric cryptography. To get more security properties, elliptic curve cryptosystem (ECC) has been used in the design of RFID authentication protocol. Recently, Liao and Hsiao proposed a new RFID authentication protocol using ECC and claimed their protocol could withstand various attacks. In this paper, we will show that their protocol suffers from the key compromise problem, i.e. an adversary could get the private key stored in the tag. To enhance the security, we propose a new RFID authentication protocol using ECC. Detailed analysis shows the proposed protocol not only could overcome weaknesses in Liao and Hsiao's protocol but also has the same performance. Therefore, it is more suitable for healthcare environments.

Mentor experiences of international healthcare students' learning in a clinical environment: A systematic review.

Science.gov (United States)

Mikkonen, Kristina; Elo, Satu; Tuomikoski, Anna-Maria; Kääriäinen, Maria

2016-05-01

Globalisation has brought new possibilities for international growth in education and professional mobility among healthcare professionals. There has been a noticeable increase of international degree programmes in non-English speaking countries in Europe, creating clinical learning challenges for healthcare students. The aim of this systematic review was to describe mentors' experiences of international healthcare students' learning in a clinical environment. The objective of the review was to identify what influences the success or failure of mentoring international healthcare students when learning in the clinical environment, with the ultimate aim being to promote optimal mentoring practice. A systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination. Seven electronic databases were used to search for the published results of previous research: CINAHL, Medline Ovid, Scopus, the Web of Science, Academic Search Premiere, Eric, and the Cochrane Library. Search inclusion criteria were planned in the PICOS review format by including peer-reviewed articles published in any language between 2000 and 2014. Five peer-reviewed articles remained after the screening process. The results of the original studies were analysed using a thematic synthesis. The results indicate that a positive intercultural mentor enhanced reciprocal learning by improving the experience of international healthcare students and reducing stress in the clinical environment. Integrating international healthcare students into work with domestic students was seen to be important for reciprocal learning and the avoidance of discrimination. Many healthcare students were found to share similar experiences of mentoring and learning irrespective of their cultural background. However, the role of a positive intercultural mentor was found to make a significant difference for international students: such mentors advocated and mediated cultural differences and

Agent-Oriented Privacy-Based Information Brokering Architecture for Healthcare Environments

Directory of Open Access Journals (Sweden)

Abdulmutalib Masaud-Wahaishi

2009-01-01

Full Text Available Healthcare industry is facing a major reform at all levels—locally, regionally, nationally, and internationally. Healthcare services and systems become very complex and comprise of a vast number of components (software systems, doctors, patients, etc. that are characterized by shared, distributed and heterogeneous information sources with varieties of clinical and other settings. The challenge now faced with decision making, and management of care is to operate effectively in order to meet the information needs of healthcare personnel. Currently, researchers, developers, and systems engineers are working toward achieving better efficiency and quality of service in various sectors of healthcare, such as hospital management, patient care, and treatment. This paper presents a novel information brokering architecture that supports privacy-based information gathering in healthcare. Architecturally, the brokering is viewed as a layer of services where a brokering service is modeled as an agent with a specific architecture and interaction protocol that are appropriate to serve various requests. Within the context of brokering, we model privacy in terms of the entities ability to hide or reveal information related to its identities, requests, and/or capabilities. A prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform JADE.

Agent-oriented privacy-based information brokering architecture for healthcare environments.

Science.gov (United States)

Masaud-Wahaishi, Abdulmutalib; Ghenniwa, Hamada

2009-01-01

Healthcare industry is facing a major reform at all levels-locally, regionally, nationally, and internationally. Healthcare services and systems become very complex and comprise of a vast number of components (software systems, doctors, patients, etc.) that are characterized by shared, distributed and heterogeneous information sources with varieties of clinical and other settings. The challenge now faced with decision making, and management of care is to operate effectively in order to meet the information needs of healthcare personnel. Currently, researchers, developers, and systems engineers are working toward achieving better efficiency and quality of service in various sectors of healthcare, such as hospital management, patient care, and treatment. This paper presents a novel information brokering architecture that supports privacy-based information gathering in healthcare. Architecturally, the brokering is viewed as a layer of services where a brokering service is modeled as an agent with a specific architecture and interaction protocol that are appropriate to serve various requests. Within the context of brokering, we model privacy in terms of the entities ability to hide or reveal information related to its identities, requests, and/or capabilities. A prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform JADE.

Patient-centred improvements in health-care built environments: perspectives and design indicators.

Science.gov (United States)

Douglas, Calbert H; Douglas, Mary R

2005-09-01

To explore patients' perceptions of health-care built environments, to assess how they perceived health-care built facilities and designs. To develop a set of patient-centred indicators by which to appraise future health-care designs. Qualitative and quantitative methodologies, including futures group conferencing, autophotographic study, novice-expert exchanges and a questionnaire survey of a representative sample of past patients. The research was carried out at Salford Royal Hospitals NHS Trust (SRHT), Greater Manchester, UK, selected for the study because of planned comprehensive redevelopment based on the new NHS vision for hospital care and service delivery for the 21st century. Participants included 35 patients who took part in an autophotographic study, eight focus groups engaged in futures conferencing, a sample of past inpatients from the previous 12 months that returned 785 completed postal questionnaires. The futures group provided suggestions for radical improvements which were categorized into transport issues; accessibility and mobility; ground and landscape designs; social and public spaces; homeliness and assurance; cultural diversity; safety and security; personal space and access to outside. Patients' autophotographic study centred on: the quality of the ward design, human interactions, the state and quality of personal space, and facilities for recreation and leisure. The novices' suggestions were organized into categories of elemental factors representing patient-friendly designs. Experts from the architectural and surveying professions and staff at SRHT in turn considered these categories and respective subsets of factors. They agreed with the novices in terms of the headings but differed in prioritizing the elemental factors. The questionnaire survey of past patients provided opinions about ward designs that varied according to where they stayed, single room, bay ward or long open ward. The main concerns were limitation of private space

Applications of electron beam technology for healthcare and environment

International Nuclear Information System (INIS)

Varshney, Lalit

2013-01-01

Radiation technology has matured from lab scale to industrial scale in many areas of interests to industry, healthcare, agriculture and environment. Some of the well established applications include radiation sterilization, wires and cable, composites for automobiles, radiation surface curing, nanomaterials, hydrogels and special materials for nuclear and aerospace industry, radiation treatment of effluents, sewage sludge etc. These applications are as a result of characteristics of high energy radiation like gamma and electron beams which are able to deliver energy directly at molecular level. Unlike nuclear based radiations, electron beam accelerator technology is amenable to easy acceptance by public as well has capability to manipulate processes and product treatment to produce varieties of advanced/smart materials for healthcare and environment. Faster dose rates and depth profiling are the important characteristics of electron beam technology which gives it an edge over gamma radiation processing. Department of Atomic Energy has an ambitious program to indigenously develop accelerator technology and utilize them for national progress. In the presentation some important applications of radiation technology will be discussed. (author)

Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad

Directory of Open Access Journals (Sweden)

Gomes Natalie

2007-02-01

Full Text Available Abstract Background The increasing global popularity of herbal remedies requires further investigation to determine the probable factors driving this burgeoning phenomenon. We propose that the users' perception of efficacy is an important factor and assessed the perceived efficacy of herbal remedies by users accessing primary health facilities throughout Trinidad. Additionally, we determined how these users rated herbal remedies compared to conventional allopathic medicines as being less, equally or more efficacious. Methods A descriptive cross-sectional study was undertaken at 16 randomly selected primary healthcare facilities throughout Trinidad during June-August 2005. A de novo, pilot-tested questionnaire was interviewer-administered to confirmed herbal users (previous or current. Stepwise multiple regression analysis was done to determine the influence of predictor variables on perceived efficacy and comparative efficacy with conventional medicines. Results 265 herbal users entered the study and cited over 100 herbs for the promotion of health/wellness and the management of specific health concerns. Garlic was the most popular herb (in 48.3% of the sample and was used for the common cold, cough, fever, as 'blood cleansers' and carminatives. It was also used in 20% of hypertension patients. 230 users (86.8% indicated that herbs were efficacious and perceived that they had equal or greater efficacy than conventional allopathic medicines. Gender, ethnicity, income and years of formal education did not influence patients' perception of herb efficacy; however, age did (p = 0.036. Concomitant use of herbs and allopathic medicines was relatively high at 30%; and most users did not inform their attending physician. Conclusion Most users perceived that herbs were efficacious, and in some instances, more efficacious than conventional medicines. We suggest that this perception may be a major contributing factor influencing the sustained and increasing

Supporting nurses' transition to rural healthcare environments through mentorship.

Science.gov (United States)

Rohatinsky, Noelle K; Jahner, Sharleen

2016-01-01

The global shortage of rural healthcare professionals threatens the access these communities have to adequate healthcare resources. Barriers to recruitment and retention of nurses in rural facilities include limited resources, professional development opportunities, and interpersonal ties to the area. Mentorship programs have been used to successfully recruit and retain rural nurses. This study aimed to explore (i) employee perceptions of mentorship in rural healthcare organizations, (ii) the processes involved in creating mentoring relationships in rural healthcare organizations, and (iii) the organizational features supporting and inhibiting mentorship in rural healthcare organizations. This study was conducted in one rural health region in Saskatchewan, Canada. Volunteer participants who were employed at one rural healthcare facility were interviewed. A semi-structured interview guide that focused on exploring and gaining an understanding of participants' perceptions of mentorship in rural communities was employed. Data were analyzed using interpretive description methodology, which places high value on participants' subjective perspective and knowledge of their experience. All seven participants were female and employed as registered nurses or licensed practical nurses. Participants recognized that the rural environment offered unique challenges and opportunities for the transition of nurses new to rural healthcare. Participants believed mentorships facilitated this transition and were vital to the personal and professional success of new employees. Specifically, their insights indicated that this transition was influenced by three factors: rural community influences, organizational influences, and mentorship program influences. Facilitators for mentorships hinged on the close working relationships that facilitated the development of trust. Barriers to mentorship included low staff numbers, limited selection of volunteer mentors, and lack of mentorship

Interoperability in healthcare: major challenges in the creation of the enterprise environment

Science.gov (United States)

Lindsköld, L.; Wintell, M.; Lundberg, N.

2009-02-01

There is today a lack of interoperability in healthcare although the need for it is obvious. A new healthcare enterprise environment has been deployed for secure healthcare interoperability in the Western Region in Sweden (WRS). This paper is an empirical overview of the new enterprise environment supporting regional shared and transparent radiology domain information in the WRS. The enterprise environment compromises 17 radiology departments, 1,5 million inhabitants, using different RIS and PACS in a joint work-oriented network and additional cardiology, dentistry and clinical physiology departments. More than 160 terabytes of information are stored in the enterprise repository. Interoperability is developed according to the IHE mission, i.e. applying standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level 7 (HL7) to address specific clinical communication needs and support optimal patient care. The entire enterprise environment is implemented and used daily in WRS. The central prerequisites in the development of the enterprise environment in western region of Sweden were: 1) information harmonization, 2) reuse of standardized messages e.g. HL7 v2.x and v3.x, 3) development of a holistic information domain including both text and images, and 4) to create a continuous and dynamic update functionality. The central challenges in this project were: 1) the many different vendors acting in the region and the negotiations with them to apply communication roles/profiles such as HL7 (CDA, CCR), DICOM, and XML, 2) the question of whom owns the data, and 3) incomplete technical standards. This study concludes that to create a workflow that runs within an enterprise environment there are a number of central prerequisites and challenges that needs to be in place. This calls for negotiations on an international, national and regional level with standardization organizations, vendors, health management and health personnel.

Distributed, signal strength-based indoor localization algorithm for use in healthcare environments.

Science.gov (United States)

Wyffels, Jeroen; De Brabanter, Jos; Crombez, Pieter; Verhoeve, Piet; Nauwelaers, Bart; De Strycker, Lieven

2014-11-01

In current healthcare environments, a trend toward mobile and personalized interactions between people and nurse call systems is strongly noticeable. Therefore, it should be possible to locate patients at all times and in all places throughout the care facility. This paper aims at describing a method by which a mobile node can locate itself indoors, based on signal strength measurements and a minimal amount of yes/no decisions. The algorithm has been developed specifically for use in a healthcare environment. With extensive testing and statistical support, we prove that our algorithm can be used in a healthcare setting with an envisioned level of localization accuracy up to room revel (or region level in a corridor), while avoiding heavy investments since the hardware of an existing nurse call network can be reused. The approach opted for leads to very high scalability, since thousands of mobile nodes can locate themselves. Network timing issues and localization update delays are avoided, which ensures that a patient can receive the needed care in a time and resources efficient way.

An integrated healthcare system for personalized chronic disease care in home-hospital environments.

Science.gov (United States)

Jeong, Sangjin; Youn, Chan-Hyun; Shim, Eun Bo; Kim, Moonjung; Cho, Young Min; Peng, Limei

2012-07-01

Facing the increasing demands and challenges in the area of chronic disease care, various studies on the healthcare system which can, whenever and wherever, extract and process patient data have been conducted. Chronic diseases are the long-term diseases and require the processes of the real-time monitoring, multidimensional quantitative analysis, and the classification of patients' diagnostic information. A healthcare system for chronic diseases is characterized as an at-hospital and at-home service according to a targeted environment. Both services basically aim to provide patients with accurate diagnoses of disease by monitoring a variety of physical states with a number of monitoring methods, but there are differences between home and hospital environments, and the different characteristics should be considered in order to provide more accurate diagnoses for patients, especially, patients having chronic diseases. In this paper, we propose a patient status classification method for effectively identifying and classifying chronic diseases and show the validity of the proposed method. Furthermore, we present a new healthcare system architecture that integrates the at-home and at-hospital environment and discuss the applicability of the architecture using practical target services.

A secure RFID mutual authentication protocol for healthcare environments using elliptic curve cryptography.

Science.gov (United States)

Jin, Chunhua; Xu, Chunxiang; Zhang, Xiaojun; Zhao, Jining

2015-03-01

Radio Frequency Identification(RFID) is an automatic identification technology, which can be widely used in healthcare environments to locate and track staff, equipment and patients. However, potential security and privacy problems in RFID system remain a challenge. In this paper, we design a mutual authentication protocol for RFID based on elliptic curve cryptography(ECC). We use pre-computing method within tag's communication, so that our protocol can get better efficiency. In terms of security, our protocol can achieve confidentiality, unforgeability, mutual authentication, tag's anonymity, availability and forward security. Our protocol also can overcome the weakness in the existing protocols. Therefore, our protocol is suitable for healthcare environments.

A Benchmarking Analysis of Open-Source Business Intelligence Tools in Healthcare Environments

Directory of Open Access Journals (Sweden)

Andreia Brandão

2016-10-01

Full Text Available In recent years, a wide range of Business Intelligence (BI technologies have been applied to different areas in order to support the decision-making process. BI enables the extraction of knowledge from the data stored. The healthcare industry is no exception, and so BI applications have been under investigation across multiple units of different institutions. Thus, in this article, we intend to analyze some open-source/free BI tools on the market and their applicability in the clinical sphere, taking into consideration the general characteristics of the clinical environment. For this purpose, six BI tools were selected, analyzed, and tested in a practical environment. Then, a comparison metric and a ranking were defined for the tested applications in order to choose the one that best applies to the extraction of useful knowledge and clinical data in a healthcare environment. Finally, a pervasive BI platform was developed using a real case in order to prove the tool viability.

Robots, multi-user virtual environments and healthcare: synergies for future directions.

Science.gov (United States)

Moon, Ajung; Grajales, Francisco J; Van der Loos, H F Machiel

2011-01-01

The adoption of technology in healthcare over the last twenty years has steadily increased, particularly as it relates to medical robotics and Multi-User Virtual Environments (MUVEs) such as Second Life. Both disciplines have been shown to improve the quality of care and have evolved, for the most part, in isolation from each other. In this paper, we present four synergies between medical robotics and MUVEs that have the potential to decrease resource utilization and improve the quality of healthcare delivery. We conclude with some foreseeable barriers and future research directions for researchers in these fields.

Greening healthcare: practicing as if the natural environment really mattered.

Science.gov (United States)

Irvine, Katherine N; Warber, Sara L

2002-01-01

The natural world's role in human well-being is an essential, yet often forgotten, aspect of healthcare. Of particular importance are the benefits one can derive through interaction with natural environments. While health is an obvious goal of allopathic medicine, many healthcare settings are neither nurturing nor healing. Reincorporating the natural world into the design of settings in which medicine is practiced is one way to complement conventional healing modalities and move healthcare toward being more "green." This article discusses the breadth of existing knowledge available on the positive aspects of interaction with nature and provides a comprehensive theoretical perspective for future research. Computerized searches were conducted using MEDLINE, PsycINFO, the Social and Scientific Science Indices, Dissertation Abstracts, Lexus-Nexus, the University of Michigan library, and the Internet. Searches were conducted from June 2001 through March 2002. Keywords used included health, well-being stress, attention, nature, garden, landscape, restorative, and healing. The literature, published between 1960 and 2001, came from various disciplines, including medicine, public health, nursing psychology, natural resources, history, and landscape architecture. Four components of well-being were used as a framework for literature selection: physical psychological-emotional social, and spiritual. Articles were qualitatively reviewed to extract theories, hypotheses, and experimental evidence. Interaction with nature positively affects multiple dimensions of human health. Physiological effects of stress on the autonomic nervous system are lessened. Psychologically, deficits in attention can be restored or minimized, and people report feeling greater satisfaction with a variety of aspects of life. The presence of the natural world promotes social health by encouraging positive social interaction and lessening the frequency of aggressive behavior. Spiritual well-being is

Work environment stressors and personnel efficacy in Nigeria's ...

African Journals Online (AJOL)

Work environment stressors and personnel efficacy in Nigeria's maritime industry. ... Journal Home > Vol 15, No 1 (2017) > ... employees and corporate organizations need to manage stress by identifying the stressors and stress levels.

Does self-efficacy mediate the relationship between transformational leadership behaviours and healthcare workers' sleep quality? A longitudinal study.

Science.gov (United States)

Munir, Fehmidah; Nielsen, Karina

2009-09-01

This paper is a report of a study conducted to investigate the longitudinal relationship between transformational leadership behaviours and employees' sleep quality, and the mediating effects of self-efficacy. Although there is evidence for the influential role of transformational leadership on health outcomes, researchers have used either attitude outcomes (e.g. job satisfaction) or softer health measures, such as general well-being. Specific measures of well-being such as sleep quality have not been used, despite its association with working conditions. A longitudinal design was used to collect data from Danish healthcare workers at time 1 in 2005 (n = 447) and 18 months later at time 2 in 2007 (n = 274). Structural equation modelling was used to investigate the relationships between transformational leadership, self-efficacy and sleep quality at both time points independently (cross-sectionally) and longitudinally. For all constructs, time 2 measures were influenced by the baseline level. Direct relationships between transformational leadership and sleep quality were found. This relationship was negative cross-sectionally at both time points, but positive between baseline and follow-up. The relationship between leadership and employees' sleep quality was not mediated by employees' self-efficacy. Our results indicate that training managers in transformational leadership behaviours may have a positive impact on healthcare workers' health over time. However, more research is needed to examine the mechanisms by which transformational leadership brings about improved sleep quality; self-efficacy was not found to be the explanation.

Decision making in high-velocity environments: implications for healthcare.

Science.gov (United States)

Stepanovich, P L; Uhrig, J D

1999-01-01

Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

A novel approach to developing applications in the pervasive healthcare environment through the use of archetypes

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Tricai Cavalini, Luciana; do Prado, Antonio Francisco; Murgante, B.; Misra, S.; Carlini, M.; Torre, C.M.; Nguyen, H.Q.; Taniar, D.; Apduhan, B.O.; Gervasi, O.

Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients to play a more active role in the treatment of their conditions. Pervasive Healthcare environments demand a huge amount of information exchange, and specific technologies has been proposed to provide

Culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment: A systematic review of qualitative studies.

Science.gov (United States)

Mikkonen, Kristina; Elo, Satu; Kuivila, Heli-Maria; Tuomikoski, Anna-Maria; Kääriäinen, Maria

2016-02-01

Learning in the clinical environment of healthcare students plays a significant part in higher education. The greatest challenges for culturally and linguistically diverse healthcare students were found in clinical placements, where differences in language and culture have been shown to cause learning obstacles for students. There has been no systematic review conducted to examine culturally and linguistically diverse healthcare students' experiences of their learning in the clinical environment. This systematic review aims to identify culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment. The search strategy followed the guidelines of the Centre of Reviews and Dissemination. The original studies were identified from seven databases (CINAHL, Medline Ovid, Scopus, Web of Science, Academic Search Premiere, Eric and Cochrane Library) for the period 2000-2014. Two researchers selected studies based on titles, abstracts and full texts using inclusion criteria and assessed the quality of studies independently. Twelve original studies were chosen for the review. The culturally and linguistically diverse healthcare students' learning experiences were divided into three influential aspects of learning in a clinical environment: experiences with implementation processes and provision; experiences with peers and mentors; and experiences with university support and instructions. The main findings indicate that culturally and linguistically diverse healthcare students embarking on clinical placements initially find integration stressful. Implementing the process of learning in a clinical environment requires additional time, well prepared pedagogical orientation, prior cultural and language education, and support for students and clinical staff. Barriers to learning by culturally and linguistically diverse healthcare students were not being recognized and individuals were not considered motivated; learners experienced the

Internet Self-Efficacy Preferences of Internet Based Environments and Achievement of Prospective Teachers

Science.gov (United States)

Ozyalcin Oskay, Ozge

2011-01-01

The aims of this study are to determine prospective chemistry teachers' internet self-efficacy and preferences of constructivist internet-assisted environments and to examine the relationship between their internet self-efficacy and their preferences for constructivist internet-assisted environments, the relationship between their achievement in…

An international survey of cleaning and disinfection practices in the healthcare environment.

Science.gov (United States)

Kenters, Nikki; Gottlieb, Thomas; Hopman, Joost; Mehtar, Shaheen; Schweizer, Marin L; Tartari, Ermira; Huijskens, E G W; Voss, Andreas

2018-05-14

Antimicrobial resistance has become an urgent global health priority. Basic hygiene practices and cleaning and disinfection of the hospital environment are key in preventing pathogen cross-transmission. To our knowledge no studies have assessed the worldwide differences in cleaning and disinfection practices in healthcare facilities. The electronic survey described here was developed in order to evaluate differences in healthcare facility cleaning practices around the world. The International Society of Antimicrobial Chemotherapy (ISAC, formerly ISC), Infection Prevention and Control work group developed a survey with 30 multiple-choice questions. The questions were designed to assess the current cleaning practices in healthcare settings around the world. A total of 110 healthcare professionals, representing 23 countries participated in the online survey. In 96% of the facilities a written cleaning policy was present. Training of cleaning staff occurred in 70% of the facilities at the start of employment. Cleaning practices and monitoring of these practices varied. In summary, the survey enabled assessment and recognition of widely differing global practices in approaches to environmental cleaning and disinfection. Development of guideline recommendations for cleaning and disinfection could improve practices and set minimum standards worldwide. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Readiness of healthcare providers for eHealth: the case from primary healthcare centers in Lebanon.

Science.gov (United States)

Saleh, Shadi; Khodor, Rawya; Alameddine, Mohamad; Baroud, Maysa

2016-11-10

eHealth can positively impact the efficiency and quality of healthcare services. Its potential benefits extend to the patient, healthcare provider, and organization. Primary healthcare (PHC) settings may particularly benefit from eHealth. In these settings, healthcare provider readiness is key to successful eHealth implementation. Accordingly, it is necessary to explore the potential readiness of providers to use eHealth tools. Therefore, the purpose of this study was to assess the readiness of healthcare providers working in PHC centers in Lebanon to use eHealth tools. A self-administered questionnaire was used to assess participants' socio-demographics, computer use, literacy, and access, and participants' readiness for eHealth implementation (appropriateness, management support, change efficacy, personal beneficence). The study included primary healthcare providers (physicians, nurses, other providers) working in 22 PHC centers distributed across Lebanon. Descriptive and bivariate analyses (ANOVA, independent t-test, Kruskal Wallis, Tamhane's T2) were used to compare participant characteristics to the level of readiness for the implementation of eHealth. Of the 541 questionnaires, 213 were completed (response rate: 39.4 %). The majority of participants were physicians (46.9 %), and nurses (26.8 %). Most physicians (54.0 %), nurses (61.4 %), and other providers (50.9 %) felt comfortable using computers, and had access to computers at their PHC center (physicians: 77.0 %, nurses: 87.7 %, others: 92.5 %). Frequency of computer use varied. The study found a significant difference for personal beneficence, management support, and change efficacy among different healthcare providers, and relative to participants' level of comfort using computers. There was a significant difference by level of comfort using computers and appropriateness. A significant difference was also found between those with access to computers in relation to personal beneficence and

Programming secure mobile agents in healthcare environments using role-based permissions.

Science.gov (United States)

Georgiadis, C K; Baltatzis, J; Pangalos, G I

2003-01-01

The healthcare environment consists of vast amounts of dynamic and unstructured information, distributed over a large number of information systems. Mobile agent technology is having an ever-growing impact on the delivery of medical information. It supports acquiring and manipulating information distributed in a large number of information systems. Moreover is suitable for the computer untrained medical stuff. But the introduction of mobile agents generates advanced threads to the sensitive healthcare information, unless the proper countermeasures are taken. By applying the role-based approach to the authorization problem, we ease the sharing of information between hospital information systems and we reduce the administering part. The different initiative of the agent's migration method, results in different methods of assigning roles to the agent.

Mindful Application of Aviation Practices in Healthcare.

Science.gov (United States)

Powell-Dunford, Nicole; Brennan, Peter A; Peerally, Mohammad Farhad; Kapur, Narinder; Hynes, Jonny M; Hodkinson, Peter D

2017-12-01

Evidence supports the efficacy of incorporating select recognized aviation practices and procedures into healthcare. Incident analysis, debrief, safety brief, and crew resource management (CRM) have all been assessed for implementation within the UK healthcare system, a world leader in aviation-based patient safety initiatives. Mindful application, in which aviation practices are specifically tailored to the unique healthcare setting, show promise in terms of acceptance and long-term sustainment. In order to establish British healthcare applications of aviation practices, a PubMed search of UK authored manuscripts published between 2005-2016 was undertaken using search terms 'aviation,' 'healthcare,' 'checklist,' and 'CRM.' A convenience sample of UK-authored aviation medical conference presentations and UK-authored patient safety manuscripts were also reviewed. A total of 11 of 94 papers with UK academic affiliations published between 2005-2016 and relevant to aviation modeled healthcare delivery were found. The debrief process, incident analysis, and CRM are the primary practices incorporated into UK healthcare, with success dependent on cultural acceptance and mindful application. CRM training has gained significant acceptance in UK healthcare environments. Aviation modeled incident analysis, debrief, safety brief, and CRM training are increasingly undertaken within the UK healthcare system. Nuanced application, in which the unique aspects of the healthcare setting are addressed as part of a comprehensive safety approach, shows promise for long-term success. The patient safety brief and aviation modeled incident analysis are in earlier phases of implementation, and warrant further analysis.Powell-Dunford N, Brennan PA, Peerally MF, Kapur N, Hynes JM, Hodkinson PD. Mindful application of aviation practices in healthcare. Aerosp Med Hum Perform. 2017; 88(12):1107-1116.

Islam and the healthcare environment: designing patient rooms.

Science.gov (United States)

Kopec, D A K; Han, Li

2008-01-01

Islam and the Muslim population are often the source of much misunderstanding and media-influenced misconceptions. Muslim patients who enter the healthcare environment are often weak and likely to experience feelings of vulnerability. Because of the complex and interwoven nature of culture and religion in a person's identity, it is important to consider patient belief systems and values when designing a patient's immediate environment. Through an exploration of literature related to culture and diversity and the beliefs and value system of the Muslim population, the authors were able to identify flexible design initiatives that could accommodate an array of cultural and spiritual practices. Islam and the Muslim population were chosen as the points of reference for this study because of the strong influence of the religion on the culture, and because of the many nuances that differ from the dominant culture within the United States. From these points of reference, a hypothetical design was developed for a patient room that considers differing notions of privacy, alternatives for cultural and religious practices, and ways to include symbolic meaning derived from attributes such as color.

Links among high-performance work environment, service quality, and customer satisfaction: an extension to the healthcare sector.

Science.gov (United States)

Scotti, Dennis J; Harmon, Joel; Behson, Scott J

2007-01-01

Healthcare managers must deliver high-quality patient services that generate highly satisfied and loyal customers. In this article, we examine how a high-involvement approach to the work environment of healthcare employees may lead to exceptional service quality, satisfied patients, and ultimately to loyal customers. Specifically, we investigate the chain of events through which high-performance work systems (HPWS) and customer orientation influence employee and customer perceptions of service quality and patient satisfaction in a national sample of 113 Veterans Health Administration ambulatory care centers. We present a conceptual model for linking work environment to customer satisfaction and test this model using structural equations modeling. The results suggest that (1) HPWS is linked to employee perceptions of their ability to deliver high-quality customer service, both directly and through their perceptions of customer orientation; (2) employee perceptions of customer service are linked to customer perceptions of high-quality service; and (3) perceived service quality is linked with customer satisfaction. Theoretical and practical implications of our findings, including suggestions of how healthcare managers can implement changes to their work environments, are discussed.

Perceived Efficacy and Intentions Regarding Seeking Mental Healthcare: Impact of Deepika Padukone, A Bollywood Celebrity's Public Announcement of Struggle with Depression.

Science.gov (United States)

Jain, Parul; Pandey, Uma Shankar; Roy, Enakshi

2017-08-01

The current research examines the impact of Deepika Padukone's (one of the most popular Bollywood celebrities) public announcement of struggle with depression on people's perceived efficacy and intentions to seek help for mental healthcare. A survey conducted with 206 participants from India, the country with the highest depression rates in the world, revealed that parasocial interaction with the celebrity mediated the effect of exposure on intentions and efficacy perceptions regarding seeking mental healthcare. Our study expands the research on celebrity influence on health conditions in an international realm and in a mental health context. The findings have immense practical implications and may raise awareness about mental health in India given the popularity and reach of Bollywood among audiences in India and beyond, the level of stigmatization attached to mental health issues in India, and the lack of available resources for care. Theoretically, the study explores processes and effects of involvement with a celebrity and discusses potential implications for the behaviors related to health.

The Effect of Family and School Cultural Environment Through Self Efficacy on Student Learning Result

Directory of Open Access Journals (Sweden)

Ely Rizky Amaliyah

2017-11-01

Full Text Available This study aims to explain the relationship between environmental variables out g a, school culture, self-efficacy and student learning outcomes Administrative Program Program at SMK. This research includes quantitative research type with the explanatory descriptive method. The sampling technique was proportionate stratified random sampling, the study sample consisted of 114 students. Data analysis in this research using path analysis. Results research shows that there is a positive and significant influence of family environment on self-efficacy, there is the positive and significant influence of school culture on self-efficacy, there is a direct positive and significant influence between the environment to the family on the results of learning. While the school culture The air does not directly influence the learning outcomes, but the air of self-efficacy ng driving direct effect on learning outcomes, and the family environment is not aired directly influence the outcome through self-efficacy jar arts students, and school culture has an indirect effect on learning outcomes through students' self-efficacy.

Effects of Gender on Teachers' Perceptions of School Environment, Teaching Efficacy, Stress and Job Satisfaction

Science.gov (United States)

Tran, Van Dat

2015-01-01

This study investigates how teachers' perceptions of school environment factors, teaching efficacy, teacher stress and job satisfaction, and to determine whether gender was a differentiating factor. A total of 387 Vietnamese junior high school teachers completed one questionnaire for four sections about school-level environment, teaching efficacy,…

Factors Influencing Healthcare Service Quality

Directory of Open Access Journals (Sweden)

Ali Mohammad Mosadeghrad

2014-07-01

Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

The role of the physical environment in conversations between people who are communication vulnerable and health-care professionals: a scoping review.

Science.gov (United States)

Stans, Steffy E A; Dalemans, Ruth J P; de Witte, Luc P; Smeets, Hester W H; Beurskens, Anna J

2017-12-01

The role of the physical environment in communication between health-care professionals and persons with communication problems is a neglected area. This study provides an overview of factors in the physical environment that play a role in communication during conversations between people who are communication vulnerable and health-care professionals. A scoping review was conducted using the methodological framework of Arksey and O'Malley. The PubMed, PsycINFO, CINAHL and Cochrane Library databases were screened, and a descriptive and thematic analysis was completed. Sixteen publications were included. Six factors in the physical environment play a role in conversations between people who are communication vulnerable and health-care professionals: (1) lighting, (2) acoustic environment, (3) humidity and temperature, (4) setting and furniture placement, (5) written information, and (6) availability of augmentative and alternative communication (AAC) tools. These factors indicated barriers and strategies related to the quality of these conversations. Relatively small and simple strategies to adjust the physical environment (such as adequate lighting, quiet environment, providing pen and paper) can support people who are communication vulnerable to be more involved in conversations. It is recommended that health-care professionals have an overall awareness of the potential influence of environmental elements on conversations. Implications for rehabilitation The physical environment is an important feature in the success or disturbance of communication. Small adjustments to the physical environment in rehabilitation can contribute to a communication-friendly environment for conversations with people who are communication vulnerable. Professionals should consider adjustments with regard to the following factors in the physical environment during conversations with people who are communication vulnerable: lighting, acoustic environment, humidity and temperature, setting

Understanding healthcare professionals' self-efficacy to resolve interprofessional conflict.

Science.gov (United States)

Sexton, Martha; Orchard, Carole

2016-05-01

Conflict within interprofessional healthcare teams, when not effectively resolved, has been linked to detrimental consequences; however, effective conflict resolution has been shown to enhance team performance, increase patient safety, and improve patient outcomes. Alarmingly, knowledge of healthcare professionals' ability to resolve conflict has been limited, largely due to the challenges that arise when researchers attempt to observe a conflict occurring in real time. Research literature has identified three central components that seem to influence healthcare professional's perceived ability to resolve conflict: communication competence, problem-solving ability, and conflict resolution education and training. The purpose of this study was to investigate the impact of communication competence, problem-solving ability, and conflict resolution education and training on healthcare professionals' perceived ability to resolve conflicts. This study employed a cross-sectional survey design. Multiple regression analyses demonstrated that two of the three central components-conflict resolution education and training and communication competence-were found to be statistically significant predictors of healthcare professionals' perceived ability to resolve conflict. Implications include a call to action for clinicians and academicians to recognize the importance of communication competence and conflict resolution education and training as a vital area in interprofessional pre- and post-licensure education and collaborative practice.

The value of information for decision-making in the healthcare environment.

Science.gov (United States)

Shabtai, Itamar; Leshno, Moshe; Blondheim, Orna; Kornbluth, Jonathan

2007-01-01

With their ever-growing importance and usability, the healthcare sector has been investing heavily in medical information systems in recent years, as part of the effort to improve medical decision-making and increase its efficiency through improved medical processes, reduced costs, integration of patients' data, etc. In light of these developments, this research aims to evaluate the contribution of information technology (IT) to improving the medical decision-making processes at the point of care of internal medicine and surgical departments and to evaluate the degree to which IT investments are worthwhile. This has been done by assessing the value of information to decision-makers (physicians) at the point of care by investigating whether the information systems improved the medical outcomes. The research included three steps (after a pilot study)--the assessment of the subjective value of information, the assessment of the realistic value of information, and the assessment of the normative value of information, the results of each step being used as the starting assumptions for the following steps. Following a discussion and integration of the results from the various steps, the results of the three assessment stages were summarized in a cost-effectiveness analysis and an overall return on investment (ROI) analysis. In addition, we tried to suggest IT strategies for decision-makers in the healthcare sector on the advisability of implementing such systems as well as the implications for managing them. This research is uniquely pioneering in the manner in which it combines an assessment of the three kinds of measures of value of information in the healthcare environment. Our aim in performing it was to contribute to researchers (by providing additional insight into the fields of decision theory, value of information and medical informatics, amongst others), practitioners (by promoting efficiency in the design of new medical IS and improving existing IS), physicians

Message generation facilities for interoperability in pervasive healthcare environments

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; do Prado, Antonio Francisco

Novel information and communication technologies enable the construction of systems that allow the provision of new healthcare services anywhere, at any time, and to anyone. Since these healthcare systems may offer their healthcare records in different electronic formats, the openEHR foundation

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

Science.gov (United States)

Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study.

Science.gov (United States)

Widerström, Micael; Wiström, Johan; Edebro, Helén; Marklund, Elisabeth; Backman, Mattias; Lindqvist, Per; Monsen, Tor

2016-12-09

During the last decades, healthcare-associated genotypes of methicillin-resistant Staphylococcus epidermidis (HA-MRSE) have been established as important opportunistic pathogens. However, data on potential reservoirs on HA-MRSE is limited. The aim of the present study was to investigate the dynamics and to which extent HA-MRSE genotypes colonize patients, healthcare workers (HCWs) and the environment in an intensive care unit (ICU). Over 12 months in 2006-2007, swab samples were obtained from patients admitted directly from the community to the ICU and patients transferred from a referral hospital, as well as from HCWs, and the ICU environment. Patients were sampled every third day during hospitalization. Antibiotic susceptibility testing was performed according to EUCAST guidelines. Pulsed-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of a subset of MRSE isolates. We identified 620 MRSE isolates from 570 cultures obtained from 37 HCWs, 14 patients, and 14 environmental surfaces in the ICU. HA-MRSE genotypes were identified at admission in only one of the nine patients admitted directly from the community, of which the majority subsequently were colonized by HA-MRSE genotypes within 3 days during hospitalization. Almost all (89%) of HCWs were nasal carriers of HA-MRSE genotypes. Similarly, a significant proportion of patients transferred from the referral hospital and fomites in the ICU were widely colonized with HA-MRSE genotypes. Patients transferred from a referral hospital, HCWs, and the hospital environment serve as important reservoirs for HA-MRSE. These observations highlight the need for implementation of effective infection prevention and control measures aiming at reducing HA-MRSE transmission in the healthcare setting.

Physical therapists' perception of workplace ethics in an evolving health-care delivery environment: a cross-sectional survey.

Science.gov (United States)

Cantu, Roberto

2018-03-30

Physical therapists are trained and obligated to deliver optimal health care and put patients first above all else. In the changing health-care environment, health-care organizations are grappling with controlling cost and increasing revenues. Moral distress may be created when physical therapists' desire to provide optimal care conflicts with their organization's goals to remain financially viable or profitable. Moral distress has been associated with low perception of ethical environment, professional burnout, and high turnover in organizations. This study identified groups who may be vulnerable to low perception of organizational ethical environment and identified self-reported strategies to remedy these perceptions. An ethics environment questionnaire was mailed to a random sample of 1200 physical therapists in Georgia. Respondents (n = 340) were analyzed by age, workplace setting, and position in organization. Therapists working in skilled nursing/assisted living environments scored the lowest on the questionnaire and voiced concerns regarding their ethical work environments. Owners and executives perceived their organizations to be more ethical than front-line clinicians. Respondent concerns included high productivity standards, aggressive coding/billing policies, decreased reimbursement, and increased insurance regulation. Possible solutions included more frequent communication between management and clinicians about ethics, greater professional autonomy, and increased training in business ethics and finance.

Neighborhood Environment, Self-Efficacy, and Physical Activity in Urban Adolescents

Science.gov (United States)

Voorhees, Carolyn C.; Yan, Alice F.; Clifton, Kelly J.; Wang, Min Qi

2011-01-01

Objectives: To test the pathways between perceptions of built environment factors and physical activity in urban youth. Methods: Three hundred fifty high school students' perceptions of neighborhood, and barrier self efficacy were measured by a Web survey. Physical activities were assessed using a one-week diary and accelerometers. Results:…

The influence of factors of work environment and burnout syndrome on self-efficacy of medical staff.

Science.gov (United States)

Nowakowska, Iwona; Rasińska, Renata; Głowacka, Maria Danuta

2016-06-02

Conditions of a healthy, friendly and safe work environment and proper work organisation increase self-efficacy and decrease or eliminate the factors causing the occurrence of burnout symptoms, all of which have a decisive impact on increasing the quality of work. The aim of the study was to analyse and assess the influence of factors of work environment and burnout syndrome on the self-efficacy of medical staff. The study comprised randomly selected professionally-active nurses working on hospital wards (N=405) on the area of two provinces in Poland. The study used the Generalized Self-Efficacy Scale, Copenhagen Burnout Inventory and a questionnaire concerning the factors that influence the process of work organisation at nursing positions in hospitals. Lower scores for self-efficacy resulted in a worse assessment of development opportunities and promotion prospects (r=-0.11), participation in the decision-making process (r=-0.11) and teamwork (r=-0.10). Lower self-efficacy contributed to the occurrence of burnout symptoms r∈[-0.19 - -0.17]. Properly shaped and used organisational factors are stimulating for professional efficiency and effectiveness, and consequently, for the quality of nursing work. Negative assessment of the factors in the work environment contributes to the occurrence of burnout symptoms and decrease in self-efficacy. Nurses with lower self-efficacy more often experienced symptoms of burnout.

Examining the Relationship between the Research Training Environment, Course Experiences, and Graduate Students’ Research Self-Efficacy Beliefs

Directory of Open Access Journals (Sweden)

Steven Chesnut

2015-10-01

Full Text Available This study examined the relationship between graduate students’ research training environment, course experience, and research self-efficacy beliefs. The findings of the descriptive and regression analyses suggest that graduate students’ (n = 161 general research, quantitative, and qualitative research self-efficacy beliefs varied and that these beliefs were related to different aspects of the research training environment and course experiences, including their own personal research experiences. While course experience variables were significant predictors of quantitative and qualitative research self-efficacy, they were not predictive of general research methods self-efficacy. Also, while mentorship was a significant predictor of general research methods self-efficacy, it was not a significant predictor of quantitative and qualitative research self-efficacy. The implications of this study for research and graduate education are discussed.

The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial.

Science.gov (United States)

Herlihey, Tracey A; Gelmi, Stefano; Cafazzo, Joseph A; Hall, Trevor N T

2017-06-01

OBJECTIVE To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment. METHODS A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard. RESULTS In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation. CONCLUSIONS This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety. Infect Control Hosp Epidemiol 2017;38:712-717.

Complexity science and leadership in healthcare.

Science.gov (United States)

Burns, J P

2001-10-01

The emerging field of complexity science offers an alternative leadership strategy for the chaotic, complex healthcare environment. A survey revealed that healthcare leaders intuitively support principles of complexity science. Leadership that uses complexity principles offers opportunities in the chaotic healthcare environment to focus less on prediction and control and more on fostering relationships and creating conditions in which complex adaptive systems can evolve to produce creative outcomes.

Versatile, immersive, creative and dynamic virtual 3-D healthcare learning environments: a review of the literature.

Science.gov (United States)

Hansen, Margaret M

2008-09-01

The author provides a critical overview of three-dimensional (3-D) virtual worlds and "serious gaming" that are currently being developed and used in healthcare professional education and medicine. The relevance of this e-learning innovation for teaching students and professionals is debatable and variables influencing adoption, such as increased knowledge, self-directed learning, and peer collaboration, by academics, healthcare professionals, and business executives are examined while looking at various Web 2.0/3.0 applications. There is a need for more empirical research in order to unearth the pedagogical outcomes and advantages associated with this e-learning technology. A brief description of Roger's Diffusion of Innovations Theory and Siemens' Connectivism Theory for today's learners is presented as potential underlying pedagogical tenets to support the use of virtual 3-D learning environments in higher education and healthcare.

Investigating Maternal Self-Efficacy and Home Learning Environment of Families Enrolled in Head Start

Science.gov (United States)

Bojczyk, Kathryn Elizabeth; Haverback, Heather Rogers; Pae, Hye K.

2018-01-01

The aim of this study was to examine the relationships between mothers' self-efficacy beliefs, their preschool children's home learning environments, and literacy skills. A sample of 112 mother-child dyads was recruited from Head Start centers in rural and urban communities. The measures included maternal self-efficacy and maternal perceptions of…

UV-C decontamination of hand-held tablet devices in the healthcare environment using the Codonics D6000™ disinfection system.

Science.gov (United States)

Muzslay, M; Yui, S; Ali, S; Wilson, A P R

2018-04-09

Mobile phones and tablet computers may be contaminated with microorganisms and become a potential reservoir for cross-transmission of pathogens between healthcare workers and patients. There is no generally accepted guidance how to reduce contamination on mobile devices in healthcare settings. Our aim was to determine the efficacy of the Codonics D6000™ UV-C disinfection device. Daily disinfection reduced contamination on screens and on protective cases (test) significantly, but not all cases (control) could be decontaminated. The median aerobic colony count on the control and the test cases was 52 (IQR 33-89) cfu/25cm 2 and 22 (IQR 10.5-41) cfu/25cm 2 respectively before disinfection. Copyright © 2018. Published by Elsevier Ltd.

Patients’ experience of important factors in the healthcare environment in oncology care

Directory of Open Access Journals (Sweden)

Helle Wijk

2013-08-01

Full Text Available Background and objective. The aim of this study was to describe what factors of the healthcare environment are perceived as being important to patients in oncology care. Design. A qualitative design was adopted using focus group interviews. Setting and participants. The sample was 11 patients with different cancer diagnoses in an oncology ward at a university hospital in west Sweden. Results. Analysis of the patients’ perceptions of the environment indicated a complex entity comprising several aspects. These came together in a structure consisting of three main categories: safety, partnership with the staff, and physical space. The care environment is perceived as a complex entity, made up of several physical and psychosocial aspects, where the physical factors are subordinated by the psychosocial factors. It is clearly demonstrated that the patients’ primary desire was a psychosocial environment where they were seen as a unique person; the patients wanted opportunities for good encounters with staff, fellow patients, and family members, supported by a good physical environment; and the patients valued highly a place to withdraw and rest. Conclusions. This study presents those attributes that are valued by cancer patients as crucial and important for the support of their well-being and functioning. The results show that physical aspects were subordinate to psychosocial factors, which emerged strongly as being the most important in a caring environment.

Healthcare service quality: towards a broad definition.

Science.gov (United States)

Mosadeghrad, Ali Mohammad

2013-01-01

The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

An empirical study to determine factors that motivate and limit the implementation of ICT in healthcare environments.

Science.gov (United States)

Gururajan, Raj; Hafeez-Baig, Abdul

2014-12-23

The maturity and usage of wireless technology has influenced health services, and this has raised expectations from users that healthcare services will become more affordable due to technology growth. There is increasing evidence to justify this expectation, as telehealth is becoming more and more prevalent in many countries. Thus, health services are now offered beyond the boundaries of traditional hospitals, giving rise to many external factors dictating their quality. This has led us to investigate the factors that motivate and limit the implementation of ICT applications in the healthcare domain. We used a mixed method approach with the qualitative aspects leading the quantitative aspects. The main reason for this approach was to understand and explore the domain through the qualitative aspects as we could be part of the discussion. Then we conducted a quantitative survey to extract more responses in order to justify the claims explored in the qualitative process. We found that there are a number of internal and external factors influencing ICT adoption in the healthcare environment so that services can be provided via ICT tools. These factors were grouped under factors contributing to improved outcomes, efficiency and the management of technology. We conceptualised that these three groups of factors drive ICT implementation to assure health services. The main lesson learned from this research was that Information Systems discipline needs to urgently consider health informatics as a serious growth area. We also found that as IS researchers, we need to 'mix' with the health environment in order to understand the environment and then develop suitable methods to answer posited research questions.

Stress-reducing effects of indoor plants in the built healthcare environment: The mediating role of perceived attractiveness

NARCIS (Netherlands)

Dijkstra, K.; Pieterse, Marcel E.; Pruyn, Adriaan T.H.

2008-01-01

Objective: Natural elements in the built healthcare environment have shown to hold potential stress-reducing properties. In order to shed light on the underlying mechanism of stress-reducing effects of nature, the present study investigates whether the stress-reducing effects of indoor plants occur

Stress-reducing effects of indoor plants in the built healthcare environment : The mediating role of perceived attractiveness

NARCIS (Netherlands)

Dijkstra, K.; Pieterse, Marcel E.; Pruyn, A.Th.

Objective: Natural elements in the built healthcare environment have shown to hold potential stress-reducing properties. In order to shed light on the underlying mechanism of stress-reducing effects of nature, the present study investigates whether the stress-reducing effects of indoor plants occur

Nanoporous aerogel as a bacteria repelling hygienic material for healthcare environment.

Science.gov (United States)

Oh, Jun Kyun; Kohli, Nandita; Zhang, Yuanzhong; Min, Younjin; Jayaraman, Arul; Cisneros-Zevallos, Luis; Akbulut, Mustafa

2016-02-26

Healthcare-associated infections (HAIs) caused by pathogenic bacteria are a worldwide problem and responsible for numerous cases of morbidity and mortality. Exogenous cross-contamination is one of the main mechanisms contributing to such infections. This work investigates the potential of hydrophobically modified nanoporous silica aerogel as an antiadhesive hygienic material that can inhibit exogenous bacterial contamination. Nanoporous silica aerogels were synthesized via sol-gel polymerization of tetraethyl orthosilicate and hydrophobized using trimethylsilyl chloride. Bacterial adhesion characteristics were evaluated via dip-inoculation in suspensions of Gram-negative Escherichia coli O157:H7 and Gram-positive Staphylococcus aureus. The attachment of E. coli O157:H7 and S. aureus to hydrophobic nanoporous silica aerogel (HNSA) was found to be significantly lower than that to hydrophilic and hydrophobic nonporous silica materials: 99.91% (E. coli O157:H7) and 99.93% (S. aureus) reduction in comparison to hydrophilic nonporous silica, and 82.95% (E. coli O157:H7) and 84.90% (S. aureus) reduction in comparison to hydrophobic nonporous silica. These results suggest that the use of HNSA as surfaces that come into contact with bacterial pathogens in the healthcare environment can improve bacterial hygiene, and therefore may reduce the rate of HAIs.

Nanoporous aerogel as a bacteria repelling hygienic material for healthcare environment

International Nuclear Information System (INIS)

Oh, Jun Kyun; Akbulut, Mustafa; Kohli, Nandita; Jayaraman, Arul; Zhang, Yuanzhong; Min, Younjin; Cisneros-Zevallos, Luis

2016-01-01

Healthcare-associated infections (HAIs) caused by pathogenic bacteria are a worldwide problem and responsible for numerous cases of morbidity and mortality. Exogenous cross-contamination is one of the main mechanisms contributing to such infections. This work investigates the potential of hydrophobically modified nanoporous silica aerogel as an antiadhesive hygienic material that can inhibit exogenous bacterial contamination. Nanoporous silica aerogels were synthesized via sol–gel polymerization of tetraethyl orthosilicate and hydrophobized using trimethylsilyl chloride. Bacterial adhesion characteristics were evaluated via dip-inoculation in suspensions of Gram-negative Escherichia coli O157:H7 and Gram-positive Staphylococcus aureus. The attachment of E. coli O157:H7 and S. aureus to hydrophobic nanoporous silica aerogel (HNSA) was found to be significantly lower than that to hydrophilic and hydrophobic nonporous silica materials: 99.91% (E. coli O157:H7) and 99.93% (S. aureus) reduction in comparison to hydrophilic nonporous silica, and 82.95% (E. coli O157:H7) and 84.90% (S. aureus) reduction in comparison to hydrophobic nonporous silica. These results suggest that the use of HNSA as surfaces that come into contact with bacterial pathogens in the healthcare environment can improve bacterial hygiene, and therefore may reduce the rate of HAIs. (paper)

Cybersecurity and privacy issues for socially integrated mobile healthcare applications operating in a multi-cloud environment.

Science.gov (United States)

Al-Muhtadi, Jalal; Shahzad, Basit; Saleem, Kashif; Jameel, Wasif; Orgun, Mehmet A

2017-05-01

Social media has enabled information-sharing across massively large networks of people without spending much financial resources and time that are otherwise required in the print and electronic media. Mobile-based social media applications have overwhelmingly changed the information-sharing perspective. However, with the advent of such applications at an unprecedented scale, the privacy of the information is compromised to a larger extent if breach mitigation is not adequate. Since healthcare applications are also being developed for mobile devices so that they also benefit from the power of social media, cybersecurity privacy concerns for such sensitive applications have become critical. This article discusses the architecture of a typical mobile healthcare application, in which customized privacy levels are defined for the individuals participating in the system. It then elaborates on how the communication across a social network in a multi-cloud environment can be made more secure and private, especially for healthcare applications.

The relationship between environment, efficacy beliefs, and academic achievement of low-income African American children in special education.

Science.gov (United States)

Bean, Kristen F; Sidora-Arcoleo, Kimberly

2012-01-01

African American students are overrepresented in special education. Ecological systems theory, social cognitive theory, and a literature review demonstrate that children's environments, particularly school, and self-efficacy impact the educational outcomes of African American children. Interventions have aimed to improve children's environmental resources and efficacy. The aim of this study was to assess the impact of environment, efficacy beliefs, and the Nurse-Family Partnership intervention on the educational achievements of African American children in special education. A secondary data analysis of 126 African American children in special education found that self-efficacy and the number of hours spent in special education were associated with their academic achievement.

Exploring the Healthcare Environment and Associations with Clinical Outcomes of People Living with HIV/AIDS.

Science.gov (United States)

Hawk, Mary; Coulter, Robert W S; Egan, James E; Friedman, Mackey Reuel; Meanley, Steven; Fisk, Stuart; Watson, Courtney; Kinsky, Suzanne

2017-12-01

Despite three decades of dramatic treatment breakthroughs in antiretroviral regimens, clinical outcomes for people living with HIV vary greatly. The HIV treatment cascade models the stages of care that people living with HIV go through toward the goal of viral suppression and demonstrates that <30% of those living with HIV/AIDS in the United States have met this goal. Although some research has focused on the ways that patient characteristics and patient-provider relationships contribute to clinical adherence and treatment success, few studies to date have examined the ways that contextual factors of care and the healthcare environment contribute to patient outcomes. Here, we present qualitative findings from a mixed-methods study to describe contextual and healthcare environment factors in a Ryan White Part C clinic that are associated with patients' abilities to achieve viral suppression. We propose a modification of Andersen's Behavioral Model of Health Services Utilization, and its more recent adaptation developed by Ulett et al., to describe the ways that clinic, system, and provider factors merge to create a system of care in which more than 86% of the patient population is virally suppressed.

Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System.

Science.gov (United States)

Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W

2016-08-01

BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); Phand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.

Enhancing the Australian healthcare sector's responsiveness to environmental sustainability issues: suggestions from Australian healthcare professionals.

Science.gov (United States)

Dunphy, Jillian L

2013-05-01

Identify strategies to implement change across the Australian healthcare sector to better support social and natural environments. Methods. Qualitative analysis of semi-structured interviews with Australian healthcare professionals. Interviewees described multiple barriers to implementing change and numerous strategies to overcome these barriers. They argued that action must be taken at the individual and systemic levels to produce substantial and effective change. The strategies recommended fall into four main categories: altering workplace cultures and professional identities, community engagement, political activity, and change from within. The overarching goals of these strategies are to reduce negative impacts on the natural environment, and increase social equity within and across generations. By implementing the strategies described, a more cohesive effort to address sustainability issues across the sector can be made. This may improve local and global health, within current and future generations. WHAT IS KNOWN ABOUT THE TOPIC? Healthcare has a significant impact on the natural and social environments, which in turn have a significant impact upon health and healthcare. WHAT DOES THIS PAPER ADD? This paper describes strategies to alter healthcare to better support environmental sustainability. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Collective implementation of the described strategies may allow a more cohesive and effective response across the Australian healthcare sector, to enhance local and global health for current and future generations.

Resilience of primary healthcare professionals working in challenging environments: a focus group study.

Science.gov (United States)

Matheson, Catriona; Robertson, Helen D; Elliott, Alison M; Iversen, Lisa; Murchie, Peter

2016-07-01

The modern primary healthcare workforce needs to be resilient. Early research framed professional resilience as avoiding 'burnout'; however, more recent literature has introduced the concept of positive adaptation to professional challenges, which results in individuals thriving in their role. To explore what primary health professionals working in challenging environments consider to be characteristics of resilience and what promotes or challenges professional resilience. A qualitative focus group in north east Scotland. Five focus groups were held with 20 health professionals (six GPs, nine nurses, four pharmacists, and a practice manager) based in rural or deprived city areas in the north east of Scotland. Inductive thematic analysis identified emerging themes. Personal resilience characteristics identified were optimism, flexibility and adaptability, initiative, tolerance, organisational skills, being a team worker, keeping within professional boundaries, assertiveness, humour, and a sense of self-worth. Workplace challenges were workload, information overload, time pressures, poor communication, challenging patients, and environmental factors (rural location). Promoters of professional resilience were strong management support, teamwork, workplace buffers, and social factors such as friends, family, and leisure activities. A model of health professional resilience is proposed that concurs with existing literature but adds the concept of personal traits being synergistic with workplace features and social networks. These facilitate adaptability and enable individual health professionals to cope with adversity that is inevitably part of the everyday experience of those working in challenging healthcare environments. © British Journal of General Practice 2016.

Decontamination Efficacy of Ultraviolet Radiation against Biofilms of Common Nosocomial Bacteria.

Science.gov (United States)

Tingpej, Pholawat; Tiengtip, Rattana; Kondo, Sumalee

2015-06-01

Ultraviolet radiation (UV) is commonly used to destroy microorganisms in the health-care environment. However, the efficacy of UV radiation against bacteria growing within biofilms has never been studied. To measure the sterilization effectiveness of UV radiation against common healthcare associated pathogens growing within biofilms. Staphylococcus aureus, Methicillin-resistant S. aureus (MRSA), Streptococcus epidermidis, Escherichia coli, ESBL-producing E. coli, Pseudomonas aeruginosa and Acinetobacter baumannii were cultivated in the Calgary Biofilm Device. Their biofilms were placed 50 cm from the UV lamp within the Biosafety Cabinet. Viability test, crystal violet assay and a scanning electron microscope were used to evaluate the germicidal efficacy. Within 5 minutes, UV radiation could kill S. aureus, MRSA, S. epidermidis, A. baumannii and ESBL-producing E. coli completely while it required 20 minutes and 30 minutes respectively to kill E. coli and P. aeruginosa. However, the amounts of biomass and the ultrastructure between UV-exposed biofilms and controls were not significantly different. UV radiation is effective in inactivating nosocomial pathogens grown within biofilms, but not removing biofilms and EPS. The biofilm of P. aeruginosa was the most durable.

Let’s be effective, let the patients talk! Does ‘patient intelligence’ have an effect on improvements in quality within the healthcare environment?

Directory of Open Access Journals (Sweden)

Nadine van Dongen

2009-10-01

Full Text Available Nadine van DongenVan Dongen Research Ltd, London, UKAbstract: This paper examines the interaction of patients within the context of efficiency in the pharmaceutical environment. Measurements of quality standards in healthcare are reviewed with an emphasis on the question of whether ‘patient intelligence’ can improve quality standards in healthcare. Something given particular consideration is the ethical point of view versus the business point of view, in relation to the integration of patients into the decision-making process of a healthcare organization. The paper focuses on the formal and informal reasons for involvement of patients in corporate and/or market access strategies for healthcare organizations.Keywords: healthcare, decision-making process, efficiency, patient intelligence, patients

The influence of factors of work environment and burnout syndrome on self-efficacy of medical staff

Directory of Open Access Journals (Sweden)

Iwona Nowakowska

2016-06-01

Properly shaped and used organisational factors are stimulating for professional efficiency and effectiveness, and consequently, for the quality of nursing work. Negative assessment of the factors in the work environment contributes to the occurrence of burnout symptoms and decrease in self-efficacy. Nurses with lower self-efficacy more often experienced symptoms of burnout.

The impact of the social and physical environments on parent-healthcare provider relationships when a child dies in PICU: Findings from a grounded theory study.

Science.gov (United States)

Butler, Ashleigh E; Copnell, Beverley; Hall, Helen

2017-12-30

This study explores the influences of the paediatric intensive care environment on relationships between parents and healthcare providers when children are dying. It forms part of a larger study, investigating parental experiences of the death of their child in intensive care. Constructivist grounded theory. Four Australian paediatric intensive care units. Audio-recorded, semi-structured interviews were conducted with twenty-six bereaved parents. Data were analysed using the constant comparison and memoing techniques common to grounded theory. The physical and social environment of the intensive care unit influenced the quality of the parent-healthcare provider relationship. When a welcoming, open environment existed, parents tended to feel respected as equal and included members of their child's care team. In contrast, environments that restricted parental presence or lacked resources for parental self-care could leave parents feeling like 'watchers', excluded from their child's care. The paediatric intensive care unit environment either welcomes and includes parents of dying children into the care team, or demotes them to the status of 'watcher'. Such environments significantly influence the relationships parents form with healthcare staff, their ability to engage in elements of their parental role, and their experiences as a whole. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Relationship between Classroom Environment and EFL Learners' Academic Self-Efficacy

Science.gov (United States)

Daemi, Masoumeh Naghsh; Tahriri, Abdorreza; Zafarghandi, Amir Mahdavi

2017-01-01

The present study sought to examine the relationship between classroom environment and English as a Foreign Language (EFL) learners' academic self-efficacy. To this end, a sample of 200 advanced EFL learners (146 females and 54 males) completed the "What is Happening In This Class?" (WIHIC) which consists of seven scales including…

Achieving compliance with healthcare waste management regulations : empirical evidence from small European healthcare units

OpenAIRE

Botelho, Anabela

2011-01-01

Healthcare units generate substantial amounts of hazardous or potentially hazardous wastes as by-products of their medical services. The inappropriate management of these wastes poses significant risks to people and the environment. In Portugal, as in other EU countries, the collection, storage, treatment and disposal of healthcare waste is regulated by law. Although legal provisions covering the safe management of healthcare waste date back to the 1990s, little is known about the compliance ...

Engagement with Mathematics Courseware in Traditional and Online Remedial Learning Environments: Relationship to Self-Efficacy and Achievement

Science.gov (United States)

Spence, Dianna J.; Usher, Ellen L.

2007-01-01

This research applied Bandura's (1986) social cognitive theory to examine engagement with courseware in traditional and online remedial mathematics learning environments. The study investigated the relationship of courseware engagement to age, computer self-efficacy, computer playfulness, and self-efficacy for self-regulated mathematics learning.…

How people who self-harm negotiate the inpatient environment: the mental healthcare workers perspective.

Science.gov (United States)

Thomas, J B; Haslam, C O

2017-09-01

WHAT IS KNOWN ABOUT THE SUBJECT?: Self-harm plays a function, commonly in the form of distress management. There has been little focussed exploration of how individuals who use self-harm to manage distress cope when prevented from self-harm in an inpatient environment and how staff respond to this issue. This paper uses the experiences of mental health staff to add to the existing knowledge that self-harm has a functional role and supports the notion that interventions for self-harm should focus on the origins of distress. It describes the potential consequences that focussing on prevention of self-harm as opposed to actually managing distress may have on service-users, how staff attempt to manage these consequences and factors that may impact on staff interventions to prevent further distress/harm. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that mental healthcare staff should aim to understand the function of self-harm, use this understanding to develop an individualized care plan with the aim of managing distress and identify barriers to the effectiveness of the interventions so they can be worked around. Introduction Literature describes self-harm as functional and meaningful. This creates difficulties for service-users detained in an inpatient environment where self-harm is prevented. Aim Mental healthcare staff were interviewed to build on existing evidence of issues with the prevention approach and explore, from a staff perspective, how self-harm prevention impacts on service-users, how they manage distress and how this impacts on staff and their approach to care. Methods Qualitative methods were used to allow unexpected themes to arise. Ten semi-structured interviews were carried out with mental healthcare staff and thematically analysed. Findings and discussion The findings provide new evidence on the benefits and limitations of the inpatient environment for individuals who self-harm. Findings indicate that being unable to self-harm can

LEAN thinking in Finnish healthcare.

Science.gov (United States)

Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

2016-01-01

Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

LEARNING ENVIRONMENT, SELF-EFFICACY, AND ATTITUDE IMPACT VOCATIONAL STUDENTS’ ENTREPRENEURIAL INTENTION?

OpenAIRE

Saptono, Ari; Purwana E.S., Dedi

2016-01-01

This research aims to examine the impact of learning environment, self-efficacy, and an entrepreneurial attitude towards entrepreneurial intention of Vocational High School students in DKI Jakarta. This study applied survey method with causal approach. Sampling techniques is random cluster sampling stages whose result in sample of 310 respondents. Research data was collected by questionnaires and then analyzed with path analysis. Research results empirically show that: a) Students entrepreneu...

Improving the efficacy of healthcare services for Aboriginal Australians.

Science.gov (United States)

Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle

2018-01-16

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for

A scoping review on bio-aerosols in healthcare and the dental environment.

Directory of Open Access Journals (Sweden)

Charifa Zemouri

Full Text Available Bio-aerosols originate from different sources and their potentially pathogenic nature may form a hazard to healthcare workers and patients. So far no extensive review on existing evidence regarding bio-aerosols is available.This study aimed to review evidence on bio-aerosols in healthcare and the dental setting. The objectives were 1 What are the sources that generate bio-aerosols?; 2 What is the microbial load and composition of bio-aerosols and how were they measured?; and 3 What is the hazard posed by pathogenic micro-organisms transported via the aerosol route of transmission?Systematic scoping review design. Searched in PubMed and EMBASE from inception to 09-03-2016. References were screened and selected based on abstract and full text according to eligibility criteria. Full text articles were assessed for inclusion and summarized. The results are presented in three separate objectives and summarized for an overview of evidence.The search yielded 5,823 studies, of which 62 were included. Dental hand pieces were found to generate aerosols in the dental settings. Another 30 sources from human activities, interventions and daily cleaning performances in the hospital also generate aerosols. Fifty-five bacterial species, 45 fungi genera and ten viruses were identified in a hospital setting and 16 bacterial and 23 fungal species in the dental environment. Patients with certain risk factors had a higher chance to acquire Legionella in hospitals. Such infections can lead to irreversible septic shock and death. Only a few studies found that bio-aerosol generating procedures resulted in transmission of infectious diseases or allergic reactions.Bio-aerosols are generated via multiple sources such as different interventions, instruments and human activity. Bio-aerosols compositions reported are heterogeneous in their microbiological composition dependent on the setting and methodology. Legionella species were found to be a bio-aerosol dependent hazard

Does the Social Working Environment Predict Beginning Teachers' Self-Efficacy and Feelings of Depression?

Science.gov (United States)

Devos, Christelle; Dupriez, Vincent; Paquay, Leopold

2012-01-01

We investigate how the social working environment predicts beginning teachers' self-efficacy and feelings of depression. Two quantitative studies are presented. The results show that the goal structure of the school culture (mastery or performance orientation) predicts both outcomes. Frequent collaborative interactions with colleagues are related…

Strategic alliances in healthcare: opportunities for the Veterans Affairs healthcare system.

Science.gov (United States)

Halverson, P K; Kaluzny, A D; Young, G J

1997-01-01

Strategic alliances are proving to be effective strategies for responding and adapting to changing environments, and as such they offer the U.S. Department of Veterans Affairs (VA) healthcare system valuable opportunities for accomplishing the goals of its major reorganization effort. This article begins with an examination of basic strategic-alliance structures that are employed across many different types of industries. Next, consideration is given to the ways in which these basic alliance structures may be adapted to the unique organizations and individuals that serve as providers, purchasers, and consumers of health services. Finally, this article explores how models of strategic alliance in healthcare can be tailored to the specific needs and constraints of the VA healthcare system through an examination of existing and potential alliance opportunities.

Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing.

Science.gov (United States)

Price, James R; Cole, Kevin; Bexley, Andrew; Kostiou, Vasiliki; Eyre, David W; Golubchik, Tanya; Wilson, Daniel J; Crook, Derrick W; Walker, A Sarah; Peto, Timothy E A; Llewelyn, Martin J; Paul, John

2017-02-01

Health-care workers have been implicated in nosocomial outbreaks of Staphylococcus aureus, but the dearth of evidence from non-outbreak situations means that routine health-care worker screening and S aureus eradication are controversial. We aimed to determine how often S aureus is transmitted from health-care workers or the environment to patients in an intensive care unit (ICU) and a high-dependency unit (HDU) where standard infection control measures were in place. In this longitudinal cohort study, we systematically sampled health-care workers, the environment, and patients over 14 months at the ICU and HDU of the Royal Sussex County Hospital, Brighton, England. Nasal swabs were taken from health-care workers every 4 weeks, bed spaces were sampled monthly, and screening swabs were obtained from patients at admission to the ICU or HDU, weekly thereafter, and at discharge. Isolates were cultured and their whole genome sequenced, and we used the threshold of 40 single-nucleotide variants (SNVs) or fewer to define subtypes and infer recent transmission. Between Oct 31, 2011, and Dec 23, 2012, we sampled 198 health-care workers, 40 environmental locations, and 1854 patients; 1819 isolates were sequenced. Median nasal carriage rate of S aureus in health-care workers at 4-weekly timepoints was 36·9% (IQR 35·7-37·3), and 115 (58%) health-care workers had S aureus detected at least once during the study. S aureus was identified in 8-50% of environmental samples. 605 genetically distinct subtypes were identified (median SNV difference 273, IQR 162-399) at a rate of 38 (IQR 34-42) per 4-weekly cycle. Only 25 instances of transmission to patients (seven from health-care workers, two from the environment, and 16 from other patients) were detected. In the presence of standard infection control measures, health-care workers were infrequently sources of transmission to patients. S aureus epidemiology in the ICU and HDU is characterised by continuous ingress of distinct

Healthcare teams over the Internet: towards a certificate-based approach.

Science.gov (United States)

Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

2002-01-01

Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modem healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has therefore become a major concern for healthcare applications over the Internet. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security policy is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

Macrocognition in the Healthcare Built Environment (mHCBE): A Focused Ethnographic Study of "Neighborhoods" in a Pediatric Intensive Care Unit.

Science.gov (United States)

O'Hara, Susan; Klar, Robin Toft; Patterson, Emily S; Morris, Nancy S; Ascenzi, Judy; Fackler, James C; Perry, Donna J

2018-04-01

The objectives of this research were to describe the interactions (formal and informal), in which macrocognitive functions occur and their location on a pediatric intensive care unit, to describe challenges and facilitators of macrocognition using space syntax constructs (openness, connectivity, and visibility), and to analyze the healthcare built environment (HCBE) using those constructs to explicate influences on macrocognition. In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple healthcare settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, "macrocognition in the healthcare built environment" (mHCBE) addresses this relationship. A focused ethnographic study was conducted including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data. Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs). Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help increase understanding of how use of the framework of Macrocognition in the HCBE can improve design and support adaptation of interprofessional team practices, maximizing macrocognitive interaction opportunities for patient, family, and team safety and quality.

Taiwan College Students' Self-Efficacy and Motivation of Learning in Online Peer Assessment Environments

Science.gov (United States)

Tseng, Sheng-Chau; Tsai, Chin-Chung

2010-01-01

Online peer assessment is an innovative evaluation method that has caught both educators' and practitioners' attention in recent years. The purpose of this study was to develop relevant questionnaires for teachers to understand student self-efficacy and motivation in online peer assessment learning environments. A total of 205 college students…

Providing healthcare services on-the-fly using multi-player cooperation game theory in Internet of Vehicles (IoV environment

Directory of Open Access Journals (Sweden)

Neeraj Kumar

2015-08-01

Full Text Available Internet of Vehicles (IoV is a leading technology of the present era. It has gained huge attention with respect to its implementation in wide variety of domains ranging from traffic safety to infotainment applications. However, IoV can also be extended to healthcare domain, where the patients can be provided healthcare services on-the-fly. We extend this novel concept in this paper and refer it as “Healthcare services on-the-fly”. The concept of game theory has been used among the vehicles to access the healthcare services while traveling. The vehicles act as players in the game and tend to form and split coalitions to access these services. Learning automata (LA act as the players for interaction with the environment and take appropriate actions based on reward and penalty. Apart from this, Virtual Machine (VM scheduling algorithm for efficient utilization of resources at cloud level has also been formulated. A stochastic reward net (SRN-based model is used to represent the coalition formation and splitting with respect to availability of resources at cloud level. The performance of the proposed scheme is evaluated using various performance evaluation metrics. The results obtained prove the effectiveness of the proposed scheme in comparison to the best, first, and random fit schemes.

Improving healthcare using Lean processes.

Science.gov (United States)

Baker, G Ross

2014-01-01

For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare. Copyright © 2014 Longwoods Publishing.

Exploring the Impact of Toxic Attitudes and a Toxic Environment on the Veterinary Healthcare Team.

Science.gov (United States)

Moore, Irene C; Coe, Jason B; Adams, Cindy L; Conlon, Peter D; Sargeant, Jan M

2015-01-01

The objective of this qualitative study was to compare veterinarians' and Registered Veterinary Technicians' (RVT's) perceptions of the veterinary healthcare team with respect to the impact of toxic attitudes and a toxic environment. Focus group interviews using a semi-structured interview guide and follow up probes were held with four veterinarian groups (23 companion animal veterinarians) and four Registered Veterinary Technician groups (26 RVTs). Thematic analysis of the discussions indicated both veterinarian and RVT participants felt team members with manifestations of toxic attitudes negatively impacted veterinary team function. These manifestations included people being disrespectful, being resistant to change, always wanting to be the "go to person," avoiding conflict, and lacking motivation. When conflict was ignored, or when people with toxic attitudes were not addressed, a toxic environment often resulted. A toxic environment sometimes manifested when "broken communication and tension between staff members" occurred as a result of employees lacking confidence, skills, or knowledge not being managed properly. It also occurred when employees did not feel appreciated, when there was difficulty coping with turnover, and when there were conflicting demands. The presence of people manifesting a toxic attitude was a source of frustration for both veterinarian and RVT participants. Prompt and consistent attention to negative behaviors is recommended to reduce the development of a toxic environment.

The influence of self-efficacy and outcome expectations on the relationship between perceived environment and physical activity in the workplace

Directory of Open Access Journals (Sweden)

Plotnikoff Ronald C

2004-03-01

Full Text Available Abstract Background Recent research and commentary contends that ecological approaches may be particularly useful for understanding and promoting physical activity participation in various settings including the workplace. Yet within the physical activity domain there is a lack of understanding of how ecological environment factors influence behaviour. Thus, the purpose of this study was to examine the relationships between perceived environment, social-cognitive variables, and physical activity behaviour. Methods Participants (N = 897 were employees from three large worksites who completed self-report inventories containing measures of self-efficacy, outcome expectations, perceptions of the workplace environment (PWES, and physical activity behaviour during both leisure-time and incorporated throughout the workday. Results Results of both bivariate and multiple regression analyses indicated the global PWES scores had a limited association with leisure-time physical activity (R2adj =.01. Sequential regression analyses supported a weak association between physical activity incorporated in the workplace and PWES (R2adj = .04 and the partial mediation of self-efficacy on the relationship between PWES and workplace physical activity (variance accounted for reduced to R2adj = .02 when self-efficacy was controlled. Conclusion Overall, the results of the present investigation indicate that self-efficacy acted as a partial mediator of the relationship between perceived environment and workplace physical activity participation. Implications of the findings for physical activity promotion using ecological-based approaches, and future directions for research from this perspective in worksite settings are discussed.

Healthcare teams over the Internet: programming a certificate-based approach.

Science.gov (United States)

Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

2003-07-01

Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modern healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has, therefore, become a major concern. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security model is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control (HAC) security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

Mobile Device Security: Perspectives of Future Healthcare Workers.

Science.gov (United States)

Hewitt, Barbara; Dolezel, Diane; McLeod, Alexander

2017-01-01

Healthcare data breaches on mobile devices continue to increase, yet the healthcare industry has not adopted mobile device security standards. This increase is disturbing because individuals are often accessing patients' protected health information on personal mobile devices, which could lead to a data breach. This deficiency led the researchers to explore the perceptions of future healthcare workers regarding mobile device security. To determine healthcare students' perspectives on mobile device security, the investigators designed and distributed a survey based on the Technology Threat Avoidance Theory. Three hundred thirty-five students participated in the survey. The data were analyzed to determine participants' perceptions about security threats, effectiveness and costs of safeguards, self-efficacy, susceptibility, severity, and their motivation and actions to secure their mobile devices. Awareness of interventions to protect mobile devices was also examined. Results indicate that while future healthcare professionals perceive the severity of threats to their mobile data, they do not feel personally susceptible. Additionally, participants were knowledgeable about security safeguards, but their knowledge of costs and problems related to the adoption of these measures was mixed. These findings indicate that increasing security awareness of healthcare professionals should be a priority.

Workplace bullying and burnout among healthcare employees: The moderating effect of control-related resources.

Science.gov (United States)

Livne, Yael; Goussinsky, Ruhama

2018-03-01

Workplace bullying is a widespread and challenging problem in healthcare organizations, bearing negative consequences for individuals and organizations. Drawing on the job demands-resources theory, in this study, we examined the relationship between workplace bullying and burnout among healthcare employees, as well as the moderating role of job autonomy and occupational self-efficacy in this relationship. Using a cross-sectional design with anonymous questionnaires, data were collected from two samples of 309 healthcare employees in a mental health facility, and 105 nurses studying for their bachelor degree in health systems administration. The findings indicated that workplace bullying was positively related to burnout dimensions, and that this relationship was moderated by job autonomy and occupational self-efficacy resources. Job autonomy interacted with workplace bullying in predicting emotional exhaustion and depersonalization; the interaction of bullying with occupational self-efficacy significantly predicted depersonalization. These results underscore the importance of control-related resources in mitigating the harmful effects of workplace bullying on employees. Implications for research and managerial practices are discussed. © 2017 John Wiley & Sons Australia, Ltd.

Psychometric Testing of the Self-Efficacy for Interdisciplinary Plans of Care Scale.

Science.gov (United States)

Molle, Elizabeth; Froman, Robin

2017-01-01

Computerized interdisciplinary plans of care have revitalized nurse-centric care plans into dynamic and meaningful electronic documents. To maximize the benefits of these documents, it is important to understand healthcare professionals' attitudes, specifically their confidence, for making computerized interdisciplinary care plans useful and meaningful documents. The purpose of the study was to test the psychometric properties of the Self-Efficacy for Interdisciplinary Plans of Care instrument intended to measure healthcare professionals' self-efficacy for using such documents. Content validity was assessed by an expert review panel. Content validity indices ranged from 0.75 to 1.00, with a scale CVI of 0.94. A sample of 389 healthcare providers completed the 14-item instrument. Principal axis factoring was used to assess factor structure. The exploratory factor analysis yielded a single-factor structure accounting for 71.76% of covariance. Cronbach internal consistency coefficient for the single factor solution was .97. The corrected item-total correlations ranged from 0.71 to 0.90. The coefficient of stability, during a 2-week period, with a subset of the sample (n = 38), was estimated at 0.82. The results of this study suggest that the Self-Efficacy for Interdisciplinary Plans of Care has sturdy reliability and validity for measuring the self-efficacy of healthcare providers to make computerized interdisciplinary plans of care meaningful and useful documents.

Effect of Motivational Scaffolding on E-Learning Environments: Self-Efficacy, Learning Achievement, and Cognitive Style

Science.gov (United States)

Valencia-Vallejo, Nilson; López-Vargas, Omar; Sanabria-Rodríguez, Luis

2018-01-01

The present research studies the effects of motivational scaffolding that favor self-efficacy and improve learning achievement in students with different cognitive styles in the Field Dependence/Independence (FDI) dimension, when they interact in an e-learning environment on mathematics. The research has an experimental design with two groups and…

Healthcare avoidance: a critical review.

Science.gov (United States)

Byrne, Sharon K

2008-01-01

The purpose of this study is to provide a critical review and synthesis of theoretical and research literature documenting the impact of avoidance on healthcare behaviors, identify the factors that influence healthcare avoidance and delay in the adult population, and propose a direction for future research. The Theory of Reasoned Action, Theory of Planned Behavior, Theory of Care-Seeking Behavior, the Transtheoretical Model, and the Behavioral Model of Health Services Use/Utilization are utilized to elaborate on the context within which individual intention to engage in healthcare behaviors occurs. Research literature on the concept of healthcare avoidance obtained by using computerized searches of CINAHL, MEDLINE, PSYCH INFO, and HAPI databases, from 1995 to 2007, were reviewed. Studies were organized by professional disciplines. Healthcare avoidance is a common and highly variable experience. Multiple administrative, demographic, personal, and provider factors are related to healthcare avoidance, for example, distrust of providers and/or the science community, health beliefs, insurance status, or socioeconomic/income level. Although the concept is recognized by multiple disciplines, limited research studies address its impact on healthcare decision making. More systematic research is needed to determine correlates of healthcare avoidance. Such studies will help investigators identify patients at risk for avoidant behaviors and provide the basis for health-promoting interventions. Methodological challenges include identification of characteristics of individuals and environments that hinder healthcare behaviors, as well as, the complexity of measuring healthcare avoidance. Studies need to systematically explore the influence of avoidance behaviors on specific healthcare populations at risk.

Integrating Healthcare Ethical Issues into IS Education

Science.gov (United States)

Cellucci, Leigh W.; Layman, Elizabeth J.; Campbell, Robert; Zeng, Xiaoming

2011-01-01

Federal initiatives are encouraging the increase of IS graduates to work in the healthcare environment because they possess knowledge of datasets and dataset management that are key to effective management of electronic health records (EHRs) and health information technology (IT). IS graduates will be members of the healthcare team, and as such,…

Board Governance: Transformational Approaches Under Healthcare Reform.

Science.gov (United States)

Zastocki, Deborah K

2015-01-01

Previous successes of healthcare organizations and effective governance practices in the pre-reform environment are not predictive of future success. Healthcare has been through numerous phases of growth and development using tried-and-true strategies. The challenge is that our toolbox does not contain what is needed to build the future healthcare delivery systems required in the post-reform world. Healthcare has had a parochial focus at the local level, with some broadening of horizons at the state and national levels. But healthcare delivery is now a global issue that requires a totally different perspective, and many countries are confronting similar issues. US healthcare reform initiatives have far-reaching implications. Compounding the reform dynamics are the simultaneously occurring, gamechanging accelerants such as enabling information technologies and mobile health, new providers of healthcare, increased consumer demands, and limited healthcare dollars, to name a few. Operating in this turbulent environment requires transformational board, executive, and physician leadership because traditional ways of planning for incremental change and attempting to time those adjustments can prove disastrous. Creating the legacy healthcare system for tomorrow requires governing boards and executive leadership to act today as they would in the desired future system. Boards need to create a culture that fosters.innovation with a tolerance for risk and some failure. To provide effective governance, boards must essentially develop new skills, expertise, and ways of thinking. The rapid rate of change requires board members to possess certain capabilities, including the ability to deal with ambiguity and uncertainty while demonstrating flexibility and adaptability, all with a driving commitment to metrics and results. This requires development plans for both individual members and the overall board. In short, the board needs to function differently, particularly regarding the

Relationships among Individual Task Self-Efficacy, Self-Regulated Learning Strategy Use and Academic Performance in a Computer-Supported Collaborative Learning Environment

Science.gov (United States)

Wilson, Kimberly; Narayan, Anupama

2016-01-01

This study investigates relationships between self-efficacy, self-regulated learning strategy use and academic performance. Participants were 96 undergraduate students working on projects with three subtasks (idea generation task, methodical task and data collection) in a blended learning environment. Task self-efficacy was measured with…

Efficacy of Stochastic Vestibular Stimulation to Improve Locomotor Performance in a Discordant Sensory Environment

Science.gov (United States)

Temple, D. R.; De Dios, Y. E.; Layne, C. S.; Bloomberg, J. J.; Mulavara, A. P.

2016-01-01

Astronauts exposed to microgravity face sensorimotor challenges incurred when readapting to a gravitational environment. Sensorimotor Adaptability (SA) training has been proposed as a countermeasure to improve locomotor performance during re-adaptation, and it is suggested that the benefits of SA training may be further enhanced by improving detection of weak sensory signals via mechanisms such as stochastic resonance when a non-zero level of stochastic white noise based electrical stimulation is applied to the vestibular system (stochastic vestibular stimulation, SVS). The purpose of this study was to test the efficacy of using SVS to improve short-term adaptation in a sensory discordant environment during performance of a locomotor task.

The Role of Self-Efficacy on the Relationship between the Workplace Environment and Physical Activity: A Longitudinal Mediation Analysis

Science.gov (United States)

Plotnikoff, Ronald C.; Pickering, Michael A.; Flaman, Laura M.; Spence, John C.

2010-01-01

Cross-sectional studies show that self-efficacy (SE) serves as a partial mediator of the effect that perceptions of workplace environment have on self-reported workplace physical activity (PA). To further explore the role SE plays in the relationship between perceptions of the workplace environment and workplace PA, cross-sectional mediation…

The Influence of Trainee Gaming Experience and Computer Self-Efficacy on Learner Outcomes of Videogame-Based Learning Environments

National Research Council Canada - National Science Library

Orvis, Karin A; Orvis, Kara L; Belanich, James; Mullin, Laura N

2005-01-01

.... The purpose of the current research was to investigate the influence of two trainee characteristics, prior videogame experience and computer self-efficacy, on learner outcomes of a videogame-based training environment...

Healthcare professionals' perceptions of the value and impact of the arts in healthcare settings: A critical review of the literature.

Science.gov (United States)

Wilson, Ceri; Bungay, Hilary; Munn-Giddings, Carol; Boyce, Melanie

2016-04-01

Internationally there is growing interest in the use of the arts in the healthcare context evidenced by the number of research studies reported in the nursing and medical literature. Establishing successful projects in healthcare environments will to some extent be reliant on the cooperation of staff working in these settings: healthcare professionals and their cultural values will be the lynchpin in the relationship between the artists organising the activities and the patients. This review appraises healthcare professionals' perceptions of the value of the arts in healthcare settings, and the impact of the arts on healthcare professionals. A critical review of the literature between 2004 and 2014 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: arts activities; healthcare settings, and healthcare providers. Studies were included if they were written in English, explored the attitudes of healthcare professionals on the use of the arts in healthcare settings or the impact of arts activities on healthcare staff. Studies conducted in community venues and/or reporting on arts therapies (art, drama or music) were excluded. An initial 52 studies were identified and following screening for relevance and quality 27 articles were reviewed. Arts interventions were diverse and included music listening, visual arts, reading and creative writing, and dance. Despite some methodological limitations of the reviewed studies it was found that the majority of staff believed that engaging in arts interventions has a positive impact on patients' health and well-being. The findings suggest that arts interventions are perceived to have an impact on patients' stress, mood, pain levels, and sleep. Furthermore, staff believed that the arts can enhance communication between staff and patients, helping to build rapport and strengthen interactions. The majority of reported staff outcomes were

Motivation and User Engagement in Fitness Tracking: Heuristics for Mobile Healthcare Wearables

Directory of Open Access Journals (Sweden)

Stavros Asimakopoulos

2017-01-01

Full Text Available Wearable fitness trackers have gained a new level of popularity due to their ambient data gathering and analysis. This has signalled a trend toward self-efficacy and increased motivation among users of these devices. For consumers looking to improve their health, fitness trackers offer a way to more readily gain motivation via the personal data-based insights the devices offer. However, the user experience (UX that accompanies wearables is critical to helping users interpret, understand, gain motivation and act on their data. Despite this, there is little evidence as to specific aspects of fitness tracker user engagement and long-term motivation. We report on a 4-week situated diary study and Healthcare Technology Self-efficacy (HTSE questionnaire assessment of 34 users of two popular American fitness trackers: JawBone and FitBit. The study results illustrate design implications and requirements for fitness trackers and other self-efficacy mobile healthcare applications.

Assessing the Efficacy of the Aerobic Methanotrophic Biofilter in Methane Hydrate Environments

Energy Technology Data Exchange (ETDEWEB)

Valentine, David

2012-09-30

In October 2008 the University of California at Santa Barbara (UCSB) initiated investigations of water column methane oxidation in methane hydrate environments, through a project funded by the National Energy Technology Laboratory (NETL) entitled: assessing the efficacy of the aerobic methanotrophic biofilter in methane hydrate environments. This Final Report describes the scientific advances and discoveries made under this award as well as the importance of these discoveries in the broader context of the research area. Benthic microbial mats inhabit the sea floor in areas where reduced chemicals such as sulfide reach the more oxidizing water that overlies the sediment. We set out to investigate the role that methanotrophs play in such mats at locations where methane reaches the sea floor along with sulfide. Mats were sampled from several seep environments and multiple sets were grown in-situ at a hydrocarbon seep in the Santa Barbara Basin. Mats grown in-situ were returned to the laboratory and used to perform stable isotope probing experiments in which they were treated with 13C-enriched methane. The microbial community was analyzed, demonstrating that three or more microbial groups became enriched in methane?s carbon: methanotrophs that presumably utilize methane directly, methylotrophs that presumably consume methanol excreted by the methanotrophs, and sulfide oxidizers that presumably consume carbon dioxide released by the methanotrophs and methylotrophs. Methanotrophs reached high relative abundance in mats grown on methane, but other bacterial processes include sulfide oxidation appeared to dominate mats, indicating that methanotrophy is not a dominant process in sustaining these benthic mats, but rather a secondary function modulated by methane availability. Methane that escapes the sediment in the deep ocean typically dissolved into the overlying water where it is available to methanotrophic bacteria. We set out to better understand the efficacy of this

The efficacy of the Internet and Social Media as Medical Marketing Tools

NARCIS (Netherlands)

Constantinides, Efthymios; Karantinou, Kalipso; Alexiou, Maria; Vlachaki, Athanasia

2016-01-01

The role and efficacy of online marketing in healthcare remains underexplored. The present study, focusing on one medical specialty, investigates the perceived role of the Internet and social media as marketing tools from the perspectives of both healthcare providers and patients. It assesses their

Steering healthcare service delivery: a regulatory perspective.

Science.gov (United States)

Prakash, Gyan

2015-01-01

The purpose of this paper is to explore regulation in India's healthcare sector and makes recommendations needed for enhancing the healthcare service. The literature was reviewed to understand healthcare's regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS). Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges. This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach). Healthcare pitfalls across the world seem to follow similar follies. India's complexity and experience is useful for emerging and developed economies. The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient's perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

Treating the Healthcare Workforce Crisis: A Prescription for a Health Informatics Curriculum

Science.gov (United States)

Campbell, S. Matt; Pardue, J. Harold; Longenecker, Herbert E., Jr.; Barnett, H. Les; Landry, Jeffrey P.

2012-01-01

A serious need exists for information systems workers who have an understanding of the healthcare environment. Traditional information systems degree programs do not adequately prepare students to enter the healthcare environment. In this paper, we propose a curriculum for a baccalaureate health informatics degree that combines the technical and…

Asian American women in science, engineering, and mathematics: Background contextual and college environment influences on self-efficacy and academic achievement

Science.gov (United States)

Vogt, Kristen E.

2005-07-01

The purpose of this research study was to examine, for undergraduate women of various Asian American ethnic backgrounds, the influence of background contextual and college environment factors on their sense of academic self-efficacy and achievement in science, technology, engineering, and mathematics (STEM) majors. Social cognitive career theory and its critiques provided a theoretical foundation for relationships from past performance, socioeconomic status, acculturation, and college environment variables (compositional diversity, racial climate, gendered climate, academic peer support), to academic self-efficacy and achievement. Data were collected through an online survey. Instrumentation included the scales of Language, Identity, and Behavioral Acculturation; Gender Discrimination; Faculty and Classroom Behavior; Interactions with Peers; and Academic Milestones Self-efficacy. The participants were 228 Asian American undergraduate women in STEM at a large public, doctoral research extensive university on the east coast; the response rate was 51%. In three MANOVAs for nine social cognitive career variables, four ethnic groups (East, South, Southeast, and Multi-ethnic Asian American) significantly differed only on socioeconomic status. In path analysis, the initial model was not a good fit and was rejected. The model was respecified through statistical and theoretical evaluation, tested in exploratory analysis, and considered a good fit. The respecified model explained 36% of semester GPA (achievement) and 28% of academic self-efficacy. The academic achievement of Asian American women in STEM was related to past performance, background contextual factors, academic self-efficacy, academic peer support, and gendered climate. The strongest direct influence on achievement was academic self-efficacy followed by past performance. The total effect of Asian acculturation on achievement was negative and the total effect of American acculturation on achievement was not

[Information, knowledge and healthcare practice: professionals participation as the key element of the gear].

Science.gov (United States)

Adam, Paula; Permanyer-Miralda, Gaietà; Solà-Morales, Oriol; Canela-Soler, Jaume

2010-02-01

This article analyzes the role of ICT within the complicated gear between information, knowledge and healthcare practices, which particular focus on two specific cases: the digitalization process of the healthcare system and the application of knowledge into the healthcare practices. In both cases, international and local experiences suggest, and sometimes demonstrate the importance of the participation, capacity-building and empowerment of healthcare practitioners for the generation, transfer and use of information and knowledge empowered by the digital tools which should bring into the system better performance, more efficacy, efficiency, equity, equality, security, quality. 2010 Elsevier España S.L. All rights reserved.

A Big Data-driven Model for the Optimization of Healthcare Processes.

Science.gov (United States)

Koufi, Vassiliki; Malamateniou, Flora; Vassilacopoulos, George

2015-01-01

Healthcare organizations increasingly navigate a highly volatile, complex environment in which technological advancements and new healthcare delivery business models are the only constants. In their effort to out-perform in this environment, healthcare organizations need to be agile enough in order to become responsive to these increasingly changing conditions. To act with agility, healthcare organizations need to discover new ways to optimize their operations. To this end, they focus on healthcare processes that guide healthcare delivery and on the technologies that support them. Business process management (BPM) and Service-Oriented Architecture (SOA) can provide a flexible, dynamic, cloud-ready infrastructure where business process analytics can be utilized to extract useful insights from mountains of raw data, and make them work in ways beyond the abilities of human brains, or IT systems from just a year ago. This paper presents a framework which provides healthcare professionals gain better insight within and across your business processes. In particular, it performs real-time analysis on process-related data in order reveal areas of potential process improvement.

Healthcare Data Analytics on the Cloud

Directory of Open Access Journals (Sweden)

Indrajit Bhattacharya

2012-04-01

Full Text Available Meaningful analysis of voluminous health information has always been a challenge in most healthcare organizations. Accurate and timely information required by the management to lead a healthcare organization through the challenges found in the industry can be obtained using business intelligence (BI or business analytics tools. However, these require large capital investments to implement and support the large volumes of data that needs to be analyzed to identify trends. They also require enormous processing power which places pressure on the business resources in addition to the dynamic changes in the digital technology. This paper evaluates the various nuances of business analytics of healthcare hosted on the cloud computing environment. The paper explores BI being offered as Software as a Service (SaaS solution towards offering meaningful use of information for improving functions in healthcare enterprise. It also attempts to identify the challenges that healthcare enterprises face when making use of a BI SaaS solution.

A randomized trial comparing two intraosseous access devices in intrahospital healthcare providers with a focus on retention of knowledge, skill, and self-efficacy.

Science.gov (United States)

Derikx, H J G M; Gerritse, B M; Gans, R; van der Meer, N J M

2014-10-01

Intraosseous access is recommended in vitally compromised patients if an intravenous access cannot be easily obtained. Intraosseous infusion can be initiated by various healthcare providers. Currently, there are two mechanical intraosseous devices approved by the U.S. Food and Drug Administration (FDA) for use in adults and children. A comparison is made in this study of the theoretical and practical performance by anesthesiologists and registered nurses of anesthesia (RNAs) in the use of the battery-powered device (device A) versus the spring-loaded needle device (device B). This study entailed a 12-month follow-up of knowledge, skill retention, and self-efficacy measured by standardized testing. A prospective randomized trial was performed, initially comparing 15 anesthesiologists and 15 RNAs, both on using the two types of intraosseous devices. A structured lecture and skill station was given with the educational aids provided by the respective manufacturers. Individual knowledge and practical skills were tested at 0, 3, and 12 months after the initial course. There was no statistical significant difference in the retention of theoretical knowledge between RNAs and anesthesiologists on all testing occasions. However, the self-efficacy of the anesthesiologists is significantly higher (p intraosseous access has been disproven, as anesthesiologists were as successful as RNAs. However, the low self-efficacy of RNAs in the use of intraosseous devices could diminish the chance of them actually using one.

Students perceive healthcare as a valuable learning environment when accepted as a part of the workplace community.

Science.gov (United States)

Hägg-Martinell, Ann; Hult, Håkan; Henriksson, Peter; Kiessling, Anna

2014-01-01

The healthcare system is complex and the education of medical and nursing students is not always a priority within it. However, education offered at the point of care provides students with opportunities to apply knowledge, and to develop the necessary skills and attitudes needed to practice their future profession. The major objective of this study was to identify students' views of generic aspects of the healthcare environment that influences their progress towards professional competence. We collected free text answers of 75 medical students and 23 nursing students who had completed an extensive questionnaire concerning their learning in clinical wards. In order to obtain richer data and a deeper understanding, we also interviewed a purposive sample of students. Qualitative content analysis was conducted. We identified three themes: (1) How management, planning and organising for learning enabled content and learning activities to relate to the syllabus and workplace, and how this management influenced space and resources for supervision and learning; (2) Workplace culture elucidated how hierarchies and communication affected student learning and influenced their professional development and (3) Learning a profession illustrated the importance of supervisors' approaches to students, their enthusiasm and ability to build relationships, and their feedback to students on performance. From a student perspective, a valuable learning environment is characterised as one where management, planning and organising are aligned and support learning. Students experience a professional growth when the community of practice accepts them, and competent and enthusiastic supervisors give them opportunities to interact with patients and to develop their own responsibilities.

System integrational and migrational concepts and methods within healthcare

DEFF Research Database (Denmark)

Endsleff, F; Loubjerg, P

1997-01-01

In this paper an overview and comparison of the basic concepts and methods behind different system integrational implementations is given, including the DHE, which is based on the coming Healthcare Information Systems Architecture pre-standard HISA, developed by CEN TC251. This standard and the DHE...... (Distributed Healthcare Environment) not only provides highly relevant standards, but also provides an efficient and well structured platform for Healthcare IT Systems....

IoT Contextual Factors on Healthcare.

Science.gov (United States)

Michalakis, Konstantinos; Caridakis, George

2017-01-01

With the emergence of the Internet of Things, new services in healthcare will be available and existing systems will be integrated in the IoT framework, providing automated medical supervision and efficient medical treatment. Context awareness plays a critical role in realizing the vision of the IoT, providing rich contextual information that can help the system act more efficiently. Since context in healthcare has its unique characteristics, it is necessary to define an appropriate context aware framework for healthcare IoT applications. We identify this context as perceived in healthcare applications and describe the context aware procedures. We also present an architecture that connects the sensors that measure biometric data with the sensory networks of the environment and the various IoT middleware that reside in the geographical area. Finally, we discuss the challenges for the realization of this vision.

Construction and application of an intelligent air quality monitoring system for healthcare environment.

Science.gov (United States)

Yang, Chao-Tung; Liao, Chi-Jui; Liu, Jung-Chun; Den, Walter; Chou, Ying-Chyi; Tsai, Jaw-Ji

2014-02-01

Indoor air quality monitoring in healthcare environment has become a critical part of hospital management and policy. Manual air sampling and analysis are cost-inhibitive and do not provide real-time air quality data and response measures. In this month-long study over 14 sampling locations in a public hospital in Taiwan, we observed a positive correlation between CO(2) concentration and population, total bacteria, and particulate matter concentrations, thus monitoring CO(2) concentration as a general indicator for air quality could be a viable option. Consequently, an intelligent environmental monitoring system consisting of a CO(2)/temperature/humidity sensor, a digital plug, and a ZigBee Router and Coordinator was developed and tested. The system also included a backend server that received and analyzed data, as well as activating ventilation and air purifiers when CO(2) concentration exceeded a pre-set value. Alert messages can also be delivered to offsite users through mobile devices.

Private health insurance and access to healthcare.

Science.gov (United States)

Duggal, Ravi

2011-01-01

The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.

Pre-Service EFL Teachers' Self-Efficacy Beliefs, Goal Orientations, and Participations in an Online Learning Environment

Science.gov (United States)

Ucar, Hasan; Yazici Bozkaya, Mujgan

2016-01-01

This study examined the pre-service EFL teachers' self-efficacy beliefs, goal orientations, and participations in an online learning environment. Embedded mixed design was used in the study. In the quantitative part of the study, the participants were 186 senior pre-service EFL teachers and data were collected on two scales and a questionnaire.…

Robustness of the healthcare utilization results from the Rotavirus Efficacy and Safety Trial (REST evaluating the human-bovine (WC3 reassortant pentavalent rotavirus vaccine (RV5

Directory of Open Access Journals (Sweden)

Van Damme Pierre

2010-06-01

Full Text Available Abstract Background The Rotavirus Efficacy and Safety Trial was a placebo-controlled Phase III study that evaluated the safety and efficacy of a three-dose pentavalent rotavirus vaccine (RV5 including its effect on healthcare utilization for rotavirus gastroenteritis (RVGE. The per-protocol (PP analyses, which counted events occurring 14 days after dose 3 among infants without protocol violations, have already been published. This paper evaluates the consistency of the healthcare utilization results based on the modified intention to treat (MITT analyses with the PP analyses. The MITT analyses include all infants receiving at least one dose of vaccine or placebo and follow-up begins after dose 1. The paper also explores the consistency of the results for different subgroups of the study population with different types of surveillance. Methods Data on healthcare utilization for acute gastroenteritis were collected via telephone interviews after administration of the first dose. Parents were either contacted every 6 weeks or every 2 weeks depending on the substudy in which they were enrolled. Those contacted every 2 weeks were also asked to complete symptom diaries. Poisson regression was used to evaluate the effect of RV5 on the rates of RVGE-associated healthcare encounters in all of the analyses. Results In the first 2 years after vaccination, RV5 reduced the combined rate of hospitalizations and emergency department (ED visits 88.9% (95% CI: 84.9, 91.9 for all RVGE regardless of serotype in the MITT analysis compared with a 94.5% (95% CI: 91.2, 96.6 reduction based on the G1-G4 PP analysis. By type of surveillance, the rate reductions for the G1-G4 PP analysis were 91.0% (95% CI: 81.7, 95.5 and 95.9% (95% CI: 92.2, 97.8 among parents contacted every 2 weeks (number evaluable = 4,451 and every 6 weeks (number evaluable = 52,683 respectively. Conclusions Our analyses demonstrated that the effect of RV5 on reducing the rate of hospitalizations

Dutch virtual integration of healthcare information.

Science.gov (United States)

de Graaf, J C; Vlug, A E; van Boven, G J

2007-01-01

As information technology creates opportunities for cooperation which crosses the boundaries between healthcare institutions, it will become an integral part of the Dutch healthcare system. Along with many involved organizations in healthcare the National IT Institute for Healthcare in the Netherlands (NICTIZ) is working on the realization of a national IT infrastructure for healthcare and a national electronic patient record (EPR). An underlying national architecture is designed to enable the Dutch EPR virtually, not in a national database, nor on a patient's smartcard. The required secure infrastructure provides generic functions for healthcare applications: patient identification, authentication and authorization of healthcare professionals. The first national applications in the EPR program using a national index of where patient data is stored, are the electronic medication record and the electronic record for after hours GP services. The rollout of the electronic medication record and electronic record for after hours GP services has been started in 2007. To guarantee progress of electronic data exchange in healthcare in the Netherlands we have primarily opted for two healthcare applications: the electronic medication record and the electronic record for after hours GP services. The use of a national switch-point containing the registry of where to find what information, guarantees that the professional receives the most recent information and omits large databases to contain downloaded data. Proper authorization, authentication as well as tracing by the national switchpoint also ensures a secure environment for the communication of delicate information.

Lean in healthcare from employees' perspectives.

Science.gov (United States)

Drotz, Erik; Poksinska, Bozena

2014-01-01

The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

Healthcare liquid waste management.

Science.gov (United States)

Sharma, D R; Pradhan, B; Pathak, R P; Shrestha, S C

2010-04-01

The management of healthcare liquid waste is an overlooked problem in Nepal with stern repercussions in terms of damaging the environment and affecting the health of people. This study was carried out to explore the healthcare liquid waste management practices in Kathmandu based central hospitals of Nepal. A descriptive prospective study was conducted in 10 central hospitals of Kathmandu during the period of May to December 2008. Primary data were collected through interview, observation and microbiology laboratory works and secondary data were collected by records review. For microbiological laboratory works,waste water specimens cultured for the enumeration of total viable counts using standard protocols. Evidence of waste management guidelines and committees for the management of healthcare liquid wastes could not be found in any of the studied hospitals. Similarly, total viable counts heavily exceeded the standard heterotrophic plate count (p=0.000) with no significant difference in such counts in hospitals with and without treatment plants (p=0.232). Healthcare liquid waste management practice was not found to be satisfactory. Installation of effluent treatment plants and the development of standards for environmental indicators with effective monitoring, evaluation and strict control via relevant legal frameworks were realized.

Work engagement and occupational stress in nurses and other healthcare workers: the role of organisational and personal factors.

Science.gov (United States)

Fiabane, Elena; Giorgi, Ines; Sguazzin, Cinzia; Argentero, Piergiorgio

2013-09-01

The aims of this study were to: (1) identify the role of organisational and personal factors in predicting work engagement in healthcare workers and (2) compare work engagement and occupational stress perceptions of healthcare professional categories. Healthcare professionals, with particular regard to nurses, are exposed to several job stressors that can adversely affect both their mental and physical health and also decrease work engagement. Work engagement can be considered as the positive opposite of burnout, and it is characterised by energy, involvement and professional efficacy. A cross-sectional survey research was conducted with self-report questionnaires. The Maslach Burnout Inventory-General Survey, the Areas of Worklife Scale and four scales from the Occupational Stress Indicator were administered to a sample of 198 hospital staff (registered nurses, nurse aides, physicians and physiotherapists), of which 110 participated in the study. The most significant predictors of energy were workload, mental health and job satisfaction; the best predictors of involvement were community, workload, mental health and job satisfaction; professional efficacy was best predicted by values and job satisfaction. In relation to the second aim, physiotherapists had the highest levels of occupational stress and disengagement from their work, while nurse aides were the most work-engaged and job-satisfied professional category, with positive perceptions of the work environment. Both organisational and personal factors were found to be significantly associated with work engagement. In this study, physiotherapists were the category with the highest risk of work-related psychological problems, whereas nurse aides had the lowest risk. Interventions aimed at improving clinical practice and psychological health of nurses and hospital staff should focus on workload, workers' personal expectations and job satisfaction. © 2013 Blackwell Publishing Ltd.

LEAN THINKING IN HEALTHCARE: REVIEW OF IMPLEMENTATION RESULTS

Directory of Open Access Journals (Sweden)

Marija Kovacevic

2016-03-01

Full Text Available For over decade, automotive industry originated lean concept has been successfully implemented in healthcare systems as a management method and philosophy with main focus on elimination of all types of wastes and looses in all tasks and processes so that time, materials, resources and medical procedures could be realized as effectively as it is possible. As main result lean concept implementation ensured to healthcare organizations to focus on their main core function and dedicate more time and efforts to patients without additional costs for them or healthcare system. However, lean implementation in healthcare could be much more difficult than in standard industrial environment and there are significant number of examples of lean in healthcare projects that failed to gain any measurable results and sustainable benefits from it. This paper presents review of some of the most successful implementations of lean tools and principles in healthcare organizations.

Health Self-Efficacy Among Populations with Multiple Chronic Conditions: the Value of Patient-Centered Communication.

Science.gov (United States)

Finney Rutten, Lila J; Hesse, Bradford W; St Sauver, Jennifer L; Wilson, Patrick; Chawla, Neetu; Hartigan, Danielle B; Moser, Richard P; Taplin, Stephen; Glasgow, Russell; Arora, Neeraj K

2016-08-01

Using cross-sectional survey data, we assessed the association between chronic illness burden and health-related self-efficacy, evaluating whether patient-centered communication is associated with self-efficacy and if that relationship varies by chronic illness burden. Data were from the Health Information National Trends Survey, a cross-sectional survey of the US adult population collected in 2012-2013 (n = 3630). Health-related self-efficacy was measured with the item: "Overall, how confident are you about your ability to take good care of your health?" and the prevalence of six chronic conditions and depression/anxiety was assessed. Patient-centered communication was measured as the frequency with which respondents perceived their healthcare providers allowed them to ask questions, gave attention to their emotions, involved them in decisions, made sure they understood how to take care of their health, helped them to deal with uncertainty, and if they felt they could rely on their healthcare providers to take care of their healthcare needs. Health-related self-efficacy was significantly lower among individuals with greater illness burden. In adjusted analysis, individuals who experienced more positive patient-centered communication reported higher levels of self-efficacy (β = 0.26, P self-efficacy were observed among patients reporting more positive patient-centered communication; the observed association was stronger among those with greater chronic illness burden.

Directions in healthcare research: pointers from retailing and services marketing.

Science.gov (United States)

Van Rompay, Thomas L J; Tanja-Dijkstra, Karin

2010-01-01

Although the importance of the environment in relation to healing processes has been well established, empirical evidence for environmental effects on patient well-being and behavior is sparse. In addition, few attempts have been made to integrate insights from related fields of research such as retailing and services marketing with findings from healthcare studies. In this paper, relevant findings and insights from these domains are discussed. What insights and findings from retailing and services marketing are (potentially) of interest to the healthcare context, and how should one interpret and follow up on these results in healthcare environments? Research in retailing and services marketing indicates that physical environmental factors (i.e., music and scent) and social environmental factors (i.e., crowded conditions) may affect consumer satisfaction and well-being. In addition, environmental effects have been shown to vary with contextual factors (e.g., the type of environment) and consumer needs (e.g., the extent to which consumers value social contact or stimulation in a specific setting). Although the evidence base for environmental factors in health environments is steadily growing, few attempts have been made to integrate findings from both domains. The findings presented indicate that environmental variables such as music and scent can contribute to patient well-being and overall satisfaction. In addition, findings suggest that these variables may be used to counteract the negative effects resulting from crowded conditions in different healthcare units. Taking into account recent developments in the healthcare industry, the importance of creating memorable and pleasant patient experiences is likely to grow in the years to come. Hence, the finding that subtle and relatively inexpensive manipulations may affect patient well-being in profound ways should inspire follow-up research aimed at unraveling the specifics of environmental influences in health

Towards a reusable architecture for message exchange in pervasive healthcare

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; do Prado, Antonio Francisco; Hammoudi, S.; Maciaszek, L.A.; Cordeiro, J.; Dietz, J.L.G.

The main objective of this paper is to present a reusable architecture for message exchange in pervasive healthcare environments meant to be generally applicable to different applications in the healthcare domain. This architecture has been designed by integrating different concepts and technologies

A wireless trust model for healthcare.

Science.gov (United States)

Wickramasinghe, Nilmini; Misra, Santosh K

2004-01-01

In today's context of escalating costs, managed care, regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and a technology savvy patient, the healthcare industry can no longer be complacent regarding embracing technologies to enable better, more effective and efficient practice management. In such an environment, many healthcare organisations are turning to m-commerce or wireless solutions. These solutions, in particular the mobile electronic patient record, have many advantages over their wired counterparts, including significant cost advantages, higher levels of physician acceptance, more functionalities as well as enabling easy accessibility to healthcare in remote geographic regions, however, they also bring with them challenges of their own. One such major challenge is security. To date, few models exist that help establish an appropriate framework, in the context of wireless in healthcare, in which to understand and evaluate all the security issues let alone facilitate the development of systematic and robust solutions. Our paper addresses this need by outlining an appropriate mobile trust model for such a scenario in healthcare organisations.

Architecture for Business Intelligence in the Healthcare Sector

Science.gov (United States)

Lee, Sang Young

2018-03-01

Healthcare environment is growing to include not only the traditional information systems, but also a business intelligence platform. For executive leaders, consultants, and analysts, there is no longer a need to spend hours in design and develop of typical reports or charts, the entire solution can be completed through using Business Intelligence software. The current paper highlights the advantages of big data analytics and business intelligence in the healthcare industry. In this paper, In this paper we focus our discussion around intelligent techniques and methodologies which are recently used for business intelligence in healthcare.

Using the dual-level modeling approach to developing applications in the pervasive healthcare environment

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Cavalini, Luciana Tricai; do Prado, Antonio Francisco

2013-01-01

Health information technology is the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and interoperable healthcare information systems are expected to lower costs, improve efficiency and reduce error, while also

Sensors for everyday life healthcare settings

CERN Document Server

Mukhopadhyay, Subhas; Jayasundera, Krishanthi; Swain, Akshya

2017-01-01

Sensors were developed to detect and quantify structures and functions of human body as well as to gather information from the environment in order to optimize the efficiency, cost-effectiveness and quality of healthcare services as well as to improve health and quality of life. This book offers an up-to-date overview of the concepts, modeling, technical and technological details and practical applications of different types of sensors. It also discusses the trends for the next generation of sensors and systems for healthcare settings. It is aimed at researchers and graduate students in the field of healthcare technologies, as well as academics and industry professionals involved in developing sensing systems for human body structures and functions, and for monitoring activities and health.

Healthcare professionals' perspectives on environmental sustainability.

Science.gov (United States)

Dunphy, Jillian L

2014-06-01

Human health is dependent upon environmental sustainability. Many have argued that environmental sustainability advocacy and environmentally responsible healthcare practice are imperative healthcare actions. What are the key obstacles to healthcare professionals supporting environmental sustainability? How may these obstacles be overcome? Data-driven thematic qualitative analysis of semi-structured interviews identified common and pertinent themes, and differences between specific healthcare disciplines. A total of 64 healthcare professionals and academics from all states and territories of Australia, and multiple healthcare disciplines were recruited. Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were de-identified to protect participant anonymity. Qualitative analysis indicated that Australian healthcare professionals often take more action in their personal than professional lives to protect the environment, particularly those with strong professional identities. The healthcare sector's focus on economic rationalism was a substantial barrier to environmentally responsible behaviour. Professionals also feared conflict and professional ostracism, and often did not feel qualified to take action. This led to healthcare professionals making inconsistent moral judgements, and feeling silenced and powerless. Constraints on non-clinical employees within and beyond the sector exacerbated these difficulties. The findings are consistent with the literature reporting that organisational constraints, and strong social identification, can inhibit actions that align with personal values. This disparity can cause moral distress and residue, leading to feelings of powerlessness, resulting in less ethical behaviour. The data highlight a disparity between personal and professional actions to address environmental sustainability. Given the constraints Australian healthcare professionals encounter, they are unlikely to

Healthcare public key infrastructure (HPKI) and non-profit organization (NPO): essentials for healthcare data exchange.

Science.gov (United States)

Takeda, Hiroshi; Matsumura, Yasushi; Nakagawa, Katsuhiko; Teratani, Tadamasa; Qiyan, Zhang; Kusuoka, Hideo; Matsuoka, Masami

2004-01-01

To share healthcare information and to promote cooperation among healthcare providers and customers (patients) under computerized network environment, a non-profit organization (NPO), named as OCHIS, was established at Osaka, Japan in 2003. Since security and confidentiality issues on the Internet have been major concerns in the OCHIS, the system has been based on healthcare public key infrastructure (HPKI), and found that there remained problems to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority by contracting with the Ministry of Economics and Trading Industries in 2003. This paper describes the experimental design with NPO and the results of the study concerning message security and HPKI. The developed system has been operated practically in Osaka urban area.

Linkages between motivation, self-efficacy, self-regulated learning and preferences for traditional learning environments or those with an online component

Directory of Open Access Journals (Sweden)

Daniel Auld

2010-10-01

Full Text Available This study assessed 96 law school students’ preferences for online, hybrid, or traditional learning environments, and their reasons for these preferences, learning strategies, and motivational orientations. A discriminant analysis revealed that non-traditional learning environment familiarity, self-efficacy, and employment status were the strongest predictors of preferences for non-traditional learning environments. Preferences for traditional environments were attributed to students’ familiarity and ability to engage in and foster personal interaction. Preferences for hybrid and online environments were attributed to opportunities for enhanced learning given the convenience and flexible manner in which students with time and familial constraints could access these environments.

Influence of Web-Aided Cooperative Learning Environment on Motivation and on Self-Efficacy Belief in Biology Teaching

Science.gov (United States)

Hevedanli, Murat

2015-01-01

The purpose of this study is to investigate the influence of the web-aided cooperative learning environment on biology preservice teachers' motivation and on their self-efficacy beliefs in biology teaching. The study was carried out with 30 biology preservice teachers attending a state university in Turkey. In the study, the pretest-posttest…

The Design and Analysis of a Secure Personal Healthcare System Based on Certificates

Directory of Open Access Journals (Sweden)

Jungho Kang

2016-11-01

Full Text Available Due to the development of information technology (IT, it has been applied to various fields such as the smart home, medicine, healthcare, and the smart car. For these fields, IT has been providing continuous prevention and management, including health conditions beyond the mere prevention of disease, improving the quality of life. e-Healthcare is a health management and medical service to provide prevention, diagnosis, treatment, and the follow-up management of diseases at any time and place in connection with information communication technology, without requiring patients to visit hospitals. However, e-Healthcare has been exposed to eavesdropping, manipulation, and the forgery of information that is personal, biological, medical, etc., and is a security threat from malicious attackers. This study suggests a security service model to exchange personal health records (PHRs for e-Healthcare environments. To be specific, this study suggests a scheme in which communicators are able to securely authorize and establish security channels by constituting the infrastructure each organization relies on. In addition, the possibility of establishing a security service model is indicated by suggesting an e-Healthcare system for a secure e-Healthcare environment as a secure personal health record system. This is anticipated to provide securer communication in e-Healthcare environments in the future through the scheme suggested in this study.

An evolving systems-based methodology for healthcare planning.

Science.gov (United States)

Warwick, Jon; Bell, Gary

2007-01-01

Healthcare planning seems beset with problems at all hierarchical levels. These are caused by the 'soft' nature of many of the issues present in healthcare planning and the high levels of complexity inherent in healthcare services. There has, in recent years, been a move to utilize systems thinking ideas in an effort to gain a better understanding of the forces at work within the healthcare environment and these have had some success. This paper argues that systems-based methodologies can be further enhanced by metrication and modeling which assist in exploring the changed emergent behavior of a system resulting from management intervention. The paper describes the Holon Framework as an evolving systems-based approach that has been used to help clients understand complex systems (in the education domain) that would have application in the analysis of healthcare problems.

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

Science.gov (United States)

Bronkhorst, Babette

2017-08-01

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

The US healthcare workforce and the labor market effect on healthcare spending and health outcomes.

Science.gov (United States)

Pellegrini, Lawrence C; Rodriguez-Monguio, Rosa; Qian, Jing

2014-06-01

has a differing effect on healthcare occupational employment per 100,000 people. Private healthcare spending positively impacts primary care physician employment ([Formula: see text] .001); whereas, Medicare spending drives up employment of physician assistants, registered nurses, and personal care attendants ([Formula: see text] .001). Medicaid and Medicare spending has a negative effect on surgeon employment ([Formula: see text] .05); the effect of private healthcare spending is positive but not statistically significant. Labor force participation, as opposed to unemployment, is a better proxy for measuring the effect of the economic environment on healthcare spending and health outcomes. Further, during economic contractions, Medicaid and Medicare's share of overall healthcare spending increases with meaningful effects on the configuration of state healthcare workforces and subsequently, provision of care for populations at-risk for worsening morbidity and mortality.

Soft qualities in healthcare. Method and tools for soft qualities design in hospitals' built environments.

Science.gov (United States)

Capolongo, S; Bellini, E; Nachiero, D; Rebecchi, A; Buffoli, M

2014-01-01

The design of hospital environments is determined by functional requirements and technical regulations, as well as numerous protocols, which define the structure and system characteristics that such environments need to achieve. In order to improve people's well-being and the quality of their experience within public hospitals, design elements (soft qualities) are added to those 'necessary' features. The aim of this research has been to experiment a new design process and also to create health care spaces with high environmental quality and capable to meet users' emotional and perceptual needs. Such needs were investigated with the help of qualitative research tools and the design criteria for one of these soft qualities - colour - were subsequently defined on the basis of the findings. The colour scheme design for the new San Paolo Hospital Emergency Department in Milan was used as case study. Focus groups were fundamental in defining the project's goals and criteria. The issues raised have led to believe that the proper procedure is not the mere consultation of the users in order to define the goals: users should rather be involved in the whole design process and become co-agents of the choices that determine the environment characteristics, so as to meet the quality requirements identified by the users themselves. The case study has shown the possibility of developing a designing methodology made by three steps (or operational tools) in which users' groups are involved in the choices, loading to plan the environments where compliance with expectations is already implied and verified by means of the process itself. Thus, the method leads to the creation of soft qualities in Healthcare.

TESTING ANTIMICROBIAL EFFICACY ON POROUS MATERIALS

Science.gov (United States)

The efficacy of antimicrobial treatments to eliminate or control biological growth in the indoor environment can easily be tested on nonporous surfaces. However, the testing of antimicrobial efficacy on porous surfaces, such as those found in the indoor environment [i.e., gypsum ...

Health survey of U.S. long-haul truck drivers: work environment, physical health, and healthcare access.

Science.gov (United States)

Apostolopoulos, Yorghos; Sönmez, Sevil; Shattell, Mona M; Gonzales, Clifford; Fehrenbacher, Caitlin

2013-01-01

While trucking in industrialized nations is linked with driver health afflictions, the role of trucking in U.S. truckers' health remains largely unknown. This paper sheds light on links between the trucking work environment and drivers' physical health. Using a cross-sectional design, 316 truckers were enrolled in the Healthy Trucker Survey. Questions included work history, physical and mental health, and healthcare access. PASW 18 was used to examine patterns among factors. 316 truckers participated. Respondents were mainly full-time, long-haul drivers with over 5 years of experience, and who spent over 17 days on the road per month. While almost 75% described their health as good, 83.4% were overweight/obese, 57.9% had sleeping disturbances, 56.3% fatigue, 42.3% musculoskeletal disorders, and about 40% cardiovascular disease concerns. About 33% had no health insurance, 70% had no regular healthcare visits, 24.4% could not afford insurance, and 42.1% took over-the-counter drugs when sick, while 20.1% waited to reach home for medical care. Exercise facilities were unavailable in over 70% of trucking worksites and 70% of drivers did not exercise regularly. The trucking occupation places drivers at high risk for poor health outcomes. Prospective studies are needed to delve into how continued exposure to trucking influences the progression of disease burden.

Holistic Leadership-Nursing's Unique Contribution to Healthcare.

Science.gov (United States)

Clarke, Pamela N; Bleich, Michael R

2018-04-01

This dialogue is focused on holistic leadership from the perspective of a well-known leader in nursing. He frames the changing healthcare environment and nursing's unique contribution on the interprofessional team.

Value co-creation in healthcare through positive deviance.

Science.gov (United States)

Zanetti, Cole Anthony; Taylor, Natalie

2016-12-01

To explore how converging fields of co-creation and positive deviance may increase value in healthcare. Informed by research in positive deviance, patient engagement, value co-creation, and quality improvement, we propose a positive deviance approach to co-creation of health. Co-creation has shown to improve health outcomes with regard to multiple health conditions. Positive deviance has also shown to improve outcomes in multiple healthcare and patient community environments. A positive deviance co-creation framework may aid in achieving improved outcomes for patients, care teams and their respective healthcare organizations. Copyright © 2016 Elsevier Inc. All rights reserved.

Sustainability and evidence-based design in the healthcare estate

CERN Document Server

Phiri, Michael

2014-01-01

This work aims to deepen our understanding of the role played by technical guidelines and tools for the design, construction and operation of healthcare facilities, ultimately establishing the impact of the physical environment on staff and patient outcomes. Using case studies largely drawn from the UK, Europe, China and Australasia, design approaches such as sustainability (e.g. targets for energy efficiency, carbon neutrality, reduction of waste), evidence-based design (EBD), and Post-Project Evaluation (PPE) are examined in order to identify policies, mechanisms and strategies that can promote an integrated learning environment that in turn supports innovation in healthcare.

Quality dementia care - Prerequisites and relational ethics among multicultural healthcare providers

OpenAIRE

Sellevold, Gerd Sylvi

2017-01-01

Background: Many nursing homes are multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Further, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. Purpose: The aim of this study is to illuminate multi-ethnic healthcare providers´ lived experiences of their own workin...

Public Healthcare Organizations: Leadership or Management?

Directory of Open Access Journals (Sweden)

Maite Martínez-Gonzalez

2016-11-01

Full Text Available This article studies the type of leadership that managers are currently exercising in the Catalan health system in Catalonia. A questionnaire (MQL-5X was sent to 120 people occupying management positions in healthcare centers and hospitals as well as 14 others who also hold such positions in these healthcare centers and hospitals, were interviewed. The mixed methods research design attests that the Catalan health system is managed through a structure of simultaneous transformational and transactional leadership. However, the efficacy of this system is conditioned purely by the communicative competence that a manager may or may not possess, as the system itself makes no effort to encourage transformational leadership. Transformation leadership inspires positive change, conveys a clear vision and enhances morale, motivation and job performance. It galvanizes a team into changing their expectations and perceptions and motivates them to work towards common goals.

Antimicrobial efficacy of alcohol-based hand gels.

Science.gov (United States)

Guilhermetti, M; Marques Wiirzler, L A; Castanheira Facio, B; da Silva Furlan, M; Campo Meschial, W; Bronharo Tognim, M C; Botelho Garcia, L; Luiz Cardoso, C

2010-03-01

In recent years, several commercial alcohol-based hand gels have appeared on the market to improve the hand-cleansing compliance of healthcare workers. Although the antimicrobial efficacy of these products has been reported in different countries, few studies have investigated this subject in Brazil. In this study, we assessed the antimicrobial efficacy of 12 alcohol-based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to the European Standard EN 1500 (EN 1500). The following alcohol gels were tested: Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel and Soft Care Gel. In addition, 70% w/w ethyl alcohol and three alcohol-based hand rubs (Sterillium, Sterillium Gel, and Spitaderm), commonly used in Europe and effective according to EN 1500, were also tested. All the products tested, except for two, were approved by the EN 1500 test protocol with a 60s application. The results confirmed the antimicrobial efficacy of the majority of the alcohol gels produced in Brazil for hand hygiene of healthcare workers. Copyright 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Visualizing desirable patient healthcare experiences.

Science.gov (United States)

Liu, Sandra S; Kim, Hyung T; Chen, Jie; An, Lingling

2010-01-01

High healthcare cost has drawn much attention and healthcare service providers (HSPs) are expected to deliver high-quality and consistent care. Therefore, an intimate understanding of the most desirable experience from a patient's and/or family's perspective as well as effective mapping and communication of such findings should facilitate HSPs' efforts in attaining sustainable competitive advantage in an increasingly discerning environment. This study describes (a) the critical quality attributes (CQAs) of the experience desired by patients and (b) the application of two visualization tools that are relatively new to the healthcare sector, namely the "spider-web diagram" and "promotion and detraction matrix." The visualization tools are tested with primary data collected from telephone surveys of 1,800 patients who had received care during calendar year 2005 at 6 of 61 hospitals within St. Louis, Missouri-based, Ascension Health. Five CQAs were found by factor analysis. The spider-web diagram illustrates that communication and empowerment and compassionate and respectful care are the most important CQAs, and accordingly, the promotion and detraction matrix shows those attributes that have the greatest effect for creating promoters, preventing detractors, and improving consumer's likelihood to recommend the healthcare provider.

Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

Science.gov (United States)

Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

2015-09-01

Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

Home nurses' turnover intentions: the impact of informal supervisory feedback and self-efficacy.

Science.gov (United States)

Van Waeyenberg, Thomas; Decramer, Adelien; Anseel, Frederik

2015-12-01

To examine how home nurses' turnover intentions are affected by the quality and frequency of supervisory feedback and by their own self-efficacy. Little is known about effective retention strategies for the growing home healthcare sector that struggles to retain an adequate workforce. While the work environment and supervisors have been found to play a key-role in nurses' turnover intentions, home nurses mostly work autonomously and apart from their supervisors. These circumstances require a customized approach and need to be understood to ensure high-quality home health care. We used a correlational, cross-sectional survey design. A convenience sample of 312 home nurses was selected from a division of a large home health care organization in Flanders, Belgium. Data were collected in 2013 using structured questionnaires and analysed using descriptive statistics, structural equation modelling and relative weight analysis. The quality of feedback was related to lower levels of turnover intentions. This relationship was fully mediated by home nurses' self-efficacy. Frequent favourable feedback was directly related to lower turnover intentions while the relationship between frequent unfavourable feedback and turnover intentions was conditional on home nurses' level of self-efficacy. This study contributes to our understanding of home nurses' turnover intentions and the role of informal supervisory feedback and home nurses' self-efficacy. © 2015 John Wiley & Sons Ltd.

Alert Workplace From Healthcare Workers' Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings.

Science.gov (United States)

Sagah Zadeh, Rana; Shepley, Mardelle; Sadatsafavi, Hessam; Owora, Arthur Hamie; Krieger, Ana C

2018-04-01

This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety. Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries. We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively. In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness ( p based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

Educational interventions to train healthcare professionals in end-of-life communication: a systematic review and meta-analysis.

Science.gov (United States)

Chung, Han-Oh; Oczkowski, Simon J W; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

2016-04-29

Practicing healthcare professionals and graduates exiting training programs are often ill-equipped to facilitate important discussions about end-of-life care with patients and their families. We conducted a systematic review to evaluate the effectiveness of educational interventions aimed at providing healthcare professionals with training in end-of-life communication skills, compared to usual curriculum. We searched MEDLINE, Embase, CINAHL, ERIC and the Cochrane Central Register of Controlled Trials from the date of inception to July 2014 for randomized control trials (RCT) and prospective observational studies of educational training interventions to train healthcare professionals in end-of-life communication skills. To be eligible, interventions had to provide communication skills training related to end-of-life decision making; other interventions (e.g. breaking bad news, providing palliation) were excluded. Our primary outcomes were self-efficacy, knowledge and end-of-life communication scores with standardized patient encounters. Sufficiently similar studies were pooled in a meta-analysis. The quality of evidence was assessed using GRADE. Of 5727 candidate articles, 20 studies (6 RCTs, 14 Observational) were included in this review. Compared to usual teaching, educational interventions to train healthcare professionals in end-of-life communication skills were associated with greater self-efficacy (8 studies, standardized mean difference [SMD] 0.57;95% confidence interval [CI] 0.40-0.75; P communication scores (8 studies, SMD 0.69; 95% CI 0.41-0.96; p communication training may improve healthcare professionals' self-efficacy, knowledge, and EoL communication scores compared to usual teaching. Further studies comparing two active educational interventions are recommended with a continued focus on contextually relevant high-level outcomes. PROSPERO CRD42014012913.

Scientific Inquiry Self-Efficacy and Computer Game Self-Efficacy as Predictors and Outcomes of Middle School Boys' and Girls' Performance in a Science Assessment in a Virtual Environment

Science.gov (United States)

Bergey, Bradley W.; Ketelhut, Diane Jass; Liang, Senfeng; Natarajan, Uma; Karakus, Melissa

2015-01-01

The primary aim of the study was to examine whether performance on a science assessment in an immersive virtual environment was associated with changes in scientific inquiry self-efficacy. A secondary aim of the study was to examine whether performance on the science assessment was equitable for students with different levels of computer game…

Smartphone threshold audiometry in underserved primary health-care contexts.

Science.gov (United States)

Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude

2016-01-01

To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Healthcare waste management status in Lagos State, Nigeria: a case study from selected healthcare facilities in Ikorodu and Lagos metropolis.

Science.gov (United States)

Longe, Ezechiel O

2012-06-01

A survey of healthcare waste management practices and their implications for health and the environment was carried out. The study assessed waste management practices in 20 healthcare facilities ranging in capacity from 40 to 600 beds in Ikorodu and metropolitan Lagos, Lagos State, Nigeria. The prevailing healthcare waste management status was analysed. Management issues on quantities and proportion of different constituents of waste, segregation, collection, handling, transportation, treatment and disposal methods were assessed. The waste generation averaged 0.631 kg bed(-1) day(-1) over the survey area. The waste stream from the healthcare facilities consisted of general waste (59.0%), infectious waste (29.7%), sharps and pathological (8.9%), chemical (1.45%) and others (0.95%). Sharps/pathological waste includes disposable syringes. In general, the waste materials were collected in a mixed form, transported and disposed of along with municipal solid waste with attendant risks to health and safety. Most facilities lacked appropriate treatment systems for a variety of reasons that included inadequate funding and little or no priority for healthcare waste management as well as a lack of professionally competent waste managers among healthcare providers. Hazards associated with healthcare waste management and shortcomings in the existing system were identified.

The characterization of the antibacterial efficacy of an electrically activated silver ion-based surface system

Science.gov (United States)

Shirwaiker, Rohan A.

There have been growing concerns in the global healthcare system about the eradication of pathogens in hospitals and other health-critical environments. The problem has been aggravated by the overuse of antibiotics and antimicrobial agents leading to the emergence of antibiotic-resistant superbugs such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) which are difficult to kill. Lower immunity of sick patients coupled with the escalating concurrent problem of antibiotic-resistant pathogens has resulted in increasing incidences of hospital acquired (nosocomial) infections. There is an immediate need to control the transmission of such infections, primarily in healthcare environments, by creating touch-contact and work surfaces (e.g., door knobs, push plates, countertops) that utilize alternative antibacterial materials like the heavy metal, silver. Recent research has shown that it is silver in its ionic (Ag+ ) and not elemental form that is antibacterial. Thus, silver-based antibacterial surfaces have to release silver ions directly into the pathogenic environment (generally, an aqueous media) in order to be effective. This dissertation presents the study and analysis of a new silver-based surface system that utilizes low intensity direct electric current (LIDC) for generation of silver ions to primarily inhibit indirect contact transmission of infections. The broader objective of this research is to understand the design, and characterization of the electrically activated silver ion-based antibacterial surface system. The specific objectives of this dissertation include: (1) Developing a comprehensive system design, and identifying and studying its critical design parameters and functional mechanisms. (2) Evaluating effects of the critical design parameters on the antibacterial efficacy of the proposed surface system. (3) Developing a response surface model for the surface system performance. These objectives are

The Impact of Student Self-efficacy on Scientific Inquiry Skills: An Exploratory Investigation in River City, a Multi-user Virtual Environment

Science.gov (United States)

Ketelhut, Diane Jass

2007-02-01

This exploratory study investigated data-gathering behaviors exhibited by 100 seventh-grade students as they participated in a scientific inquiry-based curriculum project delivered by a multi-user virtual environment (MUVE). This research examined the relationship between students' self-efficacy on entry into the authentic scientific activity and the longitudinal data-gathering behaviors they employed while engaged in that process. Three waves of student behavior data were gathered from a server-side database that recorded all student activity in the MUVE; these data were analyzed using individual growth modeling. The study found that self-efficacy correlated with the number of data-gathering behaviors in which students initially engaged, with high self-efficacy students engaging in more data gathering than students with low self-efficacy. Also, the impact of student self-efficacy on rate of change in data gathering behavior differed by gender. However, by the end of their time in the MUVE, initial student self-efficacy no longer correlated with data gathering behaviors. In addition, students' level of self-efficacy did not affect how many different sources from which they chose to gather data. These results suggest that embedding science inquiry curricula in novel platforms like a MUVE might act as a catalyst for change in students' self-efficacy and learning processes.

The relationship between school environment, preservice science teachers' science teaching self-efficacy, and their use of instructional strategies at teachers' colleges in Saudi Arabia

Science.gov (United States)

Alshalaan, Nasser A.

Studies indicate that many teachers have negative beliefs about science, which translates into low teacher efficacy, resulting in avoidance of science teaching or in ineffective science teaching behaviors. Highly efficacious teachers have been found to be more likely to use inquiry and student-centered teaching strategies, while teachers with a low sense of science-teaching efficacy are more likely to use teacher-directed strategies, such as didactic lectures and reading from the textbook (Czemiak, 1990). The purpose of this study was to investigate preservice science teachers' science-teaching self-efficacy changes and their correlation to teaching environment factors during the student teaching semester. Moreover, it explains how teaching environment factors and preservice teachers' science-teaching self-efficacy beliefs may relate to their use of teaching strategies in the science classroom during their student teacher training at teachers' colleges in Saudi Arabia. The population of this study is consisted of 184 middle and elementary preservice science teachers who were doing their student teaching at nine teachers' colleges (i.e., teachers' colleges of Riyadh, Dammam, Alrras, Almadinah, Alihsa, Jeddah, Makah, Altaief, and Abha) in Saudi Arabia during the spring semester of 2005. Three instruments were used to collect data for this study: (1) to measure science teaching self-efficacy, the researcher adapted the Science Teaching Efficacy Belief Instrument form B designed specifically for preservice teachers (STEBI-B); (2) to measure the school environment, the researcher adapted the Organizational Health Inventory (OHI), developed by Hoy, Tarter & Kottkamp (1991); and (3) to measure the type and frequency of instructional strategies that preservice science teachers use in the classroom, the researcher adapted the teaching practice subscale from The Local Systemic Change through Teacher Enhancement Science K-8 Teacher Questionnaire (Horizon Research, Inc., 2000

What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit

Directory of Open Access Journals (Sweden)

Vincenzo Russotto

2017-01-01

Full Text Available Intensive care unit- (ICU- acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62–2.81 of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit.

Science.gov (United States)

Russotto, Vincenzo; Cortegiani, Andrea; Fasciana, Teresa; Iozzo, Pasquale; Raineri, Santi Maurizio; Gregoretti, Cesare; Giammanco, Anna; Giarratano, Antonino

2017-01-01

Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62-2.81) of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour) are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

Being Nontraditional and Learning Online: Assessing the Psychosocial Learning Environments, Self-Efficacy, and Affective Outcomes among College Student Groups

Science.gov (United States)

Ashford, Roslyn La'Toya

2014-01-01

The study compared traditional and nontraditional students' attitudes about the psychosocial learning environment and their influence on self-efficacy, enjoyment of online learning, and student satisfaction by using Moos' (1979) Model of Environmental and Personal Variables and the three dimensions of social climate as its theoretical framework.…

The implementation of mindfulness in healthcare systems: a theoretical analysis.

Science.gov (United States)

Demarzo, M M P; Cebolla, A; Garcia-Campayo, J

2015-01-01

Evidence regarding the efficacy of mindfulness-based interventions (MBIs) is increasing exponentially; however, there are still challenges to their integration in healthcare systems. Our goal is to provide a conceptual framework that addresses these challenges in order to bring about scholarly dialog and support health managers and practitioners with the implementation of MBIs in healthcare. This is an opinative narrative review based on theoretical and empirical data that address key issues in the implementation of mindfulness in healthcare systems, such as the training of professionals, funding and costs of interventions, cost effectiveness and innovative delivery models. We show that even in the United Kingdom, where mindfulness has a high level of implementation, there is a high variability in the access to MBIs. In addition, we discuss innovative approaches based on "complex interventions," "stepped-care" and "low intensity-high volume" concepts that may prove fruitful in the development and implementation of MBIs in national healthcare systems, particularly in Primary Care. In order to better understand barriers and opportunities for mindfulness implementation in healthcare systems, it is necessary to be aware that MBIs are "complex interventions," which require innovative approaches and delivery models to implement these interventions in a cost-effective and accessible way. Copyright © 2015 Elsevier Inc. All rights reserved.

The NHS and market forces in healthcare: the need for organisational ethics.

Science.gov (United States)

Frith, Lucy

2013-01-01

The NHS in England is an organisation undergoing substantial change. The passage of the Health and Social Care Act 2012, consolidates and builds on previous health policies and introduces further 'market-style' reforms of the NHS. One of the main aspects of these reforms is to encourage private and third sector providers to deliver NHS services. The rationale for this is to foster a more competitive market in healthcare to encourage greater efficiency and innovation. This changing healthcare environment in the English NHS sharpens the need for attention to be paid to the ethical operation of healthcare organisations. All healthcare organisations need to consider the ethical aspects of their operation, whether state or privately run. However, the changes in the type of organisations used to provide healthcare (such as commercial companies) can create new relationships and ethical tensions. This paper will chart the development of organisational ethics as a concern in applied ethics and how it arose in the USA largely owing to changes in the organisation of healthcare financing and provision. It will be argued that an analogous transition is happening in the NHS in England. The paper will conclude with suggestions for the development of organisational ethics programmes to address some of the possible ethical issues raised by this new healthcare environment that incorporates both private and public sector providers.

Analysis of exposure to electromagnetic fields in a healthcare environment: simulation and experimental study.

Science.gov (United States)

de Miguel-Bilbao, Silvia; Martín, Miguel Angel; Del Pozo, Alejandro; Febles, Victor; Hernández, José A; de Aldecoa, José C Fernández; Ramos, Victoria

2013-11-01

Recent advances in wireless technologies have lead to an increase in wireless instrumentation present in healthcare centers. This paper presents an analytical method for characterizing electric field (E-field) exposure within these environments. The E-field levels of the different wireless communications systems have been measured in two floors of the Canary University Hospital Consortium (CUHC). The electromagnetic (EM) conditions detected with the experimental measures have been estimated using the software EFC-400-Telecommunications (Narda Safety Test Solutions, Sandwiesenstrasse 7, 72793 Pfullingen, Germany). The experimental and simulated results are represented through 2D contour maps, and have been compared with the recommended safety and exposure thresholds. The maximum value obtained is much lower than the 3 V m(-1) that is established in the International Electrotechnical Commission Standard of Electromedical Devices. Results show a high correlation in terms of E-field cumulative distribution function (CDF) between the experimental and simulation results. In general, the CDFs of each pair of experimental and simulated samples follow a lognormal distribution with the same mean.

Effect of workplace- versus home-based physical exercise on pain in healthcare workers

DEFF Research Database (Denmark)

Jakobsen, Markus Due; Sundstrup, Emil; Brandt, Mikkel

2014-01-01

BACKGROUND: The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational......, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace...... to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls...

Healthcare provider education: from institutional boxes to dynamic networks.

Science.gov (United States)

Eisler, George

2009-01-01

The world recognizes the need for close collaboration in planning between the healthcare system and the post-secondary education system; this has also been advocated in the lead article. Forums and mechanisms to facilitate this collaboration are being implemented from local to global environments. Beyond the focus on competency gaps, there are important functional co-dependencies between healthcare and post-secondary education, including the need for a more formalized continuous quality improvement approach at the inter-organizational system level. The case for this close and continuous collaborative relationship is based on the following: (1) a close functional relationship, (2) joint responsibility for healthcare provider education, (3) the urgent need to address the workforce and education strategies for almost all healthcare services areas and (4) the factors that characterize successful and sustained quality improvement in complex adaptive systems. A go-forward vision consisting of an integrated web of academic health networks is proposed, each with its particular shared vision and aligned with an overall vision for healthcare in each provincial jurisdiction, as well as with national and global healthcare objectives.

Profiling health-care accreditation organizations: an international survey.

Science.gov (United States)

Shaw, Charles D; Braithwaite, Jeffrey; Moldovan, Max; Nicklin, Wendy; Grgic, Ileana; Fortune, Triona; Whittaker, Stuart

2013-07-01

To describe global patterns among health-care accreditation organizations (AOs) and to identify determinants of sustainability and opportunities for improvement. Web-based questionnaire survey. Organizations offering accreditation services nationally or internationally to health-care provider institutions or networks at primary, secondary or tertiary level in 2010. s) External relationships, scope and activity public information. Forty-four AOs submitted data, compared with 33 in a survey 10 years earlier. Of the 30 AOs that reported survey activity in 2000 and 2010, 16 are still active and stable or growing. New and old programmes are increasingly linked to public funding and regulation. While the number of health-care AOs continues to grow, many fail to thrive. Successful organizations tend to complement mechanisms of regulation, health-care funding or governmental commitment to quality and health-care improvement that offer a supportive environment. Principal challenges include unstable business (e.g. limited market, low uptake) and unstable politics. Many organizations make only limited information available to patients and the public about standards, procedures or results.

Corporate sustainability: the environmental design and human resource management interface in healthcare settings.

Science.gov (United States)

Sadatsafavi, Hessam; Walewski, John

2013-01-01

Purpose of the Paper: The purpose of this study is to provide healthcare organizations with a new perspective for developing strategies to enrich their human resource capabilities and improve their performance outcomes. The focus of this study is on leveraging the synergy between organizational management strategies and environmental design interventions. This paper proposes a framework for linking the built environment with the human resource management system of healthcare organizations. The framework focuses on the impact of the built environment regarding job attitudes and behaviors of healthcare workers. Research from the disciplines of strategic human resource management, resource-based view of firms, evidence-based design, and green building are utilized to develop the framework. The positive influence of human resource practices on job attitudes and behaviors of employees is one mechanism to improve organizational performance outcomes. Organizational psychologists suggest that human resource practices are effective because they convey that the organization values employee contributions and cares about their well-being. Attention to employee socio-emotional needs can be reciprocated with higher levels of motivation and commitment toward the organization. In line with these findings, healthcare environmental studies imply that physical settings and features can have a positive influence on job attitudes and the behavior of caregivers by providing for their physical and socio-emotional needs. Adding the physical environment as a complementary resource to the array of human resource practices creates synergy in improving caregivers' job attitudes and behaviors and enhances the human capital of healthcare firms. Staff, evidence-based design, interdisciplinary, modeling, perceived organizational supportPreferred Citation: Sadatsafavi, H., & Walewski, J. (2013). Corporate sustainability: The environmental design and human resource management interface in

A Long-Term Follow-Up of the Efficacy of Nature-Based Therapy for Adults Suffering from Stress-Related Illnesses on Levels of Healthcare Consumption and Sick-Leave Absence: A Randomized Controlled Trial

Science.gov (United States)

Corazon, Sus Sola; Nyed, Patrik Karlsson; Sidenius, Ulrik

2018-01-01

Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia® nature-based therapy (NNBT) by comparing it to the efficacy of a validated cognitive behavioral therapy, called STreSS. The study is designed as a randomized controlled trial in which 84 participants are randomly allocated between the treatments. Long-term efficacy is investigated through data extracts from the national database of Statistics Denmark on the sick leave and the health-care consumption. The results show that both the NNBT and the STreSS lead to a significant decrease in number of contacts with a general practitioner in the period from twelve months prior to treatment to twelve months after treatment; and, a significant decrease in long-term sick leave from the month prior to treatment to twelve months after treatment. The positive long-term effects provide validation for the NNBT as an efficient treatment of stress-related illnesses. PMID:29342952

A Long-Term Follow-Up of the Efficacy of Nature-Based Therapy for Adults Suffering from Stress-Related Illnesses on Levels of Healthcare Consumption and Sick-Leave Absence: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Sus Sola Corazon

2018-01-01

Full Text Available Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia® nature-based therapy (NNBT by comparing it to the efficacy of a validated cognitive behavioral therapy, called STreSS. The study is designed as a randomized controlled trial in which 84 participants are randomly allocated between the treatments. Long-term efficacy is investigated through data extracts from the national database of Statistics Denmark on the sick leave and the health-care consumption. The results show that both the NNBT and the STreSS lead to a significant decrease in number of contacts with a general practitioner in the period from twelve months prior to treatment to twelve months after treatment; and, a significant decrease in long-term sick leave from the month prior to treatment to twelve months after treatment. The positive long-term effects provide validation for the NNBT as an efficient treatment of stress-related illnesses.

A Long-Term Follow-Up of the Efficacy of Nature-Based Therapy for Adults Suffering from Stress-Related Illnesses on Levels of Healthcare Consumption and Sick-Leave Absence: A Randomized Controlled Trial.

Science.gov (United States)

Corazon, Sus Sola; Nyed, Patrik Karlsson; Sidenius, Ulrik; Poulsen, Dorthe Varning; Stigsdotter, Ulrika Karlsson

2018-01-15

Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia ® nature-based therapy (NNBT) by comparing it to the efficacy of a validated cognitive behavioral therapy, called STreSS. The study is designed as a randomized controlled trial in which 84 participants are randomly allocated between the treatments. Long-term efficacy is investigated through data extracts from the national database of Statistics Denmark on the sick leave and the health-care consumption. The results show that both the NNBT and the STreSS lead to a significant decrease in number of contacts with a general practitioner in the period from twelve months prior to treatment to twelve months after treatment; and, a significant decrease in long-term sick leave from the month prior to treatment to twelve months after treatment. The positive long-term effects provide validation for the NNBT as an efficient treatment of stress-related illnesses.

Attribution-based motivation treatment efficacy in an online learning environment for students who differ in cognitive elaboration

OpenAIRE

Hamm, Jeremy M.; Perry, Raymond P.; Chipperfield, Judith G.; Murayama, Kou; Weiner, Bernard

2017-01-01

Attribution-based motivation treatments can boost performance in competitive achievement settings (Perry and Hamm 2017), yet their efficacy relative to mediating processes and affect-based treatments remains largely unexamined. In a two-semester, pre-post, randomized treatment study (n = 806), attributional retraining (AR) and stress-reduction (SR) treatments were administered in an online learning environment to first-year college students who differed in cognitive elaboration (low, high). L...

An exploratory study of healthcare strategic planning in two metropolitan areas.

Science.gov (United States)

Begun, James W; Kaissi, Amer A

2005-01-01

Little is known about empirical variation in the extent to which healthcare organizations conduct formal strategic planning or the extent to which strategic planning affects performance. Structural contingency and complexity science theory offer differing interpretations of the value of strategic planning. Structural contingency theory emphasizes adaptation to achieve organizational fit with a changing environment and views strategic planning as a way to chart the organization's path. Complexity science argues that planning is largely futile in changing environments. Interviews of leaders in 20 healthcare organizations in the metropolitan areas of Minneapolis/St. Paul, Minnesota, and San Antonio, Texas, reveal that strategic planning is a common and valued function in healthcare organizations. Respondents emphasized the need to continuously update strategic plans, involve physicians and the governing board, and integrate strategic plans with other organizational plans. Most leaders expressed that strategic planning contributes to organizational focus, fosters stakeholder participation and commitment, and leads to achievement of strategic goals. Because the widespread belief in strategic planning is based largely on experience, intuition, and faith, we present recommendations for developing an evidence base for healthcare strategic planning.

Patient Safety and Healthcare Quality

Directory of Open Access Journals (Sweden)

Aikaterini Toska

2012-01-01

Full Text Available Introduction: Due to a variety of circumstances and world-wide research findings, patient safety andquality care during hospitalization have emerged as major issues. Patient safety deficits may burdenhealth systems as well as allocated resources. The international community has examined severalproposals covering general and systemic aspects in order to improve patient safety; several long-termprograms and strategies have also been implemented promoting the participation of health-relatedagents, and also government agencies and non-governmental organizations.Aim: Those factors that have negative correlations with patient safety and quality healthcare weredetermined; WHO and EU programs as well as the Greek health policy were also reviewed.Method: Local and international literature was reviewed, including EU and WHO official publications,by using the appropriate keywords.Conclusions: International cooperation on patient safety is necessary in order to improvehospitalization and healthcare quality standards. Such incentives depend heavily on establishing worldwideviable and effective health programs and planning. These improvements also require further stepson safe work procedures, environment safety, hazard management, infection control, safe use ofequipment and medication, and sufficient healthcare staff.

The impact of leadership coaching in an Australian healthcare setting.

Science.gov (United States)

Grant, Anthony M; Studholme, Ingrid; Verma, Raj; Kirkwood, Lea; Paton, Bronwyn; O'Connor, Sean

2017-04-10

Purpose There is limited empirical literature on the effectiveness of leadership coaching in healthcare settings. The purpose of this paper is to explore the efficacy of leadership coaching for individuals implementing strategic change in the Australian public health system. Design/methodology/approach Using a within-subjects (pre-post) design, participants ( n=31) undertook six one-hour coaching sessions. Coaching was conducted by professional leadership coaches. Both quantitative and qualitative data were collected. Findings Participation was associated with significant improvements in goal attainment, solution-focused thinking, leadership self-efficacy, perspective-taking capacity, self-insight and resilience, and ambiguity tolerance. There were significant reductions in stress and anxiety. The benefits of coaching transferred from the workplace to the home. Many participants reported being able to use insights gained in coaching in their personal lives, and reported better work/life balance, less stress and better quality relationships at home. Originality/value Few studies have provided evaluation of leadership coaching in healthcare setting. Leadership coaching in the public health system may be an important methodology for facilitating goal attainment and fostering resilience in this vital social sector, benefiting workers in the health services, their families and ultimately their patients and the broader community.

Healthcare model with use of information and communication technology for patients with chronic disease.

Science.gov (United States)

Lisiecka-Biełanowicz, Mira; Wawrzyniak, Zbigniew

2016-07-15

The healthcare system is positioned in the patient's environment and works with other determinants of the treatment. Patient care requires a whole system compatible to the needs of organizational and technical solutions. The purpose of this study is to present a new model of patient-oriented care, in which the use of information and communication technology (ICT) can improve the effectiveness of healthcare for patients with chronic diseases. The study material is the process of healthcare for chronically ill patients. Knowledge of the circumstances surrounding ecosystem and of the patients' needs, taking into account the fundamental healthcare goals allows us to build a new models of care, starting with the economic assumptions. The method used is modeling the construction of efficient healthcare system with the patient-centered model using ICT tools. We present a new systemic concept of building patient's environment in which he is the central figure of the healthcare organization - so called patient centered system. The use of ICT in the model of chronic patient's healthcare can improve the effectiveness of this kind of care. The concept is a vision to making wide platform of information management in chronic disease in a real environment ecosystem of patient using ICT tools. On the basis of a systematic approach to the model of chronic disease, and the knowledge of the patient itself, a model of the ecosystem impacts and interactions through information feedback and the provision of services can be constructed. ICT assisted techniques will increase the effectiveness of patient care, in which nowadays information exchange plays a key role.

A narrative review of undergraduate peer-based healthcare ethics teaching.

Science.gov (United States)

Hindmarch, Thomas; Allikmets, Silvia; Knights, Felicity

2015-12-12

This study explores the literature in establishing the value of undergraduate peer-based healthcare ethics teaching as an educational methodology. A narrative review of the literature concerning peer-based ethics teaching was conducted. MEDLINE, EMBASE, CINAHL, SCOPUS databases, and the Cochrane Library, were systematically searched for studies of peer-based ethics or professionalism teaching. Selected studies related peer-based teaching to ethics education outcomes. Ten publications were identified. Selected studies were varied in their chosen intervention methodology and analysis. Collectively, the identified studies suggest peer-based ethics education is an effective and valued educational methodology in training healthcare professionals. One paper suggests peer-based ethics teaching has advantages over traditional didactic methods. Peer-based ethics teaching also receives positive feedback from student participants. However, the limited literature base demonstrates a clear need for more evaluation of this pedagogy. The current literature base suggests that undergraduate peer based healthcare ethics teaching is valuable in terms of efficacy and student satisfaction. We conclude that the medical community should invest in further study in order to capitalise upon the potential of peer-based ethics teaching in undergraduate healthcare education.

Thermal comfort in hospital and healthcare facilities : a literature review

NARCIS (Netherlands)

Sadrizadeh, S.; Loomans, M.G.L.C.

2016-01-01

Hospital and healthcare facilities need to provide a variety of indoor environments due to the diverse comfort and health needs of their patients and staff. Thermal comfort is an essential part of indoor environmental quality in the hospital work environment that affects both the patient’s own

Medical capability team: the clinical microsystem for combat healthcare delivery in counterinsurgency operations.

Science.gov (United States)

Clark, Susz; Van Steenvort, Jon K

2008-01-01

Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. This article proposes the Army Medical Department (AMEDD) develop and implement the medical capability team (MCT) for combat healthcare delivery. It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.

Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety.

Science.gov (United States)

Lachance, Chantelle C; Jurkowski, Michal P; Dymarz, Ania C; Robinovitch, Stephen N; Feldman, Fabio; Laing, Andrew C; Mackey, Dawn C

2017-01-01

Compliant flooring, broadly defined as flooring systems or floor coverings with some level of shock absorbency, may reduce the incidence and severity of fall-related injuries in older adults; however, a lack of synthesized evidence may be limiting widespread uptake. Informed by the Arksey and O'Malley framework and guided by a Research Advisory Panel of knowledge users, we conducted a scoping review to answer: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries in healthcare settings? We searched academic and grey literature databases. Any record that discussed a compliant flooring system and at least one of biomechanical efficacy, clinical effectiveness, cost-effectiveness, or workplace safety was eligible for inclusion. Two independent reviewers screened and abstracted records, charted data, and summarized results. After screening 3611 titles and abstracts and 166 full-text articles, we included 84 records plus 56 companion (supplementary) reports. Biomechanical efficacy records (n = 50) demonstrate compliant flooring can reduce fall-related impact forces with minimal effects on standing and walking balance. Clinical effectiveness records (n = 20) suggest that compliant flooring may reduce injuries, but may increase risk for falls. Preliminary evidence suggests that compliant flooring may be a cost-effective strategy (n = 12), but may also result in increased physical demands for healthcare workers (n = 17). In summary, compliant flooring is a promising strategy for preventing fall-related injuries from a biomechanical perspective. Additional research is warranted to confirm whether compliant flooring (i) prevents fall-related injuries in real-world settings, (ii) is a cost-effective intervention strategy, and (iii) can be installed without negatively impacting workplace safety. Avenues for future research are

[The Marketing of Healthcare Services in ENT-Clinics].

Science.gov (United States)

Teschner, M; Lenarz, T

2016-07-01

The provision of healthcare services in Germany is based on fundamental principles of solidarity and is highly regulated. The question arises which conditions exist for marketing for healthcare services in ENT-clinics in Germany. The marketing options will be elicited using environmentally analytical considerations. The objectives can be achieved using measures derived from external instruments (service policy, pricing policy, distribution policy or communications policy) or from an internal instrument (human resources policy). The policy environment is particularly influenced by the regulatory framework, which particularly restricts the scope for both the pricing and communications policies. All measures must, however, reflect ethical frameworks, which are regarded as the fundamental premise underlying healthcare services and may be at odds with economic factors. Scope for flexibility in pricing exists only within the secondary healthcare market, and even there only to a limited extent. The significance of price in the marketing of healthcare services is thus very low. If marketing activities are to succeed, a market analysis must be carried out exploring the relevant factors for each individual provider. However, the essential precondition for the marketing of healthcare services is trust. The marketing of healthcare services differs from that of business management-oriented enterprises in other branches of economy. In the future the importance of marketing activities will increase. © Georg Thieme Verlag KG Stuttgart · New York.

Addressing dysfunctional relations among healthcare teams: improving team cooperation through applied organizational theories.

Science.gov (United States)

Horwitz, Sujin K; Horwitz, Irwin B; Barshes, Neal R

2011-01-01

Previous research has demonstrated that communication failure and interpersonal conflicts are significant impediments among health-care teams to assess complex information and engage in the meaningful collaboration necessary for optimizing patient care. Despite the prolific research on the role of effective teamwork in accomplishing complex tasks, such findings have been traditionally applied to business organizations and not medical contexts. This chapter, therefore, reviews and applies four theories from the fields of organizational behavior (OB) and organization development (OD) as potential means for improving team interaction in health-care contexts. This study is unique in its approach as it addresses the long-standing problems that exist in team communication and cooperation in health-care teams by applying well-established theories from the organizational literature. The utilization and application of the theoretical constructs discussed in this work offer valuable means by which the efficacy of team work can be greatly improved in health-care organizations.

Improve processes on healthcare: current issues and future trends.

Science.gov (United States)

Chen, Jason C H; Dolan, Matt; Lin, Binshan

2004-01-01

Information Technology (IT) is a critical resource for improving today's business competitiveness. However, many healthcare providers do not proactively manage or improve the efficiency and effectiveness of their services with IT. Survival in a competitive business environment demands continuous improvements in quality and service, while rigorously maintaining core values. Electronic commerce continues its development, gaining ground as the preferred means of business transactions. Embracing e-healthcare and treating IT as a strategic tool to improve patient safety and the quality of care enables healthcare professionals to benefit from technology formerly used only for management purposes. Numerous improvement initiatives, introduced by both the federal government and the private sector, seek to better the status quo in IT. This paper examines the current IT climate using an enhanced "Built to Last" model, and comments on future IT strategies within the healthcare industry.

iMAGE cloud: medical image processing as a service for regional healthcare in a hybrid cloud environment.

Science.gov (United States)

Liu, Li; Chen, Weiping; Nie, Min; Zhang, Fengjuan; Wang, Yu; He, Ailing; Wang, Xiaonan; Yan, Gen

2016-11-01

To handle the emergence of the regional healthcare ecosystem, physicians and surgeons in various departments and healthcare institutions must process medical images securely, conveniently, and efficiently, and must integrate them with electronic medical records (EMRs). In this manuscript, we propose a software as a service (SaaS) cloud called the iMAGE cloud. A three-layer hybrid cloud was created to provide medical image processing services in the smart city of Wuxi, China, in April 2015. In the first step, medical images and EMR data were received and integrated via the hybrid regional healthcare network. Then, traditional and advanced image processing functions were proposed and computed in a unified manner in the high-performance cloud units. Finally, the image processing results were delivered to regional users using the virtual desktop infrastructure (VDI) technology. Security infrastructure was also taken into consideration. Integrated information query and many advanced medical image processing functions-such as coronary extraction, pulmonary reconstruction, vascular extraction, intelligent detection of pulmonary nodules, image fusion, and 3D printing-were available to local physicians and surgeons in various departments and healthcare institutions. Implementation results indicate that the iMAGE cloud can provide convenient, efficient, compatible, and secure medical image processing services in regional healthcare networks. The iMAGE cloud has been proven to be valuable in applications in the regional healthcare system, and it could have a promising future in the healthcare system worldwide.

Personal Efficacy and Factors of Effective Learning Environment in Higher Education: Croatian and American Students

Directory of Open Access Journals (Sweden)

Violeta Vidaček - Hainš

2010-06-01

Full Text Available Successful learning in higher education incorporates various factors related to knowledge, skills, habits, and motivation. Additionally, students’ personalities and self-efficacy may contribute to their adjustment, planning of activities, and achieving success. The objective of this paper is to analyze students’ needs for support services, which enhance the effectiveness of their learning environment at higher education institutions. Answers received from a sample of undergraduate freshmen at one American University and one Croatian University were analyzed and compared. The students from both countries agree that there is a need for developing self-reliance and personal responsibility in using support services, as well as for the timely and accurate information on availability of these services. Students’ suggestions and their desire to enhance effectiveness of their learning environment may be used in creating and improving support services in higher education institutions as well as training their staff.

Implementing healthcare information security: standards can help.

Science.gov (United States)

Orel, Andrej; Bernik, Igor

2013-01-01

Using widely spread common approaches to systems security in health dedicated controlled environments, a level of awareness, confidence and acceptance of relevant standardisation is evaluated. Patients' information is sensitive, so putting appropriate organisational techniques as well as modern technology in place to secure health information is of paramount importance. Mobile devices are becoming the top priorities in advanced information security planning with healthcare environments being no exception. There are less and less application areas in healthcare without having a need for a mobile functionality which represents an even greater information security challenge. This is also true in emergency treatments, rehabilitation and homecare just to mention a few areas outside hospital controlled environments. Unfortunately quite often traditional unsecured communications principles are still in routine use for communicating sensitive health related information. The security awareness level with users, patients and care professionals is not high enough so potential threats and risks may not be addressed and the respective information security management is therefore weak. Standards like ISO/IEC 27000 ISMS family, the ISO/IEC 27799 information security guidelines in health are often not well known, but together with legislation principles such as HIPAA, they can help.

Uma Abordagem Para o Desenvolvimento de Aplicações no Cuidado de Saúde Pervasivo Através do Uso de Arquétipos (An Approach to Developing Applications in the Pervasive Healthcare Environment through the use of Archetypes)

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Cavalini, Luciana Tricai; do Prado, Antonio Francisco

2013-01-01

This paper proposes an approach to develop applications in the Pervasive Healthcare environment, through the use of Archetypes. Materials and methods: Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients to play a more active role in the treatment of

A Framework for Designing a Healthcare Outcome Data Warehouse

Science.gov (United States)

Parmanto, Bambang; Scotch, Matthew; Ahmad, Sjarif

2005-01-01

Many healthcare processes involve a series of patient visits or a series of outcomes. The modeling of outcomes associated with these types of healthcare processes is different from and not as well understood as the modeling of standard industry environments. For this reason, the typical multidimensional data warehouse designs that are frequently seen in other industries are often not a good match for data obtained from healthcare processes. Dimensional modeling is a data warehouse design technique that uses a data structure similar to the easily understood entity-relationship (ER) model but is sophisticated in that it supports high-performance data access. In the context of rehabilitation services, we implemented a slight variation of the dimensional modeling technique to make a data warehouse more appropriate for healthcare. One of the key aspects of designing a healthcare data warehouse is finding the right grain (scope) for different levels of analysis. We propose three levels of grain that enable the analysis of healthcare outcomes from highly summarized reports on episodes of care to fine-grained studies of progress from one treatment visit to the next. These grains allow the database to support multiple levels of analysis, which is imperative for healthcare decision making. PMID:18066371

A framework for designing a healthcare outcome data warehouse.

Science.gov (United States)

Parmanto, Bambang; Scotch, Matthew; Ahmad, Sjarif

2005-09-06

Many healthcare processes involve a series of patient visits or a series of outcomes. The modeling of outcomes associated with these types of healthcare processes is different from and not as well understood as the modeling of standard industry environments. For this reason, the typical multidimensional data warehouse designs that are frequently seen in other industries are often not a good match for data obtained from healthcare processes. Dimensional modeling is a data warehouse design technique that uses a data structure similar to the easily understood entity-relationship (ER) model but is sophisticated in that it supports high-performance data access. In the context of rehabilitation services, we implemented a slight variation of the dimensional modeling technique to make a data warehouse more appropriate for healthcare. One of the key aspects of designing a healthcare data warehouse is finding the right grain (scope) for different levels of analysis. We propose three levels of grain that enable the analysis of healthcare outcomes from highly summarized reports on episodes of care to fine-grained studies of progress from one treatment visit to the next. These grains allow the database to support multiple levels of analysis, which is imperative for healthcare decision making.

Legal and regulatory education and training needs in the healthcare industry.

Science.gov (United States)

Henson, Steve W; Burke, Debra; Crow, Stephen M; Hartman, Sandra J

2005-01-01

As in any other industry, laws and regulations significantly impact the functioning of the healthcare industry. Some laws, such as those relating to malpractice and social insurance systems, affect the manner in which the industry operates. Other laws, such as those regulating antitrust and employment practices, affect the organization and the environment in which the industry operates. It is increasingly important that practitioners and managers be cognizant of this complex and dynamic legal minefield. This study examined healthcare managers and executives' knowledge of 9 key issues in the legal and regulatory environment of the healthcare industry. Specifically, the study focused on knowledge concerning tort and contract liability, insurance law, labor and employment regulation, criminal and ethical responsibility, antitrust regulation, the law governing business associations and recent developments. Findings suggest that the levels of knowledge required to manage legal and regulatory issues are much greater than the existing levels of knowledge.

Transitioning from learning healthcare systems to learning health care communities.

Science.gov (United States)

Mullins, C Daniel; Wingate, La'Marcus T; Edwards, Hillary A; Tofade, Toyin; Wutoh, Anthony

2018-02-26

The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care. Addressing the LHS framework implementation challenges and utilizing community levers are requisite components of a learning health care community model, version two of the LHS archetype.

Impact of peer teaching on nursing students: perceptions of learning environment, self-efficacy, and knowledge.

Science.gov (United States)

Brannagan, Kim B; Dellinger, Amy; Thomas, Jan; Mitchell, Denise; Lewis-Trabeaux, Shirleen; Dupre, Susan

2013-11-01

Peer teaching has been shown to enhance student learning and levels of self efficacy. The purpose of the current study was to examine the impact of peer-teaching learning experiences on nursing students in roles of tutee and tutor in a clinical lab environment. This study was conducted over a three-semester period at a South Central University that provides baccalaureate nursing education. Over three semesters, 179 first year nursing students and 51 third year nursing students participated in the study. This mixed methods study, through concurrent use of a quantitative intervention design and qualitative survey data, examined differences during three semesters in perceptions of a clinical lab experience, self-efficacy beliefs, and clinical knowledge for two groups: those who received peer teaching-learning in addition to faculty instruction (intervention group) and those who received faculty instruction only (control group). Additionally, peer teachers' perceptions of the peer teaching learning experience were examined. Results indicated positive response from the peer tutors with no statistically significant differences for knowledge acquisition and self-efficacy beliefs between the tutee intervention and control groups. In contrast to previous research, students receiving peer tutoring in conjunction with faculty instruction were statistically more anxious about performing lab skills with their peer tutor than with their instructors. Additionally, some students found instructors' feedback moderately more helpful than their peers and increased gains in knowledge and responsibility for preparation and practice with instructors than with peer tutors. The findings in this study differ from previous research in that the use of peer tutors did not decrease anxiety in first year students, and no differences were found between the intervention and control groups related to self efficacy or cognitive improvement. These findings may indicate the need to better prepare peer

Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings.

Science.gov (United States)

Reedy, Gabriel B; Lavelle, Mary; Simpson, Thomas; Anderson, Janet E

2017-10-01

A central feature of clinical simulation training is human factors skills, providing staff with the social and cognitive skills to cope with demanding clinical situations. Although these skills are critical to safe patient care, assessing their learning is challenging. This study aimed to develop, pilot and evaluate a valid and reliable structured instrument to assess human factors skills, which can be used pre- and post-simulation training, and is relevant across a range of healthcare professions. Through consultation with a multi-professional expert group, we developed and piloted a 39-item survey with 272 healthcare professionals attending training courses across two large simulation centres in London, one specialising in acute care and one in mental health, both serving healthcare professionals working across acute and community settings. Following psychometric evaluation, the final 12-item instrument was evaluated with a second sample of 711 trainees. Exploratory factor analysis revealed a 12-item, one-factor solution with good internal consistency (α=0.92). The instrument had discriminant validity, with newly qualified trainees scoring significantly lower than experienced trainees ( t (98)=4.88, pSkills for Healthcare Instrument provides a reliable and valid method of assessing trainees' human factors skills self-efficacy across acute and mental health settings. This instrument has the potential to improve the assessment and evaluation of human factors skills learning in both uniprofessional and interprofessional clinical simulation training.

A Study on Information Search and Commitment Strategies on Web Environment and Internet Usage Self-Efficacy Beliefs of University Students'

Science.gov (United States)

Geçer, Aynur Kolburan

2014-01-01

This study addresses university students' information search and commitment strategies on web environment and internet usage self-efficacy beliefs in terms of such variables as gender, department, grade level and frequency of internet use; and whether there is a significant relation between these beliefs. Descriptive method was used in the study.…

A new generation of healthcare buildings in South Africa: complexities and opportunities for greening

CSIR Research Space (South Africa)

De Jager, Peta

2012-07-01

Full Text Available , efficient, healing environment desirable for healthcare delivery. In South Africa there has been a commitment to transform the healthcare sector through the introduction of the national health insurance system which is to be unfolded over a 14 year period...

Strategic cycling: shaking complacency in healthcare strategic planning.

Science.gov (United States)

Begun, J; Heatwole, K B

1999-01-01

As the conditions affecting business and healthcare organizations in the United States have become more turbulent and uncertain, strategic planning has decreased in popularity. Strategic planning is criticized for stiffling creative responses to the new marketplace and for fostering compartmentalized organizations, adherence to outmoded strategies, tunnel vision in strategy formulation, and overemphasis on planning to the detriment of implementation. However, effective strategic planning can be a force for mobilizing all the constituents of an organization, creating discipline in pursuit of a goal, broadening an organization's perspective, improving communication among disciplines, and motivating the organization's workforce. It is worthwhile for healthcare organizations to preserve these benefits of strategic planning at the same time recognizing the many sources of turbulence and uncertainty in the healthcare environment. A model of "strategic cycling" is presented to address the perceived shortcomings of traditional strategic planning in a dynamic environment. The cycling model facilitates continuous assessment of the organization's mission/values/vision and primary strategies based on feedback from benchmark analysis, shareholder impact, and progress in strategy implementation. Multiple scenarios and contingency plans are developed in recognition of the uncertain future. The model represents a compromise between abandoning strategic planning and the traditional, linear model of planning based on progress through predetermined stages to a masterpiece plan.

Cyberterrorism: is the U.S. healthcare system safe?

Science.gov (United States)

Harries, David; Yellowlees, Peter M

2013-01-01

The Internet has brought with it many benefits; key among them has been its ability to allow the expansion of communication and transfer of all kinds of information throughout the U.S. healthcare system. As a consequence, healthcare has become increasingly dependent on the activities carried out in that environment. It is this very dependence that increases the likelihood of individuals or organizations conducting activities through the Internet that will cause physical and/or psychological harm. These activities have become known by the term "cyberterrorism." In the healthcare landscape this can appear in a variety of forms, such as bringing down a hospital computer system or publicly revealing private medical records. Whatever shape it takes, the general effects are the same: patient care is compromised, and trust in the health system is diminished. Fortunately no significant cyber attack has been successfully launched against a U.S. healthcare organization to date. However, there is evidence to suggest that cyber threats are increasing and that much of the U.S. healthcare system is ill equipped to deal with them. Securing cyberspace is not an easy proposition as the threats are constantly changing, and recognizing that cyberterrorism should be part of a broader information technology risk management strategy, there are several"best practices" that can be adopted by healthcare organizations to protect themselves against cyber attacks.

Education on human rights and healthcare: evidence from Serbia.

Science.gov (United States)

Vranes, Aleksandra Jovic; Mikanovic, Vesna Bjegovic; Vukovic, Dejana; Djikanovic, Bosiljka; Babic, Momcilo

2015-03-01

Ensuring and enforcing human rights in patient care are important to promote health and to provide quality and appropriate healthcare services. Therefore, continued medical education (CME) is essential for healthcare professionals to utilize their sphere of influence to affect change in healthcare practice. A total of 123 participants attended three CME courses. Course topics covered: (i) the areas of human rights and healthcare, (ii) rights, obligations and responsibilities of healthcare professionals in relation to human rights and the rights of patients, (iii) healthcare of vulnerable groups and (iv) access to essential medical services. Evaluation of the CME courses involved two components: evaluation of participants' performance and the participants' evaluation of the teaching process. The participants were assessed at the beginning and end of each course. Each of the courses was evaluated by the participants through a questionnaire distributed at the end of each course. Descriptive statistics was used for data interpretation. Knowledge of the healthcare professionals improved at the end of all the three courses. The participants assessed several aspects of the courses, including the course topics, educational methods, the course methods, organization, duration and dynamics as well as the physical environment and the technical facilities of the course, and rated each very highly. Our results corroborate the importance and necessity of courses to heighten awareness of the state of current healthcare and human rights issues to increase the involvement of healthcare professionals both locally and globally. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Antecedents, mediators, and outcomes of authentic leadership in healthcare: A systematic review.

Science.gov (United States)

Alilyyani, Bayan; Wong, Carol A; Cummings, Greta

2018-04-07

Leaders are essential in every organization to achieve patient safety and healthy work environments. Authentic leadership is a relational leadership style purported to promote healthy work environments that influence staff performance and organizational outcomes. Given recent growth in authentic leadership research in healthcare and the importance of new knowledge to inform leadership development, there is an obligation to determine what is known about the antecedents and outcomes of authentic leadership in healthcare settings and clarify mechanisms by which authentic leadership affects healthcare staff and patient outcomes. The aim of this systematic review was to examine the antecedents, mediators and outcomes associated with authentic leadership in healthcare. Systematic review. The search strategy included 11 electronic databases: ABI Inform Dateline, Academic Search Complete, Cochrane Database of Systematic Reviews, PubMed, CINAHL, Embase, ERIC, PsycINFO, Scopus, Web of Science, and ProQuest Dissertations & Theses. The search was conducted in January 2017. Published English-only quantitative research that examined the antecedents, mediators and outcomes of authentic leadership practices of leaders in healthcare settings was included. Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were analyzed through descriptive and narrative syntheses. Content analysis was used to group antecedents, outcomes and mediators into categories which were then compared to authentic leadership theory. 1036 titles and abstracts were screened yielding 136 manuscripts for full-text review which resulted in 21 included studies reported in 38 manuscripts. Significant associations between authentic leadership and 43 outcomes were grouped into two major themes: healthcare staff outcomes with 5 subthemes (personal psychological states, satisfaction with work, work environment factors, health & well-being, and

Adaptive Failure Identification for Healthcare Risk Analysis and Its Application on E-Healthcare

Directory of Open Access Journals (Sweden)

Kuo-Chung Chu

2014-01-01

Full Text Available To satisfy the requirement for diverse risk preferences, we propose a generic risk priority number (GRPN function that assigns a risk weight to each parameter such that they represent individual organization/department/process preferences for the parameters. This research applies GRPN function-based model to differentiate the types of risk, and primary data are generated through simulation. We also conduct sensitivity analysis on correlation and regression to compare it with the traditional RPN (TRPN. The proposed model outperforms the TRPN model and provides a practical, effective, and adaptive method for risk evaluation. In particular, the defined GRPN function offers a new method to prioritize failure modes in failure mode and effect analysis (FMEA. The different risk preferences considered in the healthcare example show that the modified FMEA model can take into account the various risk factors and prioritize failure modes more accurately. In addition, the model also can apply to a generic e-healthcare service environment with a hierarchical architecture.

IT-support for healthcare professionals acting in major incidents

DEFF Research Database (Denmark)

Kristensen, Margit; Kyng, Morten; Nielsen, Esben Toftdahl

2005-01-01

This paper focuses on development of it support for healthcare professionals acting in major incidents. We introduce the participatory design approach as adequate for analysis, design and development of technologies for use in complex environments and situations, and describe the actual...... the BlueBio biomonitor prototype, a wireless multifunction biomonitor. BlueBio data can be accessed by the healthcare professionals independent of where they are located and displayed on different types of devices tailored to the needs of the individual professional. Finally we discuss some challenges...

Limitations of the efficacy of surface disinfection in the healthcare setting.

Science.gov (United States)

Williams, Gareth J; Denyer, Stephen P; Hosein, Ian K; Hill, Dylan W; Maillard, Jean-Yves

2009-06-01

We examined the efficacy of 2 commercially available wipes to effectively remove, kill, and prevent the transfer of both methicillin-resistant and methicillin-susceptible Staphylococcus aureus from contaminated surfaces. Although wipes play a role in decreasing the number of pathogenic bacteria from contaminated surfaces, they can potentially transfer bacteria to other surfaces if they are reused.

The Impact of Student Self-Efficacy on Scientific Inquiry Skills: An Exploratory Investigation in "River City," a Multi-User Virtual Environment

Science.gov (United States)

Ketelhut, Diane Jass

2007-01-01

This exploratory study investigated data-gathering behaviors exhibited by 100 seventh-grade students as they participated in a scientific inquiry-based curriculum project delivered by a multi-user virtual environment (MUVE). This research examined the relationship between students' self-efficacy on entry into the authentic scientific activity and…

High fidelity medical simulation in the difficult environment of a helicopter: feasibility, self-efficacy and cost

Directory of Open Access Journals (Sweden)

Holland Carolyn

2006-10-01

Full Text Available Abstract Background This study assessed the feasibility, self-efficacy and cost of providing a high fidelity medical simulation experience in the difficult environment of an air ambulance helicopter. Methods Seven of 12 EM residents in their first postgraduate year participated in an EMS flight simulation as the flight physician. The simulation used the Laerdal SimMan™ to present a cardiac and a trauma case in an EMS helicopter while running at flight idle. Before and after the simulation, subjects completed visual analog scales and a semi-structured interview to measure their self-efficacy, i.e. comfort with their ability to treat patients in the helicopter, and recognition of obstacles to care in the helicopter environment. After all 12 residents had completed their first non-simulated flight as the flight physician; they were surveyed about self-assessed comfort and perceived value of the simulation. Continuous data were compared between pre- and post-simulation using a paired samples t-test, and between residents participating in the simulation and those who did not using an independent samples t-test. Categorical data were compared using Fisher's exact test. Cost data for the simulation experience were estimated by the investigators. Results The simulations functioned correctly 5 out of 7 times; suggesting some refinement is necessary. Cost data indicated a monetary cost of $440 and a time cost of 22 hours of skilled instructor time. The simulation and non-simulation groups were similar in their demographics and pre-hospital experiences. The simulation did not improve residents' self-assessed comfort prior to their first flight (p > 0.234, but did improve understanding of the obstacles to patient care in the helicopter (p = 0.029. Every resident undertaking the simulation agreed it was educational and it should be included in their training. Qualitative data suggested residents would benefit from high fidelity simulation in other

An architecture for message exchange in pervasive healthcare based on the use of intelligent agents

NARCIS (Netherlands)

Cavalini, L.T.; Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Cavalini, Luciana Tricai; do Prado, Antonio Francisco

2013-01-01

Aims: This paper proposes an architecture for the exchange of context-aware messages in Pervasive Healthcare environments. Materials and methods: In Pervasive Healthcare, novel information and communication technologies are applied to support the provision of health services anywhere, at anytime,

Influence of 5-HTT variation, childhood trauma and self-efficacy on anxiety traits: a gene-environment-coping interaction study.

Science.gov (United States)

Schiele, Miriam A; Ziegler, Christiane; Holitschke, Karoline; Schartner, Christoph; Schmidt, Brigitte; Weber, Heike; Reif, Andreas; Romanos, Marcel; Pauli, Paul; Zwanzger, Peter; Deckert, Jürgen; Domschke, Katharina

2016-08-01

Environmental vulnerability factors such as adverse childhood experiences in interaction with genetic risk variants, e.g., the serotonin transporter gene linked polymorphic region (5-HTTLPR), are assumed to play a role in the development of anxiety and affective disorders. However, positive influences such as general self-efficacy (GSE) may exert a compensatory effect on genetic disposition, environmental adversity, and anxiety traits. We, thus, assessed childhood trauma (Childhood Trauma Questionnaire, CTQ) and GSE in 678 adults genotyped for 5-HTTLPR/rs25531 and their interaction on agoraphobic cognitions (Agoraphobic Cognitions Questionnaire, ACQ), social anxiety (Liebowitz Social Anxiety Scale, LSAS), and trait anxiety (State-Trait Anxiety Inventory, STAI-T). The relationship between anxiety traits and childhood trauma was moderated by self-efficacy in 5-HTTLPR/rs25531 LALA genotype carriers: LALA probands maltreated as children showed high anxiety scores when self-efficacy was low, but low anxiety scores in the presence of high self-efficacy despite childhood maltreatment. Our results extend previous findings regarding anxiety-related traits showing an interactive relationship between 5-HTT genotype and adverse childhood experiences by suggesting coping-related measures to function as an additional dimension buffering the effects of a gene-environment risk constellation. Given that anxiety disorders manifest already early in childhood, this insight could contribute to the improvement of psychotherapeutic interventions by including measures strengthening self-efficacy and inform early targeted preventive interventions in at-risk populations, particularly within the crucial time window of childhood and adolescence.

The Cuban National Healthcare System: Characterization of primary healthcare services.

Directory of Open Access Journals (Sweden)

Keli Regina DAL PRÁ

2015-10-01

Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

Exploring technology impacts of Healthcare 2.0 initiatives.

Science.gov (United States)

Randeree, Ebrahim

2009-04-01

As Internet access proliferates and technology becomes more accessible, the number of people online has been increasing. Web 2.0 and the social computing phenomena (such as Facebook, Friendster, Flickr, YouTube, Blogger, and MySpace) are creating a new reality on the Web: Users are changing from consumers of Web-available information and resources to generators of information and content. Moving beyond telehealth and Web sites, the push toward Personal Health Records has emerged as a new option for patients to take control of their medical data and to become active participants in the push toward widespread digitized healthcare. There is minimal research on the impact of Web 2.0 in healthcare. This paper reviews the changing patient-physician relationship in the Healthcare 2.0 environment, explores the technological challenges, and highlights areas for research.

Consensus statement: patient safety, healthcare-associated infections and hospital environmental surfaces.

Science.gov (United States)

Roques, Christine; Al Mousa, Haifaa; Duse, Adriano; Gallagher, Rose; Koburger, Torsten; Lingaas, Egil; Petrosillo, Nicola; Škrlin, Jasenka

2015-01-01

Healthcare-associated infections have serious implications for both patients and hospitals. Environmental surface contamination is the key to transmission of nosocomial pathogens. Routine manual cleaning and disinfection eliminates visible soil and reduces environmental bioburden and risk of transmission, but may not address some surface contamination. Automated area decontamination technologies achieve more consistent and pervasive disinfection than manual methods, but it is challenging to demonstrate their efficacy within a randomized trial of the multiple interventions required to reduce healthcare-associated infection rates. Until data from multicenter observational studies are available, automated area decontamination technologies should be an adjunct to manual cleaning and disinfection within a total, multi-layered system and risk-based approach designed to control environmental pathogens and promote patient safety.

The orthopaedist's role in healthcare system governance.

Science.gov (United States)

Probe, Robert A

2013-06-01

Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

Do-it-yourself healthcare: the current landscape, prospects and consequences.

Science.gov (United States)

Carrera, Pricivel M; Dalton, Andrew R H

2014-01-01

The wider availability and increasing use of mHealth tools - covering health applications, smartphone plug-ins and gadgets is significant for healthcare. This trend epitomises broader trajectories in access to and delivery of healthcare, with greater consumer involvement and decentralisation. This shift may be conceptualised as 'do-it-yourself Healthcare' - allowing consumers to monitor and manage their health, and guide their healthcare consumption. Technology that enables data collection by patients informs them about vital health metrics, giving them more control over experiences of health or illness. The information can be used alone as empowered consumers or together with healthcare professionals in an environment of patient-centred care. Current evidence suggests a large scope for do-it-yourself Healthcare, given the availability of technologies, whilst mHealth tools enhance diagnostics, improve treatment, increase access to services and lower costs. There are, however, limitations to do-it-yourself Healthcare. Notably, its evidence base is less well developed than the availability of technologies to facilitate it. A more complex model and understanding is needed to explain motivations for and consequences of engaging in do-it-yourself Healthcare. That said, its introduction alongside existing medicine may improve quality and reduce costs - potentially improving health system sustainability whilst future generations - tomorrow's middle-aged and the elderly, will become more conducive to its spread. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

On the need for revising healthcare failure mode and effect analysis for assessing potential for patient harm in healthcare processes

International Nuclear Information System (INIS)

Abrahamsen, Håkon Bjorheim; Abrahamsen, Eirik Bjorheim; Høyland, Sindre

2016-01-01

Healthcare Failure Mode and Effect Analysis is a proactive, systematic method adapted from safety-critical industries increasingly used to assess the potential for patient harm in high-risk healthcare processes. In this paper we review and discuss this method. We point to some weaknesses and finally argue for two adjustments. One adjustment is regarding the way in which risk is evaluated, and the other is to adopt a broader evaluation of barrier performance. Examples are given from prehospital critical care and from the operating room environment within hospitals to illustrate these ideas. - Highlights: • This article discusses the appropriateness of using HFMEA in healthcare processes. • We conclude that HFMEA has an important role to play in such contexts. • We argue for two adjustments in the traditional HFMEA. • One is regarding the way risk is evaluated. • The other is to adopt a broader evaluation of barrier performance.

Simulation and modeling efforts to support decision making in healthcare supply chain management.

Science.gov (United States)

AbuKhousa, Eman; Al-Jaroodi, Jameela; Lazarova-Molnar, Sanja; Mohamed, Nader

2014-01-01

Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM) by improving the decision making pertaining processes' efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM) has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.

Simulation and Modeling Efforts to Support Decision Making in Healthcare Supply Chain Management

Directory of Open Access Journals (Sweden)

Eman AbuKhousa

2014-01-01

Full Text Available Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM by improving the decision making pertaining processes’ efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.

The Finnish healthcare services lean management.

Science.gov (United States)

Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna

2018-02-05

Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used

Promoting exercise behaviour in a secure mental health setting: Healthcare assistant perspectives.

Science.gov (United States)

Kinnafick, Florence-Emilie; Papathomas, Anthony; Regoczi, Dora

2018-05-30

Individuals with severe mental illness engage in significantly less amounts of physical activity than the general population. A secure mental health setting can exacerbate barriers to exercise, and facilitate physical inactivity and sedentary behaviour. Healthcare assistants are intimately involved in the daily lives of patients and, therefore, should be considered integral to exercise promotion in secure mental health settings. Our aim was to explore healthcare assistants' perceptions of exercise and their attitudes to exercise promotion for adult patients in a secure mental health hospital. Qualitative semi-structured interviews were conducted with 11 healthcare assistants from a large UK-based secure mental health hospital. Topics included healthcare assistants' personal experiences of exercise within a secure facility, their perceptions of exercise as an effective treatment tool for mental health, and their perceived roles and responsibilities for exercise promotion. Thematic analysis was used to analyse the data. Three main themes were identified: (i) exercise is multi-beneficial to patients, (ii) perceived barriers to effective exercise promotion, and (iii) strategies for effectives exercise promotion. Healthcare assistants considered exercise to hold patient benefits. However, core organizational and individual barriers limited healthcare assistants' exercise promotion efforts. An informal approach to exercise promotion was deemed most effective to some, whereas others committed to more formal strategies including compulsory sessions. With education and organizational support, we propose healthcare assistants are well placed to identify individual needs for exercise promotion. Their consultation could lead to more efficacious, person-sensitive interventions. © 2018 Australian College of Mental Health Nurses Inc.

Healthcare Policy Statement on the Utility of Coronary Computed Tomography for Evaluation of Cardiovascular Conditions and Preventive Healthcare: From the Health Policy Working Group of the Society of Cardiovascular Computed Tomography.

Science.gov (United States)

Slim, Ahmad M; Jerome, Scott; Blankstein, Ron; Weigold, Wm Guy; Patel, Amit R; Kalra, Dinesh K; Miller, Ryan; Branch, Kelley; Rabbat, Mark G; Hecht, Harvey; Nicol, Edward D; Villines, Todd C; Shaw, Leslee J

The rising cost of healthcare is prompting numerous policy and advocacy discussions regarding strategies for constraining growth and creating a more efficient and effective healthcare system. Cardiovascular imaging is central to the care of patients at risk of, and living with, heart disease. Estimates are that utilization of cardiovascular imaging exceeds 20 million studies per year. The Society of Cardiovascular CT (SCCT), alongside Rush University Medical Center, and in collaboration with government agencies, regional payers, and industry healthcare experts met in November 2016 in Chicago, IL to evaluate obstacles and hurdles facing the cardiovascular imaging community and how they can contribute to efficacy while maintaining or even improving outcomes and quality. The summit incorporated inputs from payers, providers, and patients' perspectives, providing a platform for all voices to be heard, allowing for a constructive dialogue with potential solutions moving forward. This article outlines the proceedings from the summit, with a detailed review of past hurdles, current status, and potential solutions as we move forward in an ever-changing healthcare landscape. Copyright © 2017 Society of Cardiovascular Computed Tomography. All rights reserved.

The paradox of lean in healthcare: Stable processes in a reactive environment

DEFF Research Database (Denmark)

Nielsen, Anders Paarup; Edwards, Kasper

2010-01-01

a limited set of tools has been used and the productivity gains are limited focusing on peripheral activities and not the core medical activities. This apparent problem with lean in health care is hypothesized to be caused by 1) the nature of healthcare work, 2) the rationality and notion of validity among...

Smart Homes for Elderly Healthcare-Recent Advances and Research Challenges.

Science.gov (United States)

Majumder, Sumit; Aghayi, Emad; Noferesti, Moein; Memarzadeh-Tehran, Hamidreza; Mondal, Tapas; Pang, Zhibo; Deen, M Jamal

2017-10-31

Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies.

Building a Healthcare System's Innovation Program.

Science.gov (United States)

Conger, Michelle D

2016-01-01

OSF HealthCare, based in Peoria, Illinois, has developed an innovative strategy to adapt to the changes and forces disrupting the healthcare environment. This strategy evolved organically from the performance improvement efforts we began more than 15 years ago, as well as from the lessons we learned from years of research into the innovative practices and platforms of other healthcare institutions and of companies in other industries. More important, the strategy reflects our mission "to serve persons with the greatest care and love."The OSF innovation model has three components: internal innovations, partnering with external entities, and validating innovations through simulation. OSF has an ongoing and comprehensive commitment to innovation. Examples include our initiative to transform our model of care in primary care clinics by expanding access, reducing costs, and increasing efficiency; our partnerships with outside entities to find revolutionary solutions and products in which we can invest; and our establishment of a world-class simulation and education center.OSF HealthCare could not do any of this if it lacked the support of its people. To that end, we continue to work on embedding a culture of innovation across all of our facilities. Ours is a culture in which everyone is encouraged to voice creative ideas and no one is afraid to fail-all for the betterment of our organization and the patients we serve.

Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers.

Science.gov (United States)

Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke

2017-01-01

Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia. The study is part of a greater participatory action research project: 'Hospice values in the care for persons with dementia'. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. The results show that good working relationships, characterized by understanding each other's vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. The results are discussed in the light of Lögstrup's relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.

The health of healthcare, Part II: patient healthcare has cancer.

Science.gov (United States)

Waldman, Deane

2013-01-01

In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare.

Career choice and perceptions of nursing among healthcare students in higher educational institutions.

Science.gov (United States)

Liaw, Sok Ying; Wu, Ling Ting; Chow, Yeow Leng; Lim, Siriwan; Tan, Khoon Kiat

2017-05-01

Due to the ageing population and competition from other healthcare courses, a greater demand in the healthcare workforce has made it challenging for educational institutions to attract school leavers to enter nursing courses. Understanding the considerations of students who have chosen non-nursing healthcare courses and their perceptions of nursing can help identify specific strategies to enhance the attractiveness of nursing course. This study aims to examine the differences between healthcare career choices and perceptions of nursing as a career choice among first-year non-nursing healthcare students. A descriptive survey design was conducted at the beginning of the healthcare courses of seven healthcare groups and from four higher educational institutions in Singapore. A total of 451 students responded, yielding an overall response rate of 52.7%. The online survey was administered using a valid and reliable 35-item parallel scale, known as the Healthcare Career Choice and Nursing Career Choice. The participants perceived prior healthcare exposure as the most influential factor and self-efficacy as the least influential factor when choosing nursing as a career. In comparison to their own healthcare career choices, nursing was perceived to have greater gender stigma and, as nurses, they would be less likely to achieve higher qualifications and career advancements, and they would be less likely to enjoy fulfilling careers. They also perceived that they would be less likely to gain their parents' support to pursue nursing and to make their parents proud. This study provides educators and policy-makers with vital information to develop key strategies to improve nursing enrolment in educational institutions. These strategies include early exposure to nursing as a rewarding career during school years, addressing the issue of gender stigma, and promoting information on the career and educational advancement of a registered nurse to parents of school leavers. Copyright �

Healthcare waste generation and its management system: the case ...

African Journals Online (AJOL)

Healthcare waste generation and its management system: the case of health ... of an environmental risk to health care workers, the public and the environment at large. ... Only four out of ten health centers used local type of incinerators, while ...

Healthcare waste management practices and risk perceptions: findings from hospitals in the Algarve region, Portugal.

Science.gov (United States)

Ferreira, Vera; Teixeira, Margarida Ribau

2010-12-01

The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.

Do students with higher self-efficacy exhibit greater and more diverse scientific inquiry skills: An exploratory investigation in "River City", a multi-user virtual environment

Science.gov (United States)

Ketelhut, Diane Jass

In this thesis, I conduct an exploratory study to investigate the relationship between students' self-efficacy on entry into authentic scientific activity and the scientific inquiry behaviors they employ while engaged in that process, over time. Scientific inquiry has been a major standard in most science education policy doctrines for the past two decades and is exemplified by activities such as making observations, formulating hypotheses, gathering and analyzing data, and forming conclusions from that data. The self-efficacy literature, however, indicates that self-efficacy levels affect perseverance and engagement. This study investigated the relationship between these two constructs. The study is conducted in a novel setting, using an innovative science curriculum delivered through an interactive computer technology that recorded each student's conversations, movements, and activities while behaving as a practicing scientist in a "virtual world" called River City. River City is a Multi-User Virtual Environment designed to engage students in a collaborative scientific inquiry-based learning experience. As a result, I was able to follow students' moment-by-moment choices of behavior while they were behaving as scientists. I collected data on students' total scientific inquiry behaviors over three visits to River City, as well as the number of sources from which they gathered their scientific data. I analyzed my longitudinal data on the 96 seventh-graders using individual growth modeling. I found that self-efficacy played a role in the number of data-gathering behaviors students engaged in initially, with high self-efficacy students engaging in more data gathering than students with low self-efficacy. However, the impact of student self-efficacy on rate of change in data gathering behavior differed by gender; by the end of the study, student self-efficacy did not impact data gathering. In addition, students' level of self-efficacy did not affect how many different

People-centric sensing in assistive healthcare

DEFF Research Database (Denmark)

Giannetsos, Thanassis; Dimitriou, Tassos; Prasad, Neeli R.

2011-01-01

, we discuss the latest advances in security and privacy protection strategies that hold promise in this new exciting paradigm. We hope this work will better highlight the need for privacy in people-centric sensing applications and spawn further research in this area. Copyright © 2011 John Wiley & Sons......As the domains of pervasive computing and sensor networking are expanding, there is an ongoing trend towards assistive living and healthcare support environments that can effectively assimilate these technologies according to human needs. Most of the existing research in assistive healthcare...... follows a more passive approach and has focused on collecting and processing data using a static-topology and an application-aware infrastructure. However, with the technological advances in sensing, computation, storage, and communications, a new era is about to emerge changing the traditional view...

Task-role-based Access Control Model in Smart Health-care System

Directory of Open Access Journals (Sweden)

Wang Peng

2015-01-01

Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

Job satisfaction and retention of health-care providers in Afghanistan and Malawi.

Science.gov (United States)

Fogarty, Linda; Kim, Young Mi; Juon, Hee-Soon; Tappis, Hannah; Noh, Jin Won; Zainullah, Partamin; Rozario, Aleisha

2014-02-17

This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P job satisfaction (F(8,332) = 4.19; P job are highly dependent on the local context. Although health-care workers in both Afghanistan and Malawi reported satisfaction with their jobs, the predictors of satisfaction, and the extent to which those predictors explained variations in job satisfaction and intention to stay on the job, differed substantially. These findings demonstrate the need for more detailed comparative human resources for health-care research, particularly regarding the relative importance of different determinants of job satisfaction and intention to stay in different contexts and the effectiveness of interventions designed to improve health-care worker performance and retention.

Healthcare waste management research: A structured analysis and review (2005-2014).

Science.gov (United States)

Thakur, Vikas; Ramesh, A

2015-10-01

The importance of healthcare waste management in preserving the environment and protecting the public cannot be denied. Past research has dealt with various issues in healthcare waste management and disposal, which spreads over various journals, pipeline research disciplines and research communities. Hence, this article analyses this scattered knowledge in a systematic manner, considering the period between January 2005 and July 2014. The purpose of this study is to: (i) identify the trends in healthcare waste management literature regarding journals published; (ii) main topics of research in healthcare waste management; (iii) methodologies used in healthcare waste management research; (iv) areas most frequently researched by researchers; and (v) determine the scope of future research in healthcare waste management. To this end, the authors conducted a systematic review of 176 articles on healthcare waste management taken from the following eight esteemed journals: International Journal of Environmental Health Research, International Journal of Healthcare Quality Assurance, Journal of Environmental Management, Journal of Hazardous Material, Journal of Material Cycles and Waste Management, Resources, Conservations and Recycling, Waste Management, and Waste Management & Research. The authors have applied both quantitative and qualitative approaches for analysis, and results will be useful in the following ways: (i) results will show importance of healthcare waste management in healthcare operations; (ii) findings will give a comparative view of the various publications; (c) study will shed light on future research areas. © The Author(s) 2015.

Healthcare professionals' work engagement in Finnish university hospitals.

Science.gov (United States)

Lepistö, Sari; Alanen, Seija; Aalto, Pirjo; Järvinen, Päivi; Leino, Kaija; Mattila, Elina; Kaunonen, Marja

2017-10-10

Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands. To describe the association between work engagement of healthcare professionals' and its background factors at five Finnish university hospitals. Survey data were collected from nurses, physicians and administrative staff (n = 561) at all five university hospitals in Finland. Data were collected using an electronic questionnaire that comprised the Utrecht Work Engagement Scale (9 items) and 13 questions regarding the respondents' backgrounds. Descriptive and correlational analyses were used to examine the data. Most respondents were female (85%) and nursing staff (72%). Baby boomers (49%) were the largest generational cohort. The work engagement composite mean for the total sample was 5.0, indicating high work engagement. Significant differences in work engagement existed only among sex and age groups. The highest work engagement scores were among administrative staff. Work engagement among healthcare professionals in Finnish university hospitals is high. High work engagement might be explained by suitable job resources and challenges, as well as opportunities provided by a frontline care environment. Attention should especially be paid to meeting the needs of young people entering the workforce to strengthen their dedication and absorption. © 2017 Nordic College of Caring Science.

The Relationship between Sources of Self-Efficacy in Classroom Environments and the Strength of Computer Self-Efficacy Beliefs

Science.gov (United States)

Srisupawong, Yuwarat; Koul, Ravinder; Neanchaleay, Jariya; Murphy, Elizabeth; Francois, Emmanuel Jean

2018-01-01

Motivation and success in computer-science courses are influenced by the strength of students' self-efficacy (SE) beliefs in their learning abilities. Students with weak SE may struggle to be successful in a computer-science course. This study investigated the factors that enhance or impede the computer self-efficacy (CSE) of computer-science…

From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decisionmaking

NARCIS (Netherlands)

Guindo, L.A.; Wagner, M.; Baltussen, R.; Rindress, D.; van Til, Janine Astrid; Kind, P.; Goetghebeur, M.

2012-01-01

Objectives Resource allocation is a challenging issue faced by health policy decisionmakers requiring careful consideration of many factors. Objectives of this study were to identify decision criteria and their frequency reported in the literature on healthcare decisionmaking. Method An extensive

[Healthcare value chain: a model for the Brazilian healthcare system].

Science.gov (United States)

Pedroso, Marcelo Caldeira; Malik, Ana Maria

2012-10-01

This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information.

The Just War Tradition: A Model for Healthcare Ethics.

Science.gov (United States)

Connolly, Chaplain John D

2018-06-01

Healthcare ethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcare ethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcare ethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a model that is thorough in its exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions. In recent years, the Just War Tradition has expanded beyond the simple consideration of going to war or not to include how the war is conducted and what the post-war phase would look like ethically. This paper is an exploration of a healthcare ethics decision making model using the tenets of the Just War Tradition as a framework. It discusses the initial consult level of decision making prior to any medical intervention, then goes further in considering the ongoing ethical paradigm during medical intervention and post intervention. Thus, this proposal is a more holistic approach to healthcare ethics decision making that encourages healthcare ethics committees to consider alternate models and ways of processing so that ultimately what is best for patient, family, staff, and the environment is all taken into consideration.

State of science: human factors and ergonomics in healthcare.

Science.gov (United States)

Hignett, Sue; Carayon, Pascale; Buckle, Peter; Catchpole, Ken

2013-01-01

The past decade has seen an increase in the application of human factors and ergonomics (HFE) techniques to healthcare delivery in a broad range of contexts (domains, locations and environments). This paper provides a state of science commentary using four examples of HFE in healthcare to review and discuss analytical and implementation challenges and to identify future issues for HFE. The examples include two domain areas (occupational ergonomics and surgical safety) to illustrate a traditional application of HFE and the area that has probably received the most research attention. The other two examples show how systems and design have been addressed in healthcare with theoretical approaches for organisational and socio-technical systems and design for patient safety. Future opportunities are identified to develop and embed HFE systems thinking in healthcare including new theoretical models and long-term collaborative partnerships. HFE can contribute to systems and design initiatives for both patients and clinicians to improve everyday performance and safety, and help to reduce and control spiralling healthcare costs. There has been an increase in the application of HFE techniques to healthcare delivery in the past 10 years. This paper provides a state of science commentary using four illustrative examples (occupational ergonomics, design for patient safety, surgical safety and organisational and socio-technical systems) to review and discuss analytical and implementation challenges and identify future issues for HFE.

Healthcare-associated infection in Burkina Faso: an assessment in a district hospital

Directory of Open Access Journals (Sweden)

Hervé Hien

2012-12-01

Full Text Available In developing countries, few data are available on healthcare-associated infections. In Burkina Faso, there has been a failure to take into account risk management and patient safety in the quality assurance program. The main objective of our study was to carry out an assessment of healthcare-associated infection in a first level hospital. We conducted a crosssectional study in June 2011 in the care units of Ziniaré District Hospital (Ziniaré, Burkina Faso. The hospital has been divided in three components: i hospital population (care providers, in-patients and patients’ guardians; ii healthcare and services organization; iii hospital environment. We included: care providers of the clinical services, hospital inpatients and patients’ guardians, hospitalization infrastructure and nursing units, and all the documents relating to standards and protocols. Data collection has been done by direct observation, interviews and biological samples taken at different settings. In hospital population, care providers and patients’ guardians represented a high source of infection: adherence to hygiene practice on the part of care providers was low (12/19, and no patients’ guardian experienced good conditions of staying in the hospital. In healthcare and services organization, healthcare waste management represented a high-risk source of infection. In hospital environment, hygiene level of the infrastructure in the hospital rooms was low (6.67%. Prevalence of isolated bacteria was 71.8%. Urinary-tract catheters infections were the most significant in our sample, followed by surgical-site infections. In total, 56.26% (9/19 of germs were -Lactamase producers (ESBL. They were represented by Escherichia coli and Klebsiella pneumoniae. Our analysis identified clearly healthcare-associated infection as a problem in Ziniaré district hospital. Hence, a national program of quality assurance in the hospitals should now integrate the risk infectious management

The impact of regulatory compliance behavior on hazardous waste generation in European private healthcare facilities

OpenAIRE

Botelho, Anabela

2013-01-01

Along with the increased provision of healthcare by private outpatient healthcare facilities within the EU countries, there is also an increase on waste generation from these facilities. A significant fraction of this waste is amongst the most hazardous of all wastes arising in communities, posing significant risks to people and the environment if inappropriately managed. The growing awareness that mismanagement of healthcare waste has serious environmental and public health consequences is r...

Innovative use of the integrative review to evaluate evidence of technology transformation in healthcare.

Science.gov (United States)

Phillips, Andrew B; Merrill, Jacqueline A

2015-12-01

Healthcare is in a period significant transformational activity through the accelerated adoption of healthcare technologies, new reimbursement systems that emphasize shared savings and care coordination, and the common place use of mobile technologies by patients, providers, and others. The complexity of healthcare creates barriers to transformational activity and has the potential to inhibit the desired paths toward change envisioned by policymakers. Methods for understanding how change is occurring within this complex environment are important to the evaluation of delivery system reform and the role of technology in healthcare transformation. This study examines the use on an integrative review methodology to evaluate the healthcare literature for evidence of technology transformation in healthcare. The methodology integrates the evaluation of a broad set of literature with an established evaluative framework to develop a more complete understanding of a particular topic. We applied this methodology and the framework of punctuated equilibrium (PEq) to the analysis of the healthcare literature from 2004 to 2012 for evidence of technology transformation, a time during which technology was at the forefront of healthcare policy. The analysis demonstrated that the established PEq framework applied to the literature showed considerable potential for evaluating the progress of policies that encourage healthcare transformation. Significant inhibitors to change were identified through the integrative review and categorized into ten themes that describe the resistant structure of healthcare delivery: variations in the environment; market complexity; regulations; flawed risks and rewards; change theories; barriers; ethical considerations; competition and sustainability; environmental elements, and internal elements. We hypothesize that the resistant nature of the healthcare system described by this study creates barriers to the direct consumer involvement and engagement

Lean healthcare.

Science.gov (United States)

Weinstock, Donna

2008-01-01

As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

Effects of Lean Six Sigma application in healthcare services: a literature review.

Science.gov (United States)

Ahmed, Selim; Manaf, Noor H A; Islam, Rafikul

2013-01-01

The healthcare organization is the place where defects and mistakes cannot be tolerated. A simple mistake can cost a human life so defects or mistakes must be eliminated in healthcare service processes. A Lean Six Sigma (LSS) approach is the best option in a healthcare environment for dealing with a critical patient. The LSS methodology optimizes the average reduction of a desired process. The expected results can be reductions in several aspects of healthcare such as patient waiting time in emergency departments, lost charges for billing in patient financial services, delinquent medical records, diagnostic result turnaround times, accounts receivable days, patients' length of stay, or medication errors. This paper mainly discusses the effects of the LSS approach in different hospitals around the world according to the literature review. This review also discusses the relationship between LSS as well as their impacts on healthcare services based on literature review.

Architecture of personal healthcare information system in ubiquitous healthcare

NARCIS (Netherlands)

Bhardwaj, S.; Sain, M.; Lee, H.-J.; Chung, W.Y.; Slezak, D.; et al., xx

2009-01-01

Due to recent development in Ubiquitous Healthcare now it’s time to build such application which can work independently and with less interference of Physician. In this paper we are try to build the whole architecture of personal Healthcare information system for ubiquitous healthcare which also

Pervasive healthcare in the home Supporting patient motivation and engagement

DEFF Research Database (Denmark)

2010-01-01

Currently, care and rehabilitation practices move, to a greater extent, out of hospitals and into private homes. This accelerating trend challenges healthcare systems and their patients. Heterogeneous settings such as private homes together with the diverse nature of the inhabitants and their con......Currently, care and rehabilitation practices move, to a greater extent, out of hospitals and into private homes. This accelerating trend challenges healthcare systems and their patients. Heterogeneous settings such as private homes together with the diverse nature of the inhabitants...... and their conditions create both technical and usability constraints and possibilities that can inform development of home-based care and rehabilitation applications. This workshop likes to investigate and discuss challenges, requirements and possibilities related to home-based healthcare applications, seen from...... environments such as private homes? Or, how can User Driven Innovation (UDI) and Participatory Design (PD) be used to create systems that are aesthetically and functionally accepted by persons subject to homebased healthcare and rehabilitation?...

Can pervasive sensing address current challenges in global healthcare?

Directory of Open Access Journals (Sweden)

Louis Atallah

2012-03-01

Full Text Available Important challenges facing global healthcare include the increase in the number of people affected by escalating healthcare costs, chronic and infectious diseases, the need for better and more affordable elderly care and expanding urbanisation combined with air and water pollution. Recent advances in pervasive sensing technologies have led to miniaturised sensor networks that can be worn or integrated within the living environment without affecting a person’s daily patterns. These sensors promise to change healthcare from snapshot measurements of physiological parameters to continuous monitoring enabling clinicians to provide guidance on a daily basis. This article surveys several of the solutions provided by these sensor platforms from elderly care to neonatal monitoring and environmental mapping. Some of the opportunities available and the challenges facing the adoption of such technologies in large-scale epidemiological studies are also discussed.

Job satisfaction and retention of health-care providers in Afghanistan and Malawi

Science.gov (United States)

2014-01-01

Background This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Methods Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. Results The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P job satisfaction (F(8,332) = 4.19; P job satisfaction and intention to stay on the job, differed substantially. These findings demonstrate the need for more detailed comparative human resources for health-care research, particularly regarding the relative importance of different determinants of job satisfaction and intention to stay in different contexts and the effectiveness of interventions designed to improve health-care worker performance and retention. PMID:24533615

Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis.

Science.gov (United States)

Zandian, Hamed; Takian, Amirhossein; Rashidian, Arash; Bayati, Mohsen; Zahirian Moghadam, Telma; Rezaei, Satar; Olyaeemanesh, Alireza

2018-03-01

One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (pfinancing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals.

Science.gov (United States)

Meng, Runtang; Li, Jingjing; Zhang, Yunquan; Yu, Yong; Luo, Yi; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying; Yu, Chuanhua

2018-04-17

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals

Science.gov (United States)

Li, Jingjing; Yu, Yong; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying

2018-01-01

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation. PMID:29673134

A Case Study of Implications and Applications of Standardized Nomenclature for Asset Management in Healthcare

Science.gov (United States)

DeFrancesco, Jennifer A.

2016-01-01

Healthcare organizations strive to adapt to the continuous change in what has become a fast-paced, high technology environment. Many organizations are charged to find efficiencies to better manage medical device assets. Increasingly, healthcare leaders opt to adopt a standardized medical device nomenclature under the purview of a set of national…

Trust in the early chain of healthcare: lifeworld hermeneutics from the patient's perspective.

Science.gov (United States)

Norberg Boysen, Gabriella; Nyström, Maria; Christensson, Lennart; Herlitz, Johan; Wireklint Sundström, Birgitta

2017-12-01

Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for a non-urgent condition and been referred to the healthcare centre. A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patients participated: seven female and three male. The setting is the early chain of healthcare in south-western Sweden. The findings show that the phenomenon of trust does not automatically involve medical care. However, attention to the patient's lifeworld in a professional caring relationship enables the patient to trust the caregiver and the healthcare environment. It is clear that the "voice of the lifeworld" enables the patient to feel trust. Trust in the early chain of healthcare entails caregivers' ability to pay attention to both medical and existential issues in compliance with the patient's information and questions. Thus, the patient must be invited to participate in assessments and decisions concerning his or her own healthcare, in a credible manner and using everyday language.

A gender study investigating physics self-efficacy

Science.gov (United States)

Sawtelle, Vashti

The underrepresentation of women in physics has been well documented and a source of concern for both policy makers and educators. My dissertation focuses on understanding the role self-efficacy plays in retaining students, particularly women, in introductory physics. I use an explanatory mixed methods approach to first investigate quantitatively the influence of self-efficacy in predicting success and then to qualitatively explore the development of self-efficacy. In the initial quantitative studies, I explore the utility of self-efficacy in predicting the success of introductory physics students, both women and men. Results indicate that self-efficacy is a significant predictor of success for all students. I then disaggregate the data to examine how self-efficacy develops differently for women and men in the introductory physics course. Results show women rely on different sources of self-efficacy than do men, and that a particular instructional environment, Modeling Instruction, has a positive impact on these sources of self-efficacy. In the qualitative phase of the project, this dissertation focuses on the development of self-efficacy. Using the qualitative tool of microanalysis, I introduce a methodology for understanding how self-efficacy develops moment-by-moment using the lens of self-efficacy opportunities. I then use the characterizations of self-efficacy opportunities to focus on a particular course environment and to identify and describe a mechanism by which Modeling Instruction impacts student self-efficacy. Results indicate that the emphasizing the development and deployment of models affords opportunities to impact self-efficacy. The findings of this dissertation indicate that introducing key elements into the classroom, such as cooperative group work, model development and deployment, and interaction with the instructor, create a mechanism by which instructors can impact the self-efficacy of their students. Results from this study indicate that

STAKEHOLDER’S ROLE IN HEALTHCARE SERVICES AND NEW INFORMATION TECHNOLOGY

OpenAIRE

Ana Maria Bobeica

2011-01-01

The purpose of this study on “stakeholder role in healthcare services” is to facilitate our understanding of increasingly unpredictable external environments, thereby facilitating our ability to manage within these environments whether as the Marketing or the IT Manager decision roles. There is agreement in the literature concerning the major steps involved in stakeholder analysis:identification of stakeholder groups (e.g., employees, owners, communities, customers); determination of the stak...

Redefining the Core Competencies of Future Healthcare Executives under Healthcare Reform

Science.gov (United States)

Love, Dianne B.; Ayadi, M. Femi

2015-01-01

As the healthcare industry has evolved over the years, so too has the administration of healthcare organizations. The signing into law of the Patient Protection and Affordable Care Act (ACA) has brought additional changes to the healthcare industry that will require changes to the healthcare administration curriculum. The movement toward a…

Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece

Directory of Open Access Journals (Sweden)

Anastasia Moysidou

2016-05-01

Full Text Available Introduction. The purpose of this study was to evaluate the knowledge and perceptions of Greek healthcare professionals about nicotine, nicotine replacement therapies and electronic cigarettes. Methods. An online survey was performed, in which physicians and nurses working in private and public healthcare sectors in Athens-Greece were asked to participate through email invitations. A knowledge score was calculated by scoring the correct answers to specific questions with 1 point. Results. A total of 262 healthcare professionals were included to the analysis. Most had daily contact with smokers in their working environment. About half of them considered that nicotine has an extremely or very important contribution to smoking-related disease. More than 30% considered nicotine replacement therapies equally or more addictive than smoking, 76.7% overestimated their smoking cessation efficacy and only 21.0% would recommend them as long-term smoking substitutes. For electronic cigarettes, 45.0% considered them equally or more addictive than smoking and 24.4% equally or more harmful than tobacco cigarettes. Additionally, 35.5% thought they involve combustion while the majority responded that nicotine in electronic cigarettes is synthetically produced. Only 14.5% knew about the pending European regulation, but 33.2% have recommended them to smokers in the past. Still, more than 40% would not recommend electronic cigarettes to smokers unwilling or unable to quit smoking with currently approved medications. Cardiologists and respiratory physicians, who are responsible for smoking cessation therapy in Greece, were even more reluctant to recommend electronic cigarettes to this subpopulation of smokers compared to all other participants. The knowledge score of the whole study sample was 7.7 (SD: 2.4 out of a maximum score of 16. Higher score was associated with specific physician specialties. Conclusions. Greek healthcare professionals appear to overestimate

Distributive justice in American healthcare: institutions, power, and the equitable care of patients.

Science.gov (United States)

Putsch, Robert W; Pololi, Linda

2004-09-01

The authors argue that the American healthcare system has developed in a fashion that permits and may support ongoing, widespread inequities based on poverty, race, gender, and ethnicity. Institutional structures also contribute to this problem. Analysis is based on (1) discussions of a group of experts convened by the Office of Minority Health, US Department of Health and Human Services at a conference to address healthcare disparities; and (2) review of documentation and scientific literature focused on health, health-related news, language, healthcare financing, and the law. Institutional factors contributing to inequity include the cost and financing of American healthcare, healthcare insurance principles such as mutual aid versus actuarial fairness, and institutional power. Additional causes for inequity are bias in decision making by healthcare practitioners, clinical training environments linked to abuse of patients and coworkers, healthcare provider ethnicity, and politics. Recommendations include establishment of core attributes of trust, relationship and advocacy in health systems; universal healthcare; and insurance systems based on mutual aid. In addition, monitoring of equity in health services and the development of a set of ethical principles to guide systems change and rule setting would provide a foundation for distributive justice in healthcare. Additionally, training centers should model the behaviors they seek to foster and be accountable to the communities they serve.

Using evidence-based medicine to protect healthcare workers from pandemic influenza: Is it possible?

Science.gov (United States)

Gralton, Jan; McLaws, Mary-Louise

2011-01-01

To use evidence-based principles to develop infection control algorithms to ensure the protection of healthcare workers and the continuity of health service provision during a pandemic. : Evidence-based algorithms were developed from published research as well as "needs and values" assessments. Research evidence was obtained from 97 studies reporting the protectiveness of antiviral prophylaxis, seasonal vaccination, and mask use. Needs and values assessments were undertaken by international experts in pandemic infection control and local healthcare workers. Opportunity and resources costs were not determined. The Australian government commissioned the development of an evidence-based algorithm for inclusion in the 2008 revision of the Australian Health and Management Plan for Pandemic Influenza. Two international infection control teams responsible for healthcare worker safety during the Severe Acute Respiratory Syndrome outbreak reviewed the evidence-based algorithms. The algorithms were then reviewed for needs and values by eight local clinicians who were considered key frontline clinicians during the contain and sustain phases. The international teams reviewed for practicability of implementation, whereas local clinicians reviewed for clinician compliance. Despite strong evidence for vaccination and antiviral prophylaxis providing significant protection, clinicians believed they required the additional combinations of both masks and face shields. Despite the equivocal evidence for the efficacy of surgical and N95 masks and the provision of algorithms appropriate for the level of risk according to clinical care during a pandemic, clinicians still demanded N95 masks plus face shields in combination with prophylaxis and novel vaccination. Conventional evidence-based principles could not be applied to formulate recommendations due to the lack of pandemic-specific efficacy data of protection tools and the inherent unpredictability of pandemics. As an alternative

Is the public healthcare sector a more strenuous working environment than the private sector for a physician?

Science.gov (United States)

Heponiemi, Tarja; Kouvonen, Anne; Sinervo, Timo; Elovainio, Marko

2013-02-01

The present study examined the differences between physicians working in public and private health care in strenuous working environments (presence of occupational hazards, physical violence, and presenteeism) and health behaviours (alcohol consumption, body mass index, and physical activity). In addition, we examined whether gender or age moderated these potential differences. Cross-sectional survey data were compiled on 1422 female and 948 male randomly selected physicians aged 25-65 years from The Finnish Health Care Professionals Study. Logistic regression and linear regression analyses were used with adjustment for gender, age, specialisation status, working time, managerial position, and on-call duty. Occupational hazards, physical violence, and presenteeism were more commonly reported by physicians working in the public sector than by their counterparts in the private sector. Among physicians aged 50 years or younger, those who worked in the public sector consumed more alcohol than those who worked in the private sector, whereas in those aged 50 or more the reverse was true. In addition, working in the private sector was most strongly associated with lower levels of physical violence in those who were older than 50 years, and with lower levels of presenteeism among those aged 40-50 years. The present study found evidence for the public sector being a more strenuous work environment for physicians than the private sector. Our results suggest that public healthcare organisations should pay more attention to the working conditions of their employees.

Saving lives: A meta-analysis of team training in healthcare.

Science.gov (United States)

Hughes, Ashley M; Gregory, Megan E; Joseph, Dana L; Sonesh, Shirley C; Marlow, Shannon L; Lacerenza, Christina N; Benishek, Lauren E; King, Heidi B; Salas, Eduardo

2016-09-01

As the nature of work becomes more complex, teams have become necessary to ensure effective functioning within organizations. The healthcare industry is no exception. As such, the prevalence of training interventions designed to optimize teamwork in this industry has increased substantially over the last 10 years (Weaver, Dy, & Rosen, 2014). Using Kirkpatrick's (1956, 1996) training evaluation framework, we conducted a meta-analytic examination of healthcare team training to quantify its effectiveness and understand the conditions under which it is most successful. Results demonstrate that healthcare team training improves each of Kirkpatrick's criteria (reactions, learning, transfer, results; d = .37 to .89). Second, findings indicate that healthcare team training is largely robust to trainee composition, training strategy, and characteristics of the work environment, with the only exception being the reduced effectiveness of team training programs that involve feedback. As a tertiary goal, we proposed and found empirical support for a sequential model of healthcare team training where team training affects results via learning, which leads to transfer, which increases results. We find support for this sequential model in the healthcare industry (i.e., the current meta-analysis) and in training across all industries (i.e., using meta-analytic estimates from Arthur, Bennett, Edens, & Bell, 2003), suggesting the sequential benefits of training are not unique to medical teams. Ultimately, this meta-analysis supports the expanded use of team training and points toward recommendations for optimizing its effectiveness within healthcare settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Why (just) information is not enough: The contributions of information services in the management of healthcare information

Science.gov (United States)

Kostagiolas, P.; Lappa, E.

2015-02-01

Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services' contributions to hospital environment is presented.

Why (just) information is not enough: The contributions of information services in the management of healthcare information

Energy Technology Data Exchange (ETDEWEB)

Kostagiolas, P., E-mail: pkostagiolas@ionio.gr [Assistant Professor Department of Archives, Library Science and Museology, Ionian University, CORFU 49100 (Greece); Lappa, E., E-mail: evlappa@med.uoa.gr [Director of Medical Library of General Hospital Attikis KAT, Nikis 2 str, 14564 KIFFISIA-ATHENS (Greece)

2015-02-09

Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services’ contributions to hospital environment is presented.

Why (just) information is not enough: The contributions of information services in the management of healthcare information

International Nuclear Information System (INIS)

Kostagiolas, P.; Lappa, E.

2015-01-01

Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services’ contributions to hospital environment is presented

Amputation Surgery in a Secondary Healthcare Facility in Nigeria ...

African Journals Online (AJOL)

... our experience in amputation surgery over a ten – year period in a secondary healthcare facility in sub- Saharan Africa. A retrospective study of 117 patients that underwent amputation in the facility between January 1998 and December 2007. Trauma remains the commonest indication for amputation in our environment.

Healthcare

Science.gov (United States)

Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

2012-01-01

This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

Public-Privat e Partnership in the System of Regional Healthcare Financing

Directory of Open Access Journals (Sweden)

Margarita Yur’evna Molchanova

2016-05-01

Full Text Available Healthcare financing reform in the Russian Federation, besides its positive consequences, has led to the emergence of several major organizational and economic problems that hinder the expansion of financing sources for this sphere, which also involves public-private partnership (PPP. The paper highlights the regional specifics of such healthcare projects compared to similar projects of other spheres of the national economy. The author describes the problems of PPP projects implementation in healthcare; they include the insufficiency of substantiation of public-private partnership application in healthcare, and the absence of typical models for establishment of relations between PPP participants. The paper presents the healthcare priorities put forward by the author; these priorities are based on the theory of the life cycle of a service. The author presents her own model for organizing a regional concession, which is the most common form of public-private partnership in healthcare so far. The cluster brings together on a voluntary basis the legally independent organizations that are interested in improving the quality and increasing the accessibility of health services. These can include medical institutions of various forms of ownership located in the region, clinics, facilities, institutions that train healthcare workers, authorities, etc. The author shows that a favorable environment for the formation and implementation of PPP projects can be created under the cluster approach to the organization of healthcare. When establishing the medical cluster, the main task is to organize interaction between all its subjects in the interest of the overall development of healthcare in the region and the implementation of one’s own interests

Economic crisis, austerity and unmet healthcare needs: the case of Greece.

Science.gov (United States)

Zavras, Dimitris; Zavras, Athanasios I; Kyriopoulos, Ilias-Ioannis; Kyriopoulos, John

2016-07-27

The programme for fiscal consolidation in Greece has led to income decrease and several changes in health policy. In this context, this study aims to assess how economic crisis affected unmet healthcare needs in Greece. Time series analysis was performed for the years 2004 through 2011 using the EU-SILC database. The dependent variable was the percentage of people who had medical needs but did not use healthcare services. Median income, unemployment and time period were used as independent variables. We also compared self-reported unmet healthcare needs drawn from a national survey conducted in pre-crisis 2006 with a similar survey from 2011 (after the onset of the crisis). A common questionnaire was used in both years to assess unmet healthcare needs, including year of survey, gender, age, health status, chronic disease, educational level, income, employment, health insurance status, and prefecture. The outcome of interest was unmet healthcare needs due to financial reasons. Ordinary least squares, as well as logistic regression analysis were conducted to analyze the results. Unmet healthcare needs increased after the enactment of austerity measures, while the year of participation in the survey was significantly associated with unmet healthcare needs. Income, educational level, employment status, and having insurance, private or public, were also significant determinants of unmet healthcare needs due to financial reasons. The adverse economic environment has significantly affected unmet health needs. Therefore health policy actions and social policy measures are essential in order to mitigate the negative impact on access to healthcare services and health status.

Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

An analysis of the functioning of mental healthcare in northwestern Poland.

Science.gov (United States)

Bażydło, Marta; Karakiewicz, Beata

Modern psychiatry faces numerous challenges related with the change of the epidemiology of mental disorders and the development of knowledge in this area of science. An answer to this situation is to be the introduction of community psychiatry. The implementation of this model in Poland was the aim of the National Mental Health Protection Programme. The aim of the study was to analyse the functioning of mental healthcare using the example of the West Pomeranian Province in Poland. The analysis relied on a qualitative method. Three group interviews in an interdisciplinary advisory panel were conducted. People representing various areas acting for people with mental disorders participated in each meeting. Based on the conclusions that were drawn, PEST and SWOT analyses of functioning of mental healthcare were performed. Within the analysis of the macro-environment of mental healthcare, the influence of the following factors was evaluated through PEST analysis: political and legal, economic, socio-cultural, and technological. All of these factors were assessed as negative for the functioning of mental healthcare. Then, a SWOT analysis was performed to indicate the strengths, weaknesses, opportunities, and threats in the functioning of mental healthcare. 1. Mental healthcare is more influenced by external factors than by internal factors. 2. Macro-environmental factors influence the functioning of mental healthcare in a significantly negative manner. 3. The basic problem in the functioning of mental healthcare is insufficient funding. 4. In order to improve the functioning of mental healthcare, it is necessary to change the funding methods, regulations, the way society perceives mental disorders, and the system of monitoring mental healthcare services.

A strategic approach to developing e-learning capability for healthcare.

Science.gov (United States)

Clarke, Angie; Lewis, Dina; Cole, Ian; Ringrose, Liz

2005-12-01

This article examines a strategic approach to developing e-learning capability to enhance learning opportunities for the workforce of a healthcare organization. Emphasis is given to the procurement of a bespoke Managed Learning Environment (MLE). Strategic organizational issues impacting on future e-learning developments are considered. The 2-year implementation plan was evaluated through a two phase external research project. The first phase focused on the effectiveness of a training programme designed to build capacity for e-learning within the Northern area and also included a virtual learning environment usability study which informed the MLE specification. The second phase evaluation is ongoing during 2005 and interim findings are presented. The MLE has been piloted and on-line learning packages have been acquired. There has been a phased take-up of e-learning opportunities and e-tutor training. Some virtual Communities of Practice have been established. Key organizational issues have been identified and ongoing findings are informing strategic planning. The healthcare MLE is offering enhanced learning opportunities and assisting area healthcare providers in training their dispersed workforces. Blended learning strategies are most successful. The need for protected time for e-learning is a key issue, financial savings are available. Progress has been slowed by identified organizational constraints-the MLE's benefits are widely recognized.

Social Influence on Information Technology Adoption and Sustained Use in Healthcare: A Hierarchical Bayesian Learning Method Analysis

Science.gov (United States)

Hao, Haijing

2013-01-01

Information technology adoption and diffusion is currently a significant challenge in the healthcare delivery setting. This thesis includes three papers that explore social influence on information technology adoption and sustained use in the healthcare delivery environment using conventional regression models and novel hierarchical Bayesian…

Evaluating Business Value of IT in Healthcare: Three Clinical Practices from Australia and the US.

Science.gov (United States)

Haddad, Peter; Schaffer, Jonathan L; Wickramasinghe, Nilmini

2015-01-01

Exponentially increasing costs in healthcare coupled with poor quality and limited access have motivated the healthcare industry to turn to IS/IT solutions to overcome these issues and facilitate superior healthcare delivery. In an environment of rapid development of new clinical informatics solutions claiming to provide better healthcare delivery, there is a paucity of systematic frameworks to robustly measure the actual value of these systems. The promised business value of these solutions has been elusive; hence, this study offers an approach for the evaluation of the business value of health IS/IT solutions based on a conceptual model, which has been validated using three clinical case studies.

Putting E-government to work in healthcare environment: a multiregional project funded by the Italian Innovation & Technology Ministry.

Science.gov (United States)

Ballardini, Luigi; Germagnoli, Fabio; Pagani, Marco; Picchi, Marco; Stoppini, Andrea; Cristiani, Paolo

2004-01-01

In 2002, the Italian Ministry of Innovation promoted a national bid for e-government projects. Specifically it allocated a budget of 120 M euro. One of the four project approved in healthcare sector was the "Information, Care ("Assistenza" in Italian) and healthcare Education by the Web" (IAEW), with a global budget of 2580 k euro, partially financed by Ministry with a quota of 830 k euro. The project involves 12 medical structures (both national excellences centers and local regional hospitals) located in two different Region of North Italy, dealing with two different healthcare regional systems (Lombardia and Emilia-Romagna), with potentially 3 millions of users.

Parental self-efficacy and its measurement - an evaluation of a parental self-efficacy measurement scale.

Science.gov (United States)

Purssell, Edward; While, Alison

2013-05-01

To field test a parental self-efficacy scale regarding its acceptability and feasibility and to describe parental self-efficacy in a convenience sample of parents with children aged 6 years old or less. Self-care within families is increasingly emphasised in health policy as a means of maximising healthcare resources. This study reports the field testing of a scale designed to measure parental self-efficacy. Cross-sectional survey of parents of children aged 6 years old or less. Subjects were recruited through a parenting internet website (n = 84) and local parenting and community organisations (n = 68) and asked to complete a questionnaire containing the scale. Data collection took place between January and August 2011. The scale, previously validated with an expert panel of professionals, gathered information about parental self-efficacy when administered either directly or through an on-line data collection portal, although there were more missing data when administered via the Internet. Although convenience and self-selecting samples precluded parameter estimation, areas of concern highlighted were difficulties differentiating children with serious illnesses and the use of the Personal Child Health Record. Use of the Internet was widespread, as was use of community pharmacists and nursery staff. Although the primary purpose was not to collect specific data, the data indicated the continuing concern of parents regarding serious illness and where additional investment may be required to meet parental needs and expectations. The previously validated scale can be used to collect information about parental self-efficacy either through a paper questionnaire or the Internet. Although there was slightly more missing data from the Internet version, the ease of its administration makes this an attractive option. Parents generally reported high levels of self-efficacy and satisfaction with services; however, the scale was able to identify areas where further investment

Use of geographic indicators of healthcare, environment and socioeconomic factors to characterize environmental health disparities.

Science.gov (United States)

Padilla, Cindy M; Kihal-Talantikit, Wahida; Perez, Sandra; Deguen, Severine

2016-07-22

An environmental health inequality is a major public health concern in Europe. However just few studies take into account a large set of characteristics to analyze this problematic. The aim of this study was to identify and describe how socioeconomic, health accessibility and exposure factors accumulate and interact in small areas in a French urban context, to assess environmental health inequalities related to infant and neonatal mortality. Environmental indicators on deprivation index, proximity to high-traffic roads, green space, and healthcare accessibility were created using the Geographical Information System. Cases were collected from death certificates in the city hall of each municipality in the Nice metropolitan area. Using the parental addresses, cases were geocoded to their census block of residence. A classification using a Multiple Component Analysis following by a Hierarchical Clustering allow us to characterize the census blocks in terms of level of socioeconomic, environmental and accessibility to healthcare, which are very diverse definition by nature. Relation between infant and neonatal mortality rate and the three environmental patterns which categorize the census blocks after the classification was performed using a standard Poisson regression model for count data after checking the assumption of dispersion. Based on geographic indicators, three environmental patterns were identified. We found environmental inequalities and social health inequalities in Nice metropolitan area. Moreover these inequalities are counterbalance by the close proximity of deprived census blocks to healthcare facilities related to mother and newborn. So therefore we demonstrate no environmental health inequalities related to infant and neonatal mortality. Examination of patterns of social, environmental and in relation with healthcare access is useful to identify census blocks with needs and their effects on health. Similar analyzes could be implemented and considered

Healthcare acquired infection (HAIs): a deadly problem that is preventable: UV can help, what's holding it back?

Science.gov (United States)

Cowan, Troy E.

2018-02-01

Healthcare Acquired Infections (HAIs) pose a significant health risk to our nation, especially to those most in need of healthcare. One in every 25 people admitted to a hospital will be infected by one or more HAIs. Significant reductions in HAI risks can be advanced through innovative technologies, such as UV antimicrobial disinfecting devices. Development of such technologies, along with the associated Behavioral, Chemical and Technological protocols to combat infectious HAIs is a worthwhile pursuit for the public good. A significant good will be accomplished by engaging optical scientists and engineers as well as healthcare professionals in opportunities to advance light-driven antimicrobial devices to halt infections. Fundamental change can be effected through a path of advancing standards and methods including optical measurements, and testing the efficacy of UV light antimicrobial devices and related technologies.

Electronic healthcare information security

CERN Document Server

Dube, Kudakwashe; Shoniregun, Charles A

2010-01-01

The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

Patients as story-tellers of healthcare journeys.

Science.gov (United States)

Lamprell, Klay; Braithwaite, Jeffrey

2016-09-01

There are gaps in our comprehension of patients' subjective experiences as they engage with and transit through the healthcare environments implicated in their treatment trajectories. Patients' stories, unlike patient experience data gathered in questionnaires and surveys, express the deeply personal, narrative nature of the journeys that patients take, creating opportunities for qualitative healthcare research. Yet narrative capabilities and propensities vary with individuals, and are affected by the stresses of illness and treatment. This article extends the growing interest in narrative competence training for both practitioners and patients with the investigation of a story-telling model that could facilitate patients to narrate their experiences of healthcare systems. This model is derived from the literary arts. In fiction and autobiography, the journey arc of the central character is often one in which he or she is compelled to leave the comfort of everyday life and face a series of extraordinary events involving challenge and change which forces the character towards practical, intellectual, psychological and philosophical adjustments that define, by the end of the story, the character's 'new normal'. This pattern is known as the 'hero journey'. Its parallels with patients' experiences of healthcare and the way people narrate their stories of illness have long been recognised. We present here a new idea for applying this model as a narrative structure by which patients may construct their stories about being in and moving through the healthcare system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Virtual reality training for health-care professionals.

Science.gov (United States)

Mantovani, Fabrizia; Castelnuovo, Gianluca; Gaggioli, Andrea; Riva, Giuseppe

2003-08-01

Emerging changes in health-care delivery are having a significant impact on the structure of health-care professionals' education. Today it is recognized that medical knowledge doubles every 6-8 years, with new medical procedures emerging everyday. While the half-life of medical information is so short, the average physician practices 30 years and the average nurse 40 years. Continuing education thus represents an important challenge to face. Recent advances in educational technology are offering an increasing number of innovative learning tools. Among these, Virtual Reality represents a promising area with high potential of enhancing the training of health-care professionals. Virtual Reality Training can provide a rich, interactive, engaging educational context, thus supporting experiential learning-by-doing; it can, in fact, contribute to raise interest and motivation in trainees and to effectively support skills acquisition and transfer, since the learning process can be settled within an experiential framework. Current virtual training applications for health-care differ a lot as to both their technological/multimedia sophistication and to the types of skills trained, varying for example from telesurgical applications to interactive simulations of human body and brain, to virtual worlds for emergency training. Other interesting applications include the development of immersive 3D environments for training psychiatrists and psychologists in the treatment of mental disorders. This paper has the main aim of discussing the rationale and main benefits for the use of virtual reality in health-care education and training. Significant research and projects carried out in this field will also be presented, followed by discussion on key issues concerning current limitations and future development directions.

Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

Science.gov (United States)

Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

2016-10-01

Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

Protecting healthcare workers in an acute care environment during epidemics: lessons learned from the SARS outbreak

Directory of Open Access Journals (Sweden)

John Casken

2011-01-01

Full Text Available During the 2002-2003 the SARS outbreak resulted in 8,450 illnesses and 812 deaths. Out of these documented cases 1706 were among healthcare workers (HCWsThe purpose of this paper is to focus on and examine the details of infection control (IC measures and which of these measures appear to be the most effective in stopping disease spread. Historically, HCWs have had poor compliance with the use of IC measures prior to the SARS outbreak. A number of lessons were learned from the SARS epidemic that should be incorporated into healthcare institutions policies and procedures. They include the following: an emphasis on the correct and immediate use of IC measures; an increased focus on HCWs recognizing early perceived threats; healthcare institutions should mandate routine in-house education with periodic updates on IC measures; administrators need to acknowledge and encourage role models among staff; engineeringcontrols should be put in place to protect staff from pathogens; and finally, there should be clear and constant communication between administration and staff.

A Mixed-Methods Research Framework for Healthcare Process Improvement.

Science.gov (United States)

Bastian, Nathaniel D; Munoz, David; Ventura, Marta

2016-01-01

The healthcare system in the United States is spiraling out of control due to ever-increasing costs without significant improvements in quality, access to care, satisfaction, and efficiency. Efficient workflow is paramount to improving healthcare value while maintaining the utmost standards of patient care and provider satisfaction in high stress environments. This article provides healthcare managers and quality engineers with a practical healthcare process improvement framework to assess, measure and improve clinical workflow processes. The proposed mixed-methods research framework integrates qualitative and quantitative tools to foster the improvement of processes and workflow in a systematic way. The framework consists of three distinct phases: 1) stakeholder analysis, 2a) survey design, 2b) time-motion study, and 3) process improvement. The proposed framework is applied to the pediatric intensive care unit of the Penn State Hershey Children's Hospital. The implementation of this methodology led to identification and categorization of different workflow tasks and activities into both value-added and non-value added in an effort to provide more valuable and higher quality patient care. Based upon the lessons learned from the case study, the three-phase methodology provides a better, broader, leaner, and holistic assessment of clinical workflow. The proposed framework can be implemented in various healthcare settings to support continuous improvement efforts in which complexity is a daily element that impacts workflow. We proffer a general methodology for process improvement in a healthcare setting, providing decision makers and stakeholders with a useful framework to help their organizations improve efficiency. Published by Elsevier Inc.

Healthcare Robotics

OpenAIRE

Riek, Laurel D.

2017-01-01

Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key sta...

E-health and healthcare enterprise information system leveraging service-oriented architecture.

Science.gov (United States)

Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

2012-04-01

To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

Ergonomics in Healthcare system-Human Factors models: a review article

Directory of Open Access Journals (Sweden)

S. Tarzimoghadam

2015-12-01

  Conclusion: Most of the published studies emphasize on application of ergonomic models in healthcare centers since these models may reduce their problems. These ergonomics approaches support patient-centered treatment processes, user-oriented design of medical environments, efficient utilization of resources and increase motivation of clinical staff.

The Impact of Environmental Design on Teamwork and Communication in Healthcare Facilities: A Systematic Literature Review.

Science.gov (United States)

Gharaveis, Arsalan; Hamilton, D Kirk; Pati, Debajyoti

2018-01-01

The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.

Gaseous and air decontamination technologies for Clostridium difficile in the healthcare environment.

Science.gov (United States)

Davies, A; Pottage, T; Bennett, A; Walker, J

2011-03-01

The recent data for hospital-acquired infections suggest that infection rates for meticillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile are beginning to decrease. However, while there is still pressure to maintain this trend, the resistance of C. difficile spores to standard detergents continues to present a problem for many UK hospitals trying to prevent its spread or control outbreaks. Alternative disinfection technologies such as gaseous decontamination are currently being marketed to the healthcare sector as an alternative/supplement to manual disinfection, and have been shown to be effective in reducing environmental contamination. When used correctly, they offer a complementary technology to manual cleaning that increases the probability of an effective reduction in viability and provides a comparatively uniform distribution of disinfectant. Three gaseous decontamination technologies are examined for their suitability in reducing environmental contamination with C. difficile: gaseous hydrogen peroxide, chlorine dioxide and ozone. Air decontamination and UV-based technologies are also briefly described. We conclude that while there is a role to play for these new technologies in the decontamination of ward surfaces contaminated with C. difficile, the requirement for both a preclean before use and the limited 'in vivo' evidence means that extensive field trials are necessary to determine their cost-effectiveness in a healthcare setting. Copyright © 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Civil society, third sector, and healthcare: the case of social cooperatives in Italy.

Science.gov (United States)

Borzaga, Carlo; Fazzi, Luca

2014-12-01

In many European countries, the third sector is considered an actor able to improve both the efficiency and the efficacy of public healthcare systems afflicted by the crisis of the welfare state. Attributed to third-sector organizations is the role of a hybrid actor tasked with the professional supply of services, not for profit but rather for mutualistic purposes, and to serve the public interest. However, empirical evidence on the capacity of the third sector to pursue objectives of social inclusion in a phase of withdrawal by the public sector is almost entirely lacking in the European countries. The article describes the results of research on the transformation of the Italian healthcare system and on the emergence of a new third sector in Italy. The results of the inquiry highlight the strategies, characteristics, and governance processes which enable third-sector organizations operating in the healthcare sector to pursue objectives of inclusion, and to serve the needs of disadvantaged groups by assuming the form of social enterprises. Copyright © 2014 Elsevier Ltd. All rights reserved.

Why healthcare providers merge.

Science.gov (United States)

Postma, Jeroen; Roos, Anne-Fleur

2016-04-01

In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

A pedagogical model for simulation-based learning in healthcare

Directory of Open Access Journals (Sweden)

Tuulikki Keskitalo

2015-11-01

Full Text Available The aim of this study was to design a pedagogical model for a simulation-based learning environment (SBLE in healthcare. Currently, simulation and virtual reality are a major focus in healthcare education. However, when and how these learning environments should be applied is not well-known. The present study tries to fill that gap. We pose the following research question: What kind of pedagogical model supports and facilitates students’ meaningful learning in SBLEs? The study used design-based research (DBR and case study approaches. We report the results from our second case study and how the pedagogical model was developed based on the lessons learned. The study involved nine facilitators and 25 students. Data were collected and analysed using mixed methods. The main result of this study is the refined pedagogical model. The model is based on the socio-cultural theory of learning and characteristics of meaningful learning as well as previous pedagogical models. The model will provide a more holistic and meaningful approach to teaching and learning in SBLEs. However, the model requires evidence and further development.

Dokazi o učinkovitosti uporabe robota in navidezne resničnosti v rehabilitaciji: Evidence on efficacy of rehabilitation robotics and virtual environment supported movement in rehabilitation:

OpenAIRE

Matjačić, Zlatko

2011-01-01

Background: Rehabilitation robotics and virtual environments are being gradually used in clinical rehabilitation environments as they enable higher number of specific movement (mobility or upper limb) repetitions while at the same time relieving physiotherapists from strenuous labor. However, as rehabilitation robotics require relatively high initial investment evidences on its efficacy are crucial for their further wide-spreading. Methods: We reviewed literature reporting on randomized clini...

The effects of parental feeding styles, children’s self-efficacy and social anxiety on adolescent obesity

Directory of Open Access Journals (Sweden)

Sema Sal ALTAN

Full Text Available ABSTRACT Objective To examine the effect of parental feeding styles and children’s self-efficacy and social anxiety on adolescent obesity. Methods The samples of this descriptive and cross-sectional study were collected by using a simple sampling method. The study group was composed of 649 Turkish secondary schools students and their parents. Three secondary schools were selected from both rural and urban areas of the province. Data of the study were collected with the child-parent socio-demographic data collection form, the parenting feeding style questionnaire, the middle school self-efficacy scale and the social anxiety scale for the adolescent. To analyze the data of the study, we used percentages, mean, correlation, and regression analysis. Results The average age of the students was 11.58+1.21 years and percentages of female students 55.0%. The factors that significantly affect male adolescent obesity were fear of social situations in general, interpersonal relations, preventive healthcare self-efficacy, and strict dietary control, respectively. The factors affect male adolescent obesity at the rate of 35.0%. The factors that significantly affect female adolescent obesity were fear of social situations in general, preventive healthcare self-efficacy, emotional feeding, social evasion and distress in new situations, and tolerant dietary control, respectively. These factors affect female adolescent obesity at the rate of 32.8%. Conclusion It is indicated that the obesity of children is affected by self-efficacy levels, social anxiety, and the parental feeding style.

Improving water, sanitation and hygiene in health-care facilities, Liberia.

Science.gov (United States)

Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

2017-07-01

The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

Science.gov (United States)

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-03-22

While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

'Broken hospital windows': debating the theory of spreading disorder and its application to healthcare organizations.

Science.gov (United States)

Churruca, Kate; Ellis, Louise A; Braithwaite, Jeffrey

2018-03-22

Research in criminology and social-psychology supports the idea that visible signs of disorder, both physical and social, may perpetuate further disorder, leading to neighborhood incivilities, petty violations, and potentially criminal behavior. This theory of 'broken windows' has now also been applied to more enclosed environments, such as organizations. This paper debates whether the premise of broken windows theory, and the concept of 'disorder', might also have utility in the context of health services. There is already a body of work on system migration, which suggests a role for violations and workarounds in normalizing unwarranted deviations from safe practices in healthcare organizations. Studies of visible disorder may be needed in healthcare, where the risks of norm violations and disorderly environments, and potential for harm to patients, are considerable. Everyday adjustments and flexibility is mostly beneficial, but in this paper, we ask: how might deviations from the norm escalate from necessary workarounds to risky violations in care settings? Does physical or social disorder in healthcare contexts perpetuate further disorder, leading to downstream effects, including increased risk of harm to patients? We advance a model of broken windows in healthcare, and a proposal to study this phenomenon.

The ALIVE program: developing a web-based professional development program for nursing leaders in the home healthcare sector.

Science.gov (United States)

Lankshear, Sara; Huckstep, Sherri; Lefebre, Nancy; Leiterman, Janis; Simon, Deborah

2010-05-01

Home healthcare nurses often work in isolation and rarely have the opportunity to meet or congregate in one location. As a result, nurse leaders must possess unique leadership skills to supervise and manage a dispersed employee base from a distance. The nature of this dispersed workforce creates an additional challenge in the ability to identify future leaders, facilitate leadership capacity, and enhance skill development to prepare them for future leadership positions. The ALIVE (Actively Leading In Virtual Environments) web-based program was developed to meet the needs of leaders working in virtual environments such as the home healthcare sector. The program, developed through a partnership of three home healthcare agencies, used nursing leaders as content experts to guide program development and as participants in the pilot. Evaluation findings include the identification of key competencies for nursing leaders in the home healthcare sector, development of program learning objectives and participant feedback regarding program content and delivery.

Designing effective eLearning for healthcare professionals

International Nuclear Information System (INIS)

Delf, P.

2013-01-01

Overview: eLearning has been identified as a versatile, economic method of delivering education, adopted by many education providers. Yet, little research has been undertaken into its impact as a sole method of delivery and effectiveness for imparting new knowledge or skills. This may have particular implications for busy healthcare practitioners wishing to access an educational programme to maintain, or extend their knowledge base in response to service needs. Aims and methodology: Following an action research approach and using an instructional design methodology, a discrete eLearning resource was devised and constructed to prepare non-medical healthcare practitioners to report radionuclide bone scans. Volunteers were recruited from across the UK to assess and establish the feasibility and efficacy of the module. Results: In terms of versatility, access, design and content, the module achieved resonance, with knowledge gains and transferability demonstrated, particularly amongst less experienced volunteers, suggesting a positive influence of the eLearning approach. Conclusions: Owing to the small-scale nature of the study, the capability of eLearning, as a sole educational medium to establish emergent skills, can only be cautiously expressed. However, as a tool for blended learning, continuing professional development, or audit purposes, it demonstrated its potential, confirming the place for this type of resource within the professional learning arena

Impact of virtual learning environment (VLE): A technological approach to genetics teaching on high school students' content knowledge, self-efficacy and career goal aspirations

Science.gov (United States)

Kandi, Kamala M.

This study examines the effect of a technology-based instructional tool 'Geniverse' on the content knowledge gains, Science Self-Efficacy, Technology Self-Efficacy, and Career Goal Aspirations among 283 high school learners. The study was conducted in four urban high schools, two of which have achieved Adequate Yearly Progress (AYP) and two have not. Students in both types of schools were taught genetics either through Geniverse, a virtual learning environment or Dragon genetics, a paper-pencil activity embedded in traditional instructional method. Results indicated that students in all schools increased their knowledge of genetics using either type of instructional approach. Students who were taught using Geniverse demonstrated an advantage for genetics knowledge although the effect was small. These increases were more pronounced in the schools that had been meeting the AYP goal. The other significant effect for Geniverse was that students in the technology-enhanced classrooms increased in science Self-Efficacy while students in the non-technology enhanced classrooms decreased. In addition, students from Non-AYP schools showed an improvement in Science and Technology Self-Efficacy; however the effects were small. The implications of these results for the future use of technology-enriched classrooms were discussed. Keywords: Technology-based instruction, Self-Efficacy, career goals and Adequate Yearly Progress (AYP).

The influence of teams, supervisors and organizations on healthcare practitioners' abilities to practise ethically.

Science.gov (United States)

Wall, Sarah; Austin, Wendy

2008-01-01

Healthcare practitioners make many important ethical decisions in their day-to-day practices. Questions arising in daily practice require practitioners to make prudent, balanced and good decisions, which are most effectively made interpersonally and reflectively. It is commonly assumed that the team-based structure of healthcare delivery can provide practitioners with the support needed to address ethical questions in their practice, especially if the team involves multidisciplinary collaboration. A phenomenological study was conducted in which the impact of the team and the larger organization on practitioners' experiences of dealing with moral challenges was uncovered. Various mental healthcare professionals shared their experiences of ethically challenging situations in their practices and described the ways in which their teammates and supervisors affected how they faced these troubling situations. These findings allow us to see that there is considerable room for healthcare managers, many of whom are nurses, to facilitate supportive, ethical environments for healthcare professionals. An understanding of the essential experience of practising ethically allows for an appreciation of the significance of the team's role in supporting it and enables healthcare managers to target support for ethical healthcare work.

Displacement Ventilation in Hospital Environments

DEFF Research Database (Denmark)

Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats

2011-01-01

Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors. In m....... In most health-care environments, harmful microorganisms and infectious aerosols may exist in relatively high concentration. They are particularly harmful to patients due to reduced immunity, and to those with open wounds.......Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...

Social support and parenting self-efficacy among Chinese women in the perinatal period.

Science.gov (United States)

Gao, Ling-Ling; Sun, Ke; Chan, Sally Wai-Chi

2014-05-01

to examine the changes in and relationship between perceived social support and parenting self-efficacy in the perinatal period among pregnant women in mainland China. this was a secondary analysis with data from part of an experimental study of the effects of an interpersonal-psychotherapy-oriented childbirth psychoeducation programme on maternal adaptation. A longitudinal design was employed in the present study. The study was carried out from July 2008 to May 2009 in one general hospital in Guangzhou, China. a convenience sample of 68 first-time mothers in mainland China completed measurement of social support and parenting self-efficacy during pregnancy and at six weeks and three months post partum. perceived social support and parenting self-efficacy declined during early motherhood. Parenting self-efficacy increased from six weeks post partum to three months post partum. Perceived social support positively correlated with parenting self-efficacy. culturally competent health-care intervention should be developed during early motherhood to promote perceived social support and parenting self-efficacy for the new mothers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

Directory of Open Access Journals (Sweden)

Kizito Kuchibanda

2015-01-01

Full Text Available The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards.

Trust in the early chain of healthcare: lifeworld hermeneutics from the patient’s perspective

Science.gov (United States)

Norberg Boysen, Gabriella; Nyström, Maria; Christensson, Lennart; Herlitz, Johan; Wireklint Sundström, Birgitta

2017-01-01

ABSTRACT Purpose: Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for a non-urgent condition and been referred to the healthcare centre. Method: A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patients participated: seven female and three male. The setting is the early chain of healthcare in south-western Sweden. Results: The findings show that the phenomenon of trust does not automatically involve medical care. However, attention to the patient’s lifeworld in a professional caring relationship enables the patient to trust the caregiver and the healthcare environment. It is clear that the “voice of the lifeworld” enables the patient to feel trust. Conclusion: Trust in the early chain of healthcare entails caregivers’ ability to pay attention to both medical and existential issues in compliance with the patient’s information and questions. Thus, the patient must be invited to participate in assessments and decisions concerning his or her own healthcare, in a credible manner and using everyday language. PMID:28793852

Authentic leaders creating healthy work environments for nursing practice.

Science.gov (United States)

Shirey, Maria R

2006-05-01

Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.

Healthcare. Executive Summary

Science.gov (United States)

Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

2012-01-01

This executive summary highlights several findings about healthcare. These are: (1) Healthcare is 18 percent of the U.S. economy, twice as high as in other countries; (2) There are two labor markets in healthcare: high-skill, high-wage professional and technical jobs and low-skill, low-wage support jobs; (3) Demand for postsecondary education in…

Systems healthcare: a holistic paradigm for tomorrow.

Science.gov (United States)

Fiandaca, Massimo S; Mapstone, Mark; Connors, Elenora; Jacobson, Mireille; Monuki, Edwin S; Malik, Shaista; Macciardi, Fabio; Federoff, Howard J

2017-12-19

Systems healthcare is a holistic approach to health premised on systems biology and medicine. The approach integrates data from molecules, cells, organs, the individual, families, communities, and the natural and man-made environment. Both extrinsic and intrinsic influences constantly challenge the biological networks associated with wellness. Such influences may dysregulate networks and allow pathobiology to evolve, resulting in early clinical presentation that requires astute assessment and timely intervention for successful mitigation. Herein, we describe the components of relevant biological systems and the nature of progression from at-risk to manifest disease. We illustrate the systems approach by examining two relevant clinical examples: Alzheimer's and cardiovascular diseases. The implications of systems healthcare management are examined through the lens of economics, ethics, policy and the law. Finally, we propose the need to develop new educational paradigms to enhance the training of the health professional in an era of systems medicine.

Using realist evaluation to assess primary healthcare teams' responses to intimate partner violence in Spain.

Science.gov (United States)

Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel; Marchal, Bruno; Vives-Cases, Carmen

2015-01-01

Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. There were several key mechanisms -the teams' self-efficacy, perceived preparation, women-centred care-, and contextual factors -an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care- that should be considered to develop adequate primary health-care responses to violence. The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus.

Science.gov (United States)

Lee, Yau-Jiunn; Shin, Shyi-Jang; Wang, Ruey-Hsia; Lin, Kun-Der; Lee, Yu-Li; Wang, Yi-Hsien

2016-02-01

To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). Overall, 295 patients with T2DM were recruited from five endocrine clinics in Taiwan through convenience sampling. Data regarding personal characteristics, empowerment perceptions, health literacy, self-efficacy, self-care behaviors, and HbA1c levels were collected. A structural equation modeling was used to validate the hypothesized model. Significant direct pathways were determined from empowerment perceptions to health literacy, from health literacy to self-efficacy, from self-efficacy to self-care behaviors, and from self-care behaviors to HbA1c levels. The empowerment perceptions and health literacy relatively influenced self-efficacy and self-care behaviors. Self-efficacy and self-care behaviors relatively influenced glycemic control in patients with T2DM. Modifying self-care behaviors have been demonstrated to be the most essential for improving glycemic control. To improve self-care behaviors, healthcare providers should target improving self-efficacy, and enhancing health literacy can be considered to be a potential strategy for improving self-efficacy. To enhance health literacy, healthcare providers could use an empowerment approach rather than an authoritative approach that emphasizes patient compliance in managing patients with T2DM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Fostering LGBT-friendly healthcare services].

Science.gov (United States)

Wei, Han-Ting; Chen, Mu-Hong; Ku, Wen-Wei

2015-02-01

LGBT (lesbian, gay, bisexual, transgender) patients suffer from stigma and discrimination when seeking healthcare. A large LGBT healthcare survey revealed that 56% of gay patients and 70% of transgender patients suffered some type of discrimination while seeking healthcare in 2014. The fostering of LGBT-friendly healthcare services is not just an advanced step of gender mainstreaming but also a fulfillment of health equality and equity. Additionally, LGBT-friendly healthcare services are expected to provide new opportunities for healthcare workers. Therefore, proactive government policies, education, research, and clinical practice should all encourage the development of these healthcare services. We look forward to a well-developed LGBT-friendly healthcare system in Taiwan.

An Increase in Healthcare-Associated Clostridium difficile Infection Associated with Use of a Defective Peracetic Acid-Based Surface Disinfectant.

Science.gov (United States)

Cadnum, Jennifer L; Jencson, Annette L; O'Donnell, Marguerite C; Flannery, Elizabeth R; Nerandzic, Michelle M; Donskey, Curtis J

2017-03-01

BACKGROUND We investigated an increase in the incidence of healthcare-associated Clostridium difficile infection (CDI) that occurred following a change from a bleach disinfectant to a peracetic acid-based disinfectant. OBJECTIVE To evaluate the efficacy of the peracetic acid-based disinfectant. DESIGN Laboratory-based product evaluation. METHODS The commercial peracetic acid-based product is activated on site by mixing a small volume of concentrated hydrogen peroxide and peracetic acid present in a "SmartCap" reservoir with the remaining contents of the container. We measured concentrations of peracetic acid in newly activated and in-use product and determined the stability of nonactivated and activated product. We tested the efficacy of the product against C. difficile spores using the American Society for Testing and Materials standard quantitative carrier disk test method. RESULTS Measured concentrations of peracetic acid (50-800 parts per million [ppm]) were significantly lower than the level stated on the product label (1,500 ppm), and similar results were obtained for containers from multiple lot numbers and from another hospital. Product with peracetic acid levels below 600 ppm had significantly reduced activity against C. difficile spores. Peracetic acid concentrations were reduced markedly after storage of either activated or nonactivated product for several weeks. The Environmental Protection Agency confirmed the finding of low disinfectant levels and ordered discontinuation of sale of the product. CONCLUSION Use of a defective peracetic acid-based surface disinfectant may have contributed to an increase in healthcare-associated CDI. Our findings highlight the importance of evaluating the efficacy of liquid disinfectants in healthcare settings. Infect Control Hosp Epidemiol 2017;38:300-305.

Healthcare Providers' Responses to Narrative Communication About Racial Healthcare Disparities.

Science.gov (United States)

Burgess, Diana J; Bokhour, Barbara G; Cunningham, Brooke A; Do, Tam; Gordon, Howard S; Jones, Dina M; Pope, Charlene; Saha, Somnath; Gollust, Sarah E

2017-10-25

We used qualitative methods (semi-structured interviews with healthcare providers) to explore: 1) the role of narratives as a vehicle for raising awareness and engaging providers about the issue of healthcare disparities and 2) the extent to which different ways of framing issues of race within narratives might lead to message acceptance for providers' whose preexisting beliefs about causal attributions might predispose them to resist communication about racial healthcare disparities. Individual interviews were conducted with 53 providers who had completed a prior survey assessing beliefs about disparities. Participants were stratified by the degree to which they believed providers contributed to healthcare inequality: low provider attribution (LPA) versus high provider attribution (HPA). Each participant read and discussed two differently framed narratives about race in healthcare. All participants accepted the "Provider Success" narratives, in which interpersonal barriers involving a patient of color were successfully resolved by the provider narrator, through patient-centered communication. By contrast, "Persistent Racism" narratives, in which problems faced by the patient of color were more explicitly linked to racism and remained unresolved, were very polarizing, eliciting acceptance from HPA participants and resistance from LPA participants. This study provides a foundation for and raises questions about how to develop effective narrative communication strategies to engage providers in efforts to reduce healthcare disparities.

Using ESB and BPEL for Evolving Healthcare Systems Towards Pervasive, Grid-Enabled SOA

Science.gov (United States)

Koufi, V.; Malamateniou, F.; Papakonstantinou, D.; Vassilacopoulos, G.

Healthcare organizations often face the challenge of integrating diverse and geographically disparate information technology systems to respond to changing requirements and to exploit the capabilities of modern technologies. Hence, systems evolution, through modification and extension of the existing information technology infrastructure, becomes a necessity. Moreover, the availability of these systems at the point of care when needed is a vital issue for the quality of healthcare provided to patients. This chapter takes a process perspective of healthcare delivery within and across organizational boundaries and presents a disciplined approach for evolving healthcare systems towards a pervasive, grid-enabled service-oriented architecture using the enterprise system bus middleware technology for resolving integration issues, the business process execution language for supporting collaboration requirements and grid middleware technology for both addressing common SOA scalability requirements and complementing existing system functionality. In such an environment, appropriate security mechanisms must ensure authorized access to integrated healthcare services and data. To this end, a security framework addressing security aspects such as authorization and access control is also presented.

Validation of a performance model on entrepreneurship based on self-efficacy, personal goal orientation and environment goal orientation using Structural Equation Modeling

OpenAIRE

Figueroa Reyes, Rodrigo

2013-01-01

Master's thesis in International hotel and tourism management Three are the main contributions that I pretend to provide through this research. First, I will combine four theoretical constructs that, to my knowledge, have not been worked through this way before. I mean that this research is attempting to validate and estimate the existing relationships between Self-efficacy, Perceived Personal Goal Orientation, Perceived Environment Goal Orientation and Perceived Personal Performance. T...

Learning teams and networks: using information technology as a means of managing work process development in healthcare organizations.

Science.gov (United States)

Korhonen, Vesa; Paavilainen, Eija

2002-01-01

This article focuses on the introduction of team learning and shared knowledge creation using computer-based learning environments and teams as networks in the development of healthcare organizations. Using computer technology, care units can be considered learning teams and the hospital a network of those learning teams. Team learning requires that the healthcare workers' intellectual capital and personal competence be viewed as an important resource in developing the quality of action of the entire healthcare organization.

ICT use for information management in healthcare system for chronic disease patient

Science.gov (United States)

Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira

2013-10-01

Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.

Knowledge, attitude, and practices about biomedical waste management among healthcare personnel: A cross-sectional study

OpenAIRE

Vanesh Mathur; S Dwivedi; M A Hassan; R P Misra

2011-01-01

Background: The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Inadequate and inappropriate knowledge of handling of healthcare waste may have serious health consequences and a significant impact on the environment as well. Objective: The objective was to assess knowledge, attitude, and practices of doctors, nurses, laboratory technicians, and sanitary staff regarding biomedical waste management. Material...

An integrative framework for sensor-based measurement of teamwork in healthcare.

Science.gov (United States)

Rosen, Michael A; Dietz, Aaron S; Yang, Ting; Priebe, Carey E; Pronovost, Peter J

2015-01-01

There is a strong link between teamwork and patient safety. Emerging evidence supports the efficacy of teamwork improvement interventions. However, the availability of reliable, valid, and practical measurement tools and strategies is commonly cited as a barrier to long-term sustainment and spread of these teamwork interventions. This article describes the potential value of sensor-based technology as a methodology to measure and evaluate teamwork in healthcare. The article summarizes the teamwork literature within healthcare, including team improvement interventions and measurement. Current applications of sensor-based measurement of teamwork are reviewed to assess the feasibility of employing this approach in healthcare. The article concludes with a discussion highlighting current application needs and gaps and relevant analytical techniques to overcome the challenges to implementation. Compelling studies exist documenting the feasibility of capturing a broad array of team input, process, and output variables with sensor-based methods. Implications of this research are summarized in a framework for development of multi-method team performance measurement systems. Sensor-based measurement within healthcare can unobtrusively capture information related to social networks, conversational patterns, physical activity, and an array of other meaningful information without having to directly observe or periodically survey clinicians. However, trust and privacy concerns present challenges that need to be overcome through engagement of end users in healthcare. Initial evidence exists to support the feasibility of sensor-based measurement to drive feedback and learning across individual, team, unit, and organizational levels. Future research is needed to refine methods, technologies, theory, and analytical strategies. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions

Real-Time Analytics for the Healthcare Industry: Arrhythmia Detection.

Science.gov (United States)

Agneeswaran, Vijay Srinivas; Mukherjee, Joydeb; Gupta, Ashutosh; Tonpay, Pranay; Tiwari, Jayati; Agarwal, Nitin

2013-09-01

It is time for the healthcare industry to move from the era of "analyzing our health history" to the age of "managing the future of our health." In this article, we illustrate the importance of real-time analytics across the healthcare industry by providing a generic mechanism to reengineer traditional analytics expressed in the R programming language into Storm-based real-time analytics code. This is a powerful abstraction, since most data scientists use R to write the analytics and are not clear on how to make the data work in real-time and on high-velocity data. Our paper focuses on the applications necessary to a healthcare analytics scenario, specifically focusing on the importance of electrocardiogram (ECG) monitoring. A physician can use our framework to compare ECG reports by categorization and consequently detect Arrhythmia. The framework can read the ECG signals and uses a machine learning-based categorizer that runs within a Storm environment to compare different ECG signals. The paper also presents some performance studies of the framework to illustrate the throughput and accuracy trade-off in real-time analytics.

Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research.

Directory of Open Access Journals (Sweden)

Surasak Saokaew

Full Text Available Health technology assessment (HTA has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced.Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases' characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided.Forty databases- 20 from Thailand and 20 from Japan-were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources.Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed.

Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research.

Science.gov (United States)

Saokaew, Surasak; Sugimoto, Takashi; Kamae, Isao; Pratoomsoot, Chayanin; Chaiyakunapruk, Nathorn

2015-01-01

Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases' characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Forty databases- 20 from Thailand and 20 from Japan-were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed.

Individual, interpersonal, and organisational factors of healthcare conflict: A scoping review.

Science.gov (United States)

Kim, Sara; Bochatay, Naike; Relyea-Chew, Annemarie; Buttrick, Elizabeth; Amdahl, Chris; Kim, Laura; Frans, Elise; Mossanen, Matthew; Khandekar, Azhar; Fehr, Ryan; Lee, Young-Mee

2017-05-01

Unresolved conflicts among healthcare professionals can lead to difficult patient care consequences. This scoping review examines the current healthcare literature that reported sources and consequences of conflict associated with individual, interpersonal, and organisational factors. We identified 99 articles published between 2001 and 2015 from PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database. Most reviewed studies relied on healthcare professionals' perceptions and beliefs associated with conflict sources and consequences, with few studies reporting behavioural or organisational change outcomes. Individual conflict sources included personal traits, such as self-focus, self-esteem, or worldview, as well as individuals' conflict management styles. These conflicts posed threats to one's physical, mental, and emotional health and to one's ability to perform at work. Interpersonal dynamics were hampered by colleagues' uncivil behaviours, such as low degree of support, to more destructive behaviours including bullying or humiliation. Perceptions of disrespectful working environment and weakened team collaboration were the main interpersonal conflict consequences. Organisational conflict sources included ambiguity in professional roles, scope of practice, reporting structure, or workflows, negatively affecting healthcare professionals' job satisfactions and intent to stay. Future inquiries into healthcare conflict research may target the following: shifting from research involving single professions to multiple professions; dissemination of studies via journals that promote interprofessional research; inquiries into the roles of unconscious or implicit bias, or psychological capital (i.e., resilience) in healthcare conflict; and diversification of data sources to include hospital or clinic data with implications for conflict sources.

Developing the organisational culture in a healthcare setting.

Science.gov (United States)

Nightingale, Adele

2018-01-17

This article aims to define organisational culture and explain why it is important to patients, carers and those working in healthcare environments. Organisational culture is not a new concept and the literature on the subject is well-established. However, because of the changing dynamics of the NHS, there has been a shift away from 'what' the NHS stands for, often relating to its history and rituals, to 'who' it functions for, including how healthcare professionals such as nurses can develop and drive the organisational culture. The article seeks to assist nurses in understanding the role of organisational culture, as well as implementing its main principles in the workplace. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Undergraduate nurses' preferred use of mobile devices in healthcare settings.

Science.gov (United States)

Mather, Carey; Cummings, Elizabeth; Allen, Penny

2015-01-01

The growth of digital technology has created challenges for appropriate and safe use of mobile or portable devices in healthcare environments. There is perceived risk that the use of mobile technology for learning may distract from provision of patient care if used by undergraduate students during work-integrated learning. This paper reports on a study that aimed to identify differences in preferred behavior of student nurses in their use of mobile technology during and away from the clinical practice environment. A previously validated online survey was administered to students during a period of work integrated learning in a range of healthcare settings in two Australian states. Respondents agreed that mobile devices could be beneficial to patient care. Overall, students proposed they would use mobile devices for accessing information, during work integrated learning, less than when away from the workplace. The development of policy to guide the use of mobile devices, in situ, is important to the provision of safe and competent care and improved health outcomes for patients.

Managing today's complex healthcare business enterprise: reflections on distinctive requirements of healthcare management education.

Science.gov (United States)

Welton, William E

2004-01-01

In early 2001, the community of educational programs offering master's-level education in healthcare management began an odyssey to modernize its approach to the organization and delivery of healthcare management education. The community recognized that cumulative long-term changes within healthcare management practice required a careful examination of healthcare management context and manpower requirements. This article suggests an evidence-based rationale for defining the distinctive elements of healthcare management, thus suggesting a basis for review and transformation of master's-level healthcare management curricula. It also suggests ways to modernize these curricula in a manner that recognizes the distinctiveness of the healthcare business enterprise as well as the changing management roles and careers within these complex organizations and systems. Through such efforts, the healthcare management master's-level education community would be better prepared to meet current and future challenges, to increase its relevance to the management practice community, and to allocate scarce faculty and program resources more effectively.

Improving Transgender Healthcare in the New York City Correctional System.

Science.gov (United States)

Jaffer, Mohamed; Ayad, John; Tungol, Jose Gabriel; MacDonald, Ross; Dickey, Nathaniel; Venters, Homer

2016-04-01

Correctional settings create unique challenges for patients with special needs, including transgender patients, who have an increased rate of overall discrimination, sexual abuse, healthcare disparities, and improper housing. As part of our correctional health quality improvement process, we sought to review and evaluate the adequacy of care for transgender patients in the New York City jail system. Using correctional pharmacy records, transgender patients receiving hormonal treatment were identified. A brief in-person survey was conducted to evaluate their care in the community before incarceration, medical care in jail, and experience in the jail environment. Survey findings and analysis of transgender patient healthcare-related complaints revealed opportunities for improvements in the provision of care and staff understanding of this population. Utilizing these findings, we conducted lesbian, gay, bisexual, and transgender (LGBT) trainings in all 12 jail clinics for medical, nursing, and mental health staff. Three months after LGBT training, patient complaints dropped by over 50%. After the development and implementation of a newly revised transgender healthcare policy, complaints dropped to zero within 6 months. Our efforts to assess the quality of care provided to transgender patients revealed significant areas for improvement. Although we have made important gains in providing quality care through the implementation of policies and procedures rooted in community standards and the express wishes of our patients, we continue to engage this patient population to identify other issues that impact their health and well-being in the jail environment.

Stakeholders' Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions.

Directory of Open Access Journals (Sweden)

Oathokwa Nkomazana

Full Text Available An adequate health workforce force is central to universal health coverage and positive public health outcomes. However many African countries have critical shortages of healthcare workers, which are worse in primary healthcare. The aim of this study was to explore the perceptions of healthcare workers, policy makers and the community on the shortage of healthcare workers in Botswana.Fifteen focus group discussions were conducted with three groups of policy makers, six groups of healthcare workers and six groups of community members in rural, urban and remote rural health districts of Botswana. All the participants were 18 years and older. Recruitment was purposive and the framework method was used to inductively analyse the data.There was a perceived shortage of healthcare workers in primary healthcare, which was believed to result from an increased need for health services, inequitable distribution of healthcare workers, migration and too few such workers being trained. Migration was mainly the result of unfavourable personal and family factors, weak and ineffective healthcare and human resources management, low salaries and inadequate incentives for rural and remote area service.Botswana has a perceived shortage of healthcare workers, which is worse in primary healthcare and rural areas, as a result of multiple complex factors. To address the scarcity the country should train adequate numbers of healthcare workers and distribute them equitably to sufficiently resourced healthcare facilities. They should be competently managed and adequately remunerated and the living conditions and rural infrastructure should also be improved.

HIV status disclosure to perinatally-infected adolescents in Zimbabwe: a qualitative study of adolescent and healthcare worker perspectives.

Directory of Open Access Journals (Sweden)

Khameer K Kidia

Full Text Available Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. As these children grow and surpass the immediate threat of death, the issue of informing them of their HIV status arises. This study aimed to understand how perinatally-infected adolescents learn about their HIV-status as well as to examine their preferences for the disclosure process.In-depth interviews were conducted with 31 (14 male, 17 female perinatally-infected adolescents aged 16-20 at an HIV clinic in Harare, Zimbabwe, and focused on adolescents' experiences of disclosure. In addition, 15 (1 male, 14 female healthcare workers participated in two focus groups that were centred on healthcare workers' practices surrounding disclosure in the clinic. Purposive sampling was used to recruit participants. A coding frame was developed and major themes were extracted using grounded theory methods.Healthcare workers encouraged caregivers to initiate disclosure in the home environment. However, many adolescents preferred disclosure to take place in the presence of healthcare workers at the clinic because it gave them access to accurate information as well as an environment that made test results seem more credible. Adolescents learned more specific information about living with an HIV-positive status and the meaning of that status from shared experiences among peers at the clinic.HIV-status disclosure to adolescents is distinct from disclosure to younger children and requires tailored, age-appropriate guidelines. Disclosure to this age group in a healthcare setting may help overcome some of the barriers associated with caregivers disclosing in the home environment and make the HIV status seem more credible to an adolescent. The study also highlights the value of peer support among adolescents, which could help reduce the burden of psychosocial care on caregivers and healthcare workers.

Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare.

Science.gov (United States)

Weller, Jennifer; Boyd, Matt; Cumin, David

2014-03-01

Modern healthcare is delivered by multidisciplinary, distributed healthcare teams who rely on effective teamwork and communication to ensure effective and safe patient care. However, we know that there is an unacceptable rate of unintended patient harm, and much of this is attributed to failures in communication between health professionals. The extensive literature on teams has identified shared mental models, mutual respect and trust and closed-loop communication as the underpinning conditions required for effective teams. However, a number of challenges exist in the healthcare environment. We explore these in a framework of educational, psychological and organisational challenges to the development of effective healthcare teams. Educational interventions can promote a better understanding of the principles of teamwork, help staff understand each other's roles and perspectives, and help develop specific communication strategies, but may not be sufficient on their own. Psychological barriers, such as professional silos and hierarchies, and organisational barriers such as geographically distributed teams, can increase the chance of communication failures with the potential for patient harm. We propose a seven-step plan to overcome the barriers to effective team communication that incorporates education, psychological and organisational strategies. Recent evidence suggests that improvement in teamwork in healthcare can lead to significant gains in patient safety, measured against efficiency of care, complication rate and mortality. Interventions to improve teamwork in healthcare may be the next major advance in patient outcomes.

Efficacy and safety of TachoSil® versus standard treatment of air leakage after pulmonary lobectomy

DEFF Research Database (Denmark)

Marta, Gabriel Mihai; Facciolo, Francesco; Ladegaard, Lars

2010-01-01

Alveolar air leakage remains a serious problem in lung surgery, being associated with increased postoperative morbidity, prolonged hospital stay and greater health-care costs. The aim of this study was to evaluate the sealing efficacy and safety of the surgical patch, TachoSil®, in lung surgery....

Licensed Healthcare Facilities

Data.gov (United States)

California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

Registered nurses' perception of self-efficacy and competence in smoking cessation after participating in a web-based learning activity.

Science.gov (United States)

Rosvall, Annica; Carlson, Elisabeth

2017-12-01

To describe how registered nurses having undergone a web-based learning activity perceive their self-efficacy and competence to support patients with smoking cessation in connection with surgery. Smoking cessation in connection with surgery reduces postoperative complications, and the support patients get from registered nurses may be important in helping them become smoke-free in connection with their surgery. Therefore, registered nurses are in need of enhanced understanding about which kind of counselling is the most effective for smoking cessation. Educating large groups of registered nurses in a digital environment appears to be a flexible and cost-effective way. A convergent mixed-method design with data collection was done using questionnaires (n = 47) and semistructured interviews (n = 11). Inclusion criteria were registered nurses in surgical wards. The samples were nonprobability and modified nested. Descriptive statistics and content analysis were used for data analysis. After completing the web-based learning activity, the registered nurses perception was that of good self-efficacy and increased competence in supporting patients with smoking cessation in connection with surgery. They improved their understanding of how to talk about smoking cessation with patients in dialogue using open-ended questions. Nevertheless, the registered nurses requested opportunities for dialogue and interaction with colleagues or topic experts. The results indicate that registered nurses can enhance their competence in supporting patients to embrace smoking cessation by learning in a digital environment. Self-efficacy and understanding of the topic seems to motivate registered nurses to counsel patients about smoking cessation. Findings from this study will be of particular interest to educators in healthcare settings who can devise further development of web-based learning activities. © 2017 John Wiley & Sons Ltd.

From efficacy to effectiveness and beyond: what next for brief interventions in primary care?

Directory of Open Access Journals (Sweden)

Amy eO'Donnell

2014-08-01

Full Text Available Background: Robust evidence supports the effectiveness of screening and brief alcohol interventions in primary healthcare. However lack of understanding about their ‘active ingredients’ and concerns over the extent to which current approaches remain faithful to their original theoretical roots, has led some to demand a cautious approach to future roll-out pending further research. Against this background, this paper provides a timely overview of the development of the brief alcohol intervention evidence base in order to assess the extent to which it has achieved the four key levels of intervention research: efficacy; effectiveness; implementation; and demonstration.Methods: Narrative overview based on:(1 results of a review of systematic reviews and meta-analyses of the effectiveness of brief alcohol intervention in primary healthcare;(2 synthesis of the findings of key additional primary studies on the improvement and evaluation of brief alcohol intervention implementation in routine primary healthcare.Results: The brief intervention field seems to constitute an almost perfect example of the evaluation of a complex intervention. Early evaluations of screening and brief intervention approaches included more tightly controlled efficacy trials and have been followed by more pragmatic trials of effectiveness in routine clinical practice. Most recently, attention has shifted to dissemination, implementation and wider-scale roll-out. However, delivery in routine primary health remains inconsistent, with an identified knowledge gap around how to successfully embed brief alcohol intervention approaches in mainstream care, and as yet unanswered questions concerning what specific intervention component prompt the positive changes in alcohol consumption.Conclusion: Both the efficacy and effectiveness of brief alcohol interventions have been comprehensively demonstrated, and intervention effects seem replicable and stable over time, and across

[The historical background and present development of evidence-based healthcare and clinical nursing].

Science.gov (United States)

Tsai, Jung-Mei

2014-12-01

Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision-making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application.

Globalization and healthcare: understanding health and medical tourism.

Science.gov (United States)

Carrera, Percivil M; Bridges, John Fp

2006-08-01

Faced with long waiting lists, the high cost of elective treatment and fewer barriers to travel, the idea of availing healthcare in another country is gaining greater appeal to many. The objective of this review is to perform a literature review of health and medical tourism, to define health and medical tourism based on the medical literature and to estimate the size of trade in healthcare. The Medline database was used for our literature review. In our initial search for 'health tourism' and 'medical tourism' we found a paucity of formal literature as well as conceptual ambiguity in the literature. Subsequently, we reviewed the literature on 'tourism' in general and in the context of healthcare. On the basis of 149 papers, we then sought to conceptualize health tourism and medical tourism. Based on our definitions, we likewise sought to estimate market capacity internationally. We defined health tourism as "the organized travel outside one's local environment for the maintenance, enhancement or restoration of an individual's wellbeing in mind and body". A subset of this is medical tourism, which is "the organized travel outside one's natural healthcare jurisdiction for the enhancement or restoration of the individual's health through medical intervention". At the international level, health tourism is an industry sustained by 617 million individuals with an annual growth of 3.9% annually and worth US$513 billion. In conclusion, this paper underscored the issue of a severely limited formal literature that is compounded by conceptual ambiguity facing health and medical tourism scholarship. In clarifying the concepts and standardizing definitions, and providing evidence with regard to the scale of trade in healthcare, we hope to assist in furthering fundamental research tasks, including the further development of reliable and comparable data, the push and pull factors for engaging in health and medical tourism, and the impact of health tourism but, more so, medical

Data mining applications in healthcare.

Science.gov (United States)

Koh, Hian Chye; Tan, Gerald

2005-01-01

Data mining has been used intensively and extensively by many organizations. In healthcare, data mining is becoming increasingly popular, if not increasingly essential. Data mining applications can greatly benefit all parties involved in the healthcare industry. For example, data mining can help healthcare insurers detect fraud and abuse, healthcare organizations make customer relationship management decisions, physicians identify effective treatments and best practices, and patients receive better and more affordable healthcare services. The huge amounts of data generated by healthcare transactions are too complex and voluminous to be processed and analyzed by traditional methods. Data mining provides the methodology and technology to transform these mounds of data into useful information for decision making. This article explores data mining applications in healthcare. In particular, it discusses data mining and its applications within healthcare in major areas such as the evaluation of treatment effectiveness, management of healthcare, customer relationship management, and the detection of fraud and abuse. It also gives an illustrative example of a healthcare data mining application involving the identification of risk factors associated with the onset of diabetes. Finally, the article highlights the limitations of data mining and discusses some future directions.

Strategic learning in healthcare organizations.

Science.gov (United States)

O'Sullivan, M J

1999-01-01

the answers; to concede that we do not always know what to do; to admit that past actions and solutions may no longer be appropriate, in fact may have been the incubators of today's problems; to question basic assumptions long held about running the institution; and to make ourselves vulnerable to the political dynamics prevalent in all organizations. Hospitals and other healthcare organizations must seek to develop and maintain a continuing state of readiness in which everyone in the organization, from front-line clinician to senior management, is poised to act in anticipation of and in response to unforeseen changes in the environment and to learn from their own experiences in confronting the future.

Managing resources and reducing waste in healthcare settings.

Science.gov (United States)

Minogue, Virginia; Wells, Bill

2016-05-18

The NHS is under pressure to increase its effectiveness and productivity. Nurses are tasked with delivering effective and efficient care, as well as improving patient safety, experiences and results. The reduction of waste in service delivery, care and treatment can release time and resources for nurses to engage in direct patient care. Nurses have an important role in reducing waste and influencing other professionals in the healthcare environment to increase their efficiency and productivity.

Women leadership barriers in healthcare, academia and business

OpenAIRE

Kalaitzi, S.; Czabanowska, K.; Fowler-Davis, S.; Brand, H.

2017-01-01

Purpose\\ud \\ud \\ud \\ud This paper maps the barriers to women leadership across healthcare, academia and business, and identifies barriers prevalence across sectors. A Barriers Thematic Map (BTM), with quantitative logic, and a prevalence chart have been developed, with the aim to uncover inequalities and provide orientation to develop inclusion and equal opportunity strategies within different work environments.\\ud \\ud \\ud \\ud \\ud Design/methodology/approach\\ud \\ud \\ud A systematic literature...

Assessing the management of healthcare waste in Hawassa city, Ethiopia.

Science.gov (United States)

Israel Deneke Haylamicheal; Mohamed Aqiel Dalvie; Biruck Desalegn Yirsaw; Hanibale Atsbeha Zegeye

2011-08-01

Inadequate management of healthcare waste is a serious concern in many developing countries due to the risks posed to human health and the environment. This study aimed to evaluate healthcare waste management in Hawassa city, Ethiopia. The study was conducted in nine healthcare facilities (HCFs) including hospitals (four), health centres (two) and higher clinics (three) in two phases, first to assess the waste management aspect and second to determine daily waste generation rate. The result showed that the median quantity of waste generated at the facilities was 3.46 kg bed(-1) day(-1) (range: 1.48-8.19 kg bed(-1) day(-1)). The quantity of waste per day generated at a HCF increased as occupancy increased (p waste generated at government HCFs was more than at private HCFs (p waste (20-63.1%) generated at the different HCFs was much higher than the WHO recommendation (10-25%). There was no waste segregation in most HCFs and only one used a complete color coding system. Solid waste and wastewater were stored, transported, treated and disposed inappropriately at all HCFs. Needle-stick injuries were prevalent in 25-100% of waste handlers employed at these HCFs. Additionally, low levels of training and awareness of waste legislation was prevalent amongst staff. The study showed that management of healthcare waste at HCFs to be poor. Waste management practices need to be improved through improved legislation and enforcement, and training of staff in the healthcare facilities in Hawassa.

Self-Efficacy and green entrepreneurship

International Nuclear Information System (INIS)

Tan, K L; Suhaida, S; Leong, Y P

2013-01-01

The objective of this study is to investigate empirically the extent to which self-efficacy contributes to the development of green entrepreneurial intention. The measurement constructs of self-efficacy were classified into market opportunities, innovative environment, initiating relationships, defining purpose, coping with challenges, and developing human resources. The study comprises 252 usable convenient samples through structured questionnaires. The coefficient of determination R 2 shows that the variance of intention to entrepreneurship is explained by the variance of the independent variables. It was also found that the model is fit for prediction.

Self-Efficacy and green entrepreneurship

Science.gov (United States)

Tan, K. L.; Suhaida, S.; Leong, Y. P.

2013-06-01

The objective of this study is to investigate empirically the extent to which self-efficacy contributes to the development of green entrepreneurial intention. The measurement constructs of self-efficacy were classified into market opportunities, innovative environment, initiating relationships, defining purpose, coping with challenges, and developing human resources. The study comprises 252 usable convenient samples through structured questionnaires. The coefficient of determination R2 shows that the variance of intention to entrepreneurship is explained by the variance of the independent variables. It was also found that the model is fit for prediction.

Healthcare financing in Croatia

Directory of Open Access Journals (Sweden)

Nevenka Kovač

2013-12-01

Full Text Available Healthcare financing system is of crucial importance for the functioning of any healthcare system, especially because there is no country in the world that is able to provide all its residents with access to all the benefits afforded by modern medicine. Lack of resources in general and rising healthcare expenditures are considered a difficult issue to solve in Croatia as well. Since Croatia gained its independence, its healthcare system has undergone a number of reforms, the primary objective of which was to optimize healthcare services to the actual monetary capacity of the Croatian economy. The objectives of the mentioned re - forms were partially achieved. The solutions that have been offered until now, i.e. consolidation measures undertaken in the last 10 years were necessary; however, they have not improved the operating conditions. There is still the issue of the deficit from the previous years, i.e. outstanding payments, the largest in the last decade. Analysis of the performance of healthcare institutions in 2011 shows that the decision makers will have to take up a major challenge of finding a solution to the difficulties the Croatian healthcare system has been struggling with for decades, causing a debt of 7 billion kuna. At the same time, they will need to uphold the basic principles of the Healthcare Act, i.e. to provide access to healthcare and ensure its continuity, comprehensiveness and solidarity, keeping in mind that the National Budget Act and Fiscal Responsibility Act have been adopted.

The Integration of Two Healthcare Systems: A Common Healthcare Problem.

Science.gov (United States)

Cassatly, Hannah; Cassatly, Michael

2015-01-01

The change in reimbursement mandated by the Affordable Care Act is causing a rapid consolidation of the marketplace as well as the delivery of clinical care in a team-based model. This case report examines the successful joining of two clinical teams concurrent with the merger of two healthcare organizations and discusses some of the difficulties encountered. A subsequent discussion focuses on the resolution: the need for physicians to embrace the team concept of healthcare delivery and for healthcare systems to facilitate this transition with team and leadership coaching.

[Factors associated with job satisfaction of human resources in healthcare].

Science.gov (United States)

Вежновець, Тетяна А; Парій, Валентин Д; Вишнивецький, Іван І; Москаленко, Максим В

Healthcare employee satisfaction is an important criterion for the efficiency of human resource management and prognostic impact factor for high turnover of staff. Furthermore, job satisfaction positively affects patient satisfaction, which is an important indicator for quality of care. The goal of our study was to identify factors associated with job satisfaction in healthcare organizations in Ukraine. We conducted sociological and psychological survey of 190 healthcare professionals (81% response rate) in Kherson City Hospital. Job satisfaction and organizational climate was assessed through developed questionnaire, "Test Motype" method of Gerchikov (motivational profile designing) and "Diagnosis Syndrome emotional burnout" method of Boyko. Spearman rank correlation was used for analysis. Job satisfaction positively correlated with personnel age and time record, career prospects, professional development, superior-subordinate, peer-to-peer and patient communications (pJob satisfaction did not correlate with responsibility of executives, factors for satisfaction of job description, working conditions and range of wages (all p> 0.05). Based on findings we developed dual job satisfaction-dissatisfaction approach specific for healthcare employee in Ukraine. This model includes internal factors such as work experience, career prospects, professional motivation; external factors such as leadership, governance, work environment, customer satisfaction and preventive factors such as staff role, job description, company policies, salary and benefits.

IT-enabled Quality Management implementations in Small Healthcare Institutions: Method and Case Study

NARCIS (Netherlands)

Navin Sewberath Misser; Johan Versendaal; Pascal Ravesteijn; Joris Mens; Koen Smit

2013-01-01

In the dynamic environment of increasing regulations, increasing patient demand, decentralization of budgets and enforcement of efficiency, small sized healthcare institutions in the Netherlands are having a difficult time. Although these service providers are usually capable of flexibly delivering

The clinical nurse leader: prepared for an era of healthcare reform.

Science.gov (United States)

Jeffers, Brenda Recchia; Astroth, Kim S

2013-01-01

Passage of the 2010 Patient Protection and Affordable Care Act will require change in the healthcare systems. The clinical nurse leader must be prepared to lead and shape the changing environment to achieve maximum outcomes for patients and families. Movement toward integrated care delivery across the care continuum, the transition of the Centers for Medicare & Medicaid Services to a value-based funding model, and accountability for high-quality, cost-effective care are just some of the drivers of this new integrated healthcare system. Reimbursement models that reward those health systems that are able to meet benchmark performance standards will result in major shifts in how health systems operate. Expertise in care coordination across the healthcare continuum is essential for maximum reimbursement. Payment for value instead of volume delivered is a major reimbursement transition coming to the acute care setting, necessitating increased attention to mining data necessary to capture quality patient outcomes for maximum reimbursement. The clinical nurse leader is ideally suited to function within these integrated systems of the future, and possesses the skills needed to assist healthcare systems to meet this challenge. © 2013 Wiley Periodicals, Inc.

Innovation in healthcare services – creating a Combined Contingency Theory and Ecosystems Approach

Science.gov (United States)

Engelseth, Per; Kritchanchai, Duangpun

2018-04-01

The purpose of this conceptual paper is to develop an analytical framework used for process development in healthcare services. Healthcare services imply a form of operations management demanding an adapted research approach. This study therefore highlights first in the introduction challenges of healthcare services as a reasoning of this study. It is a type of service that has high societal and therefore ethical concern, but at the same time needs to be carried out efficiently to economise service production resource use. Combined business and ethics concerns need to be balanced in this service supply system. In the literature review that is the bulk of this paper, first, particularities of the service industry processes are considered. This is followed by considering literature on contingency theory to consider the nature of the supply chain context of the healthcare service processes highlighting interdependencies and appropriate technology use. This developed view is then expanded to consider an ecosystems approach to encompass the environment expanding analyses to considering in balanced manner features of business, society and nature. A research model for directing both further researches on the healthcare service industry an innovation of such services in practice is introduced.

Beliefs, attitudes, and activities of healthcare personnel about influenza and pneumococcal vaccines.

Science.gov (United States)

Çiftci, Fatma; Şen, Elif; Demir, Nalan; Çiftci, Orçun; Erol, Serhat; Kayacan, Oya

2018-01-02

Vaccination of healthcare personnel (HCP) is an effective measure for preventing the spread of influenza among at-risk patients. This study was conducted to determine influenza vaccination rates and activities among HCP working at a tertiary healthcare setting. This study included 470 HCP (85 physicians, 134 nurses, 53 healthcare assistants, 44 paramedics, 47 medical secretaries, and 107 auxillary staff members) working at the emergency, cardiology, chest diseases, and internal medicine departments with the largest volume of patients with vaccination indication of two large university hospitals with similar medical practices and work environment. Each participant completed an anonymous questionnaire form. A total of 470 HCP participated in the survey. The compliance rate of the HCP to participate in the survey was 93.6%. Of these, 26.7% had been vaccinated against influenza. Vaccination in the survey year was significantly associated with having regular influenza vaccinations (OR 48.66; 95% CI:[25.09-94.369]; P<.01); having an educational level of college or higher (OR 2.07; 95% CI:[1.03-4.15]; P<.05); being a physician (OR 4.25; 95% CI:[1.28-14.07]; P< .05); and a professional experience of more than 5 years (OR 2.02; 95%CI:[1.13-5.62]; P< .05). Physicians recommended and prescribed the influenza vaccine significantly more frequently than the pneumococcal vaccine (37.6% vs 30.6%, P = .03, 25.9% vs 17.6%, P = .001, respectively). Among all HCP, the reasons for vaccination included having the opinion that the vaccine provides a partial protection against the infection (75.2%), reduces work force loss (48.8%), reduces the rates of death and severe conditions like pneumonia (43.2%), and reduces hospitalization (40.8%). The HCP had been vaccinated to protect family members (81.6%), people around (51.2%), herself/himself (47.2%), and patients (28%) fom infection. The reasons of not getting vaccinated against influenza among HCP included fear of vaccine's adverse

Application and comparison of scoring indices to predict outcomes in patients with healthcare-associated pneumonia

OpenAIRE

Fang, Wen-Feng; Yang, Kuang-Yao; Wu, Chieh-Liang; Yu, Chong-Jen; Chen, Chang-Wen; Tu, Chih-Yen; Lin, Meng-Chih

2011-01-01

Introduction Healthcare-associated pneumonia (HCAP) is a relatively new category of pneumonia. It refers to infections that occur prior to hospital admission in patients with specific risk factors following contact or exposure to a healthcare environment. There is currently no scoring index to predict the outcomes of HCAP patients. We applied and compared different community acquired pneumonia (CAP) scoring indices to predict 30-day mortality and 3-day and 14-day intensive care unit (ICU) adm...

Cell engineering: spearheading the next generation in healthcare

International Nuclear Information System (INIS)

Jayasinghe, Suwan N

2008-01-01

Manipulating living mammalian cells present fascinating possibilities for a plethora of applications within our healthcare. These imply several possibilities in tissue engineering and regenerative medicine, to those of a therapeutic nature. The physical sciences are increasingly playing a pivotal role in this endeavour by both advancing existing cell engineering technology and pioneering new protocols for the creation of biologically viable structures. In this paper, the author introduces several direct needle/channel/orifice-based cell engineering protocols, currently undergoing intense investigation for a whole host of bio-applications. Hence, each protocol's advantages and disadvantages are clearly identified, whilst recognizing their future biological and engineering challenges. In conclusion, a few selected biotechnological applications present possibilities where these protocols could undergo focused exploration. Successful development of these bio-protocols sees the emergence of unique future strategies within a clinical environment having far-reaching consequences for our healthcare

Cell engineering: spearheading the next generation in healthcare

Energy Technology Data Exchange (ETDEWEB)

Jayasinghe, Suwan N [BioPhysics Group, Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom)], E-mail: s.jayasinghe@ucl.ac.uk

2008-09-01

Manipulating living mammalian cells present fascinating possibilities for a plethora of applications within our healthcare. These imply several possibilities in tissue engineering and regenerative medicine, to those of a therapeutic nature. The physical sciences are increasingly playing a pivotal role in this endeavour by both advancing existing cell engineering technology and pioneering new protocols for the creation of biologically viable structures. In this paper, the author introduces several direct needle/channel/orifice-based cell engineering protocols, currently undergoing intense investigation for a whole host of bio-applications. Hence, each protocol's advantages and disadvantages are clearly identified, whilst recognizing their future biological and engineering challenges. In conclusion, a few selected biotechnological applications present possibilities where these protocols could undergo focused exploration. Successful development of these bio-protocols sees the emergence of unique future strategies within a clinical environment having far-reaching consequences for our healthcare.

Cell engineering: spearheading the next generation in healthcare.

Science.gov (United States)

Jayasinghe, Suwan N

2008-09-01

Manipulating living mammalian cells present fascinating possibilities for a plethora of applications within our healthcare. These imply several possibilities in tissue engineering and regenerative medicine, to those of a therapeutic nature. The physical sciences are increasingly playing a pivotal role in this endeavour by both advancing existing cell engineering technology and pioneering new protocols for the creation of biologically viable structures. In this paper, the author introduces several direct needle/channel/orifice-based cell engineering protocols, currently undergoing intense investigation for a whole host of bio-applications. Hence, each protocol's advantages and disadvantages are clearly identified, whilst recognizing their future biological and engineering challenges. In conclusion, a few selected biotechnological applications present possibilities where these protocols could undergo focused exploration. Successful development of these bio-protocols sees the emergence of unique future strategies within a clinical environment having far-reaching consequences for our healthcare.

Improving Student Commitment to Healthcare-Related Design Practice by Improving the Studio Learning Experience.

Science.gov (United States)

Tan, Lindsay; Hong, Miyoung; Albert, Taneshia West

2017-10-01

This case study explores the influence of the healthcare design studio experience on students' short-term professional goals as measured through rates of healthcare-related certification and internship/employment. The value and relevance of interior design is evident in the healthcare design sector. However, interior design students may not perceive this value if it is not communicated through their design education. Students' experience in the design studio plays a crucial role in determining career choices, and students may be more committed to career goals when there is clear connection between major coursework and professional practice. The authors compared healthcare-related certification and internship/employment levels between two student cohorts in a capstone undergraduate interior design healthcare design studio course. The first cohort was led by the existing curriculum. The second cohort was led by the revised curriculum that specifically aimed at encouraging students to commit to healthcare-related design practice. When measured at 3 months from graduation, the second cohort, led by the revised curriculum, saw a 30% increase in Evidence-based Design Accreditation and Certification exam pass rates and a 40% increase in healthcare-related internship/employment. The challenge of interior design education is to instill in emerging professionals not only professional competence but also those professional attitudes that will make them better prepared to design spaces that improve quality of life, particularly in healthcare environments. The results exceeded the project goals, and so this could be considered a promising practice for courses focused on healthcare design education.

Clinical efficacy and economic evaluation of online cognitive behavioral therapy for major depressive disorder: a systematic review and meta-analysis.

Science.gov (United States)

Ahern, Elayne; Kinsella, Stephen; Semkovska, Maria

2018-02-01

Leading cause of disability worldwide, depression is the most prevalent mental disorder with growing societal costs. As mental health services demand often outweighs provision, accessible treatment options are needed. Our systematic review and meta-analysis evaluated the clinical efficacy and economic evidence for the use of online cognitive behavioral therapy (oCBT) as an accessible treatment solution for depression. Areas covered: Electronic databases were searched for controlled trials published between 2006 and 2016. Of the reviewed 3,324 studies, 29 met the criteria for inclusion in the efficacy meta-analysis. The systematic review identified five oCBT economic evaluations. Therapist-supported oCBT was equivalent to face-to-face CBT at improving depressive symptoms and superior to treatment-as-usual, waitlist control, and attention control. Depression severity, number of sessions, or support did not affect efficacy. From a healthcare provider perspective, oCBT tended to show greater costs with greater benefits in the short term, relative to comparator treatments. Expert commentary: Although efficacious, further economic evidence is required to support the provision of oCBT as a cost-effective treatment for depression. Economic evaluations that incorporate a societal perspective will better account for direct and indirect treatment costs. Nevertheless, oCBT shows promise of effectively improving depressive symptoms, considering limited mental healthcare resources.

Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.

Science.gov (United States)

Claassens, Mareli M; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J; Enarson, Donald A; Beyers, Nulda; Borgdorff, Martien W

2013-01-01

Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.

Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

Science.gov (United States)

Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

2013-01-01

Background Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. Methods One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. Results The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). Conclusion The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB. PMID:24098461

[Interdisciplinary healthcare centres--a way of organising healthcare in the future from a health insurer's perspective].

Science.gov (United States)

Hecke, Torsten L; Hoyer, Jens Martin

2009-01-01

The German healthcare system modernization act enables healthcare providers to fund interdisciplinary healthcare centres. The Techniker Krankenkasse (TK) is a statutory health sickness fund that has contracted with some of the interdisciplinary healthcare centres named ATRIO-MED to achieve high-quality medical care and healthcare management. A range of patient-centred services is described in the cooperation agreement; in addition to central medical patient records one of the core competencies includes integrated pathways for defined diagnosis. The concept of the interdisciplinary healthcare centre is highly accepted among patients. It will serve as a platform for future TK healthcare policies.

Situated Self-efficacy in Introductory Physics Students

Science.gov (United States)

Henderson, Rachel; DeVore, Seth; Michaluk, Lynnette; Stewart, John

2017-01-01

Within the general university environment, students' perceived self-efficacy has been widely studied and findings suggest it plays a role in student success. The current research adapted a self-efficacy survey, from the ``Self-Efficacy for Learning Performance'' subscale of the Motivated Learning Strategies Questionnaire and administered it to the introductory, calculus-based physics classes (N=1005) over the fall 2015 and spring 2016 semesters. This assessment measured students' self-efficacy in domains including the physics class, other science and mathematics classes, and their intended future career. The effect of gender was explored with the only significant gender difference (p gender difference was not explained by a student's performance which was measured by test average. However, a mediation analysis showed that students' overall academic self-efficacy, measured by their math and science self-efficacy, acts as a mediator for the effect of test average on self-efficacy towards the physics class domain. This mediation effect was significant for both female (p < . 01) and male students (p < . 001) however, it was more pronounced for male students.

Data Privacy in Cloud-assisted Healthcare Systems: State of the Art and Future Challenges.

Science.gov (United States)

Sajid, Anam; Abbas, Haider

2016-06-01

The widespread deployment and utility of Wireless Body Area Networks (WBAN's) in healthcare systems required new technologies like Internet of Things (IoT) and cloud computing, that are able to deal with the storage and processing limitations of WBAN's. This amalgamation of WBAN-based healthcare systems to cloud-based healthcare systems gave rise to serious privacy concerns to the sensitive healthcare data. Hence, there is a need for the proactive identification and effective mitigation mechanisms for these patient's data privacy concerns that pose continuous threats to the integrity and stability of the healthcare environment. For this purpose, a systematic literature review has been conducted that presents a clear picture of the privacy concerns of patient's data in cloud-assisted healthcare systems and analyzed the mechanisms that are recently proposed by the research community. The methodology used for conducting the review was based on Kitchenham guidelines. Results from the review show that most of the patient's data privacy techniques do not fully address the privacy concerns and therefore require more efforts. The summary presented in this paper would help in setting research directions for the techniques and mechanisms that are needed to address the patient's data privacy concerns in a balanced and light-weight manner by considering all the aspects and limitations of the cloud-assisted healthcare systems.

Healthcare information technology and medical-surgical nurses: the emergence of a new care partnership.

Science.gov (United States)

Moore, An'Nita; Fisher, Kathleen

2012-03-01

Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals.

Employee retention: an issue of survival in healthcare.

Science.gov (United States)

Collins, Sandra K; Collins, Kevin S

2004-01-01

Successful healthcare organizations emphasize attracting human resource assets and aggressively seek to resolve and prevent high employee turnover. Understanding the key components surrounding the importance of measuring employee turnover, learning how it affects patient care, and realizing what is needed to retain quality employees is central to the resolution. Measuring employee turnover in a healthcare department is fundamental to the success of the organization and the quality of care it delivers. Some studies indicate the cost of turnover can average 150% of the employee's annual salary. Furthermore, when employees leave, their duties are shifted to the remaining personnel who feel obligated to shoulder the additional burden. The most important impact of employee turnover may be the effect on patient care. Generally, all patients prefer to be cared for by the same members of a healthcare team each time they require treatment. This involves building relationships between the patients and their respective healthcare organizations. These relationships are important to the success of the facility, especially in cases where the same treatment/care can be received elsewhere. Creating an organizational environment that is dedicated to the retention of talented personnel is the first step in reducing employee turnover. Determining why employees are leaving an organization is an important part of developing an effective strategy. One way this information can be obtained is by conducting detailed exit interviews. Organizations should focus on the following issues in order to maintain their qualified workforce in the long term: communication; decision making; compensation, benefits, and career development; recruitment; appreciation and understanding; and management.

Marketing for health-care organizations: an introduction to network management.

Science.gov (United States)

Boonekamp, L C

1994-01-01

The introduction of regulated competition in health care in several Western countries confronts health care providing organizations with changing relationships, with their environment and a need for knowledge and skills to analyse and improve their market position. Marketing receives more and more attention, as recent developments in this field of study provide a specific perspective on the relationships between an organization and external and internal parties. In doing so, a basis is offered for network management. A problem is that the existing marketing literature is not entirely appropriate for the specific characteristics of health care. After a description of the developments in marketing and its most recent key concepts, the applicability of these concepts in health-care organizations is discussed. States that for the health-care sector, dominated by complex networks of interorganizational relationships, the strategic marketing vision on relationships can be very useful. At the same time however, the operationalization of these concepts requires special attention and a distinct role of the management of health-care organizations, because of the characteristics of such organizations and the specific type of their service delivery.

Professional relations in sport healthcare: workplace responses to organisational change.

Science.gov (United States)

Malcolm, Dominic; Scott, Andrea

2011-02-01

This article examines the impact of organisational changes in UK elite sport on the professional relations among and between different healthcare providers. The article describes the processes by which demand for elite sport healthcare has increased in the UK. It further charts the subsequent response within medicine and physiotherapy and, in particular, the institutionalisation of sport-specific sub-disciplines through the introduction of specialist qualifications. Drawing on semi-structured interviews with 14 doctors and 14 physiotherapists, the article argues that organisational changes have led to intra-professional tensions within both professional groups but in qualitatively different forms reflecting the organisational traditions and professional identities of the respective disciplines. Organisational changes promoting multi-disciplinary healthcare teams have also fostered an environment conducive to high levels of inter-professional cooperation though significant elements of inter-professional conflict remain. This study illustrates how intra-professional relations are affected by specialisation, how legitimation discourses are used by different professions, and how intra- and inter-professional conflict and cooperation should be seen as highly interdependent processes. Copyright © 2010 Elsevier Ltd. All rights reserved.

Alerts in mobile healthcare applications: requirements and pilot study.

Science.gov (United States)

Kafeza, Eleanna; Chiu, Dickson K W; Cheung, S C; Kafeza, Marina

2004-06-01

Recent advances in mobile technologies have greatly extended traditional communication technologies to mobile devices. At the same time, healthcare environments are by nature "mobile" where doctors and nurses do not have fixed workspaces. Irregular and exceptional events are generated in daily hospital routines, such as operations rescheduling, laboratory/examination results, and adverse drug events. These events may create requests that should be delivered to the appropriate person at the appropriate time. Those requests that are classified as urgent are referred to as alerts. Efficient routing and monitoring of alerts are keys to quality and cost-effective healthcare services. Presently, these are generally handled in an ad hoc manner. In this paper, we propose the use of a healthcare alert management system to handle these alert messages systematically. We develop a model for specifying alerts that are associated with medical tasks and a set of parameters for their routing. We design an alert monitor that matches medical staff and their mobile devices to receive alerts, based on the requirements of these alerts. We also propose a mechanism to handle and reroute, if necessary, an alert message when it has not been acknowledged within a specific deadline.

Principles for designing and delivering psychosocial and mental healthcare.

Science.gov (United States)

Williams, Richard; Kemp, V

2018-03-08

The development of the UK's military policy includes the potential for military organisations to deploy in support of humanitarian aid operations. This paper offers an overview of the risks to people's mental health of their exposure to emergencies, major incidents, disasters, terrorism, displacement, postconflict environments in which humanitarian aid is delivered, and deployments to conflict zones. It summarises the psychosocial approach recommended by many contemporary researchers and practitioners. It differentiates the extremely common experience of distress from the mental disorders that people who are affected may develop and introduces the construct of psychosocial resilience. The authors recognise the importance of trajectories of response in separating people who are distressed and require psychosocial care from those who require mental healthcare. Finally, this paper summarises a strategic approach to designing, planning and providing psychosocial and mental healthcare, provides a model of care and outlines the principles for early psychosocial interventions that do not require training in mental healthcare to deliver them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hope, self-efficacy, spiritual well-being and job satisfaction.

Science.gov (United States)

Duggleby, Wendy; Cooper, Dan; Penz, Kelly

2009-11-01

Hope, self-efficacy, spiritual well-being and job satisfaction. This paper is a report of a study of the relations of spiritual well-being, global job satisfaction, and general self-efficacy to hope in Continuing Care Assistants. Healthcare providers have described their hope as an important part of their work and a form of work motivation. Hope may be an important factor in preventing burnout and improving job satisfaction. A concurrent triangulation mixed method design was used. Sixty-four Continuing Care Assistants (personal care aides) who registered for a 'Living with Hope' Conference completed a demographic form, Herth Hope Index, Global Job Satisfaction Questionnaire, Spiritual Well-Being Scale, General Self-Efficacy Scale, and a hope questionnaire. Data were collected in 2007. The response rate was 58%. Using linear regression, 29.9% of the variance in Herth Hope Index score was accounted for by scores from the General Self-Efficacy Scale and Spiritual Well-Being Scale. General Self-efficacy scores (positive relationship) and Spiritual Well-Being scores (negative relationship) accounted for a significant part of the variance. Qualitative data supported all findings, with the exception of the negative relationship between hope and spiritual well-being; participants wrote that faith, relationships, helping others and positive thinking helped them to have hope. They also wrote that hope had a positive influence on their job satisfaction and performance. Hope is an important concept in the work life of Continuing Care Assistants. Supportive relationships, adequate resources, encouragement by others, and improving perceptions of self-efficacy (ability to achieve goals in their workplace) may foster their hope.

Selecting for creativity and innovation potential: implications for practice in healthcare education.

Science.gov (United States)

Patterson, Fiona; Zibarras, Lara Dawn

2017-05-01

The ability to innovate is an important requirement in many organisations. Despite this pressing need, few selection systems in healthcare focus on identifying the potential for creativity and innovation and so this area has been vastly under-researched. As a first step towards understanding how we might select for creativity and innovation, this paper explores the use of a trait-based measure of creativity and innovation potential, and evaluates its efficacy for use in selection for healthcare education. This study uses a sample of 188 postgraduate physicians applying for education and training in UK General Practice. Participants completed two questionnaires (a trait-based measure of creativity and innovation, and a measure of the Big Five personality dimensions) and were also rated by assessors on creative problem solving measured during a selection centre. In exploring the construct validity of the trait-based measure of creativity and innovation, our research clarifies the associations between personality, and creativity and innovation. In particular, our study highlights the importance of motivation in the creativity and innovation process. Results also suggest that Openness to Experience is positively related to creativity and innovation whereas some aspects of Conscientiousness are negatively associated with creativity and innovation. Results broadly support the utility of using a trait-based measure of creativity and innovation in healthcare selection processes, although practically this may be best delivered as part of an interview process, rather than as a screening tool. Findings are discussed in relation to broader implications for placing more priority on creativity and innovation as selection criteria within healthcare education and training in future.

Beyond the numbers : A user-centered design approach for personal reflective healthcare technologies

NARCIS (Netherlands)

Jimenez Garcia, J.C.

2014-01-01

The current healthcare paradigm shifts towards considering the patients’ home as the primary self-care environment. Health care is changing from being solely delivered by professionals in hospitals, to considering daily-life experiences and patients’ personal contexts. In order to meet this

Devising a Structural Equation Model of Relationships between Preservice Teachers' Time and Study Environment Management, Effort Regulation, Self-Efficacy, Control of Learning Beliefs, and Metacognitive Self-Regulation

Science.gov (United States)

Sen, Senol; Yilmaz, Ayhan

2016-01-01

The objective of this study is to analyze the relationship between preservice teachers' time and study environment management, effort regulation, self-efficacy beliefs, control of learning beliefs and metacognitive self-regulation. This study also investigates the direct and indirect effects of metacognitive self-regulation on time and study…

Evaluation of bactericidal and anti-biofilm properties of a novel surface-active organosilane biocide against healthcare associated pathogens and Pseudomonas aeruginosa biolfilm.

Directory of Open Access Journals (Sweden)

Jason Murray

Full Text Available Healthcare acquired infections (HAI pose a great threat in hospital settings and environmental contamination can be attributed to the spread of these. De-contamination and, significantly, prevention of re-contamination of the environment could help in preventing/reducing this threat. Goldshield (GS5 is a novel organosilane biocide marketed as a single application product with residual biocidal activity. We tested the hypothesis that GS5 could provide longer-term residual antimicrobial activity than existing disinfectants once applied to surfaces. Thus, the residual bactericidal properties of GS5, Actichlor and Distel against repeated challenge with Staphylococcus aureus ATCC43300 were tested, and showed that GS5 alone exhibited longer-term bactericidal activity for up to 6 days on 316I stainless steel surfaces. Having established efficacy against S. aureus, we tested GS5 against common healthcare acquired pathogens, and demonstrated that, on average, a 1 log10 bactericidal effect was exhibited by GS5 treated surfaces, although biocidal activity varied depending upon the surface type and the species of bacteria. The ability of GS5 to prevent Pseudomonas aeruginosa biofilm formation was measured in standard microtitre plate assays, where it had no significant effect on either biofilm formation or development. Taken together the data suggests that GS5 treatment of surfaces may be a useful means to reducing bacterial contamination in the context of infection control practices.

Migrants' access to healthcare

DEFF Research Database (Denmark)

Norredam, Marie

2011-01-01

There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare...... according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why...... are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were...

Healthcare leadership's diversity paradox.

Science.gov (United States)

Silver, Reginald

2017-02-06

Purpose The purpose of this research study was to obtain healthcare executives' perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color. Design/methodology/approach A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified. Findings The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles. Research limitations/implications This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics. Practical implications The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of

Miniaturized soft bio-hybrid robotics: a step forward into healthcare applications.

Science.gov (United States)

Patino, T; Mestre, R; Sánchez, S

2016-10-07

Soft robotics is an emerging discipline that employs soft flexible materials such as fluids, gels and elastomers in order to enhance the use of robotics in healthcare applications. Compared to their rigid counterparts, soft robotic systems have flexible and rheological properties that are closely related to biological systems, thus allowing the development of adaptive and flexible interactions with complex dynamic environments. With new technologies arising in bioengineering, the integration of living cells into soft robotic systems offers the possibility of accomplishing multiple complex functions such as sensing and actuating upon external stimuli. These emerging bio-hybrid systems are showing promising outcomes and opening up new avenues in the field of soft robotics for applications in healthcare and other fields.

New technologies in the prevention and control of healthcare-associated infection.

LENUS (Irish Health Repository)

Humphreys, H

2010-06-01

The increased interest in healthcare-associated infection (HCAI) among the public, patients and politicians has led to the development of potential new approaches to its prevention by industrial concerns and others. Such developments include better methods of assessing hospital hygiene, enhanced decontamination of the healthcare environment, biosynthetic tissue alternatives, antibiotic-impregnated medical devices and information technology that can help improve professional practice. Although promising, many of these have not been adequately evaluated in the clinical setting, highlighting the need for greater collaboration between industry and infection prevention and control practitioners to maximise the benefit of new products and to complement conventional approaches to HCAI prevention such as education, professional practice and the provision of better facilities.

SkQ1 Ophthalmic Solution for Dry Eye Treatment: Results of a Phase 2 Safety and Efficacy Clinical Study in the Environment and During Challenge in the Controlled Adverse Environment Model.

Science.gov (United States)

Petrov, Anton; Perekhvatova, Natalia; Skulachev, Maxim; Stein, Linda; Ousler, George

2016-01-01

This Phase 2 clinical trial assessed the efficacy and safety of the novel antioxidative, renewable compound SkQ1 for topical treatment of dry eye signs and symptoms. In a single-center, randomized, double-masked, placebo-controlled, 29-day study, 91 subjects with mild to moderate dry eye instilled the study drug twice daily and recorded dry eye symptoms daily. Subjects were randomized 1:1:1 into one of three ophthalmic solution treatment groups: SkQ1 1.55 µg/mL, SkQ1 0.155 µg/mL, or 0.0 µg/mL (placebo). Subjects were exposed to a controlled adverse environment chamber at 3 of the 4 study visits (Day -7, Day 1, and Day 29). Investigator assessments occurred at all study visits. SkQ1 was safe and efficacious in treating dry eye signs and symptoms. Statistically significant improvements with SkQ1 compared to placebo occurred for the dry eye signs of corneal fluorescein staining and lissamine green staining in the central region and lid margin redness, and for the dry eye symptoms of ocular discomfort, dryness, and grittiness. In addition, SkQ1 demonstrated greater efficacy compared to placebo, although the differences were not statistically significant, for corneal fluorescein staining in other regions and/or time points (total staining score, central region, corneal sum score, and temporal region), lissamine green staining for the central and nasal regions, and blink rate scores. This Phase 2 study indicated that SkQ1 is safe and efficacious for the treatment of dry eye signs and symptoms and supported previous study results. Clinicaltrials.gov identifier: NCT02121301. Miotech S.A.

X-PAT: a multiplatform patient referral data management system for small healthcare institution requirements.

Science.gov (United States)

Masseroli, Marco; Marchente, Mario

2008-07-01

We present X-PAT, a platform-independent software prototype that is able to manage patient referral multimedia data in an intranet network scenario according to the specific control procedures of a healthcare institution. It is a self-developed storage framework based on a file system, implemented in eXtensible Markup Language (XML) and PHP Hypertext Preprocessor Language, and addressed to the requirements of limited-dimension healthcare entities (small hospitals, private medical centers, outpatient clinics, and laboratories). In X-PAT, healthcare data descriptions, stored in a novel Referral Base Management System (RBMS) according to Health Level 7 Clinical Document Architecture Release 2 (CDA R2) standard, can be easily applied to the specific data and organizational procedures of a particular healthcare working environment thanks also to the use of standard clinical terminology. Managed data, centralized on a server, are structured in the RBMS schema using a flexible patient record and CDA healthcare referral document structures based on XML technology. A novel search engine allows defining and performing queries on stored data, whose rapid execution is ensured by expandable RBMS indexing structures. Healthcare personnel can interface the X-PAT system, according to applied state-of-the-art privacy and security measures, through friendly and intuitive Web pages that facilitate user acceptance.

Model of care for a changing healthcare system: are there foundational pillars for design?

Science.gov (United States)

Booker, Catriona; Turbutt, Adam; Fox, Robyn

2016-04-01

Currently, healthcare organisations are being challenged to provide optimal clinical services within budget limitations while simultaneously being confronted by aging consumers and labour and skill shortages. Within this dynamic and changing environment, the ability to remain responsive to patient needs while managing these issues poses further challenges. Development or review of the model of care (MOC) may provide a possible solution to support efficiencies in service provision. Although MOC are not readily understood or appreciated as an efficiency strategy, they can be more easily explained by considering several recurring pillars when developing or redesigning an MOC. Generic and recurring foundational pillars include integrated care models, team functioning and communication, leadership, change management and lean thinking. These foundational pillars should be incorporated into the development and application of MOC in order to achieve desired outcomes. However, sustainability requires continuous review to enable improvement and must be integrated into routine business. Moreover, successful review of MOC requires collaboration and commitment by all stakeholders. Leaders are critical to motivating clinicians and stakeholders in the review process. Further, it is imperative that leaders engage stakeholders to commit to support the agreed strategies designed to provide efficient and comprehensive healthcare services. Redesign of MOC can significantly improve patient care by applying the agreed strategies. In the current healthcare environment, these strategies can favourably affect healthcare expenditure and, at the same time, improve the quality of interprofessional health services.

Coping self-efficacy of Chinese nursing undergraduates with their research projects.

Science.gov (United States)

Zhang, Wei; Li, Kun; Zhang, XiuMin; Chen, Li

2016-10-01

Undergraduate nursing education includes both professional knowledge and research skills. With regard to training nursing professionals for future healthcare settings, the ability to conduct research is fundamental for nurses after they graduate from universities. However, how nursing students develop coping self-efficacy and scientific skills as a specific ability during their professional study has received little attention. We studied nursing undergraduates' scientific research ability and its associated factors in the Chinese context and evaluated their self-efficacy for coping with research tasks. A total of 134 nursing undergraduates participated in the study. A purposely designed 22-item questionnaire was used to quantify students' research ability in implementing their research projects and the associated factors. Coping self-efficacy was measured with a modified Chinese version. The mean total self-efficacy score was 50.78±6.604 (M±SD). The majority (63.4%) of the students' coping self-efficacy was at a moderate level. Having "the ability to write a manuscript before conducting research projects" (P=0.006) and "topics determined by instructors after discussion with group members" (P=0.005) were the two predictive factors of good coping self-efficacy in students. Nursing undergraduates' self-efficacy was high enough to cope with their scientific research projects, but the information on procedures needed for project application was not abundant, and new training programs might be needed to meet the needs of nursing undergraduates. We should make full use of the predictors of good coping self-efficacy and promote nursing undergraduates' research ability. Copyright © 2016 Elsevier Ltd. All rights reserved.

3D medical collaboration technology to enhance emergency healthcare

DEFF Research Database (Denmark)

Welch, Gregory F; Sonnenwald, Diane H.; Fuchs, Henry

2009-01-01

Two-dimensional (2D) videoconferencing has been explored widely in the past 15-20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address...... these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays...... or with mobile devices such as personal digital assistants (PDAs). The remote professionals' viewpoints could be specified manually or automatically (continuously) via user head or PDA tracking, giving the remote viewers head-slaved or hand-slaved virtual cameras for monoscopic or stereoscopic viewing...

Making music out of noise. The Sentara Healthcare Experience Implementing e-Care.

Science.gov (United States)

Abraham, Chon; Reese, Bertram

2010-01-01

This paper describes insights from the an implementation experience with a project titled eCare, a comprehensive health IT solution integrating all environments of care and the primary business functions at Sentara Healthcare, the largest system in southeastern Virginia and northeastern North Carolina. eCare is expected to account for more than $16 million by the end of 2009, from realized benefits in quality of care, process efficiencies and firm performance. Made evident by Sentara's experience, eCare-type technology may be as much of a market differentiator for healthcare as the ATM was for banking industry, but prudent management in the implementation process is key.

[Development method of healthcare information system integration based on business collaboration model].

Science.gov (United States)

Li, Shasha; Nie, Hongchao; Lu, Xudong; Duan, Huilong

2015-02-01

Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.

Self-efficacy scale for Brazilians with type 1 diabetes

Directory of Open Access Journals (Sweden)

Daniela Alves Gastal

2007-03-01

Full Text Available CONTEXT AND OBJECTIVE: Diabetes is a public health problem and good glycemic control is able to prevent or contain its complications. Self-efficacy is a key factor in successfully achieving behavior goals. The aim of this study was to analyze the psychometric properties of the insulin management diabetes self-efficacy scale (IMDSES on type 1 diabetes patients from southern Brazil. DESIGN AND SETTING: Validation study in two cities in southern Brazil. METHODS: The psychometric properties of IMDSES were evaluated in a population of type 1 diabetes patients (n = 213, from September to December 2004, who were attended within the Brazilian public healthcare system. Principal component analysis was conducted to develop the subscales. Cronbach’s alpha was used as the reliability coefficient. RESULTS: The analysis of psychometric properties resulted in an IMDSES consisting of 20 items and three subscales: diet (alpha: 0.83, insulin (alpha: 0.92 and general management (alpha: 0.78 and accounted for 53% of the variance. Criteria validity was investigated through two parameters: glycohemoglobin, which showed significant association with self-efficacy on the insulin subscale (p = 0.04, and the variable "adherence", which was significantly associated with self-efficacy on two subscales (p < 0.05. CONCLUSIONS: This study shows that the IMDSES is valid and reliable, and can be used to measure results from diabetes educational programs and to measure self-efficacy relating to diabetes management, for possible interventions.

Joint optimization: Merging a new culture with a new physical environment.

Science.gov (United States)

Stichler, Jaynelle F; Ecoff, Laurie

2009-04-01

Nearly $200 billion of healthcare construction is expected by the year 2015, and nurse leaders must expand their knowledge and capabilities in healthcare design. This bimonthly department prepares nurse leaders to use the evidence-based design process to ensure that new, expanded, and renovated hospitals facilitate optimal patient outcomes, enhance the work environment for healthcare providers, and improve organizational performance. In this article, the authors discuss the concept of joint optimization of merging organizational culture with a new hospital facility.

Bacterial diversity among four healthcare-associated institutes in Taiwan.

Science.gov (United States)

Chen, Chang-Hua; Lin, Yaw-Ling; Chen, Kuan-Hsueh; Chen, Wen-Pei; Chen, Zhao-Feng; Kuo, Han-Yueh; Hung, Hsueh-Fen; Tang, Chuan Yi; Liou, Ming-Li

2017-08-15

Indoor microbial communities have important implications for human health, especially in health-care institutes (HCIs). The factors that determine the diversity and composition of microbiomes in a built environment remain unclear. Herein, we used 16S rRNA amplicon sequencing to investigate the relationships between building attributes and surface bacterial communities among four HCIs located in three buildings. We examined the surface bacterial communities and environmental parameters in the buildings supplied with different ventilation types and compared the results using a Dirichlet multinomial mixture (DMM)-based approach. A total of 203 samples from the four HCIs were analyzed. Four bacterial communities were grouped using the DMM-based approach, which were highly similar to those in the 4 HCIs. The α-diversity and β-diversity in the naturally ventilated building were different from the conditioner-ventilated building. The bacterial source composition varied across each building. Nine genera were found as the core microbiota shared by all the areas, of which Acinetobacter, Enterobacter, Pseudomonas, and Staphylococcus are regarded as healthcare-associated pathogens (HAPs). The observed relationship between environmental parameters such as core microbiota and surface bacterial diversity suggests that we might manage indoor environments by creating new sanitation protocols, adjusting the ventilation design, and further understanding the transmission routes of HAPs.

Social Return on Investment: A New Approach to Understanding and Advocating for Value in Healthcare.

Science.gov (United States)

Laing, Catherine M; Moules, Nancy J

2017-12-01

To determine whether the methodology of social return on investment (SROI) could be a way in which the value of a healthcare-related program (children's cancer camp) could be captured, evaluated, and communicated. The value of healthcare goes beyond what can be captured in financial terms; however, this is the most common type of value that is measured. The SROI methodology accounts for a broader concept of value by measuring social, environmental, and economic outcomes and uses monetary values to represent them. The steps/stages of an SROI analysis were applied to the context of a children's camp for this article. Applying the SROI methodology to this healthcare-related program was feasible and provided insight and understanding related to the impacts of this program. Because of SROI's flexibility, it is a tool that has great potential in a healthcare environment and for leaders to evaluate programmatic return on investment.

A fuzzy-based particle swarm optimisation approach for task assignment in home healthcare

Directory of Open Access Journals (Sweden)

Mutingi, Michael

2014-11-01

Full Text Available Home healthcare (HHC organisations provide coordinated healthcare services to patients at their homes. Motivated by the ever-increasing need for home-based care, the assignment of tasks to available healthcare staff is a common and complex problem in homecare organisations. Designing high quality task schedules is critical for improving worker morale, job satisfaction, service efficiency, service quality, and competitiveness over the long term. The desire is to provide high quality task assignment schedules that satisfy the patient, the care worker, and the management. This translates to maximising schedule fairness in terms of workload assignments, avoiding task time window violation, and meeting management goals as much as possible. However, in practice, these desires are often subjective as they involve imprecise human perceptions. This paper develops a fuzzy multi-criteria particle swarm optimisation (FPSO approach for task assignment in a home healthcare setting in a fuzzy environment. The proposed approach uses a fuzzy evaluation method from a multi-criteria point of view. Results from illustrative computational experiments show that the approach is promising.

Student Perceptions of SocialSim for Simulation-Based Interprofessional Education in Healthcare

Science.gov (United States)

Smith, Mary Kathryn

2016-01-01

This descriptive qualitative study investigates perceptions of students regarding the use of SocialSim, a tool designed to deliver simulation in a virtual environment using social media as a platform to facilitate inteprofessional education. There have been exponential changes in U.S. healthcare system in recent years, prompting the need for…

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

Science.gov (United States)

DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

2013-06-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.

Ethical issues in healthcare financing.

Science.gov (United States)

Maharaj, S R; Paul, T J

2011-07-01

The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life. Access to healthcare has been a perpetual challenge to healthcare providers who must take into account important factors such as equity, efficiency and effectiveness in designing healthcare systems to meet the four goals of good healthcare. The underlying philosophy may designate health as being a basic human right, an investment, a commodity to be bought and sold, a political demand or an expenditure. The design, policies and operational arrangements will usually reflect which of the above philosophies underpin the healthcare system, and consequently, access. Mechanisms for funding include fee-for-service, cost sharing (insurance, either private or government sponsored) free-of-fee at point of delivery (payments being made through general taxes, health levies, etc) or cost-recovery. For each of these methods of financial access to healthcare services, there are ethical issues which can compromise the four principles of ethical practices in healthcare, viz beneficence, non-maleficence, autonomy and justice. In times of economic recession, providing adequate healthcare will require governments, with support from external agencies, to focus on poverty reduction strategies through provision of preventive services such as immunization and nutrition, delivered at primary care facilities. To maximize the effect of such policies, it will be necessary to integrate policies to fashion an intersectoral approach.

Healing environment: A review of the impact of physical environmental factors on users

NARCIS (Netherlands)

Joost van Hoof; E.R.C.M. Huisman; H.S.M. Kort; E. Morales

2012-01-01

In recent years, the effects of the physical environment on the healing process and well-being have proved to be increasingly relevant for patients and their families (PF) as well as for healthcare staff. The discussions focus on traditional and institutionally designed healthcare facilities (HCF)

Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare.

Science.gov (United States)

Pearson, Alan; Srivastava, Rani; Craig, Dianna; Tucker, Donna; Grinspun, Doris; Bajnok, Irmajean; Griffin, Pat; Long, Leslye; Porritt, Kylie; Han, Thuzar; Gi, Aye A

2007-03-01

Objectives  The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria  This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy  The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological

Recommended Vaccines for Healthcare Workers

Science.gov (United States)

... Vaccination Resources for Healthcare Professionals Recommended Vaccines for Healthcare Workers Recommend on Facebook Tweet Share Compartir On ... for More Information Resources for Those Vaccinating HCWs Healthcare workers (HCWs) are at risk for exposure to ...

Minority mothers' healthcare beliefs, commonly used alternative healthcare practices, and potential complications for infants and children.

Science.gov (United States)

Hannan, Jean

2015-06-01

Complementary and alternative healthcare practices have increased substantially in the United States especially with low-income ethnic minority mothers. These mothers often have provider mistrust, language barriers, differing health belief systems, and as a result are less likely to seek preventive health screening, access healthcare services, and use alternative remedies for their infants and children that are potentially harmful or lethal. Therefore, the purpose of this article is to examine healthcare beliefs, commonly used alternative healthcare practices, and their potential complications for infants and children. A search of CINAHL and PubMed (1980-2012) was conducted using the following terms: alternative healthcare practice, mothers' health beliefs, cultural health beliefs, folk remedies, and infant health practices. Given the changing U.S. population and an increasing immigrant population, examining alternative healthcare practices mothers use for their infants and children is especially important for providers in addressing healthcare for this group. The use of alternative healthcare practices is rarely discussed by parents with healthcare providers for fear of disapproval. When interviewing ethnic minority mothers and caregivers questions should include the use of alternative healthcare practices for infants and children and information regarding the potential dangers should be provided to them. ©2014 American Association of Nurse Practitioners.

A pilot study to assess the effectiveness and cost of routine universal use of peracetic acid sporicidal wipes in a real clinical environment.

Science.gov (United States)

Saha, Avinandan; Botha, Stefan Louis; Weaving, Paul; Satta, Giovanni

2016-11-01

Peracetic acid sporicidal wipes have been shown to be an effective disinfectant, but in controlled test environments. Their high cost may restrict use. This pilot study investigated the efficacy and compared the costs of routine universal use of peracetic acid sporicidal wipes versus sporicidal quaternary ammonium compound and alcohol wipes in the disinfection of a hospital environment. The routine universal use of peracetic acid wipes (Clinell Sporicidal; GAMA Healthcare Ltd, London, UK) was allocated to a study ward, whereas the control ward continued with the use of quaternary ammonium compound wipes (Tuffie 5; Vernacare, Bolton, UK) and alcohol wipes (PDI Sani-Cloth 70; PDI, Flint, UK). Twenty high-touch areas in the 2 wards were sampled for the presence of indicator organisms. The weekly detection rates of indicator organisms and weekly healthcare associated infection (HCAI) rates in the 2 wards were compared and examined for decreasing trends over the trial period. The detection rates of indicator organisms and HCAI rates were not significantly different in the 2 wards, and did not decrease significantly over the trial period. However, the peracetic acid wipes seem to be more effective against gram-negative organisms but at a significantly higher cost. Further prospective studies are needed to assess the cost-effectiveness of peracetic acid wipes. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The importance of moral emotions for effective collaboration in culturally diverse healthcare teams.

Science.gov (United States)

Cook, Catherine; Brunton, Margaret

2018-04-01

Moral emotions shape the effectiveness of culturally diverse teams. However, these emotions, which are integral to determining ethically responsive patient care and team relationships, typically go unrecognised. The contribution of emotions to moral deliberation is subjugated within the technorational environment of healthcare decision-making. Contemporary healthcare organisations rely on a multicultural workforce charged with the ethical care of vulnerable people. Limited extant literature examines the role of moral emotions in ethical decision-making among culturally diverse healthcare teams. Moral emotions are evident in ethnocentric moral perspectives that construct some colleagues' practices as 'other'. This article examines how moral emotions are evoked when cultural dissonance influences nurses' moral perceptions. We use a qualitative investigation of teamwork within culturally diverse healthcare organisations. We use Haidt's () account of moral emotions to examine practice-based accounts of 36 internationally educated and 17 New Zealand educated nurses practising in New Zealand. The study provides evidence that moral emotions are frequently elicited by communication and care practices considered 'foreign'. The main implication is that although safe practice in healthcare organisations is reliant on highly functioning teams, collaboration is challenged by interprofessional power relations of contested culturally shaped values. We address practice-based strategies that enable engagement with moral emotions to enhance effective teamwork. © 2017 John Wiley & Sons Ltd.

Healthcare Scheduling by Data Mining: Literature Review and Future Directions

Directory of Open Access Journals (Sweden)

Maria M. Rinder

2012-01-01

Full Text Available This article presents a systematic literature review of the application of industrial engineering methods in healthcare scheduling, with a focus on the role of patient behavior in scheduling. Nine articles that used mathematical programming, data mining, genetic algorithms, and local searches for optimum schedules were obtained from an extensive search of literature. These methods are new approaches to solve the problems in healthcare scheduling. Some are adapted from areas such as manufacturing and transportation. Key findings from these studies include reduced time for scheduling, capability of solving more complex problems, and incorporation of more variables and constraints simultaneously than traditional scheduling methods. However, none of these methods modeled no-show and walk-ins patient behavior. Future research should include more variables related to patient and/or environment.

A system dynamics approach for healthcare waste management: a case study in Istanbul Metropolitan City, Turkey.

Science.gov (United States)

Ciplak, Nesli; Barton, John R

2012-06-01

Healthcare waste consists of various types of waste materials generated at hospitals, medical research centres, clinics and laboratories. Although 75-90% of this waste is classified as 'domestic' in nature, 20-25% is deemed to be hazardous, which if not disposed of appropriately, poses a risk to healthcare workers, patients, the environment and even the whole community. As long as healthcare waste is mixed with municipal waste and not segregated prior to disposal, costs will increase substantially. In this study, healthcare waste increases along with the potential to decrease the amounts by implementing effective segregation at healthcare facilities are projected to 2040. Our long-term aim is to develop a system to support selection and planning of the future treatment capacity. Istanbul in Turkey was used as the case study area. In order to identify the factors affecting healthcare waste generation in Istanbul, observations were made and interviews conducted in Istanbul over a 3 month period. A system dynamics approach was adopted to build a healthcare waste management model using a software package, Vensim Ple Plus. Based on reported analysis, the non-hazardous municipal fraction co-disposed with healthcare waste is around 65%. Using the projected waste generation flows, reducing a municipal fraction to 30% has the potential to avoid some 8000 t year(-1) of healthcare waste by 2025 and almost 10 000 t year(-1) by 2035. Furthermore, if segregation practices ensured healthcare waste requiring incineration was also selectively managed, 77% of healthcare waste could be diverted to alternative treatment technologies. As the throughput capacity of the only existing healthcare waste treatment facility in Istanbul, Kemerburgaz Incinerator, has already been exceeded, it is evident that improved management could not only reduce overall flows and costs but also permit alternative and cheaper treatment systems (e.g. autoclaving) to be adopted for the healthcare waste.

Lean six sigma in healthcare.

Science.gov (United States)

de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

2006-01-01

Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

Quantum Physics Principles and Communication in the Acute Healthcare Setting: A Pilot Study.

Science.gov (United States)

Helgeson, Heidi L; Peyerl, Colleen Kraft; Solheim-Witt, Marit

This pilot study explores whether clinician awareness of quantum physics principles could facilitate open communication between patients and providers. In the spirit of action research, this study was conceptualized with a holistic view of human health, using a mixed method design of grounded theory as an emergent method. Instrumentation includes surveys and a focus group discussion with twelve registered nurses working in an acute care hospital setting. Findings document that the preliminary core phenomenon, energy as information, influences communication in the healthcare environment. Key emergent themes include awareness, language, validation, open communication, strategies, coherence, incoherence and power. Research participants indicate that quantum physics principles provide a language and conceptual framework for improving their awareness of communication and interactions in the healthcare environment. Implications of this pilot study support the feasibility of future research and education on awareness of quantum physics principles in other clinical settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Work-related quality of life of Ugandan healthcare workers.

Science.gov (United States)

Opollo, J G; Gray, J; Spies, L A

2014-03-01

To describe perceived work-related quality of life of Ugandan healthcare workers. A secondary aim was to seek participant input on ways to improve work environments. Poor patient outcomes, decreased employee motivation and decisions to leave the organization have been linked to poor work conditions. Interventions to correct healthcare worker shortage in developing countries require information about work quality of life. Descriptive cross-sectional study conducted in health and educational settings in Uganda in July 2011. Participants completed the Biographical Information Scale demographic questionnaire and the validated 24-item Work-Related Quality of Life scale. Sample included 146 healthcare workers employed in various settings. Participants reported poorer quality of work life on the work conditions, control at work and home-work interface subscales. Participants perceived stress at work to be low and experienced higher job career satisfaction. There was a significant relationship between work-related quality of life, gender and hours worked. Participants' suggestions to improve work life ranged from simple no-cost suggestions to more complex system level interventions. Work-related quality of life was low in this convenience sample. Perceived stress at work was lower than expected, but may have been due to nurses' expectations of a normal work assignment. Predominantly women, the participants had significant caregiving responsibilities. Nurses must acquire a seat at the table where crucial decisions about nursing and its future are made. By advancing leadership skills, nurses can effectively advocate for organizational changes that address broad factors related to increasing job satisfaction, and retaining and attracting nurses. Nurses can influence work quality of life individually and collectively by identifying workplace concerns, demanding safe work environments, fostering teamwork and enhancing professional growth. © 2014 International Council of Nurses.

Identification of core objectives for teaching sustainable healthcare education.

Science.gov (United States)

Teherani, Arianne; Nishimura, Holly; Apatira, Latifat; Newman, Thomas; Ryan, Susan

2017-01-01

Physicians will be called upon to care for patients who bear the burden of disease from the impact of climate change and ecologically irresponsible practices which harm ecosystems and contribute to climate change. However, physicians must recognize the connection between the climate, ecosystems, sustainability, and health and their responsibility and capacity in changing the status quo. Sustainable healthcare education (SHE), defined as education about the impact of climate change and ecosystem alterations on health and the impact of the healthcare industry on the aforementioned, is vital to prevention of adverse health outcomes due to the changing climate and environment. To systematically determine which and when a set of SHE objectives should be included in the medical education continuum. Fifty-two SHE experts participated in a two-part modified-Delphi study. A survey was developed based on 21 SHE objectives. Respondents rated the importance of each objective and when each objective should be taught. Descriptive statistics and an item-level content validity index (CVI) were used to analyze data. Fifteen of the objectives achieved a content validity index of 78% or greater. The remaining objectives had content validity indices between 58% and 77%. The preclinical years of medical school were rated as the optimal time for introducing 13 and the clinical years for introducing six of the objectives. Respondents noted the definition of environmental sustainability should be learned prior to medical school and identifying ways to improve the environmental sustainability of health systems in post-graduate training. This study proposes SHE objectives for the continuum of medical education. These objectives ensure the identity of the physician includes the requisite awareness and competence to care for patients who experience the impact of climate and environment on health and advocate for sustainability of the health systems in which they work. CVI: Content validity

Improving Healthcare through Lean Management

DEFF Research Database (Denmark)

Nielsen, Anders Paarup; Edwards, Kasper

2011-01-01

The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare....... The paper concludes by discussing the implications of hypothesis two, three, and four for the successful application of lean management within healthcare. Is it concluded that this requires a transformative and contingent approach to lean management where the universal principles of the lean philosophy...

Innovation in medicine and healthcare 2015

CERN Document Server

Torro, Carlos; Tanaka, Satoshi; Howlett, Robert; Jain, Lakhmi

2016-01-01

Innovation in medicine and healthcare is an interdisciplinary research area, which combines the advanced technologies and problem solving skills with medical and biological science. A central theme of this proceedings is Smart Medical and Healthcare Systems (modern intelligent systems for medicine and healthcare), which can provide efficient and accurate solution to problems faced by healthcare and medical practitioners today by using advanced information communication techniques, computational intelligence, mathematics, robotics and other advanced technologies. The techniques developed in this area will have a significant effect on future medicine and healthcare.    The volume includes 53 papers, which present the recent trend and innovations in medicine and healthcare including Medical Informatics; Biomedical Engineering; Management for Healthcare; Advanced ICT for Medical and Healthcare; Simulation and Visualization/VR for Medicine; Statistical Signal Processing and Artificial Intelligence; Smart Medic...

Methodological Challenges in Examining the Impact of Healthcare Predictive Analytics on Nursing-Sensitive Patient Outcomes.

Science.gov (United States)

Jeffery, Alvin D

2015-06-01

The expansion of real-time analytic abilities within current electronic health records has led to innovations in predictive modeling and clinical decision support systems. However, the ability of these systems to influence patient outcomes is currently unknown. Even though nurses are the largest profession within the healthcare workforce, little research has been performed to explore the impact of clinical decision support on their decisions and the patient outcomes associated with them. A scoping literature review explored the impact clinical decision support systems containing healthcare predictive analytics have on four nursing-sensitive patient outcomes (pressure ulcers, failure to rescue, falls, and infections). While many articles discussed variable selection and predictive model development/validation, only four articles examined the impact on patient outcomes. The novelty of predictive analytics and the inherent methodological challenges in studying clinical decision support impact are likely responsible for this paucity of literature. Major methodological challenges include (1) multilevel nature of intervention, (2) treatment fidelity, and (3) adequacy of clinicians' subsequent behavior. There is currently insufficient evidence to demonstrate efficacy of healthcare predictive analytics-enhanced clinical decision support systems on nursing-sensitive patient outcomes. Innovative research methods and a greater emphasis on studying this phenomenon are needed.

Efficacy and efficiency of a lean cataract pathway: a comparative study.

Science.gov (United States)

van Vliet, Ellen Joan; Sermeus, Walter; van Gaalen, Claudia M; Sol, Johannes C A; Vissers, Jan M H

2010-12-01

The demand for cataract surgery is rising, calling for pathways that have good access and are cost-effective. Lean thinking is a management strategy, aimed at improving quality while reducing costs. Lean production processes are designed to identify gaps between expected and actual performance. To analyse the efficacy and efficiency of a lean cataract pathway. Lean care delivered to a prospective cohort (616 cataract patients) was compared (1) with traditional care delivered to a historical cohort (591 cataract patients) and (2) with expected lean care in the prospective cohort. To evaluate efficacy, the authors analysed how many patients received care that adhered to the lean pathway's specifications. To evaluate efficiency, the authors analysed how often patients visited the hospital and how many additional patients could access the pathway. In the lean pathway, patient visits decreased by 23%, and access to the cataract pathway increased with 42%. A 40% decrease in patient visits and a 76% increase in access could have been realised if healthcare staff would have adhered to the lean pathway's specifications. Lean pathways can realise large improvements, and still have a significant gap between expected and actual care delivery. The challenge for healthcare teams is not to improve care delivery by using lean pathways as opposed to using traditional pathways, but to strive for optimal performance by consistently adhering to the specifications of the lean pathway.

Strategies for healthcare information systems

NARCIS (Netherlands)

Stegwee, R.A.; Spil, Antonius A.M.

2001-01-01

Information technologies of the past two decades have created significant fundamental changes in the delivery of healthcare services by healthcare provider organizations. Many healthcare organizations have been in search of ways and strategies to keep up with continuously emerging information

Impact of storage environment on the efficacy of hermetic storage bags.

Science.gov (United States)

Lane, Brett; Woloshuk, Charles

2017-05-01

Small hermetic bags (50 and 100 kg capacities) used by smallholder farmers in several African countries have proven to be a low-cost solution for preventing storage losses due to insects. The complexity of postharvest practices and the need for ideal drying conditions, especially in the Sub-Sahara, has led to questions about the efficacy of the hermetic bags for controlling spoilage by fungi and the potential for mycotoxin accumulation. This study compared the effects of environmental temperature and relative humidity at two locations (Indiana and Arkansas) on dry maize (14% moisture content) in woven polypropylene bags and Purdue Improved Crop Storage (PICS) hermetic bags. Temperature and relative humidity data loggers placed in the middle of each bag provided profiles of environmental influences on stored grain at the two locations. The results indicated that the PICS bags prevented moisture penetration over the three-month storage period. In contrast, maize in the woven bags increased in moisture content. For both bag types, no evidence was obtained indicating the spread of Aspergillus flavus from colonized maize to adjacent non-colonized maize. However, other storage fungi did increase during storage. The number of infected kernels did not increase in the PICS bags, but the numbers in the woven bags increased significantly. The warmer environment in Arkansas resulted in significantly higher insect populations in the woven bags than in Indiana. Insects in the PICS bags remained low at both locations. This study demonstrates that the PICS hermetic bags are effective at blocking the effects of external humidity fluctuations as well as the spread of fungi to non-infected kernels.

Ontology-Driven Knowledge-Based Health-Care System, An Emerging Area - Challenges And Opportunities - Indian Scenario

Science.gov (United States)

Sunitha, A.; Babu, G. Suresh

2014-11-01

Recent studies in the decision making efforts in the area of public healthcare systems have been tremendously inspired and influenced by the entry of ontology. Ontology driven systems results in the effective implementation of healthcare strategies for the policy makers. The central source of knowledge is the ontology containing all the relevant domain concepts such as locations, diseases, environments and their domain sensitive inter-relationships which is the prime objective, concern and the motivation behind this paper. The paper further focuses on the development of a semantic knowledge-base for public healthcare system. This paper describes the approach and methodologies in bringing out a novel conceptual theme in establishing a firm linkage between three different ontologies related to diseases, places and environments in one integrated platform. This platform correlates the real-time mechanisms prevailing within the semantic knowledgebase and establishing their inter-relationships for the first time in India. This is hoped to formulate a strong foundation for establishing a much awaited basic need for a meaningful healthcare decision making system in the country. Introduction through a wide range of best practices facilitate the adoption of this approach for better appreciation, understanding and long term outcomes in the area. The methods and approach illustrated in the paper relate to health mapping methods, reusability of health applications, and interoperability issues based on mapping of the data attributes with ontology concepts in generating semantic integrated data driving an inference engine for user-interfaced semantic queries.

Awareness of the healthcare system and rights to healthcare in the Colombian population.

Science.gov (United States)

Delgado Gallego, María Eugenia; Vázquez-Navarrete, María Luisa

2013-01-01

To analyze changes in users' awareness of the healthcare system and of their rights to healthcare in Colombia in the last 10 years, as well as the factors that influence users' awareness. We carried out a descriptive study to compare the results of two cross-sectional studies based on two surveys of users of the Colombian healthcare system. The first survey was performed in 2000 and the second in 2010. The municipalities of Tuluá (urban area) and Palmira (rural area) were surveyed. In both surveys, a stratified, multistage probability sample was selected. There were 1497 users in the first sample and 1405 in the second. Changes in awareness of the healthcare system and associated factors in each year were assessed through multivariate logistic regressions. Users' awareness of the healthcare system was limited in 2000 and was significantly lower in 2010, except for that relating to health insurers and providers. In contrast, more than 90% of users in both surveys perceived themselves as having healthcare rights. The factors consistently associated with greater awareness were belonging to a high socioeconomic stratum and having higher education. The most underprivileged users were less likely to be aware of the healthcare system, hampering their ability to make informed decisions and to exercise their health rights. To correct this situation, health institutions and the government should act decisively to reduce social inequalities. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Spirituality and healthcare: Towards holistic people-centred healthcare in South Africa

Directory of Open Access Journals (Sweden)

Andre de la Porte

2016-07-01

Full Text Available Healthcare in South Africa is in a crisis. Problems with infrastructure, management, human resources and the supply of essential medicines are at a critical level. This is compounded by a high burden of disease and disparity in levels of service delivery, particularly between public and private healthcare. The government has put ambitious plans in place, which are part of the National Development Plan to ward 2030. In the midst of this we find the individual person and their family and community staggering under the suffering caused by disease, poverty, crime and violence. There is a more than 70% chance that this person and their family and community are trying to make sense of this within a spiritual framework and that they belong to a faith-based community. This article explores the valuable contribution of spirituality, spiritual and pastoral work, the faith-based community (FBC and faith-based organisations (FBOs to holistic people-centred healthcare in South Africa. Keywords: Healthcare; Spirituality; Clinical Spiritual Counselling

An ICT-Based Platform to Monitor Protocols in the Healthcare Environment.

Science.gov (United States)

Rorís, Víctor M Alonso; Gago, Juan M Santos; Sabucedo, Luis Álvarez; Merino, Mateo Ramos; Valero, Javier Sanz

2016-10-01

Procedures from the healthcare domain involve highly critical actions as they may pose a risk for patients' life. Therefore, a large effort is devoted to the standardization in clinical praxis and to the control of quality for these protocols in order to minimize hazards. In this line, this work is compelled to provide an ICT-based support to carry out these controls in a simple and effective manner. Using a methodology based on HACCP and taking advantage of Semantic tools, a holistic platform of services for traceability and control of processes has been designed and implemented. The applied paradigm is based on the use of Control Points as singular points to generate traces using observations and measures relevant for the processes considered. Based on those, it is possible to offer services for advanced querying and knowledge inference. The local deployment just requires regular mobile phones or tablets making this solution cost-effective and easily replicable.

Healthcare is primary

Directory of Open Access Journals (Sweden)

Raman Kumar

2015-01-01

Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

Self-medication among healthcare and non-healthcare students at University of Ljubljana, Slovenia.

Science.gov (United States)

Klemenc-Ketis, Zalika; Hladnik, Ziga; Kersnik, Janko

2010-01-01

To determine the incidence of self-medication among University of Ljubljana students and the effect of the type of curriculum on the pattern of self-medication. The study included a sample of 1,294 students who freely accessed a self-administered web-based questionnaire in the Slovene language that consisted of a preliminary letter introducing the term 'self-treatment' and 2 sections about self-medication. The preliminary letter asked participants to report the practice of self-treatment during the past year. The main outcome measures were percentages of those reporting self-medication during the past year, which were then used to compare healthcare and non-healthcare students. A majority of students (1,195, 92.3%), both healthcare and non-healthcare, reported the use of some sort of self-medication during the study period. More healthcare students in their senior year (353, 94.1%) than those in their junior year (245, 89.4%) used self-medication (p = 0.04). Healthcare students (p = 0.05) thought that self-medication without improvement of the symptoms should last for 1 week or less. They acquired the drugs for self-medication from pharmacies; thought that previous doctors' advice in a similar situation was a more important reason for self-medication; would seek the advice of a physician or pharmacist for different ways of self-treatment, and quite interestingly thought that self-medication was not very safe. On the other hand, non-healthcare students acquired the drugs from healers and friends. The study showed that self-medication was common among all University of Ljubljana students, but that healthcare-related education in students and young adults led to more responsible use of self-medication. Copyright 2010 S. Karger AG, Basel.

Healthcare Engineering Defined: A White Paper.

Science.gov (United States)

Chyu, Ming-Chien; Austin, Tony; Calisir, Fethi; Chanjaplammootil, Samuel; Davis, Mark J; Favela, Jesus; Gan, Heng; Gefen, Amit; Haddas, Ram; Hahn-Goldberg, Shoshana; Hornero, Roberto; Huang, Yu-Li; Jensen, Øystein; Jiang, Zhongwei; Katsanis, J S; Lee, Jeong-A; Lewis, Gladius; Lovell, Nigel H; Luebbers, Heinz-Theo; Morales, George G; Matis, Timothy; Matthews, Judith T; Mazur, Lukasz; Ng, Eddie Yin-Kwee; Oommen, K J; Ormand, Kevin; Rohde, Tarald; Sánchez-Morillo, Daniel; Sanz-Calcedo, Justo García; Sawan, Mohamad; Shen, Chwan-Li; Shieh, Jiann-Shing; Su, Chao-Ton; Sun, Lilly; Sun, Mingui; Sun, Yi; Tewolde, Senay N; Williams, Eric A; Yan, Chongjun; Zhang, Jiajie; Zhang, Yuan-Ting

2015-01-01

Engineering has been playing an important role in serving and advancing healthcare. The term "Healthcare Engineering" has been used by professional societies, universities, scientific authors, and the healthcare industry for decades. However, the definition of "Healthcare Engineering" remains ambiguous. The purpose of this position paper is to present a definition of Healthcare Engineering as an academic discipline, an area of research, a field of specialty, and a profession. Healthcare Engineering is defined in terms of what it is, who performs it, where it is performed, and how it is performed, including its purpose, scope, topics, synergy, education/training, contributions, and prospects.

Benchmarking local healthcare-associated infections: Available benchmarks and interpretation challenges

Directory of Open Access Journals (Sweden)

Aiman El-Saed

2013-10-01

Full Text Available Summary: Growing numbers of healthcare facilities are routinely collecting standardized data on healthcare-associated infection (HAI, which can be used not only to track internal performance but also to compare local data to national and international benchmarks. Benchmarking overall (crude HAI surveillance metrics without accounting or adjusting for potential confounders can result in misleading conclusions. Methods commonly used to provide risk-adjusted metrics include multivariate logistic regression analysis, stratification, indirect standardization, and restrictions. The characteristics of recognized benchmarks worldwide, including the advantages and limitations are described. The choice of the right benchmark for the data from the Gulf Cooperation Council (GCC states is challenging. The chosen benchmark should have similar data collection and presentation methods. Additionally, differences in surveillance environments including regulations should be taken into consideration when considering such a benchmark. The GCC center for infection control took some steps to unify HAI surveillance systems in the region. GCC hospitals still need to overcome legislative and logistic difficulties in sharing data to create their own benchmark. The availability of a regional GCC benchmark may better enable health care workers and researchers to obtain more accurate and realistic comparisons. Keywords: Benchmarking, Comparison, Surveillance, Healthcare-associated infections

Romanian healthcare system at a glance

Directory of Open Access Journals (Sweden)

Christiana Balan

2013-04-01

Full Text Available The Romanian healthcare system is facing constant challenges to produce high quality care with low costs. Objectives The paper aims to analyze the efficiency of the Romanian healthcare system in terms of resources allocation. The evaluation and the dimension of healthcare system efficiency are important for identifying a balance between the resources required and the health outcomes. Prior Work Previous studies describe the Romanian healthcare system as a system in transition. This study focuses on the relationship between the inputs and outputs of the system. Approach In order to assess the efficiency of the Romanian healthcare system we use Data Envelopment Analysis approach. Both input and output healthcare indicators are observed for the period 1999-2010 and the years when healthcare inputs have been used efficiently are identified. Results The results show that human, financial, and technological resources have been used at maximum capacity in 1999, 2003, 2004, 2007 and 2010. Implications Though efficiency is defined differently by diverse stakeholders, healthcare policies should focus on rising the responsibility of communities and individuals for better treatments and services and better access to information on healthcare providers. Value The paper is an empirically based study of the healthcare resources allocation in Romania.

Improving healthcare practice behaviors: an exploratory study identifying effective and ineffective behaviors in healthcare.

Science.gov (United States)

Van Fleet, David D; Peterson, Tim O

2016-01-01

The purpose of this paper is to present the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients. The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups. The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities. The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners' instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1997). With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers. The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider. Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as

Healthcare. State Report

Science.gov (United States)

Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

2012-01-01

This report projects education requirements linked to forecasted job growth in healthcare by state and the District of Columbia from 2010 through 2020. It complements a larger national report which projects educational demand for healthcare for the same time period. The national report shows that with or without Obamacare, the United States will…

Machine Learning for Healthcare: On the Verge of a Major Shift in Healthcare Epidemiology.

Science.gov (United States)

Wiens, Jenna; Shenoy, Erica S

2018-01-06

The increasing availability of electronic health data presents a major opportunity in healthcare for both discovery and practical applications to improve healthcare. However, for healthcare epidemiologists to best use these data, computational techniques that can handle large complex datasets are required. Machine learning (ML), the study of tools and methods for identifying patterns in data, can help. The appropriate application of ML to these data promises to transform patient risk stratification broadly in the field of medicine and especially in infectious diseases. This, in turn, could lead to targeted interventions that reduce the spread of healthcare-associated pathogens. In this review, we begin with an introduction to the basics of ML. We then move on to discuss how ML can transform healthcare epidemiology, providing examples of successful applications. Finally, we present special considerations for those healthcare epidemiologists who want to use and apply ML. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

The Hazards of Data Mining in Healthcare.

Science.gov (United States)

Househ, Mowafa; Aldosari, Bakheet

2017-01-01

From the mid-1990s, data mining methods have been used to explore and find patterns and relationships in healthcare data. During the 1990s and early 2000's, data mining was a topic of great interest to healthcare researchers, as data mining showed some promise in the use of its predictive techniques to help model the healthcare system and improve the delivery of healthcare services. However, it was soon discovered that mining healthcare data had many challenges relating to the veracity of healthcare data and limitations around predictive modelling leading to failures of data mining projects. As the Big Data movement has gained momentum over the past few years, there has been a reemergence of interest in the use of data mining techniques and methods to analyze healthcare generated Big Data. Much has been written on the positive impacts of data mining on healthcare practice relating to issues of best practice, fraud detection, chronic disease management, and general healthcare decision making. Little has been written about the limitations and challenges of data mining use in healthcare. In this review paper, we explore some of the limitations and challenges in the use of data mining techniques in healthcare. Our results show that the limitations of data mining in healthcare include reliability of medical data, data sharing between healthcare organizations, inappropriate modelling leading to inaccurate predictions. We conclude that there are many pitfalls in the use of data mining in healthcare and more work is needed to show evidence of its utility in facilitating healthcare decision-making for healthcare providers, managers, and policy makers and more evidence is needed on data mining's overall impact on healthcare services and patient care.

How Competent Are Healthcare Professionals in Working According to a Bio-Psycho-Social Model in Healthcare? The Current Status and Validation of a Scale.

Directory of Open Access Journals (Sweden)

Dominique Van de Velde

Full Text Available Over the past decades, there has been a paradigm shift from a purely biomedical towards a bio-psycho-social (BPS conception of disability and illness, which has led to a change in contemporary healthcare. However, there seems to be a gap between the rhetoric and reality of working within a BPS model. It is not clear whether healthcare professionals show the necessary skills and competencies to act according to the BPS model.The aim of this study was (1 to develop a scale to monitor the BPS competencies of healthcare professionals, (2 to define its factor-structure, (3 to check internal consistency, (4 test-retest reliability and (5 feasibility.Item derivation for the BPS scale was based on qualitative research with seven multidisciplinary focus groups (n = 58 of both patients and professionals. In a cross-sectional study design, 368 healthcare professionals completed the BPS scale through a digital platform. An exploratory factor analysis was performed to determine underlying dimensions. Statistical coherence was expressed in item-total correlations and in Cronbach's α coefficient. An intra-class-correlation coefficient was used to rate the test-retest reliability.The qualitative study revealed 45 items. The exploratory factor analysis showed five underlying dimensions labelled as: (1 networking, (2 using the expertise of the client, (3 assessment and reporting, (4 professional knowledge and skills and (5 using the environment. The results show a good to strong homogeneity (item-total ranged from 0.59 to 0.79 and a strong internal consistency (Cronbach's α ranged from 0.75 to 0.82. ICC ranged between 0.82 and 0.93.The BPS scale appeared to be a valid and reliable measure to rate the BPS competencies of the healthcare professionals and offers opportunities for an improvement in the healthcare delivery. Further research is necessary to test the construct validity and to detect whether the scale is responsive and able to detect changes over time.

Evaluation of ethical reflections in community healthcare: a mixed-methods study.

Science.gov (United States)

Söderhamn, Ulrika; Kjøstvedt, Helga Tofte; Slettebø, Åshild

2015-03-01

Ethical reflections over care practices are important. In order to be able to perform such reflections, healthcare professionals must learn to think critically about their care practice. The aim of this study was to evaluate whether an introduction to and practice in ethical reflections in community healthcare have consequences for the healthcare personnel's practice. A mixed-methods design was adopted with five focus group interviews and an electronic questionnaire based on results from the interviews. A total of 29 community healthcare personnel with experience in ethical reflections participated in the interviews. The electronic questionnaire was sent via email to 2382 employees in community healthcare services in 13 municipalities in southern part of Norway. The study was guided by the intentions of the Declaration of Helsinki and ethical standard principles and approved by the Norwegian Social Science Data Services. An introduction to and practice in performing ethical reflections brought about an ethical awareness with understanding and respect for both colleagues and patients. The leader had a key role. Lack of time was a hindrance for ethical reflections. Three factors could predict meaningful ethical reflections: higher age of personnel, higher percentage of employment and longer experience with ethical reflections. According to other studies, ethical reflections may enhance moral development of colleagues and their actions as advocates for the patients. A deepened ethical awareness, professional competency and sufficient time resources will guarantee proper caregiving. A supportive environment that prioritizes participation in reflection meetings is decisive. To practice ethical reflections will provide better care for patients. A challenge for the community healthcare system is to offer adequate positions that provide the personnel an opportunity to be involved as caregivers and to participate in ethical reflections. © The Author(s) 2014.

Impact of imaging room environment: staff job stress and satisfaction, patient satisfaction, and willingness to recommend.

Science.gov (United States)

Quan, Xiaobo; Joseph, Anjali; Ensign, Janet C

2012-01-01

The built environment significantly affects the healthcare experiences of patients and staff. Healthcare administrators and building designers face the opportunity and challenge of improving healthcare experience and satisfaction through better environmental design. The purpose of the study was to evaluate how a novel environmental intervention for imaging rooms, which integrated multiple elements of healing environments including positive distractions and personal control over environment, affects the perceptions and satisfactions of its primary users-patients and staff. Anonymous questionnaire surveys were conducted to compare patient and staff perceptions of the physical environment, satisfaction, and stress in two types of imaging rooms: imaging rooms with the intervention installed (intervention rooms) and traditionally designed rooms without the intervention (comparison rooms). Imaging technologists and patients perceived the intervention rooms to be significantly more pleasant-looking. Patients in the intervention rooms reported significantly higher levels of environmental control and were significantly more willing to recommend the intervention rooms to others. The environmental intervention was effective in improving certain aspects of the imaging environment: pleasantness and environmental control. Further improvement of the imaging environment is needed to address problematic areas such as noise.

STOCHASTIC COLOURED PETRINET BASED HEALTHCARE INFRASTRUCTURE INTERDEPENDENCY MODEL

Directory of Open Access Journals (Sweden)

N. Nukavarapu

2016-06-01

Full Text Available The Healthcare Critical Infrastructure (HCI protects all sectors of the society from hazards such as terrorism, infectious disease outbreaks, and natural disasters. HCI plays a significant role in response and recovery across all other sectors in the event of a natural or manmade disaster. However, for its continuity of operations and service delivery HCI is dependent on other interdependent Critical Infrastructures (CI such as Communications, Electric Supply, Emergency Services, Transportation Systems, and Water Supply System. During a mass casualty due to disasters such as floods, a major challenge that arises for the HCI is to respond to the crisis in a timely manner in an uncertain and variable environment. To address this issue the HCI should be disaster prepared, by fully understanding the complexities and interdependencies that exist in a hospital, emergency department or emergency response event. Modelling and simulation of a disaster scenario with these complexities would help in training and providing an opportunity for all the stakeholders to work together in a coordinated response to a disaster. The paper would present interdependencies related to HCI based on Stochastic Coloured Petri Nets (SCPN modelling and simulation approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The entire model would be integrated with Geographic information based decision support system to visualize the dynamic behaviour of the interdependency of the Healthcare and related CI network in a geographically based environment.

Stochastic Coloured Petrinet Based Healthcare Infrastructure Interdependency Model

Science.gov (United States)

Nukavarapu, Nivedita; Durbha, Surya

2016-06-01

The Healthcare Critical Infrastructure (HCI) protects all sectors of the society from hazards such as terrorism, infectious disease outbreaks, and natural disasters. HCI plays a significant role in response and recovery across all other sectors in the event of a natural or manmade disaster. However, for its continuity of operations and service delivery HCI is dependent on other interdependent Critical Infrastructures (CI) such as Communications, Electric Supply, Emergency Services, Transportation Systems, and Water Supply System. During a mass casualty due to disasters such as floods, a major challenge that arises for the HCI is to respond to the crisis in a timely manner in an uncertain and variable environment. To address this issue the HCI should be disaster prepared, by fully understanding the complexities and interdependencies that exist in a hospital, emergency department or emergency response event. Modelling and simulation of a disaster scenario with these complexities would help in training and providing an opportunity for all the stakeholders to work together in a coordinated response to a disaster. The paper would present interdependencies related to HCI based on Stochastic Coloured Petri Nets (SCPN) modelling and simulation approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The entire model would be integrated with Geographic information based decision support system to visualize the dynamic behaviour of the interdependency of the Healthcare and related CI network in a geographically based environment.

Big Data, Big Problems: A Healthcare Perspective.

Science.gov (United States)

Househ, Mowafa S; Aldosari, Bakheet; Alanazi, Abdullah; Kushniruk, Andre W; Borycki, Elizabeth M

2017-01-01

Much has been written on the benefits of big data for healthcare such as improving patient outcomes, public health surveillance, and healthcare policy decisions. Over the past five years, Big Data, and the data sciences field in general, has been hyped as the "Holy Grail" for the healthcare industry promising a more efficient healthcare system with the promise of improved healthcare outcomes. However, more recently, healthcare researchers are exposing the potential and harmful effects Big Data can have on patient care associating it with increased medical costs, patient mortality, and misguided decision making by clinicians and healthcare policy makers. In this paper, we review the current Big Data trends with a specific focus on the inadvertent negative impacts that Big Data could have on healthcare, in general, and specifically, as it relates to patient and clinical care. Our study results show that although Big Data is built up to be as a the "Holy Grail" for healthcare, small data techniques using traditional statistical methods are, in many cases, more accurate and can lead to more improved healthcare outcomes than Big Data methods. In sum, Big Data for healthcare may cause more problems for the healthcare industry than solutions, and in short, when it comes to the use of data in healthcare, "size isn't everything."

Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa

NARCIS (Netherlands)

Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

2013-01-01

Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB