People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.
Pourhosseini, Samira Sadat; Ardalan, Ali; Mehrolhassani, Mohammad Hossien
Health care management in disasters is one of the main parts of disaster management. Health in disasters is affected by performance of various sectors, and has an interactive impact on various aspects of disaster management. The aim of this study was to identify the most important themes affecting the healthcare management in disaster. In this qualitative study with a content analysis approach, in-depth interviews in two steps with 30 disaster experts and managers were conducted to collect the data. Eleven themes affecting healthcare management in disasters were identified. These themes were related to human resources management, resources management, victims' management transfer, environmental hygiene monitoring, nutrition management, mental health control, inter-agency coordination, training, technology management, information and communication management, and budget management. Providing effective health care service in disasters requires a comprehensive look at the various aspects of disaster management. Effective factors on the success of healthcare in disaster are not limited to the scope of healthcare. There should be a close relationship and interaction between different sectors of disaster management.
Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas
BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase th...
Rhineland leadership practices contrast sharply with the prevailing Anglo/US business model of short-term maximization of profitability, and are said to lead to greater corporate sustainability, at least in highly developed economies. However, the applicability of Rhineland leadership to less developed economies has not yet been demonstrated. This paper sets out to compare the business practices of a social enterprise that delivers healthcare services in Thailand and Avery's 19 sustainable leadership practices derived from Rhineland enterprises. Adopting a case study approach, multi-data collection methods included non-participant observations made during visits to the enterprise, and reference to internal and published documentation and information. Semi-structured interview sessions were held with many stakeholders, including top management, staff, patients and a former consultant. In the Thai healthcare organization studied, evidence was found for compliance with 15 of Avery's 19 sustainable leadership elements, but to varying degrees. The elements were grouped into six core sets of practices: adopting a long-term perspective, staff development, organizational culture, innovation, social responsibility, and ethical behavior. One element was found to be not applicable, and no evidence was found for conformity with Rhineland principles on the remaining three sustainable practices. The paper concludes that Avery's 19 Rhineland practices provide a useful framework for evaluating the corporate sustainability of this Thai enterprise. Healthcare enterprises in Thailand and possibly in other Asian countries that wish to sustain their organizational success could adopt Avery's 19 Sustainable Leadership Grid elements to examine their leadership practices, and adjust them to become more sustainable. The relevance of Rhineland sustainable leadership principles to enterprises in less developed economies remains to be investigated. This study attempts to uncover this unknown.
Healthcare organisations are an enigma to many people inand outside the service. Organisational fuzziness is a common state, characterised by a lack of clarity, lack of awareness, lack of organisational knowledge, and the reliance on practice and custom instead of transparency. The objective of this study was to obtain a better understanding of what causes this fuzziness and provide an actionable description of fuzzy organisations. Such a description is essential to managing and preventing organisational fuzziness. We used a longitudinal case study in an integrated healthand social care organisation to obtain a thorough understanding of how the organisation functions. These indepth insights allowed the identification of three generators of fuzziness. We found that the three main generators of organisational fuzziness are change, informal organisation and complexity. Organisational fuzziness is thus partly due to the inherent complexities of human systems. However, also continuous change and the inability of the system to adapt its formal structures resulted in structures deteriorating or no longer being appropriate. Existing approaches to explain unclear or absent structures in healthcare organisations by describing these organisations as complex adaptive systems (CAS) are too simplistic. While aspects relating to people and their interactions are indeed complex, fuzziness of structural aspects are often the result of continuous change and insufficient organisational capacity to adapt to it.
This thesis focuses on improving safety management for healthcare and social assistance service providers who deliver healthcare for patients and client in Healthcare and Social centers and homes. The quality of these provided services is dependent heavily on attitudes and well-being of its care workers and staff. Therefore, healthcare and social assistant workers’ (HCSA) safety is crucial to the quality of patient care, though it remains a challenge in countries of various levels of developm...
Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis
To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Khanal, Saval; Veerman, Lennert; Nissen, Lisa; Hollingworth, Samantha
The healthcare systems in many Low-and Middle-Income Countries (LMICs) like Nepal have long focused on preventing and treating infectious diseases. Little is known about their preparedness to address the increasing prevalence of Non-Communicable Diseases (NCDs). This study aimed to investigate the use of healthcare services by patients with NCDs in Nepal. Nine healthcare providers (including health assistants, pharmacy assistants, nurse, specialised nurse, practicing pharmacists, chief hospital pharmacist, doctors and specialised doctor) from Pokhara, Nepal, were recruited using purposive sampling. In depth interviews about the magnitude of NCDs, first point of care, screening and diagnosis, prevention and management, follow-up, and healthcare system responses to NCD burden were conducted. Data were thematically analysed with a deductive approach. Although the healthcare system in Nepal is still primarily focused on communicable infectious diseases, healthcare providers are aware of the increasing burden of NCDs and NCD risk factors. The first points of care for patients with NCDs are government primary healthcare facilities and private pharmacies. NCDs are often diagnosed late and opportunistically. NCD prevention and treatment is unaffordable for many people. There are no government sponsored NCD screening programs. There are problems associated with screening, diagnosis, treatment and follow-up of patients with NCDs in Nepal. Healthcare providers believe that the current healthcare system in Nepal is inadequate to address the growing problem of NCDs. The health system of Nepal will face challenges to incorporate programs to prevent and treat NCDs in addition to the pre-existing communicable diseases.
Roig, Francesc; Saigí, Francesc
Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.
Ludmila Mourão Xavier Gomes
Full Text Available OBJECTIVE: To evaluate the quality of healthcare provided to sickle cell disease children by primary healthcare services in a region of high prevalence. METHODS: A cross-sectional, descriptive study was performed by interviewing members of families with sickle cell disease children. The children had been identified from the Neonatal Screening Program in Minas Gerais state over the last 12 years in towns of the Montes Claros-Bocaiuva microregion. A structured questionnaire specially developed for this study and based on three axes was used: indicators of the child's health (immunization, growth and development, prophylaxis antibiotic therapy, perception of care by the family (health education and accessibility and knowledge of the family about the disease. RESULTS: Sixty-three of 71 families with children identified as having sickle cell disease were interviewed. The predominant genotypes were Hb SS (44.4% and Hb SC (41.2%. Adequate monitoring of growth and development was recorded for the first year of life in 23 children (36.6% and for the second year of life in 18 children (28.6%. The basic vaccination schedule was completed by 44 children (69.8% but 62 vaccination record cards (98.4% identified delays of special vaccines. Regular use of prophylactic penicillin was reported by 55 caregivers (87.3%. The family's perception of the care provided suggests poor accessibility to health services and lack of opportunities to answer doubts. The average performance of families in knowledge testing was 59.8%. CONCLUSION: The quality of healthcare is unsatisfactory. The care provided to children with sickle cell disease in primary healthcare services needs improvements.
Keshvari, Mahrokh; Mohammadi, Eesa; Farajzadegan, Ziba; Zargham-Boroujeni, Ali
Primary healthcare (PHC) providers play a major role in provision of public health in rural areas in Iran. They are considered as the key elements of health development in rural population. There is limited research on clarification of their experiences from provision of health services in their working conditions. This study aimed to clarify the experience of PHC providers from working conditions in giving primary health services in health houses (district branches of rural health care centers). This is a content analysis qualitative study, conducted through personal and group interviews with 12 health workers working in health care centers in rural areas in Isfahan province, 2010. Sampling continued until data saturation. Data were analyzed through conventional content analysis and constant comparative method. Data analysis led to extraction of 11 categories, and finally, four themes of "ignoring the rights," "causing tension in working climate," "pressure or overload of expectations beyond the power," and "occupational worn out" were yielded from the categories. These themes reveal the concepts and nature of PHC providers' experiences from giving health care at health houses as the first level of PHC centers. The results of the present study showed that the PHC providers work in a tense condition in health houses. Although they devote themselves to the health of society members, their own health is neglected. Policy makers and authorities should amend working conditions of PHC providers through modification of resources and making supportive and collaborative strategies to improve the quality of services and promote the health level of the service receivers.
Mónica Ruiz-Casares; Janet Cleveland; Youssef Oulhote; Catherine Dunkley-Hickin; Cécile Rousseau
Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec...
Ruiz-Casares, Mónica; Cleveland, Janet; Oulhote, Youssef; Dunkley-Hickin, Catherine; Rousseau, Cécile
Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec...
Devkota, Hridaya Raj; Murray, Emily; Kett, Maria; Groce, Nora
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth. The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes. Mean ATDP score among healthcare providers (78.52; SD = 14.75), was low compared to the normative score of 100 or higher. Nurses/auxiliary nurse midwives obtained the highest mean score (85.59, SD = 13.45), followed by general clinical health workers (Mean score = 82.64, SD 15.10). The lowest score was obtained by Female Community Health Volunteers (FCHV) (Score = 73.75, SD = 13.40) (P disability (P disability training and who did not was also found statistically insignificant (P > 0.05). This may reflect the small number of individuals, who have had training on disability thus far, or the nature or
Veenema, Tener Goodwin; Rains, Adam B; Casey-Lockyer, Mary; Springer, Janice; Kowal, Mary
Globally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters. To determine based upon systematic and accurate measurement the scope and quality of health care services rendered in disaster shelters and to describe the health outcomes experienced by shelter residents. An integrative review of English-language literature pertaining to the assessment, evaluation, and systematic measurement of healthcare quality and client outcomes in disaster and emergency shelters was undertaken. Articles were identified using a structured search strategy of six databases and indexing services (PubMed, CINAHL, EMBase, Scopus, Web of Science, and Google Scholar). Limited literature exists pertaining specifically to metrics for quality of health care in acute disaster and emergency shelters, and the literature that does exist is predominately U.S. based. Analysis of the existing evidence suggests that nurse staffing levels and staff preparedness, access to medications/medication management, infection control, referrals, communication, and mental health may be important concepts related to quality of disaster health care services. A small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ali Mohammad Mosadeghrad
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 o...
Ruiz-Casares, Mónica; Cleveland, Janet; Oulhote, Youssef; Dunkley-Hickin, Catherine; Rousseau, Cécile
Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.
Full Text Available Following changes to the Interim Federal Health (IFH program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.
Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have
Loza, Oralia; Alvarez, Carlos R; Peralta-Torres, David
Sexual and gender minorities, including lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, experience barriers to healthcare as a result of stigma, discrimination, and poor cultural competence by healthcare and social services providers (HCSSP). The purpose of the study is to increase access to care and services for the LGBTQ community in a U.S.-Mexico border city by identifying LGBTQ-friendly HCSSP. A survey, developed based on concerns voiced in a predominantly Hispanic LGBTQ community, was administered to HCSSP and used to create a referral list, "The Purple Pages of El Paso" (PPoEP). Overall, 77 HCSSP have responded and 43 are included in the most recent version of the PPoEP. This model for developing a referral list of providers can be adapted in areas where LGBTQ communities face similar barriers to care and services. To be effective in reducing barriers to care, PPoEP must be updatable and sustainable.
Ali Mohammad Mosadeghrad
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.
Full Text Available Abstract Background: Despite the success of developed countries in preventing the spread of HIV/AIDS, the disease is expanding in developing countries where an unfavorable attitude exists among people, health professionals and employees. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLWHA. Methods: The study is a cross-sectional survey. The data were gathered using a structured questionnaire. The study sample included 575 health care providers of public and private hospitals in Shiraz. The data were gathered using a structured questionnaire in spring 2014. Data analysis was carried out using the Statistical Package for Social Sciences, version 21. Results: The most dominant attitude of the health care providers toward HIV/AIDS patients was related to fear (42.42%. According to the results of this study, there was a significant relationship between stigmatized attitude of the health care providers and their religious beliefs, society stigmatized attitude, and knowledge of transmission routes. The relationship between social stigmatized attitude of health care providers and their knowledge of transmission routes, with their willingness to provide services to patients is significant, as well (P<0.05. 39.6% and 46.2% of the respondents preferred not to provide services to the prostitutes and homosexual patients. Conclusion: Fear of contamination and social stigmatized attitude are the main impediments to dealing with patients and providing services to them. Hence, it seems that creating an effective knowledge about transmission and correcting the socio-cultural beliefs of health providers are two key strategies to tackle this problem.
Yamashita, Tadashi; Suplido, Sherri Ann; Llave, Cecilia; Tuliao, Maria Teresa R; Tanaka, Yuko; Matsuo, Hiroya
Given the shortage of medical professionals in the Philippines, Barangay Health Workers (BHWs) may play a role in providing postpartum healthcare services. However, as there are no reports regarding BHW activities in postpartum healthcare, we conducted this study to understand postpartum healthcare services and to explore the challenges and motivations of maternal health service providers. Focus group interview (FGI) of 13 participants was conducted as qualitative research methodology at Muntinlupa City. The results were analyzed according to the interview guide. The proceedings of the FGI were transcribed verbatim, and researchers read and coded the transcripts. The codes were then used to construct categories. Four important activities were highlighted among 11 analysis codes. These activities were "Assessment of postpartum women's conditions," "Recommendation to visit a health facility," "Measurement of blood-pressure and vitamin intake," and "Providing postpartum health information." Among five analysis codes, we identified three challenges that BHWs face, which were "No current information regarding postpartum care," "Some postpartum women do not want to receive healthcare services from BHW," and "Too many assigned postpartum women." Among five analysis codes, we identified two reasons for continuing BHW activities, which were "Hospitality to help postpartum women and their family in the community" and "Performance of mission in providing BHW services." This study is the first to evaluate BHW activities in postpartum healthcare services. Our results indicate that BHWs play a potentially important role in evaluating postpartum women's physical and mental conditions through home-visiting services. However, several difficulties adversely affected their activities, and these must be addressed to maximize the contributions of BHWs to the postpartum healthcare system.
Full Text Available Abstract Background In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC services to street-dwellers. Methods This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another. Results The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p p Conclusions As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.
Uddin, Jasim; Koehlmoos, Tracey P; Saha, Nirod C; Islam, Ziaul; Khan, Iqbal A; Quaiyum, M A
In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers. This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another. The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas. As the findings of the study showed the promise of this approach, the strategies could
Efficient healthcare systems in developing economies are significant indicators of development. ... access to quality healthcare can be improved with efficient healthcare support programs and deferred payment options. ... Healthcare Services; Healthcare Providers; Multinomial Logistic Model; Healthcare Systems; Primary.
Keli Regina DAL PRÁ
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.
Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans
Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. 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/
Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
M. L.S. Mataboge
Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia
Abstract The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator‐initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor‐investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator‐initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter‐institutional capacity. PMID:24455986
Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal.
Kohrt, Brandon A; Jordans, Mark J D; Turner, Elizabeth L; Sikkema, Kathleen J; Luitel, Nagendra P; Rai, Sauharda; Singla, Daisy R; Lamichhane, Jagannath; Lund, Crick; Patel, Vikram
Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k = 34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities (n = 150); indirect beneficiaries are their patients (n = 100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mhGAP), clinical
Pindyck, Talia; Kalishman, Summers; Flatow-Trujillo, Lainey; Thornton, Karla
Background: American Indians/Alaskan Natives have a high mortality associated with hepatitis C virus, yet treatment rates are low. The ECHO (Extension for Community Healthcare Outcomes) model™, a videoconferencing technology for primary care providers, is underutilized at Indian Health Service facilities. Purpose: To ascertain Indian Health Service providers’ benefit of and barriers to utilizing hepatitis C virus TeleECHO clinics. Methods: We electronically sent an Active Participant Survey t...
U.S. Department of Health & Human Services — The POS file contains data on characteristics of hospitals and other types of healthcare facilities, including the name and address of the facility and the type of...
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.
Wei, Han-Ting; Chen, Mu-Hong; Ku, Wen-Wei
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.
Conclusions: Antiretroviral-based HIV prevention is acceptable and accessible to meet the growing demand for safer conception services in Kenya, since medically assisted interventions are currently cost prohibitive. Cross-disciplinary training for health providers would expand confidence in all prevention options and foster the tailoring of counselling to couples’ preferences.
Conclusions: Healthcare providers demonstrated attitudes and perceptions in antibiotic prescribing or use of laboratory derived information in infection diagnosis that could have negative impacts on antibiotic prescribing. Key words: Healthcare providers, Lesotho, antibiotic prescribing, laboratory derived information ...
Paterson, Pauline; Meurice, François; Stanberry, Lawrence R; Glismann, Steffen; Rosenthal, Susan L; Larson, Heidi J
While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations. Copyright Â© 2016. Published by Elsevier Ltd.
Mosadeghrad, Ali Mohammad
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.
Full Text Available Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR, one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing . S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.
A systematic review of studies conducted from 2008 till 2015 was undertaken to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in an attempt to obtain an overall picture of how wellequipped the healthcare providers are to provide optimal breast cancer education, ...
Stecker, Mona; Epstein, Nancy; Mark M Stecker; Ausman, James I.; Harrigan, Noyes
Background: Patient safety is a top priority of healthcare organizations. The Joint Commission (TJC) is now requiring that healthcare organizations promulgate polices to investigate and resolve disruptive behavior among employees. Methods: Our aims in this investigation utilizing the Provider Conflict Questionnaire (PCQ: Appendix A) included; determining what conflicts exist among a large sample of healthcare providers, how to assess the extent and frequency of disruptive behaviors, and what ...
U.S. Department of Health & Human Services — This dataset include facility details, performance rate, measure score, and the state and national average scores for each of the ICH CAHPS survey metrics that are...
regarded their patients as particularly vulnerable, they felt a strong and protective attachment towards them. A second barrier identified was a lack of .... parents to keep their children in adolescent care. Youth healthcare providers aimed to ... Patient attachment to adolescent healthcare providers and facilities. In all five sites ...
Conclusion: Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.
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.
A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during ...
Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.
In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...
... Employment and Training Administration Apria Healthcare Customer Service Department; Fourteen Locations in... Healthcare, Customer Service Department, Thirteen Locations in Missouri: Cameron, Cape Girardeau, Columbia... Healthcare, Customer Service Department. The Clinton, Missouri location provided data entry services in the...
Full Text Available The aim of the study was to reduce food waste in a hospital, a hospital cafeteria, and a residential home by applying a participatory approach in which the employees were integrated into the process of developing and implementing measures. Initially, a process analysis was undertaken to identify the processes and structures existing in each institution. This included a 2-week measurement of the quantities of food produced and wasted. After implementing the measures, a second measurement was conducted and the results of the two measurements were compared. The average waste rate in the residential home was significantly reduced from 21.4% to 13.4% and from 19.8% to 12.8% in the cafeteria. In the hospital, the average waste rate remained constant (25.6% and 26.3% during the reference and control measurements. However, quantities of average daily food provided and wasted per person in the hospital declined. Minimizing overproduction, i.e., aligning the quantity of meals produced to that required, is essential to reducing serving losses. Compliance of meal quality and quantity with customer expectations, needs, and preferences, i.e., the individualization of food supply, reduces plate waste. Moreover, establishing an efficient communication structure involving all actors along the food supply chain contributes to decreasing food waste.
Basinga, Paulin; Gertler, Paul J; Binagwaho, Agnes; Soucat, Agnes L B; Sturdy, Jennifer; Vermeersch, Christel M J
Evidence about the best methods with which to accelerate progress towards achieving the Millennium Development Goals is urgently needed. We assessed the effect of performance-based payment of health-care providers (payment for performance; P4P) on use and quality of child and maternal care services in health-care facilities in Rwanda. 166 facilities were randomly assigned at the district level either to begin P4P funding between June, 2006, and October, 2006 (intervention group; n=80), or to continue with the traditional input-based funding until 23 months after study baseline (control group; n=86). Randomisation was done by coin toss. We surveyed facilities and 2158 households at baseline and after 23 months. The main outcome measures were prenatal care visits and institutional deliveries, quality of prenatal care, and child preventive care visits and immunisation. We isolated the incentive effect from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments made to the treatment facilities. We estimated a multivariate regression specification of the difference-in-difference model in which an individual's outcome is regressed against a dummy variable, indicating whether the facility received P4P that year, a facility-fixed effect, a year indicator, and a series of individual and household characteristics. Our model estimated that facilities in the intervention group had a 23% increase in the number of institutional deliveries and increases in the number of preventive care visits by children aged 23 months or younger (56%) and aged between 24 months and 59 months (132%). No improvements were seen in the number of women completing four prenatal care visits or of children receiving full immunisation schedules. We also estimate an increase of 0·157 standard deviations (95% CI 0·026-0·289) in prenatal quality as measured by compliance with Rwandan prenatal care clinical practice guidelines. The P4P scheme in Rwanda had
Johnson, Brooke Ronald; Maksutova, Elmira; Boobekova, Aigul; Davletova, Ainura; Kazakbaeva, Chinara; Kondrateva, Yelena; Landoulsi, Sihem; Lazdane, Gunta; Monolbaev, Kubanychbek; Seuc Jo, Armando H
To demonstrate the feasibility and safety of training midlevel healthcare providers (midwives and family nurses) to provide medical abortion and postabortion contraception in underserved areas in Kyrgyzstan. This was an implementation study at four referral facilities and 28 Felsher Obstetric Points in two districts to train their midwives and family nurses to deliver safe and effective abortion care with co-packaged mifepristone-misoprostol and provide contraceptives postabortion. The outcome of abortion - complete abortion, incomplete abortion or o-going pregnancy - was the primary end point measured. An international consultant trained 18 midwives and 14 family nurses (with midwifery diplomas) to provide medical abortion care. Supervising gynecologists based in the referral centers and study investigators based in Bishkek provided monthly monitoring of services and collection of patient management forms. A voluntary self-administered questionnaire at the follow-up visit documented women's acceptability of medical abortion services. All study data were cross-checked and entered into an online data management system for descriptive analysis. Between August 2014 and September 2015, midwives provided medical abortion to 554 women with a complete abortion rate of 97.8%, of whom 62% chose to use misoprostol at home. No women were lost to follow-up. Nearly all women (99.5%) chose a contraceptive method postabortion; 61% of women receiving services completed the acceptability form, of whom more than 99% indicated a high level of satisfaction with the service and would recommend it to a friend. This study demonstrates that trained Kyrgyz midwives and nurses can provide medical abortion safely and effectively. This locally generated evidence can be used by the Kyrgyz Ministry of Health to reduce unintended pregnancy and expand safe abortion care to women in underserved periurban and rural settings. Success in scaling up midwife/nurse provision of medical abortion in
Full Text Available Abstract Background In Vietnam, the health-sector reforms since 1989 have lead to a rapid increase in out-of-pocket expenses. This paper examines the choice of medical provider and household healthcare expenditure for different providers in a rural district of Vietnam following healthcare reform. Methods The study consisted of twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample – Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002. Results The use of private health providers and self-treatment are quite common for both episodes (60% and 23% of all illness episodes and expenditure (60% and 12.8% of healthcare expenditure The poor tend to use self-treatment more frequently than wealthier members of the community (31% vs. 14.5% of illness episodes respectively. All patients in this study often use private services before public ones. The poor use less public care and less care at higher levels than the rich do (8% vs.13% of total illness episodes, which decomposes into 3% vs. 7% at district level, and 1% vs. 3% at the provincial or central level, respectively. The education of the patients significantly affects healthcare decisions. Those with higher education tend to choose healthcare providers rather than self-treatment. Women tend to use drugs or healthcare services more often than men do. Patients in two highest quintiles use health services more than in the lowest quintile. Moreover, seriously ill patients frequently use more drugs, healthcare services, public care than those with less severe illness. Conclusion The results are useful for policy makers and healthcare professionals to (i formulate healthcare policies-of foremost importance are methods used to reduce self-treatment and no treatment; (ii the management of private practices and maintaining public healthcare providers at all levels
Elise M van der Elst
Full Text Available Introduction: Men who have sex with men (MSM in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs about the health issues and needs of MSM patients. Methods: Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in serving MSM patients and impacts of programme participation on HCWs’ personal attitudes and professional capacities. Results: Before participating in the training programme, HCWs described secondary stigma, lack of professional education about MSM, and personal and social prejudices as barriers to serving MSM clients. After completing the programme, HCWs expressed greater acknowledgement of MSM patients in their clinics, endorsed the need to treat MSM patients with high professional standards and demonstrated sophisticated awareness of the social and behavioural risks for HIV among MSM. Conclusions: Findings provide support for this approach to improving health services for MSM patients. Further efforts are needed to broaden the reach of this training in other areas, address identified barriers to HCW participation and evaluate programme effects on patient and HCW outcomes using rigorous methodology.
Sun, Tara Qian; Medaglia, Rony
Public healthcare ecosystems are complex networks of diverse actors that are subject to pressures to innovate, also a result of technological advancements. Artificial Intelligence (AI), in particular, has the potential to transform the way hospitals, doctors, patients, government agencies......, and IT providers cocreate value in a healthcare ecosystem. Adopting a ServiceDominant (S-D) logic perspective, we present part of an ongoing doctoral project that focuses on the role of shared worldview of technology in service cocreation. Using the lens of Technology Frames of Reference (TFR) theory, we...... investigate how different actors frame the cognitive assistant IBM Watson used in a healthcare service ecosystem in China for decision-making in the treatment of cancer patients. Drawing on preliminary findings, we present a tentative research model that links technology framing to value cocreation...
Apr 4, 2013 ... and the parents and healthcare providers' views on hospitalised children being visited by other children. ... Subjects: Nurses, paediatricians and parents of hospitalised children. Results: A total of 161 ... because it promotes healing, gives the sick child psychological satisfaction and relieves anxiety in the ...
Despite this, however, majority of the healthcare providers and the parents acknowledged the importance of the hospitalised children being visited by other children. This is because it promotes healing, gives the sick child psychological satisfaction and relieves anxiety in the hospitalised child, the accompanying parent and ...
U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...
Purpose: To evaluate the attitudes and perceptions of health care providers towards clinical pharmacy services at King Khalid University Hospital Riyadh Saudi Arabia Method: A cross-sectional survey of healthcare providers was conducted in King Khalid University Hospital, Riyadh, Saudi Arabia from September to ...
Purpose: To explore healthcare providers' (HCPs) and medical students' attitudes to, and perceptions of the pharmaceutical services that clinical pharmacists can provide in United Arab Emirates. Methods: A total of 535 participants (265 HCPs and 270 medical students) were asked to complete a questionnaire over a ...
Tien, James M; Goldschmidt-Clermont, Pascal J
Engineering has and will continue to have a critical impact on healthcare; the application of technology-based techniques to biological problems can be defined to be technobiology applications. This paper is primarily focused on applying the technobiology approach of systems engineering to the development of a healthcare service system that is both integrated and adaptive. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components - people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.
Bauer, Patricia W; Broman, Clifford L; Pivarnik, James M
To examine healthcare provider knowledge, beliefs, and practices regarding exercise during pregnancy using a cross-sectional 31-question pen and paper survey. Ninety-three practicing healthcare providers, M.D. (n = 45) and D.O. (n = 14) physicians and certified nurse midwives (C.N.M., n = 34), from hospitals and birth centers around Michigan participated in this study. Descriptive characteristic data, provider knowledge, beliefs, and practices regarding exercise during pregnancy, common exercise restrictions given to pregnant patients, and provider awareness of current American College of Obstetricians and Gynecologists (ACOG) exercise and pregnancy guidelines were collected. Descriptive statistics and chi-square analyses were completed. Overall, 99% of respondents believed that exercise during pregnancy is beneficial, 64% of all respondents believed that maternal exercise heart rate should not exceed 140 beats per minute (bpm), and 60% of M.D.s and 86% of D.O.s were not familiar with the 1994 ACOG guidelines for exercise and pregnancy (p exercise during pregnancy were positive, not all were aware of or followed current ACOG recommendations. Different strategies for dissemination of current research may be warranted.
Chao, Chia Chen; Jen, Wen Yuan; Li, Yu-Chuan; Chi, Y P; Chen, Chang-I; Feng, Chen Chjeh
Improving healthcare service quality for illness of treatment, illness prevention and patient service is difficult for most hospitals because the hospitals are lack adequate resources and labor. In order to provide better healthcare service quality for patients, mobile technology can be used to manage healthcare in a way that provides the optimal healthcare service for patients. Pursuing utilization of mobile technology for better patient service, Taipei Medical University Municipal W. F. Teaching Hospital has implemented a mobile healthcare service (m-HS) system to increase healthcare service quality. The m-HS system improves the quality of medical care as well as healthcare service. The m-HS is a multi-functional healthcare management agent, meets the mobile tendency of the present society. This study seeks to discuss the m-HS architecture and workflow processes. We believe the m-HS does have the potential to improve healthcare service quality. Finally, the conclusions and suggestions for the m-HS are given.
Zhan, X X; Zhang, Z X; Sun, F; Peng, W J; Zhang, H; Yan, W R
To explore the attitudes of primary healthcare workers, including township public health workers (TPHWs) and village doctors (ViDs), towards web-based training on basic public health services (BPHS) and to examine the factors influencing their attitudes. Cross-sectional study. Questionnaires addressing training status, needs, and attitudes towards web-based public health training were administered to 2768 primary healthcare workers from May to September 2013. Multivariate logistic regression models were used to identify the factors that were significantly associated with a positive attitude towards web-based public health training. Among the 2768 participants, 90.6% of the TPHWs and 86.9% of the ViDs expressed a positive attitude towards web-based BPHS training. TPHWs who had a positive attitude towards previous public health training (odds ratio [OR] = 2.75, 95% confidence interval [CI] = 1.28-5.93) and better computer skills (OR = 2.59, 95% CI = 1.03-6.48) were more likely to adopt web-based training on BPHS, as were ViDs who had better computer skills (OR = 2.54, 95% CI = 1.58-4.11) and better Internet speeds (neutral: OR = 2.81, 95% CI = 1.58-5.01; satisfied: OR = 2.53, 95% CI = 1.28-5.01). TPHWs who tended to read papers (OR = 0.24, 95% CI = 0.11-0.50) and were aged 50 years or older (OR = 0.34, 95% CI = 0.14-0.87), as were ViDs who tended to read papers (OR = 0.48, 95% CI = 0.29-0.77), expressed a more negative attitude towards web-based BPHS training. The findings indicated that most primary healthcare workers have a positive attitude towards web-based BPHS training. More priority measures, such as conducting computer training, improving Internet quality and integrating mobile technology, are recommended and will further improve the implementation of web-based public health training programs. Copyright Â© 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Full Text Available . These features can be traced back to the days in South African history where healthcare facilities were racially segregated and both curative and preventive healthcare services were separated by the Public Health Amendment act of 1897 (Coovadia et al. 2009... was greeted with enormous reform measures to redress the discrimination, disempowerment, underdevelopment and ill-health service delivery that had greatly weakened the healthcare system. Although the government has implemented bold initiatives to strengthen...
Ferreira-Furegato, Antonia Regina; Aparecida Frari-Galera, Sueli; Pillon, Sandra Cristina; Ferreira-Santos, Jair Licio; Araujo-Pitia, Ana Celeste; Cardoso, Lucilene
Describing profiles for professional psychiatric service categories in Ribeirão Preto. This was an exploratory study of 8 services (3 hospitals and 5 extra-hospital facilities). Data was collected using questionnaires and semi-structured interviews with professionals who worked for all these services. 74 % of the professionals working for the eight services investigated took part in the study. Doctors and nurses predominated in the hospitals and multidisciplinary teams in extra-hospital facilities. Ages ranged from 24 to 68, females predominating (73 %). 127 (88 %) of the 144 subjects in this study had received specific education after graduating in their respective areas but only 48.5 % had studied mental health. Doctors (42/44) and nurses (36/42) predominated in the teams; 121 (83 %) earned over R$ 1,000 per month as their salary. The teams mainly consisted of doctors and nurses, although it was considered that other professionals were important in constituting such teams. One of the main problems hampering reform in the psychiatric field is how services are provided for the population. No country has been able to make the necessary reforms for overcoming all the barriers. The service network studied met the minimum prerequisites for providing psychiatric care for the community.
Web services are often used for search computing where data is retrieved from servers providing information of different kinds. Such data providing web services return a set of objects for a given set of parameters without any side effects. There is need to enable general and scalable search capabilities of data from data providing web services, which is the topic of this Thesis. The Web Service MEDiator (WSMED) system automatically provides relational views of any data providing web service ...
Ezihe Loretta Ahanonu
Full Text Available This study sought to assess the attitude of Healthcare Providers towards providing contraceptives for unmarried adolescents in four Local Government Areas in Ibadan, Nigeria.A cross-sectional descriptive study was conducted among 490 Healthcare Providers in 24 randomly selected healthcare facilities using self-administered, pre-tested questionnaires.More than half (57.5% of the respondents perceived the provision of contraceptives for unmarried adolescents as promoting sexual promiscuity. The attitude of 42.7% of them was informed by the Nigerian culture which does not support premarital sex. About half (51.7%, reported that unmarried adolescents should be asked to abstain from sex rather than providing them with contraceptives. Over a third (44.2% reported that providers should not provide services for both married and unmarried adolescents.Many healthcare providers have unfavourable attitudes towards the provision of contraceptives for unmarried adolescents. There is a need for further training of Healthcare Providers to address this situation.
Smailhodzic, Edin; Boonstra, Albert; Langley, David
Social media represent specific types of technologies that are end-user driven and end-users are able to drive disruptive change giving little time to organizations to react. With rapid and powerful emergence of social media communities in healthcare, this sector is faced with new and alternative
Smailhodzic, E.; Boonstra, A.; Langley, D.J.
Social media represent specific types of technologies that are end-user driven and end-users are able to drive disruptive change giving little time to organizations to react. With rapid and powerful emergence of social media communities in healthcare, this sector is faced with new and alternative
Jeon, Eun Min; Seo, Hwa Jeong
In order to adopt and activate telemedicine it is necessary to survey how medical staff, who are providers of medical service, and consumers, who are the service targets, perceive information and communication technology (ICT)-based healthcare service. This study surveyed the awareness and acceptability of ICT-based healthcare by involving service targets, specifically workers and students living in the Seoul and Gyeonggi regions who are consumers of healthcare service. To determine the correlation among awareness of ICT-based healthcare, the need for self-management, and acceptability, this study conducted a correlation analysis and a simple regression analysis. According to the responses to the questions on the need for ICT-based healthcare service by item, blood pressure (n = 279, 94.3%) and glucose (n = 277, 93.6%) were revealed to be the physiological signal monitoring area. Among the six measurement factors affecting ICT-based healthcare service acceptability, age, health concerns, and effect expectation had the most significant effects. As effect expectation increased, acceptability became 4.38 times higher ( p ICT-based healthcare service. The fact that acceptability is higher among people who have family disease history or greater health concerns may lead to service targets' more active participation. This study also confirmed that a policy to motivate active participation of those in their 40s (who had high prevalence rates) was needed.
Samuel, Cherian; Gonapa, Kasiviswanadh; Chaudhary, P K; Mishra, Ananya
The purpose of this paper is to analyse health service supply chain systems. A great deal of literature is available on supply chain management in finished goods inventory situations; however, little research exists on managing service capacity when finished goods inventories are absent. System dynamics models for a typical service-oriented supply chain such as healthcare processes are developed, wherein three service stages are presented sequentially. Just like supply chains with finished goods inventory, healthcare service supply chains also show dynamic behaviour. Comparing options, service reduction, and capacity adjustment delays showed that reducing capacity adjustment and service delays gives better results. The study is confined to health service-oriented supply chains. Further work includes extending the study to service-oriented supply chains with parallel processing, i.e. having more than one stage to perform a similar operation and also to study the behaviour in service-oriented supply chains that have re-entrant orders and applications. Specific case studies can also be developed to reveal factors relevant to particular service-oriented supply chains. The paper explains the bullwhip effect in healthcare service-oriented supply chains. Reducing stages and capacity adjustment are strategic options for service-oriented supply chains. The paper throws light on policy options for managing healthcare service-oriented supply chain dynamics.
Eleuch, Amira ep Koubaa
This study aims to assess Japanese patients' healthcare service quality perceptions and to shed light on the most meaningful service features. It follows-up a study published in IJHCQA Vol. 21 No. 7. Through a non-linear approach, the study relied on the scatter model to detect healthcare service features' importance in forming overall quality judgment. Japanese patients perceive healthcare services through a linear compensatory process. Features related to technical quality and staff behavior compensate for each other to decide service quality. A limitation of the study is the limited sample size. Non-linear approaches could help researchers to better understand patients' healthcare service quality perceptions. The study highlights a need to adopt an evolution that enhances technical quality and medical practices in Japanese healthcare settings. The study relies on a non-linear approach to assess patient overall quality perceptions in order to enrich knowledge. Furthermore, the research is conducted in Japan where healthcare marketing studies are scarce owing to cultural and language barriers. Japanese culture and healthcare system characteristics are used to explain and interpret the results.
Castelli, A.; Colombo, C.; Garlaschelli, A.; Pepe, G.
The INCAS Project arises from the needs of an Italian oil company in order to support the doctors responsible for the healthcare in remote drilling sites. The INCAS telemedicine1 system implements a prototype of teleconsultation medical service allowing for the interactive on-line connection with Italian healthcare reference centres in order to: • provide support to the expatriate doctor with the diagnoses and treatment of routine complaints; • contribute to the general improvement of healthcare in remote areas.
Reyes-Morales, Hortensia; Flores-Hernández, Sergio; Sauceda-Valenzuela, Alma Lucila; Vértiz-Ramírez, José de Jesús; Juárez-Ramírez, Clara; Wirtz, Veronika J; Pérez-Cuevas, Ricardo
To identify users' perception about ambulatory healthcare services quality and associated factors in Mexico. Analysis of the 2006 and 2012 National Surveys of Health and Nutrition that included users' perception of healthcare services and improvement in health status. A multivariate regression analysis allowed identifying the associated factors with the perception of improved health status. Between 2006 and 2012, users' positive perception of healthcare services increased from 82 to 85%, and user report of improvement in health status increased from 79 to 81%. Health status improvement, explanations about the disease and treatment, being attended without appointment, freedom to choose the provider and short waiting time were associated with a perception of better quality of care. Users' perception about the quality of care in ambulatory healthcare settings has improved, yet it is still neccessary to strengthen organizational strategies to provide healthcare when needed and to improve fulfillment of users' expectations.
Previous research has investigated the HIV healthcare transition in North America and Europe, yet none has been conducted in SA. Our study is the first to describe the ... Analysis of interview transcripts revealed several overarching perspectives that were corroborated by survey responses. One barrier identified was the ...
Moradi, G; Mohraz, M; Gouya, M M; Dejman, M; Alinaghi, S S; Rahmani, K; Malekafzali-Ardakani, H
This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region.
Teschner, M; Lenarz, T
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.
Lin, Ying-Siou; Lin, Yen-Chun; Lou, Meei-Fang
To report an analysis of the concept of safety climate in healthcare providers. Compliance with safe work practices is essential to patient safety and care outcomes. Analysing the concept of safety climate from the perspective of healthcare providers could improve understanding of the correlations between safety climate and healthcare provider compliance with safe work practices, thus enhancing quality of patient care. Concept analysis. The electronic databases of CINAHL, MEDLINE, PubMed and Web of Science were searched for literature published between 1995-2015. Searches used the keywords 'safety climate' or 'safety culture' with 'hospital' or 'healthcare'. The concept analysis method of Walker and Avant analysed safety climate from the perspective of healthcare providers. Three attributes defined how healthcare providers define safety climate: (1) creation of safe working environment by senior management in healthcare organisations; (2) shared perception of healthcare providers about safety of their work environment; and (3) the effective dissemination of safety information. Antecedents included the characteristics of healthcare providers and healthcare organisations as a whole, and the types of work in which they are engaged. Consequences consisted of safety performance and safety outcomes. Most studies developed and assessed the survey tools of safety climate or safety culture, with a minority consisting of interventional measures for improving safety climate. More prospective studies are needed to create interventional measures for improving safety climate of healthcare providers. This study is provided as a reference for use in developing multidimensional safety climate assessment tools and interventional measures. The values healthcare teams emphasise with regard to safety can serve to improve safety performance. Having an understanding of the concept of and interventional measures for safety climate allows healthcare providers to ensure the safety of their
Full Text Available This study aimed to explore the perception healthcare sector teachers, students and graduates from two institutions of higher learning in Rio Grande do Sul, on the generation of waste from healthcare services. It used a qualitative research approach, performed with 13 teachers, 18 students and 12 healthcare professionals, who were collected through a focus group. The main results showed there is a perception toward the importance of proper segregation and disposal of Healthcare Service Waste, also there is a lack of concern for the reduction of these wastes. Therefore, the issue requires a broader understanding of the environment, with a view of planetary sustainability, exposing needs to provide the healthcare professionals with knowledge and awareness of the importance of handling these types of waste.
In Taiwan, campus health problems are placing more and more pressure on school-based health centers (SBHCs). Moreover, SBHCs have insufficient resources to actively provide follow-up healthcare for students and faculty found to be overweight, chronically ill, or at high risk. In order to improve the quality of SBHC healthcare, a project was begun to enhance the efficiency of campus healthcare services by employing web-based and cell phone-based services. This project employed the Mobile Automated Medical Alert (MAMA) system, which was designed especially for campus health center use. Before implementing the MAMA system, a focus group of healthcare related staff identified areas in which SBHC healthcare services might be improved by the system and created a questionnaire to measure student and faculty response to the proposed services. Modifications to the MAMA design and service offerings were made based upon these questionnaire results. After the initial brainstorming session, the MAMA team created a survey instrument that was administered to students and faculty in order to understand their attitudes toward the proposed mobile healthcare services. Two hundred questionnaires were distributed to students and faculty at a private technical college in central Taiwan. Among the respondents, 100% had cellular phones and used short-text messages. Ninety-five percent of the student respondents and 85% of the faculty respondents agreed that mobile healthcare system would improve the quality of the health care their SBHC was currently providing. Based on these positive survey responses, the MAMA system was implemented. The current paper describes the process by which the MAMA team brainstormed proposed services and administered their survey. Survey results and the consequent changes to the MAMA system are discussed. Finally, recommendations are made for MAMA system use and a description is offered of the impact such systems might have on the future of college campus
Green, Andy J; Elmberg, Johan
Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation. © 2013 The Authors. Biological Reviews © 2013 Cambridge Philosophical Society.
Kondasani, Rama Koteswara Rao; Panda, Rajeev Kumar
The purpose of this paper is to analyse how perceived service quality and customer satisfaction lead to loyalty towards healthcare service providers. In total, 475 hospital patients participated in a questionnaire survey in five Indian private hospitals. Descriptive statistics, factor analysis, regression and correlation statistics were employed to analyse customer perceived service quality and how it leads to loyalty towards service providers. Results indicate that the service seeker-service provider relationship, quality of facilities and the interaction with supporting staff have a positive effect on customer perception. Findings help healthcare managers to formulate effective strategies to ensure a better quality of services to the customers. This study helps healthcare managers to build customer loyalty towards healthcare services, thereby attracting and gaining more customers. This paper will help healthcare managers and service providers to analyse customer perceptions and their loyalty towards Indian private healthcare services.
Giacco, Domenico; Matanov, Aleksandra; Priebe, Stefan
The article reviews recent evidence on improving access to mental healthcare for immigrants and best practice of care provision. Language barriers, different beliefs and explanatory models of illness, confidentiality concerns, stigma, reluctance to seek psychological help outside families, and social deprivation may prevent immigrants from accessing mental healthcare. Pathways are influenced by families, primary care practitioners, voluntary organizations, and social services. Interpreting services are often not available, and data documentation on immigrants' use of services is inconsistent. Nonmedical specific services for immigrants can be effective in outreach activities. Cultural training of staff can improve clinicians' attitudes and patients' satisfaction with care. Integrative approaches between primary and mental healthcare, psychoeducational programs, and technological innovations have been developed to improve access to care. Immigrants can face significant barriers in accessing mental healthcare. Strategies to overcome these barriers are as follows: increased coordination and communication between voluntary organizations, social services and mental health services; training of staff on cross-cultural issues; integration of mental healthcare with primary care; psychoeducational initiatives focused on families and broader social groups; and technology-based interventions.
The objective of this study was to explore and describe the experiences of health care providers managing sexual assault victims in the emergency unit of a community hospital in the Nkangala district in the Mpumalanga Province. A qualitative, phenomenological design was applied. Purposeful sampling was used to select ...
Objective: To determine providers' willingness to use (WTU) topical anaesthetic cream (TAC) to alleviate childhood pain. This information will be useful for successful implementation of TAC in Nigeria. Subjects and Methods: The study was undertaken in hospitals in southeast Nigeria. Intervieweradministered questionnaire ...
F. Eijkenaar (Frank)
textabstractHealthcare systems around the world are characterized by a suboptimal delivery of healthcare services. There has been a growing belief among policymakers that many deficiencies (e.g., in the quality of care) stem from flawed provider payment systems creating perverse incentives for
Compton, David A.; Whitehead, Michael B.
Much is written about the availability of healthcare services among elements of the U.S. population, with a large proportion of the literature focusing on access. Although physical access is an overarching issue for many, educators must remember that a key factor in providing complete and competent healthcare is to understand the patient and any…
Health care systems in Norway and the western world have experienced extensive changes due to patients living longer with complex conditions that require coordinated care. A Norwegian healthcare reform has led to significant restructuring in service delivery as a devolution of services to municipalities. Partners from three rural healthcare services, students from four professional programmes, and one lecturer from each of the professional programmes used a collaborative approach to obtain new knowledge through interprofessional practice. Using an action research design, the research group facilitated democratic processes through dialogues with healthcare services and students. The design is visualised as a cyclical process in which each cycle contributes to improvements, innovations, and increased understanding. A total of 32 students and 3 supervisors were interviewed before and after the clinical practice experiences. Fieldwork was conducted during three clinical periods. Interprofessional student groups formed small healthcare teams and assessed patients with chronic and long-term conditions. Students prepared and negotiated patient follow-up. The teams' responsibilities led to reflective practices that enhanced their professional knowledge. The teams achieved a new understanding of patient situations, which influenced "second opinions" for patients with complex conditions and led to innovative practices. The change in perception of patient needs led to a changed professional approach. The students' perceptions changed as they learned from and about each other and in collaboration with the health service; this led to more coordinated care of patients with complex conditions. Interprofessional learning in community settings provided a platform to improve both healthcare education and rural healthcare services. This research contributes to knowledge of how students' placement in interprofessional teams can enhance students learning from, with and about each other
Full Text Available Healthcare information technology is a key enabler for care transformation to provide quality care at low cost and better population health. Many healthcare organizations have established IT Program Management and adopted ITIL best practice to manage IT services. However, ITIL and traditional project management are heavily process oriented, and neither flexible nor effective enough for swift response to changing business demand. Lean methodologies are increasingly deployed by healthcare providers to improve workflow process management but only has limited use cases documented in healthcare IT service. This paper introduces the Lean A3 Thinking methodology and its value in identifying and eliminating wastes to provide agile and effective solutions in response to customer requests. We present a case study of applying Lean A3 Thinking to improve clinical informatics reporting service. The initial evaluation results are promising and indicate that both ITIL and Lean A3 Thinking focus on customer and service quality, complementing each other well. ITIL provides a framework for ITSM based on a set of best practice to manage IT services. Lean A3 Thinking specifies a set of framework and tools for improving quality of services and processes by eliminating wastes. Proper balance between Lean and ITIL principles for ITSM needs more research and further study.
Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy
The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, phealthcare services is associated with lower per capita expenditures. LHDs, especially those serving healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.
McMahon, Shannon A; Ho, Lara S; Brown, Hannah; Miller, Laura; Ansumana, Rashid; Kennedy, Caitlin E
Although research on the epidemiology and ecology of Ebola has expanded since the 2014-15 outbreak in West Africa, less attention has been paid to the mental health implications and the psychosocial context of the disease for providers working in primary health facilities (rather than Ebola-specific treatment units). This study draws on 54 qualitative interviews with 35 providers working in eight peripheral health units of Sierra Leone's Bo and Kenema Districts. Data collection started near the height of the outbreak in December 2014 and lasted 1 month. Providers recounted changes in their professional, personal and social lives as they became de facto first responders in the outbreak. A theme articulated across interviews was Ebola's destruction of social connectedness and sense of trust within and across health facilities, communities and families. Providers described feeling lonely, ostracized, unloved, afraid, saddened and no longer respected. They also discussed restrictions on behaviors that enhance coping including attending burials and engaging in physical touch (hugging, handshaking, sitting near, or eating with colleagues, patients and family members). Providers described infection prevention measures as necessary but divisive because screening booths and protective equipment inhibited bonding or 'suffering with' patients. To mitigate psychiatric morbidities and maladaptive coping mechanisms-and to prevent the spread of Ebola-researchers and program planners must consider the psychosocial context of this disease and mechanisms to enhance psychological first aid to all health providers, including those in peripheral health settings. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.
Chahal, Hardeep; Bala, Madhu
The purpose of the study is to examine three significant components of service brand equity--i.e. perceived service quality, brand loyalty, and brand image--and analyze relationships among the components of brand equity and also their relationship with brand equity, which is still to be theorized and developed in the healthcare literature. Effective responses were received from 206 respondents, selected conveniently from the localities of Jammu city. After scale item analysis, the data were analyzed using factor analysis, correlations, t-tests, multiple regression analysis and path modeling using SEM. The findings of the study support that service brand equity in the healthcare sector is greatly influenced by brand loyalty and perceived quality. However, brand image has an indirect effect on service brand equity through brand loyalty (mediating variable). The research can be criticized on the ground that data were selected conveniently from respondents residing in the city of Jammu, India. But at the same time the respondents were appropriate for the study as they have adequate knowledge about the hospitals, and were associated with the selected hospital for more than four years. Furthermore, the validity and reliability of the data are strong enough to take care of the limitations of the convenience sampling selection method. The study has unique value addition to the service marketing vis-à-vis healthcare literature, from both theoretical and managerial perspectives. The study establishes a direct and significant relationship between service brand equity and its two components, i.e. perceived service quality and brand loyalty in the healthcare sector. It also provides directions to healthcare service providers in creating, enhancing, and maintaining service brand equity through service quality and brand loyalty, to sustain competitive advantage.
Ezihe Loretta Ahanonu
Objective This study sought to assess the attitude of Healthcare Providers towards providing contraceptives for unmarried adolescents in four Local Government Areas in Ibadan, Nigeria. Materials and methods A cross-sectional descriptive study was conducted among 490 Healthcare Providers in 24 randomly selected healthcare facilities using self-administered, pre-tested questionnaires. Results More than half (57.5%) of the respondents perceived the provision of contraceptives for unmarried adole...
Lubis, Arlina Nurbaity; Lumbanraja, Prihatin; Lubis, Rahmawaty; Hasibuan, Beby Kendida
Service sector increases rapidly especially in Indonesia. This can be seen from the distribution of the percentage of Product Domestic Bruto (PDB) based on job vacancy showing that the service sector contribution approaches 50%. One of the service/care industries with rapid growth is healthcare service. It can be seen from the government plan year 2015-2016 to do healthcare reinforcement. Generally, healthcare is identically related to hospital. A hospital is a professional healthcare institu...
Maria V. Ciasullo
Full Text Available In the service economy, scholars and practitioners are even more focused on the development and appliance of innovative services. The importance of service innovation is rising in many sectors and among different organizations. Several disciplines (e.g., marketing, management, operations research, etc. deal with this innovation, a concept widely used, but with different definitions. In this paper, service innovation has been analyzed according to the Service Dominant Logic (S-D Logic and a service ecosystem perspective. The literature still calls for a greater understanding of how a new or renewed combination of resources affects the shaping of service ecosystems. To contribute to filling this gap, this study explores the practices that different actors, enact to co-create value in novel ways; i.e., service innovation. The paper is structured as follows. In the first section, the main academic contributions on service research have been reviewed, focusing on healthcare service innovation. This is followed by the research method and discussion of the research findings. Finally, the theoretical and managerial implications have been detailed and an agenda for future research suggested. The paper offers interesting insights to develop new or renewed practices that foster the reshaping and maintaining of a healthcare service ecosystem. Some recommendations are included to support managers in the development of service innovation strategies.
Ali Maher; Alireza Saadati; Seyed Mojtaba Hosseini
Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was...
This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.
Glenn, Zandra M; Mahdavian, Soheyla L; Woodard, Todd J
Medication Therapy Management (MTM) has been a way for pharmacist to enhance their position as an integral member of the health care team as the need for improved clinical and economic outcomes in relation to the US health care system became apparent. MTM Certificate training programs are provided by numerous organizations. Collaboration Practice Agreements (CPA) are gaining significance as the role of the pharmacist is expanding in the care of patients as part of a multidisciplinary health care team. One major hurdle that many pharmacists are faced with is receiving reimbursement for the services provided. The Medicare Modernization Act of 2003 recognized that pharmacists play an important role in the management of patient care and that pharmacists bring an expertise and knowledge that will help to identify and resolve patient medication therapy problems. © The Author(s) 2014.
Westheimer, Joshua M.; Steinley-Bumgarner, Michelle; Brownson, Chris
Objective and Participants: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants…
Schweitzer, Marco; Hoerbst, Alexander
Electronic Health Records (EHRs) play a crucial role in healthcare today. Considering a data-centric view, EHRs are very advanced as they provide and share healthcare data in a cross-institutional and patient-centered way adhering to high syntactic and semantic interoperability. However, the EHR functionalities available for the end users are rare and hence often limited to basic document query functions. Future EHR use necessitates the ability to let the users define their needed data according to a certain situation and how this data should be processed. Workflow and semantic modelling approaches as well as Web services provide means to fulfil such a goal. This thesis develops concepts for dynamic interfaces between EHR end users and a service oriented eHealth infrastructure, which allow the users to design their flexible EHR needs, modeled in a dynamic and formal way. These are used to discover, compose and execute the right Semantic Web services.
Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin
Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system.
Efficient healthcare systems in developing economies are significant indicators of development. Health can either be optimised households' choices between preventive and curative healthcare services. In Cameroon like other developing countries, domestic healthcare service is either considered to be a normal or luxury ...
Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Matthews, Fiona E.; Murray, Stuart; Baron-Cohen, Simon; Brayne, Carol
Qualitative semi-structured interviews were conducted with service providers regarding the current healthcare provision and education services for children with Autism Spectrum Conditions (ASC) and their families in mainland China. 10 service providers described the current policy and identified unmet needs within current practice. Providers…
Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn
In this protocol for a pilot study we seek to establish the feasibility of using a web-based survey to simultaneously supply healthcare organisations and agencies with feedback on a key aspect of the care experience they provide and increase the generic health decision literacy of the individuals...
Youm, Sekyoung; Park, Seung-Hun
The objectives of this study are (1) to establish a ubiquitous healthcare (u-healthcare) center for those who wish to use u-healthcare, allowing them to experience the service, and (2) to evaluate the users' awareness and expectations of the service based on their overall assessment. To establish the u-healthcare center, a kiosk, devices for health checkup, a body-type examination system, and a physical fitness assessment system were installed. Also, a u-healthcare Web site was developed. A survey was conducted on 280 individuals who visited the u-healthcare center and used the service, to determine (1) individual awareness of u-healthcare before using the service and their change of perception after use, (2) factors that affect the use of u-healthcare, and (3) the effects of disease awareness on exercise habits. Only 25.4% of the participants were aware of u-healthcare, and only 36% who saw the u-healthcare center recognized that it was where the u-healthcare service was provided. The group of individuals who were willing to use the u-healthcare showed statistically significant differences in their satisfaction with the overall environment of the center, as well as the specificity of the descriptions, examination results, kindness of the staff, and their responses. Additionally, the group of individuals who were diagnosed with chronic diseases and the group who were not showed statistically significant differences in the number of days on which they exercised lightly or took a walk. To promote the usage of u-healthcare service, the understanding of the service and the credibility of examination results need to be increased by sharing successful cases. Furthermore, to expand the use of the system that allows a person to regularly check his or her state of health, a lifelong periodical management system linked with another medical welfare program will be needed.
Ellis, Michael J; Ritchie, Lesley; Selci, Erin; Chu, Stephanie; McDonald, Patrick; Russell, Kelly
Concussion is an emerging public health concern, but care of patients with a concussion is presently unregulated in Canada. Independent, blinded Google Internet searches were conducted for the terms "concussion" and "concussion clinic" and each of the Canadian provinces and territories. The first 10 to 15 concussion healthcare providers per province were identified. A critical appraisal of healthcare personnel and services offered on the provider's Web site was conducted. Fifty-eight concussion healthcare providers were identified using this search methodology. Only 40% listed the presence of an on-site medical doctor (M.D.) as a member of the clinical team. Forty-seven percent of concussion healthcare providers advertised access to a concussion clinic, program, or center on their Web site. Professionals designated as team leaders, directors, or presidents among concussion clinics, programs, and centers included a neuropsychologist (15%), sports medicine physician (7%), neurologist (4%), and neurosurgeon (4%). Services offered by providers included baseline testing (67%), physiotherapy (50%), and hyperbaric oxygen therapy (2%). This study indicates that there are numerous concussion healthcare providers in Canada offering diverse services with clinics operated by professionals with varying levels of training in traumatic brain injury. In some cases, the practices of these concussion clinics do not conform to current expert consensus guidelines.
Makanjee, Chandra R; Bergh, Anne-Marie; Hoffmann, Willem A
Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. AIM AND SETTING: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex. A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars). Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof. Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider-patient centred when a referral for a diagnostic imaging investigation is included.
Whelan, Christopher J; Wenny, Daniel G; Marquis, Robert J
Ecosystem services are natural processes that benefit humans. Birds contribute the four types of services recognized by the UN Millennium Ecosystem Assessment-provisioning, regulating, cultural, and supporting services. In this review, we concentrate primarily on supporting services, and to a lesser extent, provisioning and regulating services. As members of ecosystems, birds play many roles, including as predators, pollinators, scavengers, seed dispersers, seed predators, and ecosystem engineers. These ecosystem services fall into two subcategories: those that arise via behavior (like consumption of agricultural pests) and those that arise via bird products (like nests and guano). Characteristics of most birds make them quite special from the perspective of ecosystem services. Because most birds fly, they can respond to irruptive or pulsed resources in ways generally not possible for other vertebrates. Migratory species link ecosystem processes and fluxes that are separated by great distances and times. Although the economic value to humans contributed by most, if not all, of the supporting services has yet to be quantified, we believe they are important to humans. Our goals for this review are 1) to lay the groundwork on these services to facilitate future efforts to estimate their economic value, 2) to highlight gaps in our knowledge, and 3) to point to future directions for additional research.
Barreras para la normalización de la telemedicina en un sistema de salud basado en la concertación de servicios Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts
participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. Methods: We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. Results: The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (redefinition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. Conclusions: In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer.
Mir, Ali Mohammad; Shaikh, Muhammad Saleem; Rashida, Gul; Mankani, Neha
The availability of properly trained and motivated providers is a prerequisite for provision of easily accessible healthcare. Pakistan has been listed by the World Health Organization in its World Health Report 2006 as one of 57 countries with a critical health workforce deficiency. This study examines the factors associated with the willingness of public sector healthcare providers to leave government service and recommends measures that can be adopted to attract and retain staff in the country's public healthcare system. A stratified, random sampling methodology was adopted to recruit a nationally representative sample of 1,296 public sector healthcare providers, including paramedics, medical doctors, and specialists. A semi-structured questionnaire was used to interview these providers. Logistic regressions measured the association with determinants of their willingness to leave the public health sector for better prospects elsewhere. A third of all healthcare providers who were interviewed were of the view that, provided the opportunity, they would leave government service. The odds of willingness to leave service were highest among providers from the region of Azad Jammu and Kashmir (adjusted odds ratio [AOR] = 4.33; 95% CI, 2.49-7.54) followed by the province of Balochistan (AOR = 4.21; 95% CI, 2.41-7.33), and the region of Gilgit Baltistan (AOR = 3.34; 95% CI, 1.67-6.67). Providers who expressed dissatisfaction in the manner their performance was evaluated and those who were dissatisfied with the current salary, each had higher odds of considering leaving government service (AOR = 1.67; 95% CI, 1.18-2.40 and AOR = 2.03; 95% CI, 1.47-2.81, respectively). Providers who reported experiencing interference in their work by influential politicians of the area were more inclined to leave (AOR = 1.44; 95% CI, 1.05-1.98). This study clearly highlights the need to implement more focused strategies in the public healthcare system in Pakistan in
He, Chenguang; Fan, Xiaomao; Li, Ye
Ubiquitous healthcare services are becoming more and more popular, especially under the urgent demand of the global aging issue. Cloud computing owns the pervasive and on-demand service-oriented natures, which can fit the characteristics of healthcare services very well. However, the abilities in dealing with multimodal, heterogeneous, and nonstationary physiological signals to provide persistent personalized services, meanwhile keeping high concurrent online analysis for public, are challenges to the general cloud. In this paper, we proposed a private cloud platform architecture which includes six layers according to the specific requirements. This platform utilizes message queue as a cloud engine, and each layer thereby achieves relative independence by this loosely coupled means of communications with publish/subscribe mechanism. Furthermore, a plug-in algorithm framework is also presented, and massive semistructure or unstructured medical data are accessed adaptively by this cloud architecture. As the testing results showing, this proposed cloud platform, with robust, stable, and efficient features, can satisfy high concurrent requests from ubiquitous healthcare services.
Zhou, Wei-Jiao; Wan, Qiao-Qin; Liu, Cong-Ying; Feng, Xiao-Lin; Shang, Shao-Mei
Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty.
P. V. Nikitin
Full Text Available A whole variety of mobile technologies may be arbitrarily divided into several groups: prevention of diseases; determination of different diagnostic parameters; monitoring of the disease course and treatment effectiveness; consulting support, and telemedicine. Novel technologies offer much prospect for healthcare services, a possibility of improving the quality and availability of medical care. However, there are some problems and contraindications associated specifically with the inadequate participation of the medical professionals in the elaboration of applications, the low computer literacy of the population, and the high cost of such technologies. Nevertheless, the development of medical mobile concepts covers new areas, including the emergence of more complex programs for analyzing diagnostic information, the involvement of novel types of handheld devices and integration of the applications into the social networks. The paper considers the major possibilities of mobile medicine, problems, and prospects for its development.
Full Text Available Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world's adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents.This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015.At the national level 13.9% (95%CI: 6.9-26.0 of healthcare units provide low quality, 68.6% (95%CI: 58.4-77.3 medium quality and 17.5% (95%CI: 11.9-25.0 high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best.The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care.
attended.16 This gathering marked the first attempt by any country to try to orchestrate multinational assistance programs to the NIS.17 “President...Victor Storms Provides Defibrillator Training to Ukrainian Nurses at Simferopol Municipal Clinical Hospital, September 2010.61 Supporting the...the role of healthcare in nation-building. RAND’s team of experts including political scientists, physicians, and economists examined past attempts
Sex worker-specific health services aim to respond to the challenges that this key population faces in accessing healthcare. ... North Star Alliance (North Star) is a public-private partnership providing a healthcare service package in roadside wellness clinics (RWCs) to at-risk populations along transport corridors in ...
Vissink, A.; Baat, C. de
Many patients who visit a dentist, oral hygienist or other oral healthcare provider use medicines. As a result of the ageing of the Dutch population, the number of patients using medicines will further increase, including the number of patients who are using more than one medicine. In addition to
Anstey, Kyle; Wright, Linda
Patient requests for a healthcare provider of a particular race or sexual orientation create a conflict of obligations. On the one hand, providers have a duty to deliver clinically indicated care consistent with patient preferences. On the other hand, providers have legal, professional, and organizational assurances that they should not suffer workplace discrimination. Protecting healthcare providers from harm while maintaining obligations to patients requires unambiguous messaging to both parties. Providers need to be clear that their organization will not be complicit in discrimination against them, instead supporting their needs and preferences for management of the situation. In a context of patient-centered care, harm principle-based boundaries of respect for autonomy must be defined. A Caregiver preference guideline developed and used at University Health Network, Toronto provides a standardized way for the organization to decide when it will honor patient requests for providers of a particular background. This process stresses dialogue, assessment of clinical feasibility, and empowerment and support for affected care providers.
Erin J Starzyk
Full Text Available The emerging science demonstrates various health benefits associated with infant male circumcision and adult male circumcision; yet rates are declining in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that healthcare providers present evidence-based risk and benefit information for infant male circumcision to parent(s and guardian(s. The purpose of this study was to assess providers' level of infant male circumcision knowledge and to identify the associated characteristics.An online survey was administered to healthcare providers in the family medicine, obstetrics, and pediatrics medical specialties at an urban academic health center. To assess infant male circumcision knowledge, a 17 point summary score was constructed to identify level of provider knowledge within the survey.Ninety-two providers completed the survey. Providers scored high for the following knowledge items: adverse event rates, protects against phimosis and urinary tract infections, and does not prevent hypospadias. Providers scored lower for items related to more recent research: protection against cervical cancer, genital ulcer disease, bacterial vaginosis, and reduction in HIV acquisition. Two models were constructed looking at (1 overall knowledge about male circumcision, and (2 knowledge about male circumcision reduction in HIV acquisition. Pediatricians demonstrated greater overall infant male circumcision knowledge, while obstetricians exhibited significantly greater knowledge for the HIV acquisition item.Providers' knowledge levels regarding the risks and benefits of infant male circumcision are highly variable, indicating the need for system-based educational interventions.
Sinclair, Shane; Torres, Mia-Bernadine; Raffin-Bouchal, Shelley; Hack, Thomas F; McClement, Susan; Hagen, Neil A; Chochinov, Harvey M
The purpose of this qualitative study was to investigate advanced cancer patients' perspectives on the importance, feasibility, teaching methods, and issues associated with training healthcare providers in compassionate care. This study utilized grounded theory, a qualitative research method, to develop an empirical understanding of compassion education rooted in direct patient reports. Audio-recorded semi-structured interviews were conducted to obtain an in-depth understanding of compassion training from the perspectives of hospitalized advanced cancer patients (n = 53). Data were analyzed in accordance with grounded theory to determine the key elements of the underlying theory. Three overarching categories and associated themes emerged from the data: compassion aptitude, cultivating compassion, and training methods. Participants spoke of compassion as an innate quality embedded in the character of learners prior to their healthcare training, which could be nurtured through experiential learning and reflective practices. Patients felt that the innate qualities that learners possessed at baseline were further fashioned by personal and practice experiences, and vocational motivators. Participants also provided recommendations for compassion training, including developing an interpersonal relationship with patients, seeing the patient as a person, and developing a human connection. Teaching methods that patients suggested in compassion training included patient-centered communication, self-reflection exercises, and compassionate role modeling. This study provides insight on compassion training for both current and future healthcare providers, from the perspectives of the end recipients of healthcare provider training - patients. Developing a theoretical base for patient centred, evidence-informed, compassion training is a crucial initial step toward the further development of this core healthcare competency.
Pfaff, Nicole Franzen; Tillett, Jackie
Listeriosis and toxoplasmosis are foodborne illnesses that can have long-term consequences when contracted during pregnancy. Listeriosis is implicated in stillbirth, preterm labor, newborn sepsis, and meningitis, among other complications. Toxoplasmosis is associated with blindness, cognitive delays, seizures, and hearing loss, among other significant disabilities. Healthcare providers who understand the fundamentals of Listeria and Toxoplasma infection will have the tools to identify symptoms and high-risk behaviors, educate women to make safer decisions, and provide anticipatory guidance if a pregnant woman would become infected with either of these foodborne illnesses.
Lowenstein, Lisa M; Perrin, Eliana M; Berry, Diane; Vu, Maihan B; Pullen Davis, Lisa; Cai, Jianwen; Tzeng, Janice P; Ammerman, Alice S
To prevent childhood obesity, parents and their children's healthcare providers need to engage in effective dialogue. We know much about mothers' experiences, but very little about fathers' experiences. We explored African-American, Caucasian, and Latino fathers' perceptions and experiences communicating with their children's provider during clinic visits regarding weight, diet, and physical activity. Focus groups (n=3), grouped by race/ethnicity, including a total of 24 fathers, were conducted. The men were asked open-ended questions; responses were recorded and transcribed, and analyzed using ATLAS.ti. Findings revealed that these fathers were involved in their children's healthcare and found providers to be helpful partners in keeping their children healthy, yet they generally felt "left out" during clinic appointments. The quality of the relationship with their children's provider influenced how receptive fathers were to discussing their children's weight, diet, and physical activity behaviors. Fathers made suggestions to help improve communication between providers and fathers, such as personalizing the discussion. These fathers expressed strong feelings about the provider-parent relationship when discussing weight, diet, and physical activity.
Chandra R. Makanjee
Full Text Available Background: Much has been written about the patient-centred approach in doctor–patient consultations. Little is known about interactions and communication processes regarding healthcare providers’ and patients’ perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation.Aim and setting: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex.Methods: A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars.Results: Two main themes guided our analysis: (1 provider perspectives; and (2 patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof.Conclusion: Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider–patient centred when a referral for a diagnostic imaging investigation is included.
Abidi, S S
Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.
Kennewell, Suzanne; Baker, Laura
Purpose - The purpose of this paper is to explore the experiences of staff in a large, public health service involved in transitioning support services to a shared services model. It aims to understand their perceptions of the benefits and risks arising from this change. Design/methodology/approach - Thematic analysis of qualitative data from semi-structured interviews with both service provider and customer agency staff was used to identify, analyze and report patterns of benefits and risks within data. Findings - Staff expressed the need for relevant subject-matter-experts to work within customer agencies to facilitate effective communication between the customer agency and shared services provider, reflecting observations found in out-sourcing literature. Research limitations/implications - Results point to significant challenges continuing to occur for shared services in healthcare. Risks identified suggest a more intimate relationship between clinical and support services than previously discussed. Originality/value - Previous discussion of the shared services model has not considered the skills, knowledge and ability required by staff in the customer agency. This research indicates that in the absence of such consideration, the concepts of the shared services model are weakened.
Mu, Y.; Bossink, Bart; Vinig, T.
This study hypothesizes and empirically tests the influence of involvement of (1) frontline employees and (2) top managers in ideation process on healthcare service innovation quality. Based on data from 168 service innovation projects in Dutch healthcare organizations, the empirical results
Kaderli, Reto; Pfortmueller, Carmen A; Businger, Adrian P
In the last decade assessing the quality of healthcare has become increasingly important across the world. Switzerland lacks a detailed overview of how quality management is implemented and of its effects on medical procedures and patients' concerns. This study aimed to examine the systematics of quality management in Switzerland by assessing the providers and collected parameters of current quality initiatives. In summer 2011 we contacted all of the medical societies in Switzerland, the Federal Office of Public Health, the Swiss Medical Association (FMH) and the head of Swiss medical insurance providers, to obtain detailed information on current quality initiatives. All quality initiatives featuring standardised parameter assessment were included. Of the current 45 initiatives, 19 were powered by medical societies, five by hospitals, 11 by non-medical societies, two by the government, two by insurance companies or related institutions and six by unspecified institutions. In all, 24 medical registers, five seals of quality, five circles of quality, two self-assessment tools, seven superior entities, one checklist and one combined project existed. The cost of treatment was evaluated by four initiatives. A data report was released by 24 quality initiatives. The wide variety and the large number of 45 recorded quality initiatives provides a promising basis for effective healthcare quality management in Switzerland. However, an independent national supervisory authority should be appointed to provide an effective review of all quality initiatives and their transparency and coordination.
... Conservation Service 7 CFR Part 652 RIN 0578-AA48 Technical Service Provider Assistance AGENCY: Natural... Final rule amends the Natural Resources Conservation Service (NRCS) regulations for technical service provider (TSP) provisions under the Food Security Act of 1985. The Food, Conservation, and Energy Act of...
The Relationship between Environmental Turbulence, Management Support, Organizational Collaboration, Information Technology Solution Realization, and Process Performance, in Healthcare Provider Organizations
Muglia, Victor O.
The Problem: The purpose of this study was to investigate relationships between environmental turbulence, management support, organizational collaboration, information technology solution realization, and process performance in healthcare provider organizations. Method: A descriptive/correlational study of Hospital medical services process…
Pillay, Datuk Ir M S; Ghazali, Roslan Johari Dato Mohd; Manaf, Noor Hazilah Abd; Abdullah, Abu Hassan Asaari; Bakar, Azman Abu; Salikin, Faisal; Umapathy, Mathyvani; Ali, Roslinah; Bidin, Noriah; Ismail, Wan Ismefariana Wan
This is a national study which aims to determine the average waiting time in Malaysian public hospitals and to gauge the level of patient satisfaction with the waiting time. It also aims to identify factors perceived by healthcare providers which contribute to the waiting time problem. Self-administered questionnaires were the main method of data collection. Two sets of questionnaires were used. The first set solicited information from patients on their waiting time expereince. The second set elucidated information from hospital employees on the possible causes of lengthy waiting time. The questionnaires were administered in 21 public hospitals throughout all 13 states in Malaysia. A total of 13,000 responses were analysed for the patient survey and almost 3,000 were analysed for the employee survey. The findings indicate that on average, patients wait for more than two hours from registration to getting the prescription slip, while the contact time with medical personnel is only on average 15 minutes. Employee surveys on factors contributing to the lengthy waiting time indicate employee attitude and work process, heavy workload, management and supervision problems, and inadequate facilities to be among the contributory factors to the waiting time problem. Public healthcare in Malaysia is in a state of "excess demand", where demand for subsidised healthcare far outstrips supply, due to the large fee differential between public and private healthcare services. There is a need for hospital managers to reduce the boredom faced by patients while waiting, and to address the waiting time problem in a more scientific manner, as has been carried out in other countries through simulation and modelling techniques. Healthcare organisations are keen to address their waiting time problem. However, not much research has been carried out in this area. The study thus fills the lacuna in waiting time studies in healthcare organisations.
Sandefer, Ryan H; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M
The use of patient focused technology has been proclaimed as a means to improve patient satisfaction and improve care outcomes. The Center for Medicaid/Medicare Services, through its EHR Incentive Program, has required eligible hospitals and professionals to send and receive secure messages from patients in order to receive financial incentives and avoid reimbursement penalties. Secure messaging between providers and patients has the potential to improve communication and care outcomes. The purpose of this study was to use National Health Interview Series (NHIS) data to identify the patient characteristics associated with communicating with healthcare providers via email. Individual patient characteristics were analyzed to determine the likelihood of emailing healthcare providers. The use of email for this purpose is associated with educational attainment, having a usual place of receiving healthcare, income, and geography. Publicly available data such as the NHIS may be used to better understand trends in adoption and use of consumer health information technologies.
H. de Vries (Harwin); J.J. van de Klundert (Joris); A.P.M. Wagelmans (Albert)
markdownabstractProviding long distance truck drivers with adequate access to prevention, testing, and treatment services for HIV, Sexually Transmitted Infections (STIs), Tuberculosis (TB), and Malaria is suggested to be an extremely effective way to reduce the burden and the spread of these
Morris, Zoë Slote; Clarkson, Peter John
We argue that social marketing can be used as a generic framework for analysing barriers to the take-up of clinical guidelines, and planning interventions which seek to enable this change. We reviewed the literature on take-up of clinical guidelines, in particular barriers and enablers to change; social marketing principles and social marketing applied to healthcare. We then applied the social marketing framework to analyse the literature and to consider implications for future guideline policy to assess its feasibility and accessibility. There is sizeable extant literature on healthcare practitioners' non-compliance with clinical guidelines. This is an international problem common to a number of settings. The reasons for poor levels of take up appear to be well understood, but not addressed adequately in practice. Applying a social marketing framework brings new insights to the problem." We show that a social marketing framework provides a useful solution-focused framework for systematically understanding barriers to individual behaviour change and designing interventions accordingly. Whether the social marketing framework provides an effective means of bringing about behaviour change remains an empirical question which has still to be tested in practice. The analysis presented here provides strong motivation to begin such testing.
Skär, Lisa; Söderberg, Siv
The aim of this paper is to discuss the importance of ethical aspects when implementing eHealth services in healthcare. Challenges in healthcare today include a growing older population and, as a consequence, an increased need for healthcare services. One possible solution is the use of eHealth services. Discussion paper. Research literature published from 2000 - 2017 in CINAHL, PubMed and Scopus. Implementing eHealth services in healthcare involves ethical challenges where different technologies can solve different problems in different ways. eHealth services should therefore be developed and implemented based on the patient's specific needs and conditions for use and in accordance with the healthcare professionals' presumption to provide high quality care. To preserve patients' integrity, dignity and autonomy, healthcare professionals must include ethical aspects when implementing and using eHealth services in healthcare. Healthcare professionals have to take responsibility for the eHealth services introduced, explaining why and how they are implemented based on a person-centered approach. More knowledge is needed about ethical aspects when implementing eHealth services to improve the quality of care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Blobel, B; Pharow, P; Engel, K
Establishing the Shared Care environment, communication and co-operation between healthcare establishments involved must be provided in a trustworthy way. This challenge is even more important for health networks using the Internet. In that context, services assuring both communication security and application security must be provided. Especially in the e-health environment, additionally to identity-related services certifying data or properties of principals, trustworthiness or authorisation for objects, components and functions must be established by Trusted Third Parties (TTP). Within the European Commission's Information Society Technologies (IST) Programme, the HARP project provides the "HARP Cross-Security Platform (HCSP)" needed in the open Web environment of pan-European networks. The solutions are under implementation and evaluation in the German ONCONET enabling a trustworthy framework for both health professionals and patients as well as supporting clinical studies.
Blatnik, Patricia; Bojnec, Štefan; Tušak, Matej
Abstract The chief aim of this study was to analyze secondary healthcare providers' efficiency, focusing on the efficiency analysis of Slovene general hospitals. We intended to present a complete picture of technical, allocative, and cost or economic efficiency of general hospitals. Methods We researched the aspects of efficiency with two econometric methods. First, we calculated the necessary quotients of efficiency with the stochastic frontier analyze (SFA), which are realized by econometric evaluation of stochastic frontier functions; then, with the data envelopment analyze (DEA), we calculated the necessary quotients that are based on the linear programming method. Results Results on measures of efficiency showed that the two chosen methods produced two different conclusions. The SFA method concluded Celje General Hospital is the most efficient general hospital, whereas the DEA method concluded Brežice General Hospital was the hospital to be declared as the most efficient hospital. Conclusion Our results are a useful tool that can aid managers, payers, and designers of healthcare policy to better understand how general hospitals operate. The participants can accordingly decide with less difficulty on any further business operations of general hospitals, having the best practices of general hospitals at their disposal. PMID:28730180
U.S. Department of Health & Human Services — CMS is continuously analyzing performance and quality of the Provider Customer Service Programs (PCSPs) of the contractors and will be identifying trends and making...
Al Onazi, Mariam; Al Jondeby, Mohamed; Azeem, Mubashar; Al Sayyari, Abdulla
We aimed to assess the empathy level of healthcare providers as perceived by hemodialysis (HD) patients and its determinants. This survey included 100 hemodialysis patients from two major dialysis units in Riyadh, Saudi Arabia (Units A and B). Patients were asked to score their perception of empathy by health care providers in 13 areas using 1 to 5 Likert Scale. Unit "A" contained more patients with diabetic nephropathy than unit "A". Unit "B" contained a higher number of native Arabic speaking nurses and its patients had longer mean duration on dialysis compared to unit "A". The overall score given for doctors empathy was 81.6% (84.5% for Unit "A" doctors and 78.8% for Unit "B" doctors (P=0.01). The overall score given for nurses empathy was 73.6% (76.2% for Unit "A" nurses and 70.9% for Unit "B" nurses (P=0.002). Female patients' perception of empathy was significantly greater than male patients in 8 out of 13 questions. Older patients gave higher score than younger patients. Patients with lower educational level perceived higher empathy levels than patients with higher education. Significantly lower scores were given by patients who received their dialysis treatment at night. We observed no differences in scores in relation to patients' duration on dialysis, diabetic status or Charlson Co-morbidity Index (CCI). Empathy goes beyond the language barrier. Patients dialyzed in evening shifts perceive less empathy from healthcare workers. The higher scores given by older, female and less educated patients might simply reflect their lower expectation of empathy.
Häuser, W; Neugebauer, E; Petzke, F
Within the last ten years healthcare services research has developed into an independent interdisciplinary field of research. A selective search of the literature was conducted in the database Google Scholar and the database on healthcare services research in Germany (http://versorgungsforschung-deutschland.de) for healthcare services research projects on pain in Germany. Healthcare services research projects were conducted by pharmaceutical companies, patient self-help organizations, scientific societies, statutory health insurance companies and university departments on acute and chronic pain. Valid data on the epidemiology, grading and treatment of chronic pain are available. There was an overuse of opioids and invasive procedures in patients with chronic low back pain, fibromyalgia syndrome and somatoform pain disorders. Databases for patients with chronic pain are currently constructed by pain societies. The fragmentation of data from health insurance companies, old age pension insurances, clinical institutions and population surveys and inconsistencies in diagnosing or encoding chronic pain impede the carrying out of significant longitudinal studies. Based on the data available, the needs of care for patients with chronic pain and the necessary care services cannot be derived. Important topics of future healthcare services research on pain are longitudinal studies on the cost efficacy and risks of inpatient and outpatient pain therapy based on routine data of health insurance companies, old age pension insurances and pain registries, longitudinal studies on "patient careers" (i.e. sequences of healthcare) and the identification of potential starting points for control of healthcare.
Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke
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.
Venkataraman, Shruthi; Jordan, Gerald; Pope, Megan A; Iyer, Srividya N
To better understand cultural competence in early intervention for psychosis, we compared service users' and service providers' perceptions of the importance of providers being culturally competent and attentive to aspects of culture. At a Canadian early intervention programme, a validated scale was adapted to assess service user (N = 51) and provider (N = 30) perceptions of service providers' cultural competence and the importance accorded thereto. Analyses of variance revealed that the importance of service providers being culturally competent was rated highest by service providers, followed by visible minority service users, followed by white service users. Providers rated themselves as being more interested in knowing about service users' culture than service users perceived them to be. Service users accorded less import to service providers' cultural competence than providers themselves, owing possibly to varied socialization. A mismatch in users' and providers' views on providers' efforts to know their users' cultures may influence mental healthcare outcomes. © 2017 John Wiley & Sons Australia, Ltd.
Among others, it was found that the illnesses/diseases that were prevalent in the study area were related to ... Keywords: Traditional healthcare, Western healthcare, farmers, disease. INTRODUCTION ... the services are available, difficulties associated with transportation, communication, illiteracy, nature of illnesses; family ...
Expansion of ART sites in rural areas and decentralisation of HIV care at government hospitals will reduce travel distance and transport costs and ensure universal access to healthcare services among PLWHA. Keywords: healthcare, access, inequalities, HIV and AIDS, Nigeria African Journal of AIDS Research 2013, 12(2): ...
Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel
The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.
Murphie, Phyllis; Hex, Nick; Setters, Jo; Little, Stuart
"Non-delivery" home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers. Provide update for oxygen prescribers on options for home oxygen provision.Provide update on the evidence base for available self-fill oxygen technologies.Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems.
Taylor, April; Lizzi, Michele; Marx, Alison; Chilkatowsky, Maryann; Trachtenberg, Symme W; Ogle, Sue
Care coordination has been a key theme in national forums on healthcare quality, design, and improvement. This article describes the characteristics of a care coordination program aimed at supporting families in building care coordination competencies and providers in the coordination of care across multiple specialties. The program included implementation of a Care Coordination Counselor (CC Counselor) and several supporting tools-Care Binders, Complex Scheduling, Community Resources for Families Database, and a Care Coordination Network. Patients were referred by a healthcare provider to receive services from the CC Counselor or to receive a Care Binder organizational tool. To assess the impact of the counselor role, we compared patient experience survey results from patients receiving CC Counselor services to those receiving only the Care Binder. Our analysis found that patients supported by the CC Counselor reported greater agreement with accessing care coordination resources and identifying a key point person for coordination. Seventy-five percent of CC Counselor patients have graduated from the program. Our findings suggest that implementation of a CC Counselor role and supporting tools offers an integrative way to connect patients, families, and providers with services and resources to support coordinated, continuous care. © 2012 National Association for Healthcare Quality.
Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina
Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…
Melo, Elsa Maria de Oliveira Pinheiro de; Ferreira, Pedro Lopes; Lima, Regina Aparecida Garcia de; Mello, Débora Falleiros de
to analyze the answers of parents and health care professionals concerning the involvement of parents in the care provided to hospitalized children. exploratory study based on the conceptual framework of pediatric healthcare with qualitative data analysis. three dimensions of involvement were highlighted: daily care provided to children, opinions concerning the involvement of parents, and continuity of care with aspects related to the presence and participation of parents, benefits to the child and family, information needs, responsibility, right to healthcare, hospital infrastructure, care delivery, communication between the parents and health services, shared learning, and follow-up after discharge. the involvement of parents in the care provided to their children has many meanings for parents, nurses and doctors. Specific strategies need to be developed with and for parents in order to mobilize parental competencies and contribute to increasing their autonomy and decision-making concerning the care provided to children.
Boak, George; Dickens, Victoria; Newson, Annalisa; Brown, Louise
The purpose of this paper is to analyse the introduction of distributed leadership and team working in a therapy department in a healthcare organisation and to explore the factors that enabled the introduction to be successful. This paper used a case study methodology. Qualitative and quantitative information was gathered from one physiotherapy department over a period of 24 months. Distributed leadership and team working were central to a number of system changes that were initiated by the department, which led to improvements in patient waiting times for therapy. The paper identifies six factors that appear to have influenced the successful introduction of distributed learning and team working in this case. This is a single case study. It would be interesting to explore whether these factors are found in other cases where distributed leadership is introduced in healthcare organisations. The paper provides an example of successful introduction of distributed leadership, which has had a positive impact on services to patients. Other therapy teams may consider how the approach may be adopted or adapted to their own circumstances. Although distributed leadership is thought to be important in healthcare, particularly when organisational change is needed, there are very few studies of the practicalities of how it can be introduced.
Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit
Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.
Ahmed, Nizam U; Alam, Mohammed M; Sultana, Fadia; Sayeed, Shahana N; Pressman, Aliza M; Powers, Mary Beth
The NGO Service Delivery Program (NSDP), a USAID-funded programme, is the largest NGO programme in Bangladesh. Its strategic flagship activity is the essential services package through which healthcare services are administered by NGOs in Bangladesh. The overall goal of the NSDP is to increase access to essential healthcare services by communities, especially the poor. Recognizing that the poorest in the community often have no access to essential healthcare services due to various barriers, a study was conducted to identify what the real barriers to access by the poor are. This included investigations to further understand the perceptions of the poor of real or imagined barriers to accessing healthcare; ways for healthcare centres to maximize services to the poor; how healthcare providers can maximize service-use; inter-personal communication between healthcare providers and those seeking healthcare among the poor; and ways to improve the capacity of service providers to reach the poorest segment of the community. The study, carried out in two phases, included 24 static and satellite clinics within the catchment areas of eight NGOs under the NSDP in Bangladesh, during June-September 2003. Participatory urban and rural appraisal techniques, focus-group discussions, and in-depth interviews were employed as research methods in the study. The target populations in the study included males and females, service-users and non-users, and special groups, such as fishermen, sex workers, potters, Bedes (river gypsies), and lower-caste people-all combined representing a heterogeneous community. The following four major categories of barriers emerged as roadblocks to accessing quality healthcare for the poor: (a) low income to be able to afford healthcare, (b) lack of awareness of the kind of healthcare services available, (c) deficiencies and inconsistencies in the quality of services, and (d) lack of close proximity to the healthcare facility. Those interviewed perceived
Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.
... provisions by expanding the definition Technical Service Provider Assistance, which contained an error in the omission of ``Indian Tribe'' in the definition of Technical Service Provider. DATES: Effective Date: This amendment is effective on August 10, 2010. FOR FURTHER INFORMATION CONTACT: Angel Figueroa, Team Leader...
Jatlaoui, Tara C; Zapata, Lauren B; Curtis, Kathryn M; Folger, Suzanne G; Marchbanks, Polly A; Mandel, Michele G; Jamieson, Denise J
Whether providers who regularly provide family planning services consider contraceptive methods as unsafe for women with obesity is unknown. We analyzed questionnaire responses received from December 2009 to March 2010 from 635 office-based physicians and 1323 Title X clinic providers delivering family planning services, who were randomly sampled (response rate 65%) before the release of national evidence-based contraception guidelines. We examined provider and clinical setting characteristics and clinic patient demographics for association with provider misconceptions about safety of combined oral contraceptives (COCs), depot medroxyprogesterone acetate (DMPA), or intrauterine devices (IUDs) for women with obesity. If providers considered methods as unsafe or do not know, we categorized those responses as misconceptions. We used multivariable logistic regression to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). A substantial proportion of respondents had misconceptions about the safety of COCs (31%), DMPA (24%), copper (Cu) (18%), and levonorgestrel (LNG)-IUDs (16%) for women with obesity. Provider type was associated with increased odds of misconceptions for all four methods compared with office-based obstetrician/gynecologists. Not having the method available onsite was associated with safety misconceptions of DMPA (aOR 1.90, 95% CI 1.07-3.36), Cu-IUD (aOR 4.19, 95% CI 1.51-11.61), and LNG-IUD (aOR 5.25, 95% CI 1.67-16.49). While the majority of providers considered all four contraceptive methods safe for women with obesity, substantial proportions had misconceptions about safety of COCs, DMPA, and IUDs. Provider education, particularly among certain specialties, is needed to increase knowledge regarding moderate and highly effective contraceptive methods among this patient population.
The trends in the provision of ecosystem services during restoration and succession of subtropical forests and plantations were quantified, in terms of both receiver and donor values, based on a case study of a 3-step secondary succession series that included a 400-year-old subtropical forest and a 23-year history of growth on 3 subtropical forest plantations in Southeastern China. The ‘People's Republic of China Forestry Standard: Forest Ecosystem Service Valuation Norms’ was revised and applied to quantify the receiver values of ecosystem services, which were then compared with the emergy-based, donor values of the services. The results revealed that the efficiencies of subtropical forests and plantations in providing ecosystem services were 2 orders of magnitude higher than similar services provided by the current China economic system, and these efficiencieskept increasing over the course of succession. As a result, we conclude that afforestation is an efficient way to accelerate both the ability and efficiency of subtropical forests to provide ecosystem services. This paper is significant because it examines the dynamics of the provision of ecosystem services by forests over a succession series that spans 400 years. The paper also examines the rate of increase of services during forest restoration over a period of 23 years. The emergy used in ecosystem services provision is compared to the provision of similar services by economic means in the Chinese e
Lee, Jaymi F; Litten, Jason B; Grampp, Gustavo
Healthcare providers use recombinant biologics such as monoclonal antibodies to treat a variety of serious illnesses. Manufacturing of approved biotechnology products is complex, and the quality of the resulting biologic is dependent on careful control of process inputs and operating conditions. Biosimilars, which are similar but not identical to innovator biologics, are entering regulatory evaluation, approval, and marketing in regions with biosimilar approval pathways. This article describes the evaluation and potential impact of manufacturing process changes and biosimilar product development, and explores the similarities and distinctions between the two. Regulatory agencies generally require a comparability exercise following a manufacturing process change. This comparability is focused primarily on analytical characterization of the approved product before and after the manufacturing process change, with non-clinical and clinical confirmation required when determined necessary. When developing a biosimilar, the manufacturer does not have access to key information including the innovator manufacturer's cell line, cell culture conditions, purification procedures, and fill and finish processes. Further, the biosimilar manufacturer does not have access to information about the innovator manufacturer's product development history, including knowledge about the quality attributes of lots used in non-clinical and clinical development. We define the biosimilar manufacturer's lack of information as the knowledge gap. As a result, a biosimilarity exercise to compare a biosimilar to an approved innovator biologic requires a rigorous evaluation to ensure the safety and efficacy of the biosimilar. Given the knowledge gap under which biosimilars are developed, data to establish biosimilarity should go beyond a simple comparability exercise.
Jaruseviciene, L.; Orozco, M.; Ibarra, M.
Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicarag...
Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.
Poulymenopoulou, M; Malamateniou, F; Vassilacopoulos, G
Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.
Although the appearance of medical ethics as a science is a recently preoccupation, the ancient writings show that ethics precepts have been always modulated the medical practices. At the origin of medical ethics, in archaic societies and also in the most evolved ones from antiquity we are always found three elements: the ethics exigencies which the practician had to respect, the moral significations of the healthcare and the decisions which the state had to make for its citizens regarding th...
Full Text Available Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was descriptive using correlation by structural equations modelling. The studied population included those patients who provided their medicines from pharmacies of rural healthcare centers in Abhar and Soltanieh counties. The samples included 384 of these patients. Data was collected by outsourcing and service quality questionnaires. A structural equation modelling was used to analyze data by LISREAL software. Results indicated a positive significant effect of outsourced pharmacies of rural healthcare centers on quality of tangibles, reliability, responsiveness, assurance and empathy. findings emphasize the role of outsourcing on quality of services. Outsourced pharmacies of rural healthcare centers of Abhar and Soltanieh counties lead to improved service quality.
V. S. Aćimović-Raspopović; V. Radonjić
In this paper possible applications of responsive pricing scheme and Stackelberg game for pricing telecommunication services with service provider as a leader and users acting as followers are analyzed...
LETIA, I. A.
Full Text Available The key requirement for a service industry organization to reach competitive advantages through product diversification is the existence of a well defined method for building service bundles. Based on the idea that the quality of a service or its value is given by the difference between expectations and perceptions, we draw the main components of a frame that aims to support the client and the provider agent in an active collaboration meant to co-create service bundles. Following e3-value model, we structure the supporting knowledge around the relation between needs and satisfying services. We deal with different perspectives about quality through an ontological extension of Value Based Argumentation. The dialog between the client and the provider takes the form of a persuasion whose dynamic object is the current best configuration. Our approach for building service packages is a demand driven approach, allowing progressive disclosure of private knowledge.
In order to respond to the multiple paradoxes of current medical and healthcare services, some health professionals have chosen to operate as collective entities by creating multidisciplinary health houses. This trend is the practical outcome of an initiative that began in the early 2000s and that resulted in the creation of the Federation of health and healthcare houses (Fédération des maisons de soin et de santé), now known as the French federation of health houses and medical hubs (Fédération française des maisons et pôles de santé). Health houses offer a rich and varied range of prospects for improving the provision of healthcare services for local populations. Because of their multidisciplinary focus, health houses provide a comprehensive service for patients (i.e. treatment projects) with the possibility of articulating public healthcare policies around the coordination of prevention, education, screening and healthcare services (i.e. healthcare projects). They restore patients to a central position within the healthcare system and promote the provision of healthcare services aimed at ?fragile' populations. Socio-medical coordination also optimizes the use of hospitalization and the quality of home healthcare. To ensure the provision of such services, these new modes of organization require other means in addition to consultation fees. The "structure fee" (or forfait structure) is one such key element. The French federation of health houses and medical hubs is thus conceived in partnership with administrative and policy-making bodies on questions concerning access to healthcare, medical demography and the development of health houses and medical hubs.
BACKGROUND: This study sought to determine the level of satisfaction of patients with the healthcare services at Federal Medical Centre, Bida (FMCB) Nigeria and the factors associated with patients' satisfaction. METHODS: The study utilized exit interview of 480 patients, sampled at the 9 service points of the Centre.
Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith
Purpose: Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. Methods: This study compared 24,427 refugee children from...... and psychiatrists in private practice. Results: Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40–0.45) among refugee boys...... and 0.35 (95 % CI 0.33–0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Conclusions: Refugee children used fewer psychiatric healthcare services than Danish...
Ferreira-Furegato, Antonia R; Frari-Galera, Sueli A; Pillon, Sandra C; Cardoso, Lucilene
Mental health reform in Brazil presupposes mental health becoming integrated into the Brazilian health system, involving multidisciplinary teams whose professional practice has yet to be defined. The present study forms part of a project aimed at understanding human resources practices in Brazilian mental healthcare services. This was a descriptive, exploratory study using a sample of highly qualified practitioners involved in the Ribeirao Preto/SP public mental health network. The project was approved by the Ribeirao Preto College of Nursing/University of Sao Paulo's ethics committee. A semi-structured questionnaire was used and the data was statistically analyzed. One hundred and forty-four of the 193 practitioners from the 8 public mental and psychiatric health care services agreed to participate. It was observed that current practice was mainly based on individual care, emphasizing medical, psychological and nursing care. Group activities were more frequently provided by community services. Mental care was infrequently prescribed and a low value was placed on activities like observation, recording and therapeutic interaction. Mental care services were being structured; however, practitioners still had difficulties in implementing current policy.
Background: Periodic assessment of the services in health facilities will enable health policy makers to identify deficiencies and improve on the quality of health services rendered. Evaluation of patients' satisfaction is one of the ways of doing this assessment. Only few studies have addressed this issue in sub-Saharan ...
In 1998, the Oregon Department of Transportation undertook the Social Services Provider Survey as part of an investigation of the transportation needs of mobility impaired individuals in Oregon. This survey was designed to gain information about the ...
Vermont Center for Geographic Information — (Link to Metadata) The VT Wireless Internet Service Provider (ISP) dataset (WISP2006) includes polygons depicting the extent of Vermont's WISP broadband system as of...
Vermont Center for Geographic Information — (Link to Metadata) The VT Wireless Internet Service Provider (ISP) dataset (WISP2007) includes polygons depicting the extent of Vermont's WISP broadband system as of...
Patki, Tapasya; Bates, Natalie; Ghatikar, Girish
Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates this pro......Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates...
The existence of a right to healthcare or, at least, access to healthcare services, is a right that exists in terms of the Bill of Rights in the Constitution of the Republic of South Africa, 1996. This article explores the scope and ambit of the right and its meaning within the context of both of constitutional directives, the duties imposed upon the State to progressively realise the right for its citizens and the practical implications of the right with reference to existing healthcare infrastructure in the Republic of South Africa.
Eliacin, Johanne; Flanagan, Mindy; Monroe-DeVita, Maria; Wasmuth, Sarah; Salyers, Michelle P; Rollins, Angela L
Provider burnout is a critical problem in mental health services. Contributing factors have been explicated across three domains: personal, job and organizational characteristics. Of these, organizational characteristics, including workplace environment, appear to be particularly important given that most interventions addressing burnout via the other domains (e.g. bolstering personal coping skills) have been modestly effective at best. This study builds on previous research by using social capital as a framework for the experience of work social milieu, and aims to provide a richer understanding of how workplace social environment might impact burnout and help create more effective ways to reduce burnout. Providers (n = 40) taking part in a larger burnout intervention study were randomly selected to take part in interviews regarding their workplace environment and burnout. Participant responses were analyzed thematically. Workplace social milieu revolved around two primary themes: workplace social capital in provider burnout and the protective qualities of social capital in cohesive work teams that appear to mitigate burnout. These results imply that work environments where managers support collaboration and social interaction among work teams may reduce burnout.
Introduction: bypassing refers to a person's decision to seek care at a healthcare facility that is not the nearest one of its type to the person's home. Methods: this study examined inpatient care facility bypassing in urban Bo, Sierra Leone using data from 1,980 women with children 15 years of age and younger who were ...
Full Text Available Background: Logistic Service Providers main concern was to ensure reliability for a low price (Christopher, 2005. Dutch Logistic Service Providers still have these two aspects at the top of their list, but also have to take in a new aspect: sustainability. 88% Of the investigated Logistic Service Providers have included sustainability in the company's goals. These Logistic Service Providers have developed different strategies to achieve a higher level of sustainability. This paper presents the results of a study into what Logistic Service Providers say what they are doing, or intend to do, to improve sustainability for their transport services. In this way insight is given in the attitude of Dutch Logistic Service Providers towards sustainability and how they intend to translate this into business practise: internal solutions or new methods incorporating external partners. Methods: Various methods of the investigations were used, among which the analysis of the statements about the sustainabilityon the websites of various companies as well as the questionnaire per Internet. The research covered 50 largest logistics companies operating in the Netherlands and 60 companies that competed for the award "Lean and Green" advertised in the Netherlands. In addition, the Internet survey was answered by 41 companies that belong to the network of our university. Results: The investigation has shown that sustainability is handled by the logistics company as an integral part of the corporate strategy. In contrast, shippers depend in the choice of logistics services primarily on such classical aspects as the reliability or the price and the sustainability play a minor role. Conclusions: Trying to find methods to improve the sustainability, Dutch logistics service providers, in the first place, look for solutions that increase the efficiency and therefore the cost reduction potential. Solutions, which require the involvement of clients, were less often
Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.
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…
Full Text Available Abstract Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years. Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making
Buccoliero, Luca; Bellio, Elena; Mazzola, Maria; Solinas, Elisa
The study aims at investigating the characteristics and the satisfaction determinants of the emerging patient profile. This profile appears to be more demanding and "empowered" compared to the ones traditionally conceived, asking for unconventional healthcare services and for a closer relationship with providers. Both qualitative (semi-structured interviews and focus groups) and quantitative (survey) analyses were performed on a random sample of 2808 Italian citizens-patients. Analyses entailed descriptive statistics, bivariate analysis and linear regressions. Four relevant dimensions of patient 2.0 experience were identified through a literature review on experiential marketing in healthcare. Beta coefficients exhibited the effect that different healthcare experiential elements have on patient 2.0 satisfaction. Results allow to state that a new marketing approach, based on patient 2.0 characteristics and value drivers, should be adopted in the healthcare sector. Critical satisfaction drivers and new technological healthcare guidelines are identified in order to match the new patient profile needs.
Young, Savannah S; Lewis, Denise C; Gilbey, Peter; Eisenman, Arie; Schuster, Richard; Seponski, Desiree M
Israel has provided immediate healthcare to Syrian children, civilians and fighters since early 2013 despite being in an official state of war with Syria since 1973. We present qualitative findings from a larger mixed-methods phenomenological study to understand how the geopolitical and social history of Israel and Syria influences healthcare providers and Syrian patient caregivers in northern Israel. Theories of humanization and cognitive dissonance guided this study and frame the beliefs and experiences of healthcare providers who treated wounded Syrians in Israeli hospitals. Findings indicate healthcare providers and Syrian caregivers adjusted their beliefs to allow for positive healthcare experiences. Qualitative analysis revealed two major themes: supportive and hindering systemic elements contributing to the healthcare provider-patient-caregiver relationship. Internal psychological developments, contextual factors, and relational processes influenced humanization of the other within the relationship. This study illuminates unique ethical and humanitarian demands relevant for healthcare workers and those with whom they interact.
Ramsaran-Fowdar, Rooma Roshnee
The paper aims to focus on an augmented SERVQUAL instrument that was used to measure private patients' service expectations and perceptions. A questionnaire was administered to 750 and 34 per cent responded. A new service quality instrument called PRIVHEALTHQUAL emerged from the study, based on factor and reliability analysis. The "reliability and fair and equitable treatment" factor was found to be the most important healthcare service quality dimension. Adds to the existing body of research on service quality and demonstrates that SERVQUAL is not a generic service quality measure for all industries.
Changing consumer behavior drives the demand for convenient and easy-to-use mobile applications across industries. This also impacts the financial sector. Banks are eager to offer their services as mobile applications to match the modern consumer needs. The mobile applications are not independently able to provide the required functionality; they interact with the existing core business functions by consuming secure Web Services over the Internet. The thesis analyses th...
Desai, Tejas; Ali, Sadeem; Fang, Xiangming; Thompson, Wanda; Jawa, Pankaj; Vachharajani, Tushar
Gender disparities in income continue to exist, and many studies have quantified the gap between male and female workers. These studies paint an incomplete picture of gender income disparity because of their reliance on notoriously inaccurate or incomplete surveys. We quantified gender reimbursement disparity between female and male healthcare providers using objective, non-self-reported data and attempted to adjust the disparity against commonly held beliefs as to why it exists. We analysed over three million publicly available Medicare reimbursement claims for calendar year 2012 and compared the reimbursements received by male and female healthcare providers in 13 medical specialties. We adjusted these reimbursement totals against how hard providers worked, how productive each provider was, and their level of experience. We calculated a reimbursement differential between male and female providers by primary medical specialty. The overall adjusted reimbursement differential against female providers was -US$18 677.23 (95% CI -US$19 301.94 to -US$18 052.53). All 13 specialties displayed a negative reimbursement differential against female providers. Only two specialties had reimbursement differentials that were not statistically significant. After adjustment for how hard a physician works, his/her years of experience and his/her productivity, female healthcare providers are still reimbursed less than male providers. Using objective, non-survey data will provide a more accurate understanding of this reimbursement inequity and perhaps lead the medical profession (as a whole) towards a solution that can reverse this decades-old injustice. 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/
Liao, Wen-Hwa; Qiu, Wan-Li
Numerous differences exist between the healthcare industry and other industries. Difficulties in the business operation of the healthcare industry have continually increased because of the volatility and importance of health care, changes to and requirements of health insurance policies, and the statuses of healthcare providers, which are typically considered not-for-profit organizations. Moreover, because of the financial risks associated with constant changes in healthcare payment methods and constantly evolving information technology, healthcare organizations must continually adjust their business operation objectives; therefore, cloud computing presents both a challenge and an opportunity. As a response to aging populations and the prevalence of the Internet in fast-paced contemporary societies, cloud computing can be used to facilitate the task of balancing the quality and costs of health care. To evaluate cloud computing service systems for use in health care, providing decision makers with a comprehensive assessment method for prioritizing decision-making factors is highly beneficial. Hence, this study applied the analytic hierarchy process, compared items related to cloud computing and health care, executed a questionnaire survey, and then classified the critical factors influencing healthcare cloud computing service systems on the basis of statistical analyses of the questionnaire results. The results indicate that the primary factor affecting the design or implementation of optimal cloud computing healthcare service systems is cost effectiveness, with the secondary factors being practical considerations such as software design and system architecture.
Fong, Ee-May; Chung, Wan-Young
Noncontact electrocardiogram (ECG) measurement technique has gained popularity these days owing to its noninvasive features and convenience in daily life use. This paper presents mobile cloud computing for a healthcare system where a noncontact ECG measurement method is employed to capture biomedical signals from users. Healthcare service is provided to continuously collect biomedical signals from multiple locations. To observe and analyze the ECG signals in real time, a mobile device is used as a mobile monitoring terminal. In addition, a personalized healthcare assistant is installed on the mobile device; several healthcare features such as health status summaries, medication QR code scanning, and reminders are integrated into the mobile application. Health data are being synchronized into the healthcare cloud computing service (Web server system and Web server dataset) to ensure a seamless healthcare monitoring system and anytime and anywhere coverage of network connection is available. Together with a Web page application, medical data are easily accessed by medical professionals or family members. Web page performance evaluation was conducted to ensure minimal Web server latency. The system demonstrates better availability of off-site and up-to-the-minute patient data, which can help detect health problems early and keep elderly patients out of the emergency room, thus providing a better and more comprehensive healthcare cloud computing service.
Full Text Available Noncontact electrocardiogram (ECG measurement technique has gained popularity these days owing to its noninvasive features and convenience in daily life use. This paper presents mobile cloud computing for a healthcare system where a noncontact ECG measurement method is employed to capture biomedical signals from users. Healthcare service is provided to continuously collect biomedical signals from multiple locations. To observe and analyze the ECG signals in real time, a mobile device is used as a mobile monitoring terminal. In addition, a personalized healthcare assistant is installed on the mobile device; several healthcare features such as health status summaries, medication QR code scanning, and reminders are integrated into the mobile application. Health data are being synchronized into the healthcare cloud computing service (Web server system and Web server dataset to ensure a seamless healthcare monitoring system and anytime and anywhere coverage of network connection is available. Together with a Web page application, medical data are easily accessed by medical professionals or family members. Web page performance evaluation was conducted to ensure minimal Web server latency. The system demonstrates better availability of off-site and up-to-the-minute patient data, which can help detect health problems early and keep elderly patients out of the emergency room, thus providing a better and more comprehensive healthcare cloud computing service.
Herand, Deniz; Gürder, Filiz; Taşkin, Harun; Yuksel, Emre Nuri
The current Turkish healthcare management system has a structure that is extremely inordinate, cumbersome and inflexible. Furthermore, this structure has no common point of view and thus has no interoperability and responds slowly to innovations. The purpose of this study is to show that using which methods can the Turkish healthcare management system provide a structure that could be more modern, more flexible and more quick to respond to innovations and changes taking advantage of the benefits given by a service-oriented architecture (SOA). In this paper, the Turkish healthcare management system is chosen to be examined since Turkey is considered as one of the Third World countries and the information architecture of the existing healthcare management system of Turkey has not yet been configured with SOA, which is a contemporary innovative approach and should provide the base architecture of the new solution. The innovation of this study is the symbiosis of two main integration approaches, SOA and Health Level 7 (HL7), for integrating divergent healthcare information systems. A model is developed which is based on SOA and enables obtaining a healthcare management system having the SSF standards (HSSP Service Specification Framework) developed by the framework of the HSSP (Healthcare Services Specification Project) under the leadership of HL7 and the Object Management Group.
Cutter-Wilson, Elizabeth; Richmond, Tracy
Teen dating violence (TDV) is a serious and potentially lethal form of relationship violence in adolescence. TDV is highly correlated with several outcomes related to poor physical and mental health. Although incidence and prevalence data indicate high rates of exposure to TDV among adolescents throughout the United States, significant confusion remains in healthcare communities concerning the definition and implications of TDV. Additionally, healthcare providers are uncertain about effective screening and intervention methods. The article will review the definition and epidemiology of TDV and discuss possible screening and intervention strategies. TDV research is a relatively new addition to the field of relationship violence. Although some confusion remains, the definition and epidemiology of TDV are better understood, which has greatly led to effective ways in which to screen and intervene when such violence is detected. Universal screening with a focus on high-risk subgroups combined with referrals to local and national support services are key steps in reducing both primary and secondary exposure. TDV is a widespread public health crisis with serious short-term and long-term implications. It is necessary for pediatric and adolescent healthcare providers to be aware of TDV and its potential repercussions, as well as possible methods for screening and intervention. More research is needed to better understand TDV as well as to further define effective screening and intervention protocol for the clinical environment.
Christin, Nicolas; Liebeherr, Joerg
For the past decade, a lot of Internet research has been devoted to providing different levels of service to applications. Initial proposals for service differentiation provided strong service guarantees, with strict bounds on delays, loss rates, and throughput, but required high overhead in terms of computational complexity and memory, both of which raise scalability concerns. Recently, the interest has shifted to service architectures with low overhead. However, these newer service architectures only provide weak service guarantees, which do not always address the needs of applications. In this paper, we describe a service architecture that supports strong service guarantees, can be implemented with low computational complexity, and only requires to maintain little state information. A key mechanism of the proposed service architecture is that it addresses scheduling and buffer management in a single algorithm. The presented architecture offers no solution for controlling the amount of traffic that enters the network. Instead, we plan on exploiting feedback mechanisms of TCP congestion control algorithms for the purpose of regulating the traffic entering the network.
Su, Shu; Zhang, Fan; Liu, Qin; Wang, Yang; Wen, Jing; Tang, Xiaojun; Zhang, Lei
To investigate the use of reproductive healthcare services among migrant women workers in Chong Qing, China, and provide suggestions to improve the utilization of these services by young women. In a qualitative interview-based study between March, 2013 and June, 2013, personal in-depth interviews were conducted among young women workers, factory doctors, healthcare service providers, and policy-makers in Chong Qing, China. Women workers seldom visited hospitals and did so only when their pain became unbearable. The workers' use of reproductive healthcare services was particularly influenced by the high cost of hospitalization and long waiting periods. Factory doctors could only solve minor problems. Public healthcare providers stated that migrant women had a higher morbidity rate from reproductive tract infections as compared with local women. The policy-makers considered that the health system was beneficial to women's reproductive health; however, few workers had good comprehension of government policies. Migrant women workers are vulnerable owing to lack of reproductive health care. The government and both social and health enterprise should consider the convenience of these women and the affordability of treatments when formulating reproductive healthcare policies. Effective measures should be taken to improve the use of these services by migrant women workers. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Ee-May Fong; Wan-Young Chung
Noncontact electrocardiogram (ECG) measurement technique has gained popularity these days owing to its noninvasive features and convenience in daily life use. This paper presents mobile cloud computing for a healthcare system where a noncontact ECG measurement method is employed to capture biomedical signals from users. Healthcare service is provided to continuously collect biomedical signals from multiple locations. To observe and analyze the ECG signals in real time, a mobile device is used...
Birgelen, M.J.H. van; Sen, H.; Riel, A.C.R. van; Semeijn, J.
The purpose of this study is to examine how healthcare clients’ perceptions of employee emotional competence (EEC), influences satisfaction and loyalty, specifically the role of rapport and trust in this mechanism. This is a rather neglected topic in services research, which may contribute to better
Shafei, Ingy; Walburg, J.A.; Taher, Ahmed F.
Purpose – This paper aims to develop a model that encompasses the constructs and sub-constructs consumers use in evaluating healthcare service quality (HSQ) in Egypt. Design/methodology/approach – Factor analysis was performed on 40 variables to identify the constructs. Ordinal logistic regression
Van der Watt, R
Full Text Available A public multi-disciplinary primary-level hospital delivers clinical services to both in and out patients within its catchment area. A multi-disciplinary hospital is a healthcare facility of which the commissioning or transition into operations is a...
The relationship between farmers' health and agricultural productivity has been established in literature. The study assessed utilization of Western and Traditional healthcare services by farm- families in Ukwa-East Local Government of Abia State. The population of study comprised all farm-families in the 19 Community that ...
Multiple regression analysis of our data showed that common business practices and introvert and extrovert personality traits, out of the nine causal variables predicted media self employment providing services among male graduates. Among the females graduates, only common business practices and introvert personality ...
information centre to the community of users. But many have failed to serve this purpose after spending lots of money due to some reason and the other. This survey study is aimed at assessing Effectiveness of Reference Services in Providing Students' Information Needs in. Some Selected Tertiary Institutions in Borno State ...
Barbarito, Fulvio; Pinciroli, Francesco; Mason, John; Marceglia, Sara; Mazzola, Luca; Bonacina, Stefano
Information technologies (ITs) have now entered the everyday workflow in a variety of healthcare providers with a certain degree of independence. This independence may be the cause of difficulty in interoperability between information systems and it can be overcome through the implementation and adoption of standards. Here we present the case of the Lombardy Region, in Italy, that has been able, in the last 10 years, to set up the Regional Social and Healthcare Information System, connecting all the healthcare providers within the region, and providing full access to clinical and health-related documents independently from the healthcare organization that generated the document itself. This goal, in a region with almost 10 millions citizens, was achieved through a twofold approach: first, the political and operative push towards the adoption of the Health Level 7 (HL7) standard within single hospitals and, second, providing a technological infrastructure for data sharing based on interoperability specifications recognized at the regional level for messages transmitted from healthcare providers to the central domain. The adoption of such regional interoperability specifications enabled the communication among heterogeneous systems placed in different hospitals in Lombardy. Integrating the Healthcare Enterprise (IHE) integration profiles which refer to HL7 standards are adopted within hospitals for message exchange and for the definition of integration scenarios. The IHE patient administration management (PAM) profile with its different workflows is adopted for patient management, whereas the Scheduled Workflow (SWF), the Laboratory Testing Workflow (LTW), and the Ambulatory Testing Workflow (ATW) are adopted for order management. At present, the system manages 4,700,000 pharmacological e-prescriptions, and 1,700,000 e-prescriptions for laboratory exams per month. It produces, monthly, 490,000 laboratory medical reports, 180,000 radiology medical reports, 180
Kreye, Melanie; Nandrup-Bus, Troels
It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through...... quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being able to take responsibility and accountability for ones work. Service employees were found to feel proud...
Radl-Karimi, Christina; Nicolaisen, Anne; Sodemann, Morten; Batalden, Paul; von Plessen, Christian
Immigrant patients often meet barriers to patient-centred healthcare in their new host countries. Given the heterogeneity of patients from ethnic minorities, established strategies for patient centredness might not work in their case. The concept of coproduction provides a new perspective on how to collaboratively create the highest possible value for both the patient and the healthcare system. The concept acknowledges that all service is coproduced and directs attention to the relationship between patient and care provider. Coproduction is still a new concept in healthcare and its use with vulnerable groups of patients requires further study. This protocol outlines a scoping review to be conducted on the current knowledge on coproduction of service by immigrants and their service providers in the healthcare sector. We will use Joanna Briggs methodology for scoping reviews. The data will stem from the following databases: PubMed, Scopus, Ovid EMBASE, EBSCO CINAHL, EBSCO PsycINFO, Cochrane Library and Web of Science. We will also screen the websites of national authorities and research organisations for publications and review the literature lists of the identified articles for relevant references. We will include all types of literature on coproduction of healthcare or social service by immigrants and service providers, including their relationship with one another, communication and collaboration. Two reviewers will independently screen eligible publications and extract data using a checklist developed for this scoping review. The results of the study will provide an innovative perspective on the coproduction of value in healthcare service by immigrant patients and care providers. We will present the results at national and international conferences, seminars and other events with relevant stakeholders and immigrant patients, and publish them in a peer-reviewed journal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article
ŢOGOE GRETI DANIELA
Full Text Available The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain through a thorough and detailed approach as different sides (conceptual and practical looking projections of accounting issues related to regulatory developments and practices in the field. This paper addresses various concepts, accounting treatments, and books and accounting documents used both freelancers in providing accounting services and legal persons authorized accounting profession. In terms of methodology and research perspective, the whole scientific approach combined with quantitative and qualitative research theoretical perspective (descriptive-conceptual with practice perspective (empirical analyzing the main contributions of various authors (Romanian and foreign to knowledge in the field. Following the survey believe that the amendments to the national legislation will support entities providing accounting services, by cutting red tape on Administrative Burdens, and consequently will increase profitability and increase service quality.
Hamilton, F L; Greaves, F; Majeed, A; Millett, C
Financial incentives are seen as one approach to encourage more systematic use of smoking cessation interventions by healthcare professionals. A systematic review was conducted to examine the evidence for this. Medline, Embase, PsychINFO, Cochrane Library, ISI Web of Science and sources of grey literature were used as data sources. Studies were included if they reported the effects of any financial incentive provided to healthcare professionals to undertake smoking cessation-related activities. Data extraction and quality assessment for each study were conducted by one reviewer and checked by a second. A total of 18 studies were identified, consisting of 3 randomised controlled trials and 15 observational studies. All scored in the mid range for quality. In all, 8 studies examined smoking cessation activities alone and 10 studied the UK's Quality and Outcomes Framework targeting quality measures for chronic disease management including smoking recording or cessation activities. Five non-Quality and Outcomes Framework studies examined the effects of financial incentives on individual doctors and three examined effects on groups of healthcare professionals based in clinics and general practices. Most studies showed improvements in recording smoking status and smoking cessation advice. Five studies examined the impact of financial incentives on quit rates and longer-term abstinence and these showed mixed results. Financial incentives appear to improve recording of smoking status, and increase the provision of cessation advice and referrals to stop smoking services. Currently there is not sufficient evidence to show that financial incentives lead to reductions in smoking rates.
increased health vote while revising allocation based more on need other than solely on budgetary allocation of funds, increased staffing and providence of incentives for disadvantaged areas, and monitoring of drug supply and dispensing at health centres. 1. Introduction. According to the World Health Organization (WHO), ...
Hweissa, N Ab; Lim, J N W; Su, T T
In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women. © 2016 John Wiley & Sons Ltd.
de Viggiani, Nick
Police custody healthcare services for detainees in the UK are most commonly outsourced to independent healthcare providers who employ custody nurses and forensic physicians to deliver forensic healthcare services. A pilot was introduced in 2008 by the Department of Health to explore the efficacy of commissioning custody healthcare via the NHS, in the wake of the 2005-2006 shift of prison healthcare to the NHS. The objective was to improve quality and accountability through NHS commissioning and the introduction of NHS governance to the management and delivery of custody healthcare. This article discusses key themes that arose from the project evaluation, which focused on the commissioning relationship between the police, the NHS commissioner and the private healthcare provider. The evaluation observed an evolving relationship between the police, the local NHS and the front-line nurses, which was complicated by the quite distinctive professional values and ideologies operating, with their contrasting organisational imperatives and discordant values and principles. A key challenge for commissioners is to develop synergy between operational and strategically located stakeholders so that they can work effectively towards common goals. Government policy appears to remain focused on creating safe, supportive and humane custody environments that balance criminal justice and health imperatives and support the rights and needs of detainees, victims, professionals and the public. This remains an ambitious agenda and presents a major challenge for new criminal justice health partnerships. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Eighty one percent of medical students expressed confidence in the ability of clinical pharmacists to minimize medication errors. Although slightly more than half of the respondents (53%) reported that they did not have clinical pharmacy services in their institutions, there was substantial willingness among physicians and ...
Anton Persic; Mirko Markic
The purpose of the paper is to define key leadership models, to recognize advantages and benefits, and define influence factors of business success on leadership systems integration in service providing organizations in Slovenia. We use quantitative research with frequent analysis complex questions to present and analyse some factors of leadership standards and build a new regression leadership model of organization. We have sent the questionnaire to 89 organizations, all with certificate sys...
Svendsen, Edel Jannecke; Moen, Anne; Pedersen, Reidar; Bjørk, Ida Torunn
The aim of this study was to increase understanding of parent-healthcare provider interaction in situations where newly admitted preschool children resist peripheral vein cannulation. Parent-healthcare provider interaction represents an important context for understanding children's resistance to medical procedures. Knowledge about this interaction can provide a better understanding of how restraint is used and talked about. Symbolic interactionism informed the understanding of interaction. An exploratory, qualitative study was chosen because little is known about these interactions. During 2012-2013, 14 naturalistic peripheral vein cannulation -attempts with six newly hospitalized preschool children were video recorded. Eight parents/relatives, seven physicians and eight nurses participated in this study. The analytical foci of turn-taking and participant structure were used. The results comprised three patterns of interactions. The first pattern, 'parents supported the interaction initiated by healthcare providers', was a response to the children's expressed resistance and they performed firm restraint together. The second pattern, 'parents create distance in interaction with healthcare providers', appeared after failed attempts and had a short time span. Parents stopped following up on the healthcare providers' interaction and their restraint became less firm. In the third pattern, 'healthcare providers reorient in interaction', healthcare providers took over more of the restraint and either helped each other to continue the interaction or they stopped it. Knowledge about the identified patterns of interactions can help healthcare providers to better understand and thereby prepare both parents and themselves for situations with potential use of restraint. © 2015 John Wiley & Sons Ltd.
In addition clinical pharmacist are to monitor patient adherence to therapy, provide drug information, monitor patient responses and laboratory values, and provide patient and provider education. Other responsibilities carried out by clinical pharmacists may include but are not limited to: prevention of medication errors, ...
Full Text Available Objectives – The purpose of this research project was to gain insight into the information behaviour of healthcare services managers as they use information while engaged in decision-making unrelated to individual patient care. Methods – This small-scale, exploratory, multiple case study used the critical incident technique in nineteen semi-structured interviews. Responses were analyzed using ‘Framework,’ a matrix-based content analysis system. Results – This paper presents findings related to the internal information that healthcare services managers need and use. Their decisions are influenced by a wide variety of factors. They must often make decisions without all of the information they would prefer to have. Internal information and practical experience set the context for new research-based information, so they are generally considered first.Conclusions – Healthcare services managers support decisions with both facts and value-based information. These results may inform both delivery of health library services delivery and strategic health information management planning. They may also support librarians who extend their skills beyond managing library collections and teaching published information retrieval skills, to managing internal and external information, teaching information literacy, and supporting information sharing.
Mu, Y.; Bossink, Bart; Vinig, T.
Drawing on an integration of service-dominant (S-D) logic and the dynamic capabilities approach, this study focuses on the relatively under-researched issue of service innovation quality in healthcare services. We propose a conceptual framework for the relationships between user-induced and
Mu, Y.; Bossink, Bart; Vinig, T.
Drawing on an integration of service-dominant (S-D) logic and the dynamic capabilities approach, this study focuses on the relatively under-researched issue of service innovation quality in healthcare services. We propose a conceptual framework for the relationships between user-induced and
Pepper, Jessica K; McRee, Annie-Laurie; Gilkey, Melissa B
Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that may serve as a "gateway" to tobacco use by adolescents. Use of e-cigarettes by U.S. adolescents rose from 3% in 2011 to 7% in 2012. We sought to describe healthcare providers' awareness of e-cigarettes and to assess their comfort with and attitudes toward discussing e-cigarettes with adolescent patients and their parents. A statewide sample (n = 561) of Minnesota healthcare providers (46% family medicine physicians, 20% pediatricians, and 34% nurse practitioners) who treat adolescents completed an online survey in April 2013. Nearly all providers (92%) were aware of e-cigarettes, and 11% reported having treated an adolescent patient who had used them. The most frequently cited sources of information about e-cigarettes were patients, news stories, and advertisements, rather than professional sources. Providers expressed considerable concern that e-cigarettes could be a gateway to tobacco use but had moderately low levels of knowledge about and comfort discussing e-cigarettes with adolescent patients and their parents. Compared with pediatricians and nurse practitioners, family medicine physicians reported knowing more about e-cigarettes and being more comfortable discussing them with patients (both p adolescents may need to incorporate screening and counseling about e-cigarettes into routine preventive services, particularly if the prevalence of use continues to increase in this population. Education about e-cigarettes could help providers deliver comprehensive preventive services to adolescents at risk of tobacco use. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Van Rompay, Thomas L J; Tanja-Dijkstra, Karin
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
Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly
Phillips, Karon L; Chiriboga, David A; Jang, Yuri
Preliminary studies have revealed an association between cultural competence and an improvement in the quality of healthcare services, increased patient satisfaction, and increased effectiveness of services. This study examined factors that helped to explain patients' perceptions of their providers' interpersonal sensitivity - one component of cultural competence. The respondents were 2075 racially/ethnically diverse adults, aged 50 years and older, who responded to a national telephone survey. Results indicate that one of the main factors predicting interpersonal sensitivity is self-rated physical health: those who reported better health were more likely to see their provider as exhibiting higher levels of sensitivity. This was true for Hispanic/Latino patients. The results also suggest that having a provider of the same race/ethnicity was a significant factor only for Hispanic/Latino patients. Despite findings from previous research, racial/ethnic concordance may not be universally effective in improving interpersonal sensitivity in healthcare settings for all racial/ethnic groups.
This article deals with the transnational healthcare practices of Central and Eastern European migrants in Europe, taking the case of Romanian migrants in Ireland. It explores the implications of migrants' transnational healthcare practices for the transformation of citizenship in Europe, more particularly in terms of access to free public healthcare. The article places these practices in the larger perspective of global care chains, seen as including transnational flows of healthcare seekers and healthcare workers that link distant healthcare systems in an emerging European healthcare assemblage. The study adopted a holistic perspective, taking into account both formal and informal practices, as well as the use of healthcare services in both the host and the origin countries of migrants. These were explored during multi-sited fieldwork in Romania and Ireland, conducted between 2012 and 2013, and combining a variety of sources and methods (semi-structured interviews, informal conversations, documentary analysis, etc.). The article explores the links between migrants' transnational healthcare practices and two other important processes: 1) inequalities in access to healthcare services in migrants' countries of origin and of destination; and 2) the contribution of healthcare privatisation to these inequalities. It shows that Romanian migrants' transnational healthcare practices function as strategies of social mobility for migrants, while also reflecting the increasing privatisation of healthcare services in Ireland and Romania. The article argues that these processes are far from specific to Ireland, Romania, and the migration flows uniting them. Rather, they draw our attention to the rise of an unevenly developed European healthcare assemblage and citizenship regime in which patients' movements across borders are closely interlinked with diminishing and increasingly unequal access to public healthcare services. Copyright © 2014 Elsevier Ltd. All rights reserved.
Hsieh, Chang-tseh; Lin, Binshan
The utilisation of IS/IT could offer a substantial competitive advantage to healthcare service providers through the realisation of improved clinical, financial, and administrative outcomes. In this study, 42 journal articles were reviewed and summarised with respect to identified benefits and challenges of the development and implementation of electronic medical records, tele-health, and electronic appointment reminders. Results of this study help pave the knowledge foundation for management of the behavioural healthcare to learn how to apply state-of-the-art information technology to offer higher quality, clinically proven effective services at lower costs than those of their competitors.
Feyissa Garumma T
Full Text Available Abstract Background Stigma and discrimination against people living with human immunodeficiency virus (HIV are obstacles in the way of effective responses to HIV. Understanding the extent of stigma / discrimination and the underlying causes is necessary for developing strategies to reduce them. This study was conducted to explore stigma and discrimination against PLHIV amongst healthcare providers in Jimma zone, Southwest Ethiopia. Methods A cross-sectional study, employing quantitative and qualitative methods, was conducted in 18 healthcare institutions of Jimma zone, during March 14 to April 14, 2011. A total of 255 healthcare providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support and HIV-related stigma and discrimination. Factor analysis was employed to create measurement scales for stigma and factor scores were used in one way analysis of variance (ANOVA, T-tests, Pearson’s correlation and multiple linear regression analyses. Qualitative data collected using key-informant interviews and Focus Group Discussions (FGDs were employed to triangulate with the findings from the quantitative survey. Results Mean stigma scores (as the percentages of maximum scale scores were: 66.4 for the extra precaution scale, 52.3 for the fear of work-related HIV transmission, 49.4 for the lack of feelings of safety, 39.0 for the value-driven stigma, 37.4 for unethical treatment of PLHIV, 34.4 for discomfort around PLHIV and 31.1 for unofficial disclosure. Testing and disclosing test results without consent, designating HIV clients and unnecessary referral to other healthcare institutions and refusal to treat clients were identified. Having in-depth HIV knowledge, the perception of institutional support, attending training on stigma and discrimination, educational level of degree or higher, high HIV case loads, the presence of ART service in the healthcare facility and claiming to be
Feyissa, Garumma T; Abebe, Lakew; Girma, Eshetu; Woldie, Mirkuzie
Stigma and discrimination against people living with human immunodeficiency virus (HIV) are obstacles in the way of effective responses to HIV. Understanding the extent of stigma / discrimination and the underlying causes is necessary for developing strategies to reduce them. This study was conducted to explore stigma and discrimination against PLHIV amongst healthcare providers in Jimma zone, Southwest Ethiopia. A cross-sectional study, employing quantitative and qualitative methods, was conducted in 18 healthcare institutions of Jimma zone, during March 14 to April 14, 2011. A total of 255 healthcare providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support and HIV-related stigma and discrimination. Factor analysis was employed to create measurement scales for stigma and factor scores were used in one way analysis of variance (ANOVA), T-tests, Pearson's correlation and multiple linear regression analyses. Qualitative data collected using key-informant interviews and Focus Group Discussions (FGDs) were employed to triangulate with the findings from the quantitative survey. Mean stigma scores (as the percentages of maximum scale scores) were: 66.4 for the extra precaution scale, 52.3 for the fear of work-related HIV transmission, 49.4 for the lack of feelings of safety, 39.0 for the value-driven stigma, 37.4 for unethical treatment of PLHIV, 34.4 for discomfort around PLHIV and 31.1 for unofficial disclosure. Testing and disclosing test results without consent, designating HIV clients and unnecessary referral to other healthcare institutions and refusal to treat clients were identified. Having in-depth HIV knowledge, the perception of institutional support, attending training on stigma and discrimination, educational level of degree or higher, high HIV case loads, the presence of ART service in the healthcare facility and claiming to be non-religious were negative predictors of stigma and
Cherguit, Jasmina; Burns, Jan; Pettle, Sharon; Tasker, Fiona
This article is a report of a study of lesbian co-mothers' experiences of UK maternity healthcare services. With the increase in fertility provision to lesbian couples, maternity healthcare services are increasingly coming into contact with lesbian co-mothers. Literature highlights the need to investigate donor-conceived lesbian families and an absence of research focusing on the unique experiences of co-mothers in the maternity process. The study followed a qualitative design and interpretative phenomenological analysis methodology. A qualitative study was carried out involving ten lesbian co-mothers, whose children were conceived via anonymous donor insemination to their partners. Data collection took place between May-September 2009. Interpretative phenomenological analysis revealed two main types of co-mothers' experiences, those connected with maternity service structures and interpersonal experiences with maternity care staff. Co-mothers felt excluded by heterocentric organizational service structures. However, the co-mothers' overwhelming experiences with staff were positive and inclusive. Despite this, co-mothers reported that any ambiguous or non-inclusive experiences with professionals left them questioning whether these experiences were due to homophobic attitudes or professional incompetence. The results indicate that these lesbian co-mothers felt predominantly included and accepted by maternity services. Ambiguous interpersonal experiences, however, evoked doubts in this regard. In addition, organizational heterocentric structural barriers remain. Structural service delivery changes could facilitate co-mothers' feelings of inclusion and highlight the important role practitioners have in contributing to co-mothers' experiences. © 2012 Blackwell Publishing Ltd.
Hernández-Aceituno, Ana; Pérez-Tasigchana, Raúl F; Guallar-Castillón, Pilar; López-García, Esther; Rodríguez-Artalejo, Fernando; Banegas, José R
Data on the combined impact of healthy behaviors on healthcare use in older adults are limited. Study with community-dwelling individuals aged ≥60 years from the Spanish Seniors-ENRICA cohort, recruited in 2008-2010, followed through 2012-2013, and analyzed in 2016 (N=2,021). At baseline, the following healthy behaviors were self-reported: three traditional (never smoking, being physically active, having a healthy diet) and three emerging (sleeping 7-8 hours/day, sitting healthy behaviors and healthcare services used in 2012-2013 were summarized with ORs and 95% CIs from multiple logistic regression, adjusting for demographics, lifestyles, comorbidities, and baseline health services used. Most single healthy behaviors were associated with lower use of most health services. Compared with participants with zero or one healthy behavior, those with five or six healthy behaviors showed lower risk of polypharmacy (OR=0.46, 95% CI=0.24, 0.85, p-trend=0.001), visits to the primary care physician (OR=0.50, 95% CI=0.26, 0.96, p-trend=0.013), and hospitalization (OR=0.50, 95% CI=0.24, 1.01, p-trend=0.016). No association was found with visits to the medical specialist. The combination of five to six healthy behaviors in older adults is associated with half the risk of polypharmacy and using several healthcare services. In an era of constrained resources in most countries, this information may help inform health policy to control healthcare spending in the future. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Gilmartin, Heather; Goyal, Anupama; Hamati, Mary C; Mann, Jason; Saint, Sanjay; Chopra, Vineet
Mindfulness practice, where an individual maintains openness, patience, and acceptance while focusing attention on a situation in a nonjudgmental way, can improve symptoms of anxiety, burnout, and depression. The practice is relevant for health care providers; however, the time commitment is a barrier to practice. For this reason, brief mindfulness interventions (eg, ≤ 4 hours) are being introduced. We systematically reviewed the literature from inception to January 2017 about the effects of brief mindfulness interventions on provider well-being and behavior. Studies that tested a brief mindfulness intervention with hospital providers and measured change in well-being (eg, stress) or behavior (eg, tasks of attention or reduction of clinical or diagnostic errors) were selected for narrative synthesis. Fourteen studies met inclusion criteria; 7 were randomized controlled trials. Nine of 14 studies reported positive changes in levels of stress, anxiety, mindfulness, resiliency, and burnout symptoms. No studies found an effect on provider behavior. Brief mindfulness interventions may be effective in improving provider well-being; however, larger studies are needed to assess an impact on clinical care. Published by Elsevier Inc.
Ramona Fernanda Ceriotti Toassi
Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.
dearth in knowledge. Key words: Survey, Knowledge, Diabetes Mellitus, Health care providers, Nigeria. Introduction. Childhood type 1 diabetes mellitus like many other non-communicable diseases is increasing in prevalence and its complications lead to death. 1 The Nigeria University commission curriculum for paediatric.
V. S. Aćimović-Raspopović
Full Text Available In this paper possible applications of responsive pricing scheme and Stackelberg game for pricing telecommunication services with service provider as a leader and users acting as followers are analyzed. We have classified users according to an elasticity criterion into inelastic, partially elastic and elastic users. Their preferences are modelled through utility functions, which describe users’ sensitivity to changes in the quality of service and price. In the proposed algorithm a bandwidth management server is responsible for performing automatic optimal bandwidth allocation to each user’s session while maximizing its expected utility and the overall service provider’s revenue. The pricing algorithm is used for congestion control and more efficient network capacity utilization. We have analyzed different scenarios of the proposed usage-based pricing algorithm. Particularly, the influence of the number of service classes on price setting in terms of service provider’s revenue and total users’ utility maximization are discussed. The model is verified through numerous simulations performed by software that we have developed for that purpose.
V Jordan Greenbaum
Full Text Available V. Jordan Greenbaum discusses ways healthcare providers can identify children trafficked for sex to provide for their physical and mental health and their social and educational needs.
Ahmed, Selim; Tarique, Kazi Md; Arif, Ishtiaque
Purpose The purpose of this paper is to investigate service quality, patient satisfaction and loyalty in Bangladesh's healthcare sector. It identifies healthcare quality conformance, patient satisfaction and loyalty based on demographics such as gender, age and marital status. It examines the differences between public and private healthcare sectors regarding service quality, patient satisfaction and loyalty. Design/methodology/approach The authors distributed 450 self-administered questionnaires to hospital patients resulting in 204 useful responses (45.3 per cent response rate). Data were analysed based on reliability analysis, exploratory factor analysis, independent samples t-tests, ANOVA and discriminant analysis using SPSS version 23. Findings Findings indicate that single patients perceive tangibles, reliability, empathy and loyalty higher compared to married patients. Young patients (⩽20 years) have a higher tangibles, empathy and loyalty scores compared to other age groups. The authors observed that private hospital patients perceive healthcare service quality performance higher compared to patients in public hospitals. Research limitations/implications The authors focussed solely on the Bangladesh health sector, so the results might not be applicable to other countries. Originality/value The findings provide guidelines for enhancing service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector and other countries.
Khan, M M H; Grübner, Oliver; Krämer, Alexander
To compare patterns of healthcare service user preference between urban slums in Dhaka and adjacent rural areas and to identify key determinants of those preferences. The data were collected through baseline surveys conducted in 2008 and 2009. A total of 3207 subjects aged 10-90 years were systematically selected from 12 big slums in Dhaka and 3 rural villages outside Dhaka. Two frequently used healthcare sources utilized in 1 month preceding the baseline survey were pharmacies (slum, 42.6%; rural, 30.1%) and government hospitals/clinics (GVHC; slum, 13.5%; rural, 8.9%). According to the multilevel logistic regression analysis adjusted for age, sex and marital status, the likelihood of using pharmacies and GVHC were higher for those subjects who used non-hygienic toilets, who reported food deficiency at a family level, who expressed dissatisfaction about family income and who stated poor health status. Some more factors namely overweight, living in permanently structured house, smoking bidis and less frequency of watching TV were associated with higher likelihood of using GVHC. Pharmacy was the most dominant healthcare service in both areas. As persons running pharmacies often provide poor quality of healthcare services, they need continuous training and back-up supports to improve their quality of services and to strengthen the overall healthcare system in Bangladesh.
Möller, Thorsten; Schuldt, Heiko; Gerber, Andreas; Klusch, Matthias
Healthcare digital libraries (DLs) increasingly make use of dedicated services to access functionality and/or data. Semantic (web) services enhance single services and facilitate compound services, thereby supporting advanced applications on top of a DL. The traditional process management approach tends to focus on process definition at build time rather than on actual service events in run time, and to anticipate failures in order to define appropriate strategies. This paper presents a novel approach where service coordination is distributed among a set of agents. A dedicated component plans compound semantic services on demand for a particular application. In failure, the planner is reinvoked to define contin- gency strategies. Finally, matchmaking is effected at runtime by choosing the appropriate service provider. These combined technologies will provide key support for highly flexible next-generation DL applications. Such technologies are under development within CASCOM.
Lopez, Fanny Y.; DeMeester, Rachel H.; Jia, Justin L.; Peek, Monica E.; Vela, Monica B.
Abstract Effective shared decision making (SDM) between patients and healthcare providers has been positively associated with health outcomes. However, little is known about the SDM process between Latino patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), and their healthcare providers. Our review of the literature identified unique aspects of Latino LGBTQ persons’ culture, health beliefs, and experiences that may affect their ability to engage in SDM with their healthcare providers. Further research needs to examine Latino LGBTQ patient–provider experiences with SDM and develop tools that can better facilitate SDM in this patient population. PMID:27617356
Castor, Charlotte; Hallström, Inger; Hansson, Helena; Landgren, Kajsa
To explore healthcare professionals' conceptions of caring for sick children in home care services. Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. An inductive qualitative design. Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise using a phenomenographic analysis. Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges such as feelings of inadequacy and fear and professional growth such as increased competence and satisfaction. Conceptions of whether the home or the hospital was the best place for care differed. Adapting to the child's care was conceived as important. Cooperation with paediatric departments and a well-functioning team work were important organisational aspects. Providing home care for children was a challenging but rewarding task for healthcare professionals used to care for adults. To provide care with a child perspective was experienced as important even though there were conflicting conceptions of how this should be done. Close cooperation with paediatric departments and teamwork were prerequisites that make up for the low number of paediatric patients and facilitate confidence and competence. A sufficient number of referred children and enabling healthcare professionals to be part of the re-organising and implementation processes might facilitate the home care services for sick children. Enough time and good teamwork must be emphasised. Early referrals, continuous cooperation with paediatric clinics complemented with
Cameron, Jacqui; Ritter, Alison
Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Examples of the use of contingency management provided by key informants demonstrated an over-inclusive definition: all the examples did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study.
Full Text Available This paper focuses on the issues of smart metering market and considers different services provided by smart metering from consumer point of view. Firstly, smart metering deployment challenges emerging and conventional tariffs, which modify a consumer behavior and thus, the entire electric energy market can be optimized since the customer is motivated to consume less energy. Secondly, the authors illustrate changes in electricity quality, which have an impact on consumer relations with utility. Additionally, two main indices of grid resilience – SAIDI and SAIFI – are exemplified to reveal the improvement potential of smart metering implementation in certain regions of Russia that also influence the consumer. Finally, in-home display and privacy problem directly reflect the consumer’s behavior, thus the private life rights should not be violated as they are guaranteed by law.
Walker, Bruce F; Stomski, Norman J; Price, Anne; Jackson-Barrett, Elizabeth
To identify Indigenous people's views about gaps and practical solutions for the delivery of healthcare services in the Pilbara. A structured guide was used to interview three Indigenous language groups from the Pilbara region of Western Australia. The responses were analysed with the use of content analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues. Many respondents said that there were insufficient health professionals near country, which was compounded by a lack of adequate transport to reach healthcare services. Moreover, respondents commonly indicated that they would be unable to secure adequate accommodation for themselves and any carer when needing to leave country to undergo medical care. The importance of secondary healthcare interventions was highlighted, particularly health promotion initiatives that improved diet and exercise levels and reduced substance abuse. Assuming responsibility for one's own health was seen as integral to improving the overall health of communities. The respondents saw role models as the most important influence in leading people to take responsibility for improving their own health. This study provides Indigenous perspectives about gaps and solutions in healthcare service delivery in the Pilbara region of Western Australia. Although initiatives have commenced to address the shortfall in health professionals and inadequate transport to healthcare, there are still gaps in service provision. Mobile health services were strongly supported as an integral measure to address these gaps. WHAT IS KNOWN ABOUT THIS TOPIC? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous people in the region, Indigenous people experience a significantly higher mortality rate for
Micheal Kofi Boachie
Full Text Available Background In early 2012, National Health Insurance Scheme (NHIS members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs and direction of association of such factors with the choice of PPP. Methods Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63% and doctors (39.92%, distance or proximity (49.60%, provider reputation (39.52%, waiting time (39.92, additional charges (37.10%, and recommendations (48.79% were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027, availability of doctors (-1.82, additional charges (-2.14 and reputation (-2.09 were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59, waiting time (1.45, residence (-2.62, gender (-2.89, and reputation (-2.69 were statistically significant at 1% level. Presence of additional charges (-1.29 was statistically significant at 5% level. Conclusion Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by
Boachie, Micheal Kofi
In early 2012, National Health Insurance Scheme (NHIS) members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs) and direction of association of such factors with the choice of PPP. Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63%) and doctors (39.92%), distance or proximity (49.60%), provider reputation (39.52%), waiting time (39.92), additional charges (37.10%), and recommendations (48.79%) were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027), availability of doctors (-1.82), additional charges (-2.14) and reputation (-2.09) were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59), waiting time (1.45), residence (-2.62), gender (-2.89), and reputation (-2.69) were statistically significant at 1% level. Presence of additional charges (-1.29) was statistically significant at 5% level. Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by ensuring constant availability of
Paradies, Yin; Truong, Mandy; Priest, Naomi
Although considered a key driver of racial disparities in healthcare, relatively little is known about the extent of interpersonal racism perpetrated by healthcare providers, nor is there a good understanding of how best to measure such racism. This paper reviews worldwide evidence (from 1995 onwards) for racism among healthcare providers; as well as comparing existing measurement approaches to emerging best practice, it focuses on the assessment of interpersonal racism, rather than internalized or systemic/institutional racism. The following databases and electronic journal collections were searched for articles published between 1995 and 2012: Medline, CINAHL, PsycInfo, Sociological Abstracts. Included studies were published empirical studies of any design measuring and/or reporting on healthcare provider racism in the English language. Data on study design and objectives; method of measurement, constructs measured, type of tool; study population and healthcare setting; country and language of study; and study outcomes were extracted from each study. The 37 studies included in this review were almost solely conducted in the U.S. and with physicians. Statistically significant evidence of racist beliefs, emotions or practices among healthcare providers in relation to minority groups was evident in 26 of these studies. Although a number of measurement approaches were utilized, a limited range of constructs was assessed. Despite burgeoning interest in racism as a contributor to racial disparities in healthcare, we still know little about the extent of healthcare provider racism or how best to measure it. Studies using more sophisticated approaches to assess healthcare provider racism are required to inform interventions aimed at reducing racial disparities in health.
Full Text Available Introduction. Patients satisfaction is a very important part of any clinical practice both for evaluation and improvement of healthcare services. Objective. The aim of this study was to determine patient satisfaction with public outpatient healthcare services at secondary and tertiary level and to assess possible differences between the two levels. Methods. In a quantitative cross-sectional study, a convenient sample of 646 patients who experienced public outpatient healthcare services at the secondary and tertiary level during the last two months were interviewed. Patient satisfaction questionnaires, with statements regarding various aspects of satisfaction, were completed during face-to-face interviews (response rate 84.6%. The research instrument was tested for internal consistency using the Cronbach’s coefficient alpha estimate. Results. The patients were significantly more satisfied in tertiary than in secondary outpatient healthcare facilities in almost all aspects of assessment related to general settings, nurse/administrative staff performance and physician performance (p<0.001. The patients in the secondary healthcare services (SHCS were more satisfied than in the tertiary healthcare services (THCS but only regarding the information on location (83.9% vs.78.3% and possibilities to enter and move inside the department (88.8% vs. 83.3%. Analysis of data for SHCS and THCS showed that there was no significant difference between the mean overall satisfaction scores with regard to patients’ gender, age, marital status, educational level, employment and number of visits. Conclusion. There is a need to improve the current level of patient-provider relationship and communication, as well as that of hospital environment, while special efforts should be made to address the problem of patient waiting time and hospital bureaucracy.
Balogh, Robert; McMorris, Carly A; Lunsky, Yona; Ouellette-Kuntz, Helene; Bourne, Laurie; Colantonio, Angela; Gonçalves-Bradley, Daniela C
When compared to the general population, persons with an intellectual disability have lower life expectancy, higher morbidity, and more difficulty finding and obtaining healthcare. Organisational interventions are used to reconfigure the structure or delivery of healthcare services. This is the first update of the original review. To assess the effects of organisational interventions of healthcare services for the mental and physical health problems of persons with an intellectual disability. For this update we searched CENTRAL, MEDLINE, EMBASE, CINAHL and other databases, from April 2006 to 4 September 2015. We checked reference lists of included studies and consulted experts in the field. Randomised controlled trials of organisational interventions of healthcare services aimed at improving care of mental and physical health problems of adult persons with an intellectual disability. We employed standard methodological procedures as outlined in the Cochrane Handbook of Systematic Reviews of Interventions, in addition to specific guidance from the Cochrane Effective Practice and Organisation of Care (EPOC) Group. We identified one new trial from the updated searches.Seven trials (347 participants) met the selection criteria. The interventions varied but had common components: interventions that increased the intensity and frequency of service delivery (4 trials, 200 participants), community-based specialist behaviour therapy (1 trial, 63 participants), and outreach treatment (1 trial, 50 participants). Another trial compared two active arms (traditional counselling and integrated intervention for bereavement, 34 participants).The included studies investigated interventions dealing with the mental health problems of persons with an intellectual disability; none focused on physical health problems. Four studies assessed the effect of organisational interventions on behavioural problems for persons with an intellectual disability, three assessed care giver burden, and
Lin, Chunqing; Wu, Zunyou; Rou, Keming; Pang, Lin; Cao, Xiaobin; Shoptaw, Steven; Detels, Roger
The Methadone Maintenance Therapy (MMT) program has been initiated in China since 2004. As of the end of November, 2008, 558 MMT clinics had been established countrywide. The objective of this study was to elucidate the difficulties and challenges as perceived by service providers working in MMT clinics. One service provider from each of the 28 MMT study clinics in Zhejiang and Jiangxi Provinces of China participated in a face-to-face in-depth interview for about 1-2h to describe their perceptions of working in MMT clinics. Qualitative data were analysed using ATLAS.ti. The grounded theory was used to guide the data analysis. Participants identified major problems in providing services in MMT clinics including lack of resources, professional training, and institutional support. Difficulties in pursuit of career, concern for personal safety, low income, heavy working load, and poor opinion of MMT by Chinese society often contributed to greater stress and burnout among the service providers. The MMT programs in China desperately need additional resource allocation and institutional support for the current and perhaps future expansion of the programs. The service providers are in urgent need of professional training to improve the quality of care they can offer MMT clients. Copyright 2009 Elsevier B.V. All rights reserved.
P Cheena Chawla
Interpretation & conclusions: The findings reinforce continued medical education of healthcare providers, particularly those from the government sector on HPV vaccination for cervical cancer prevention. Public education is also pertinent for a successful HPV vaccination programme in the country.
Aragaw, Amanu; Yigzaw, Tegbar; Tetemke, Desalegn; G/Amlak, Wubalem
Cultural competency is now a core requirement for maternal health providers working in multicultural society. However, it has not yet received due attention in Ethiopia. This study aimed to determine the level of cultural competence and its associated factors among maternal health care providers in Bahir Dar City Administration, Northwest Ethiopia. Institution based cross-sectional study was carried out using both quantitative and qualitative methods. Maternal health care providers from all health facilities were our study participants. Structured Questionnaire with some modification of Campinha Bacote's tool was used to collect quantitative data from health workers and semi structured guide line was used for qualitative data among women. While quantitative data analysis was done using SPSS, qualitative data was analyzed using open code software. P-value of less than 0.05 was taken to determine statistical significance. Cronbach's alpha was used to test internal reliability and a factor loading of 0.3 or greater was the criterion used to retain items. Two hundred seventy four health workers and seven women were involved in the study. The overall competency level was 57.3 % thought vary in different subscales or stages. Of the cultural competent health workers near to three fourth (73.0 %) were in awareness stage which is the earliest stage of competence in which individuals were aware only their own culture but not the world view of their clients. The voices of mothers in the qualitative assessment also showed discordance in cultural competence with their healthcare providers. Female health workers almost six times [AOR,5.5; 2.71, 11.30] more competent than male providers and those who got in-service training related to maternal care provided services more culturally competent than their counter parts with [AOR,3.5; 1.4, 8.64]. Reliability Cronbach's α coefficient value of cultural competence subscales showed 0.672,0 .719, 0.658, 0.714, and 0.631 for cultural
Sixsmith, Judith; Callender, Matthew; Hobbs, Georgina; Corr, Susan; Huber, Jörg W
This research explored the experiences of service users and providers during the implementation of the National Service Framework (NSF) for Long-Term (Neurological) Conditions (LTNCs). A participatory qualitative research design was employed. Data were collected using 50 semi-structured interviews with service users, 25 of whom were re-interviewed on three occasions. Forty-five semi-structured interviews were also conducted with service providers who worked with individuals with LTNCs. Interviews focused on health, well-being and quality of life in relation to service provision, access and delivery. Data were thematically analysed individually and collaboratively during two data analysis workshops. Three major themes were identified that related to the implementation of the NSF: "Diagnosis and treatment", "Better connected services" and "On-going rehabilitation". Service users reported that effective care was provided when in hospital settings but such treatments often terminated on return to their communities despite on-going need. In hospital and community settings, service providers indicated that they lacked the support and resources to provide continuous care, with patients reaching a crisis point before referral to specialist care. This research highlighted a range of issues concerning the recent UK-drive towards patient-centred approaches within healthcare, as service users were disempowered within the LTNC care pathway. Moreover, service providers indicated that resource constraints limited their ability to provide long-term, intensive and integrated service provision. Our research suggests that many service users with long-term neurological conditions experienced disconnections between services within their National Service Framework care pathway. For health and social care practitioners, a lack of continuity within a care pathway was suggested to be most pertinent following immediate care and moving to rehabilitative care. Our findings also indicate that
Handel, Andrew S.; Ayala, Efra?n Beltr?n; Borbor-Cordova, Mercy J.; Fessler, Abigail G.; Finkelstein, Julia L.; Espinoza, Roberto Xavier Robalino; Ryan, Sadie J.; Stewart-Ibarra, Anna M.
Background Dengue fever is a rapidly emerging infection throughout the tropics and subtropics with extensive public health burden. Adequate training of healthcare providers is crucial to reducing infection incidence through patient education and collaboration with public health authorities. We examined how public sector healthcare providers in a dengue-endemic region of Ecuador view and manage dengue infections, with a focus on the 2009 World Health Organization (WHO) Dengue Guidelines. Metho...
MacDougall, D M; Halperin, B A; MacKinnon-Cameron, D.; Li, Li; McNeil, S.A.; Langley, J. M.; Halperin, S. A.
Objectives Vaccine coverage for recommended vaccines is low among adults. The objective of this study was to assess the knowledge, attitudes, beliefs and behaviours of adults and healthcare providers related to four vaccine-preventable diseases and vaccines (diphtheria-tetanus-pertussis, zoster, pneumococcus and influenza). Design We undertook a survey and focus groups of Canadian adults and healthcare providers (doctors, nurses, pharmacists). A total of 4023 adults completed the survey and 6...
Nielsen, Gitte; Larsen, Karen Lyng; Uhrenfeldt, Lisbeth
REVIEW QUESTION/OBJECTIVE:: The objective is to identify and synthesize findings from qualitative studies of older (over 65 years) hospitalized patients' experiences of the barriers and facilitators to their dialogues with healthcare providers (HCPs) concerning their health and well-being.Specifi......REVIEW QUESTION/OBJECTIVE:: The objective is to identify and synthesize findings from qualitative studies of older (over 65 years) hospitalized patients' experiences of the barriers and facilitators to their dialogues with healthcare providers (HCPs) concerning their health and well...
Rivas, Carlos; Anido, Luis; Fernandez, Manuel
This paper presents an open platform to support the development and deployment of healthcare services at home using the TV as the main gateway. Unlike previous systems based on proprietary and closed solutions, our proposal is completely open allowing the easy integration of new services or the integration with external platforms. This is possible thanks to the use of a PC-based Set Top Box called Home Theater Personal (HTPC) that can be easily connected to the TV and Internet. This solution is not tight to particular Software and Hardware providers. It allows an easy integration of different telemedicine devices through Bluetooth and USB standard protocols. Additionally, any software developer/provider can include new services and healthcare modules through a simple to use add/on platform.
İbrahim H. Kayral
Full Text Available The purpose of healthcare services is to protect and improve individuals’ physical, mental and social health and ensure its continuity to increase the level of welfare and happiness in the society. As in all service organizations, service quality has an important place in healthcare organizations. Therefore, measuring the impacts of the efforts made by enterprises for service quality and the clients’ perceptions of the services provided, assessing how their perceptions differ in different dimensions of quality, and taking new measures according to the results are the key to continuous improvement. In this study, with respect to the abovementioned issues, perception of the quality of services provided in the field of health by those who receive them is compared according to different types of hospitals providing such service, and evaluations are made accordingly. Thus, whether patients’ perceptions of service quality differ according to hospital types, in what dimensions of quality these differences occur and perceived quality by different patient profiles like age, sex, incomes etc. are assessed. In the measurement of service quality, a set of 34 questions with six dimensions was used, which was used by Kara, Tarım and Zaim (2003 in several hospitals and then used in several research studies in Turkey on service quality in healthcare enterprises (Çaha, 2007; Kara, 2006. Based on the findings of the research, it can be said that public general branch hospitals are perceived as quality at the same level with private hospitals and even they reach higher levels of patient satisfaction. On the other hand, when the sub-dimensions of quality are examined, it is seen that public hospitals are still behind private hospitals in terms of physical quality.
Bourka, A; Kaliontzoglou, A; Polemi, D; Georgoulas, A; Sklavos, P
The paper presents the enrichment of an existing e-referral / e-prescription application within a Regional Healthcare Information Network with security functionality, solving current authentication, integrity, non-repudiation and confidentiality issues and thus significantly enhancing the overall system security, operability, applicability and user acceptance. The application makes use of an underlying PKI framework, in order to provide strong authentication, digital signature, encryption and time-stamping services. XML is used for the representation of the healthcare data itself, the encrypted form of this data, as well as the relevant data security information, following W3C standards.
Huh, Joung T; Weaver, Christopher M; Martin, Jennifer L; Caskey, Nicholas H; O'Riley, Alisa; Kramer, Betty Josea
Older adults are among the highest at risk for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental health care, but providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of healthcare providers who may see older adults in their care settings. One hundred thirty-two participants from two Veterans Affairs Medical Centers participated in a 6.5-hour-long workshop in the assessment and management of suicide risk in older adults. Participants were asked to complete pre- and postworkshop case notes and report on subjective changes in knowledge, attitudes, and confidence in assessment and managing suicide risk in older adults. Participants included social workers, nurses, physicians, psychologists, and occupational therapists from a variety of care settings, including outpatient and inpatient medical, outpatient and inpatient mental health, specialty clinics, home, and community. After the workshop, participants demonstrated improvement in the overall quality of case notes (P = .001), greater ability to recognize important conceptual suicide risk categories (P = .003), and reported heightened awareness of the importance of late-life suicide. The results suggest that educational training may have beneficial effect on the ability of multidisciplinary care providers to identify and manage suicide risk in elderly adults. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei
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
Ganapathy, Krishnan; Kanwar, Vikrant; Bhatnagar, Tarun; Uthayakumaran, N
Providing healthcare in remote mountainous areas is challenging. The increasing availability of mobile connectivity needs to be exploited by offering healthcare through a mobile medium, popularly known as mobile health (m-health). It is essential to understand the awareness, perception, and attitude of healthcare providers (HCPs) in deploying m-health. Their outlook on new technologies influences patient adoption. Reports on attitudes regarding healthcare through mobile phones are now confined to views from the recipient. This study from August 1 to September 30, 2014 analyzed the views of 592 HCPs (12.3% of all HCPs) in Himachal Pradesh, India. They included faculty and students of the two medical colleges, as well as HCPs from all of the 12 districts. Although Himachal Pradesh has the highest teledensity of all states in India (117.6%), only 58.8% of HCPs (of those surveyed, 72% lived in suburban areas and 24.8% in Shimla, the state capital) would easily recommend m-health. Self-perceived ability to use mobile services was 85%. Fifty-nine percent used mobile devices for social networking, and 52.4% used Wi-Fi. Sixty-one percent of those interviewed were females, and 39% were males. The transformative potential of m-health hinges on its acceptance and use by all stakeholders. The study suggests that as HCPs in Himachal Pradesh are already using mobile value added services and are highly information technology literate, addressing their specific concerns could lead to use of m-health in Himachal Pradesh. Healthcare delivery in Himachal Pradesh is still suboptimal. With increasing connectivity, awareness, and commencement of telemedicine services in Himachal Pradesh, m-health has the potential to be a reality.
Full Text Available Twitter channels are increasingly popular at medical conferences. Many groups, including healthcare providers and third party entities (e.g., pharmaceutical or medical device companies use these channels to communicate with one another. These channels are unregulated and can allow third party commercial entities to exert an equal or greater amount of Twitter influence than healthcare providers. Third parties can use this influence to promote their products or services instead of sharing unbiased, evidence-based information. In this investigation we quantified the Twitter influence that third party commercial entities had in 13 major medical conferences.We analyzed tweets contained in the official Twitter hashtags of thirteen medical conferences from 2011 to 2013. We placed tweet authors into one of four categories based on their account profile: healthcare provider, third party commercial entity, none of the above and unknown. We measured Twitter activity by the number of tweet authors per category and the tweet-to-author ratio by category. We measured Twitter influence by the PageRank of tweet authors by category.We analyzed 51159 tweets authored by 8778 Twitter account holders in 13 conferences that were sponsored by 5 medical societies. A quarter of all authors identified themselves as healthcare providers, while only 18% could be identified as third party commercial entities. Healthcare providers had a greater tweet-to-author ratio than their third party commercial entity counterparts (8.98 versus 6.93 tweets. Despite having less authors and composing less tweets, third party commercial entities had a statistically similar PageRank as healthcare providers (0.761 versus 0.797.The Twitter influence of third party commercial entities (PageRank is similar to that of healthcare providers. This finding is interesting because the number of tweets and third party commercial entity authors required to achieve this PageRank is far fewer than that
Desai, Tejas; Dhingra, Vibhu; Shariff, Afreen; Shariff, Aabid; Lerma, Edgar; Singla, Parteek; Kachare, Swapnil; Syed, Zoheb; Minhas, Deeba; Madanick, Ryan; Fang, Xiangming
Twitter channels are increasingly popular at medical conferences. Many groups, including healthcare providers and third party entities (e.g., pharmaceutical or medical device companies) use these channels to communicate with one another. These channels are unregulated and can allow third party commercial entities to exert an equal or greater amount of Twitter influence than healthcare providers. Third parties can use this influence to promote their products or services instead of sharing unbiased, evidence-based information. In this investigation we quantified the Twitter influence that third party commercial entities had in 13 major medical conferences. We analyzed tweets contained in the official Twitter hashtags of thirteen medical conferences from 2011 to 2013. We placed tweet authors into one of four categories based on their account profile: healthcare provider, third party commercial entity, none of the above and unknown. We measured Twitter activity by the number of tweet authors per category and the tweet-to-author ratio by category. We measured Twitter influence by the PageRank of tweet authors by category. We analyzed 51159 tweets authored by 8778 Twitter account holders in 13 conferences that were sponsored by 5 medical societies. A quarter of all authors identified themselves as healthcare providers, while only 18% could be identified as third party commercial entities. Healthcare providers had a greater tweet-to-author ratio than their third party commercial entity counterparts (8.98 versus 6.93 tweets). Despite having less authors and composing less tweets, third party commercial entities had a statistically similar PageRank as healthcare providers (0.761 versus 0.797). The Twitter influence of third party commercial entities (PageRank) is similar to that of healthcare providers. This finding is interesting because the number of tweets and third party commercial entity authors required to achieve this PageRank is far fewer than that needed by
Dhingra, Vibhu; Shariff, Afreen; Shariff, Aabid; Lerma, Edgar; Singla, Parteek; Kachare, Swapnil; Syed, Zoheb; Minhas, Deeba; Madanick, Ryan; Fang, Xiangming
Introduction Twitter channels are increasingly popular at medical conferences. Many groups, including healthcare providers and third party entities (e.g., pharmaceutical or medical device companies) use these channels to communicate with one another. These channels are unregulated and can allow third party commercial entities to exert an equal or greater amount of Twitter influence than healthcare providers. Third parties can use this influence to promote their products or services instead of sharing unbiased, evidence-based information. In this investigation we quantified the Twitter influence that third party commercial entities had in 13 major medical conferences. Methods We analyzed tweets contained in the official Twitter hashtags of thirteen medical conferences from 2011 to 2013. We placed tweet authors into one of four categories based on their account profile: healthcare provider, third party commercial entity, none of the above and unknown. We measured Twitter activity by the number of tweet authors per category and the tweet-to-author ratio by category. We measured Twitter influence by the PageRank of tweet authors by category. Results We analyzed 51159 tweets authored by 8778 Twitter account holders in 13 conferences that were sponsored by 5 medical societies. A quarter of all authors identified themselves as healthcare providers, while only 18% could be identified as third party commercial entities. Healthcare providers had a greater tweet-to-author ratio than their third party commercial entity counterparts (8.98 versus 6.93 tweets). Despite having less authors and composing less tweets, third party commercial entities had a statistically similar PageRank as healthcare providers (0.761 versus 0.797). Conclusion The Twitter influence of third party commercial entities (PageRank) is similar to that of healthcare providers. This finding is interesting because the number of tweets and third party commercial entity authors required to achieve this Page
Wiysonge, Charles S; Abdullahi, Leila H; Ndze, Valantine N; Hussey, Gregory D
trial, 115 pharmacies: improvements in four of six pharmacy indicators; low-certainty evidence). The outcome in three multifaceted intervention studies was the quality of pharmacy practice; including the ability to ask questions, give advice, and provide appropriate treatment. The trials applied regulation, training, and peer influence in sequence; and the study design does not permit separation of the effects of the different interventions. Two trials conducted among 136 pharmacies in Vietnam found that the multifaceted intervention may improve the quality of pharmacy practice; but the third study, involving 146 pharmacies in Vietnam and Thailand, found that the intervention may have little or no effects on the quality of pharmacy practice (low-certainty evidence). Only two studies (both conducted in Vietnam) reported cost data, with no rigorous assessment of the economic implications of implementing the interventions in resource-constrained settings. No study reported data on equity, mortality, morbidity, adverse effects, satisfaction, or attitudes. Authors' conclusions Training probably improves quality of care (i.e. adherence to recommended practice), regulation may improve quality of care, and we are uncertain about the effects of co-ordination on quality of private for-profit healthcare services in LMICs. The likelihood that further research will find the effect of training to be substantially different from the results of this review is moderate; implying that monitoring of the impact is likely to be needed if training is implemented. The low certainty of the evidence for regulation implies that the likelihood of further research finding the effect of regulation to be substantially different from the results of this review is high. Therefore, an impact evaluation is warranted if government regulation of private for-profit providers is implemented in LMICs. Rigorous evaluations of these interventions should also assess other outcomes such as impacts on equity
Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei
Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.
Boyce, Melanie; Bungay, Hilary; Munn-Giddings, Carol; Wilson, Ceri
This review provides an updated evaluation of the emerging body of literature on the value of the arts in healthcare settings. Internationally, there is growing interest in the use of the arts in the healthcare context supported by the number of research studies reported in the nursing and medical literature. There is evidence that arts interventions have positive effects on psychological and physiological outcomes on patients in a hospital environment. A critical review of the literature between 2011 and 2016 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: cultural activities, outcomes and healthcare settings. Initial searches identified 131 potentially relevant articles. Following screening and review by the research team, a total of 69 studies were included in the final review. The majority of studies examined the effect of music listening on patients/service users (76.8%). These studies were primarily quantitative focusing on the measurable effects of music listening in a surgical context. Overall, the studies in the review support the growing evidence base on the value of the arts in a variety of healthcare settings for patients/service users. The review findings suggest that now is the time for different voices and art forms to be considered and represented in the research on arts in healthcare. Further research is also required to strengthen the existing evidence base. © 2017 John Wiley & Sons Ltd.
Schriver, Michael; Cubaka, Vincent K; Nyirazinyoye, Laetitia
of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda. SETTING: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5). METHODS: Focus groups were facilitated......, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems. CONCLUSION: External supervision appeared driven...... by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers' experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory...
Elaine Amaral de Paula
Full Text Available ABSTRACT Objective: to assess the structure and results obtained by the "Chronic Renal Patients Care Program" in a Brazilian city. Method: epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14 physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes. Results: most units lacked sufficient offices for physicians and nurses to provide consultations, had incomplete staffing, and most professionals had not received proper qualification to provide care for chronic renal disease. Physicians from PHC units classified as capable more frequently referred patients to the secondary care service in the early stages of chronic renal disease (stage 3B when compared to physicians of units considered not capable (58% vs. 36% (p=0.049. Capable PHC units also more frequently presented stabilized glomerular filtration rates (51% when compared to partially capable units (36% and not capable units (44% (p=0.046. Conclusion: patients cared for by primary healthcare units that scored higher in structure and process criteria presented better clinical outcomes. Objective: to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. Method: this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. Results: the coping strategies most often used by
In located services, such as restaurants, about half of all switching is based on access to the service; in non-located services, such as credit cards, access problems are minor and service failure is often the reason for switching. The orders of events, or sequences, involved in switching are also examined; different sequences ...
Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali
Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients' personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in
Trivedi, Paraag; Rosaasen, Nicola; Mansell, Holly
Adequate patient education is essential for preparing potential recipients for kidney transplantation. Health-care providers play a vital role in education and can identify gaps in patient understanding. To identify deficits in patient knowledge from the perspective of a transplant multidisciplinary care team and determine whether their perceptions align with patients who have previously undergone a transplant. An open call was advertised for health-care providers to attend a focus group discussion regarding the educational needs of pretransplant patients in 1 Canadian center. A predetermined, semistructured set of questions was used to collect the views of transplant caregivers. A moderator, assistant moderator, and research assistant facilitated the discussion, which was transcribed verbatim. Paper surveys were distributed to collect opinions of those unable to attend or uncomfortable to voice their opinion in an open forum. Qualitative analysis software was used to identify any emergent themes. Results were compared to a previous study undertaken in transplant recipients. Despite pre- and posttransplant education, specific themes emerged including misconceptions about the assessment process and time on the wait list and the surgery, incongruency between patient expectations and outcome, and confusion regarding medications. Health-care provider perceptions were remarkably consistent with transplant recipients. Health-care providers identified gaps in patient understanding indicating that transplant candidates may not be internalizing what is taught. Innovative educational approaches may be needed to provide more successful patient education. Similarities between health-care provider and patient perceptions suggest that care providers are a valuable source of information.
Gritzalis, D; Lambrinoudakis, C
Personal and medical data processed by Healthcare Information Systems must be protected against unauthorized access, modification and withholding. Security measures should be selected to provide the required level of protection in a cost-efficient manner. This is only feasible if specific characteristics of the information system are examined on a basis of a risk analysis methodology. This paper presents the results of a risk analysis, based on the CRAMM methodology, for a healthcare organization offering a patient home-monitoring service through the transmission of vital signs, focusing on the identified security needs and the proposed countermeasures. The architectural and functional models of this service were utilized for identifying and valuating the system assets, the associated threats and vulnerabilities, as well as for assessing the impact on the patients and on the service provider, should the security of any of these assets is affected. A set of adequate organizational, administrative and technical countermeasures is described for the remote vital signs monitoring service, thus providing the healthcare organization with a data protection framework that can be utilized for the development of its own security plan.
Victoor, A.; Reitsma-van Rooijen, M.; Jong, J. de; Delnoij, D.; Friele, R.; Rademakers, J.
Background: Various European healthcare systems encourage patients to make an active choice of healthcare provider, both as a worthwhile effort for patients and an instrument to encourage competition between providers. In previous research, patient groups were distinguished
Tsui, Courtney Kwan-Yee; Shanmugasegaram, Shamila; Jamnik, Veronica; Wu, Gilbert; Grace, Sherry L
Cardiac rehabilitation (CR) is significantly underutilized. However, physician endorsement promotes greater patient utilization. This study examined perceptions of provider endorsement by patients (1) of sociodemographic groups who are often less represented in CR and by clinical indication and (2) by type of healthcare provider and place of referral. Referred cardiac (N = 1156) inpatients from 11 hospitals across Ontario completed a sociodemographic survey inhospital and a mailed followup survey 1 year later. Respondents self-reported perceived healthcare provider endorsement of CR on a 5-point Likert scale, type of referring healthcare provider, and where the referral was initiated. The overall perceived strength of healthcare provider endorsement to CR was 3.75 ± 1.15. Patients who perceived greater endorsement were significantly more likely to enrol (OR = 2.07) and attend a greater percentage of CR sessions (P endorsement of CR than their respective counterparts. Perception of CR endorsement did not differ significantly on the basis of location of referral initiation (P ≥ .05), but those who discussed CR with family doctors (P endorsement than those discussing CR with nurses. Given the proven benefits of CR, all healthcare providers are recommended to universally and strongly encourage CR participation among their patients in order to optimize utilization and subsequent recovery.
Hooten, W Michael; Bruce, Barbara K
The purpose of this study was to assess the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain. The setting was a continuing medical education conference that was specifically designed to deliver content about chronic pain and prescription opioids to providers without specialty expertise in pain medicine. Conference attendees with prescribing privileges were eligible to participate, including physicians, physician assistants, and advance practice nurses. Study participants completed a questionnaire using an electronic response system. Study participants completed a validated questionnaire that was specifically developed to measure the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain. The questionnaire was completed by 128 healthcare providers. The majority (58 percent) indicated that they were "likely" to prescribe opioids for chronic pain. A significant proportion of respondents had favorable beliefs and attitudes toward improvements in pain (p opioids. However, a significant proportion had negative beliefs and attitudes about medication abuse (p opioids could significantly increase the complexity of patient care and could unfavorably impact several administrative aspects of clinical practice. The beliefs and attitudes identified in this study highlight important educational gaps that exist among healthcare providers about prescribing opioids. Knowledge of these educational gaps could build the capacity of medical educators to develop targeted educational materials that could improve the opioid prescribing practices of healthcare providers.
Azeem, Eman; Gillani, Syed Wasif; Siddiqui, Ammar; Shammary H A, Al; Poh, Vinci; Syed Sulaiman, Syed Azhar; Baig, Mirza
Breast cancer is the most common cancer among women in Malaysia. Therefore, it is highly important for the public to be educated on breast cancer and to know the steps to detect it early on. Healthcare providers are in the prime position to provide such education to the public due to their high knowledge regarding health and their roles in healthcare. The present systematic review involved studies conducted in recent years to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in attempts to obtain an overall picture of how well equipped our healthcare providers are to provide optimal breast cancer education, and to see their perceptions and actual involvement in said education. The systematic review was conducted via a primary search of various databases and journal websites, and a secondary search of references used by eligible studies. Criteria for eligibility included being published from the year 2008 till present, being conducted in Malaysia, and being written in the English language. A total of two studies were eligible for this review. Findings show that Malaysian future and current healthcare providers have moderate knowledge on breast cancer, have a positive towards involvement of breast cancer education, but have poor actual involvement.
Panari, Chiara; Levati, W; Bonini, A; Tonelli, M; Alfieri, E; Artioli, Giovanna
A strategic Human Resources Management approach, that overcomes anadministrative Personnel Management, is becoming crucial for hospital organizations. In this sense, the aimof this work was to examine the figure of healthcare provider using the concept of role, as expected behaviourin term of integration in the organizational culture. The instrument used to analyse the healthcareprovider figure was "role mapping". Particularly, semistructured interviews were conducted and involved to36 health professionals of four units in order to examine the behaviour expectations system towards thehealthcare providers. The analysis revealed that the expectations of different professionals relatedto the healthcare provider were dissimilar. Physicians' expectations referred to technical preparation and efficiency,while nurses and nurse coordinators required collaboration in equip work and emotional support forpatients. In all Operating Units, directors were perceived as missing persons with vague expectations of efficiency.Differences concerned also the four Units. For example, in intensive care Unit, the role of healthcareprovider was clearer and this figure was perceived as essential for patients' care and for the equip teamwork.On the contrary, in Recovery Unit the healthcare provider was underestimated, the role was ambiguous andnot integrated in the equip even if there was a clear division of tasks between nurses and healthcare providers. The "role mapping" instrument allows to identify healthcare provider profile and find possible roleambiguity and conflicts in order to plan adequate human resources management interventions.
Majrooh, Muhammad Ashraf; Hasnain, Seema; Akram, Javaid; Siddiqui, Arif; Shah, Fatimah; Memon, Zahid Ali
Almost one-fifth of the world's population constitutes women of reproductive age who are repeatedly exposed to pregnancy and childbearing. Many are often at high risk of illness and mortality during pregnancy and require maternal healthcare services for early detection of complications. More than 0.5 million women die every year worldwide due to pregnancy-related complications. Almost 0.03 million of them are in Pakistan. Maternal healthcare in Pakistan is poor and results in high rates of morbidity and mortality. This paper evaluates the accessibility of antenatal care (ANC) services in primary healthcare settings in the Punjab province of Pakistan during the period June 2010- August 2011. The paper uses a cross-sectional study including mix methods (qualitative and quantitative). Nine districts were included in the project; one from each administrative tier or division. Nineteen health facilities, including two rural health centres (RHCs) and 17 basic health units (BHUs) were randomly selected from each district. The total sample was 171 health facilities. The qualitative assessment was carried out through focus-group discussions (FGDs) and indepth interviews with clients, providers, and health managers. The reasons for the gaps in service accessibility were the distant location of facilities, a lack of transport, and inconvenient facility working hours. The issues of service accessibility were further exacerbated by sociocultural factors such as low levels of client awareness, a lack of decision-making by clients, and the influence of spiritual healers and quacks. Health managers further pointed out weak co-ordination between vertical programmes and routine integrated health services, and a lack of human resources in distantly located facilities. In order to increase the accessibility of ANC services, facility working hours must be extended and adjusted according to the convenience of clients in primary healthcare (PHC) facilities. The utilisation of ANC
Full Text Available Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM, which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS. Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy.
Byrne, J. L.; Davies, Melanie J; Willaing, I.
: The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management......Aims: To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Methods: A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17...... in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31–60% of healthcare professionals across the different...
Ranstad, Karin; Midlöv, Patrik; Halling, Anders
OBJECTIVE: To study the associations between active choice of primary care provider and healthcare utilization, multimorbidity, age, and sex, comparing data from primary care and all healthcare in a Swedish population. DESIGN: Descriptive cross-sectional study using descriptive analyses including t......-test, correlations, and logistic regression modelling in four separate models. SETTING AND SUBJECTS: The population (151 731) and all healthcare in Blekinge in 2007. MAIN OUTCOME MEASURE: Actively or passively listed in primary care, registered on 31 December 2007. RESULTS: Number of consultations (OR 1.31, 95% CI 1...... data (OR 2.11, 95% CI 2.08-2.15 and OR 2.14, 95% CI 2.11-2.17, respectively) than using data from all healthcare. Number of consultations and multimorbidity level were correlated and had similar associations with active listing in primary care. Modelling number of consultations, multimorbidity level...
Krajewski-Jaime, Elvia R.; And Others
Cultural competence assumes greater importance in the United States as international relations shift and the United States changes its own demographic makeup. Hispanics have significant health care needs and cultural beliefs that influence their acceptance of service. As part of an effort to build cultural competence in undergraduate social work…
Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W
There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.
Goodman, Matthew J; Schorling, John B
Healthcare providers are under increasing stress and work-related burnout has become common. Mindfulness-based interventions have a potential role in decreasing stress and burnout. The purpose of this study was to determine if a continuing education course based on mindfulness-based stress reduction could decrease burnout and improve mental well-being among healthcare providers, from different professions. This was a pre-post observational study conducted in a university medical center. A total of 93 healthcare providers, including physicians from multiple specialties, nurses, psychologists, and social workers who practiced in both university and community settings, participated. The intervention was a continuing education course based on mindfulness-based stress reduction that met 2.5 hours a week for 8 weeks plus a 7-hour retreat. The classes included training in four types of formal mindfulness practices, including the body scan, mindful movement, walking meditation and sitting meditation, as well as discussion focusing on the application of mindfulness at work. The course was offered 11 times over 6 years. The main outcome measures were work-related burnout as measured by the Maslach Burnout Inventory and self-perceived mental and physical well-being as measured by the SF-12v2. Maslach Burnout Inventory scores improved significantly from before to after the course for both physicians and other healthcare providers for the Emotional Exhaustion (p burnout scores and mental well-being for a broad range of healthcare providers.
Mösko, Mike-Oliver; Gil-Martinez, Fernanda; Schulz, Holger
Mental healthcare services need to be sensitive towards the cultural needs of patients. Cross-cultural opening is an organizational process to fulfil these needs. This study aims to provide representative structural and procedural data regarding the use of German outpatient mental healthcare services by allochthonous patients, the diversity of psychotherapists in outpatient mental healthcare service, the cross-cultural encounters of therapists and the cross-cultural sensitivity of psychotherapists working in this healthcare area. Of all public outpatient psychotherapists in Hamburg, 81% (n = 485) participated in this survey. Regarding the distribution of the population in this metropolis, allochthonous therapists were underrepresented. Unlike the overall distribution of foreign inhabitants, the largest groups of immigrant therapists came from England, German-speaking countries and other countries within the European Union. The proportion of allochthonous patients in outpatient mental healthcare service was almost half of the proportion of the allochthonous in the general population. Psychotherapists with a migration background regarded themselves as having a higher level of cross-cultural sensitivity than their native colleagues, especially those who have had fewer cross-cultural encounters. Overall, psychotherapists named different challenges in providing cross-cultural treatment. For the German outpatient mental healthcare service to be more accessible to immigrants and their descendants, a greater number of bilingual psychotherapists must gain access to the mental healthcare service, and more advanced cross-cultural sensitivity training and supervision should be provided. German outpatient psychotherapists are culturally and linguistically diverse. Nevertheless, psychotherapists with a migration background are underrepresented in outpatient mental healthcare services. Patients with a migration background are also underrepresented in the German outpatient mental
Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research
Robertshaw, Luke; Dhesi, Surindar
Objectives To thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries. Design Systematic review and qualitative thematic synthesis. Methods Searches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs. Results Twenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes. Conclusions A range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group. PMID:28780549
Ginossar, Tamar; Oetzel, John; Hill, Ricky; Avila, Magdalena; Archiopoli, Ashley; Wilcox, Bryan
One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p organizational culture (i.e., critical appraisal) was positively related to depersonalization (p organizational communication interventions might protect HIV health-care providers from burnout.
Hammoud, Maya M; White, Casey B; Fetters, Michael D
Differences in the social and religious cultures of Arab Americans and American Muslims raise challenges to healthcare access and delivery. These challenges go far beyond language to encompass entire world views, concepts of health, illness, and recovery and even death. Medical professionals need a more informed understanding and consideration of the rich and diverse array of beliefs, expectations, preferences, and behavioral make up of the social cultures of these patients to ensure that they are providing the best and most comprehensive care possible. Improved understanding will enhance a provider's ability to offer quality healthcare and to build trusting relationships with patients. Here, we provide a broad overview of Arab culture and Islamic religious beliefs that will assist providers in delivering culturally sensitive healthcare to these groups. We offer insight into the behaviors, requirements, and preferences of Arab American and American Muslim patients, especially as they apply to women's health.
Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin
Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs
Yohanes Baptista Dafferianto Trinugroho
Full Text Available Technology innovations have pushed today’s healthcare sector to an unprecedented new level. Various portable and wearable medical and fitness devices are being sold in the consumer market to provide the self-empowerment of a healthier lifestyle to society. Many vendors provide additional cloud-based services for devices they manufacture, enabling the users to visualize, store and share the gathered information through the Internet. However, most of these services are integrated with the devices in a closed “silo” manner, where the devices can only be used with the provided services. To tackle this issue, an information integration platform (IIP has been developed to support communications between devices and Internet-based services in an event-driven fashion by adopting service-oriented architecture (SOA principles and a publish/subscribe messaging pattern. It follows the “Internet of Things” (IoT idea of connecting everyday objects to various networks and to enable the dissemination of the gathered information to the global information space through the Internet. A patient-centric healthcare service environment is chosen as the target scenario for the deployment of the platform, as this is a domain where IoT can have a direct positive impact on quality of life enhancement. This paper describes the developed platform, with emphasis on dependability aspects, including availability, scalability and security.
medical supervisors will be dictated by the specialty of the patient population involved (for example, chief, pediatric service for well child physical...of osteopathy ). (2) PAs may write routine orders on inpatients, using DA Form 4256 (Doctor’s Orders). (3) When required, inpatient treatment...which FAP clients may be located. (2) FAP personnel are the primary source of care for clients involved in alleged/substantiated child /spouse abuse
Bentley, Michael; Freeman, Toby; Baum, Fran; Javanparast, Sara
This article draws on data from a 5-year project that examined the effectiveness of Comprehensive primary healthcare (CPHC) in local communities. A hallmark of CPHC services is interprofessional teamwork. Drawing from this study, our article presents factors that enabled, or hindered, healthcare teams working interprofessionally in Australian primary healthcare (PHC) services. The article reports on the experiences of teams working in six Australian PHC services (four managed by state governments, one non-government sexual health organisation, and one Aboriginal community-controlled health service) during a time of significant health sector restructure. Findings are drawn from two key methods: an online survey of practitioners and managers (n = 154), and interviews with managers and practitioners (n = 60) from the six study sites. The majority of survey respondents worked with other health professionals in their service to provide interprofessional care to clients. Processes included formal team meetings, case conferencing, referring clients to other health professionals if needed, informal communication with other health professionals about clients, and team-based delivery of care. A range of interrelated factors affected interprofessional work at the services, from contextual, organisational, processual, and relational domains. Funding cuts and policy changes that saw a reorientation and re-medicalisation of South Australian services undermined interprofessional work, while a shared CPHC culture and commitment among some staff was helpful in resisting some of these effects. The co-location of services was a factor in PHC teams working interprofessionally and not only enabled some PHC teams to work more interprofessionally but also created barriers to interprofessional teamwork through disruption resulting from restructuring of services. Our study indicates the importance of decision makers taking into account the potential effects of policy and structural
Yoshiura, Vinicius Tohoru; de Azevedo-Marques, João Mazzoncini; Rzewuska, Magdalena; Vinci, André Luiz Teixeira; Sasso, Ariane Morassi; Miyoshi, Newton Shydeo Brandão; Furegato, Antonia Regina Ferreira; Rijo, Rui Pedro Charters Lopes; Del-Ben, Cristina Marta; Alves, Domingos
Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized
Wohlgenant, Kelly C.; Cates, Sheryl C.; Godwin, Sandria L.; Speller-Henderson, Leslie
Adults aged 60 or older are more likely than younger adults to experience severe complications or even death as a result of foodborne infections. This study investigated which specific groups of healthcare providers or other caregivers are most receptive to providing food safety information to older adults. Telephone-based focus groups were…
Rojas de la Escalera, D
Medical imaging is one of the most important diagnostic instruments in clinical practice. The technological development of digital medical imaging has enabled healthcare services to undertake large scale projects that require the participation and collaboration of many professionals of varied backgrounds and interests as well as substantial investments in infrastructures. Rather than focusing on systems for dealing with digital medical images, this article deals with the management of projects for implementing these systems, reviewing various organizational, technological, and human factors that are critical to ensure the success of these projects and to guarantee the compatibility and integration of digital medical imaging systems with other health information systems. To this end, the author relates several lessons learned from a review of the literature and the author's own experience in the technical coordination of digital medical imaging projects. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.
Visse, Merel; Widdershoven, Guy A M; Abma, Tineke A
The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated. A new moral climate needs to be developed, particularly in the early stages of integrated services. Who should do what, with whom and why? Departing from a relational and hermeneutic perspective, this article shows that professionals in integrated service networks embark upon a moral learning process when starting to work together for the client's benefit. In this context, instrumental ways of thinking about responsibilities are actually counterproductive. Instead, professionals need to find out who they are in relation to other professionals, what core values they share and what responsibilities derive from these aspects. This article demonstrates moral learning by examining the case of an integrated social service network. The network's development and implementation were supported by responsive evaluation, enriched by insights of care ethics and hermeneutic ethics.
Hambly, H; Robling, M; Crowne, E; Hood, K; Gregory, J W
To identify training needs in communication skills and to assess training preferences of staff working in paediatric diabetes services, which will inform the development of a learning programme in behaviour change counselling for healthcare professionals. Three hundred and eighty-five staff in 67 UK paediatric diabetes services were sent questionnaires to determine their previous communication skills training, to measure their self-reported view of the importance of and confidence in addressing common clinical problems and to assess the perceived feasibility of training methods to improve skillfulness. Two hundred and sixty-six questionnaires (69%) were returned from 65 services. Sixteen per cent of doctors, nurses and dietitians reported no previous training in communication skills and 47% had received no training since graduating. Respondents rated psychosocial issues as more important to address than medical issues within consultations (t = 8.93, P skills for diabetes professionals. The survey will inform the development of a tailored learning programme for health professionals in UK paediatric diabetes clinics.
Fogarty, Linda; Kim, Young Mi; Juon, Hee-Soon; Tappis, Hannah; Noh, Jin Won; Zainullah, Partamin; Rozario, Aleisha
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 Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P 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.
Krakower, Douglas S.; Mayer, Kenneth H.
Purpose of Review To review the most recent studies assessing the preparedness of healthcare practitioners to provide anti-HIV pre-exposure prophylaxis (PrEP) and to suggest areas for future implementation research. Recent Findings As PrEP is a bio-behavioral intervention, healthcare providers are likely to play a critical role in implementing PrEP in care settings. Studies suggest that many specialized providers are aware of PrEP and support its provision as a public health intervention, though knowledge and acceptance are less among generalists. Therefore, utilization of PrEP by clinicians has been limited to a few early adopters. Concerns about the efficacy and long-term safety of PrEP, and perceived barriers to prescribing PrEP, could limit prescribing behaviors and intentions. Resistance to performing routine HIV risk assessments by clinicians is an additional barrier to implementing PrEP, though innovative tools to help clinicians routinely perform risk assessments are being developed. Summary Interventions are needed to engage a broader array of healthcare providers in PrEP provision. Utilizing a framework based on diffusion of innovation theory, this review proposes strategies that can be implemented and evaluated to increase PrEP prescribing by healthcare providers. If resources are invested in training clinicians to provide PrEP, then these stakeholders could enhance the use of PrEP as part of a prevention package by primary providers. PMID:26417953
Kshetri, Nir; Dholakia, Nikhilesh
- The issue of offshore outsourcing of healthcare services is a critical but little-examined problem in healthcare research. The purpose of this study is to contribute to filling this void. A library-based study was carried out of the development of the Indian medical transcription offshoring industry. Findings- Cost-saving potential and the degree of outsourceability are higher for medical transcription compared with most services. Offshoring experience, typically in a low-value BPO, helps to enhance productivity and international linkages required for the success of medical transcription. Research limitations/implications - An important area of future research concerns comparing India's factor endowments in medical transcription outsourcing with other services. Further research is also needed to examine how India differs from its regional competitors in terms of factors endowments associated with these services. Another extension would be to investigate the drivers of offshoring of higher value services such as radiological readings. Practical implications - ICT infrastructures needed for outsourcing require much less investment compared with leading capital-intensive industries. The development patterns of the Indian medical and offshoring industries indicate that India may attract higher skilled medical functions in the future. The Indian offshoring industry is shifting its focus from BPO to knowledge process outsourcing (KPO). Developing countries need to shift to greater automation and greater levels of skill training to retain and reinforce their comparative advantages. This paper's greatest value stems from the fact that it examines the drivers of a new but rapidly growing healthcare industry.
Worrell, Jane; Gibson, Phillip; Allen, Deborah
The radioactive properties of radon have been known for decades, but the risks of exposure have been understated in most professional healthcare curriculums. Healthcare providers in areas with low levels of radon exposure may not consider radon to be a main source of concern in the development of lung and other cancers. Just as nurses counsel patients to avoid tobacco exposure, they should advocate that patients have their homes tested for radon. This article aims to increase radon awareness and address opportunities for providers to work toward various objectives to reduce radon exposure. .
Steele, Amii Corbisiero; Kaal, Julia; Thompson, Amanda L.; Barrera, Maru; Compas, Bruce E.; Davies, Betty; Fairclough, Diane L.; Foster, Terrah L.; Gilmer, Mary Jo; Hogan, Nancy; Vannatta, Kathryn; Gerhardt, Cynthia A.
Objective To determine how to improve care for families by obtaining their advice to healthcare providers and researchers after a child’s death from cancer. Design Families with a surviving sibling (ages 8-17) were recruited from cancer registries at three hospitals in the United States and Canada 3-12 months (M = 10.4, SD = 3.5) after the child’s death. Setting Data were collected in the home. Participants Participants (N = 99) included 36 mothers, 24 fathers, and 39 siblings from 40 families. Outcome Measures Each participant completed a qualitative interview that was audio recorded, transcribed, and coded for thematic content. Findings Five major themes included the need for: (a) improved communication with the medical team, (b) more compassionate care, (c) increased access to resources, (d) ongoing research, as well as (e) offering praise. Interwoven within the five themes was a subtheme of continuity of care. Conclusions Many participants were pleased with the care the child with cancer received, but others noted areas in need of improvement, particularly medical communication and continuity of care. Additional research is needed to inform interventions to improve services for families of children with life-limiting conditions. PMID:23612375
Johnstone, Megan-Jane; Kanitsaki, Olga
This qualitative study has as its focus an exploration of health service providers' perceptions and experiences of the processes and implications of delivering workplace cultural diversity education for staff. Data were obtained from conducting in-depth individual and focus group interviews with a purposeful sample of 137 healthcare professionals,…
Liu, Li; Chen, Weiping; Nie, Min; Zhang, Fengjuan; Wang, Yu; He, Ailing; Wang, Xiaonan; Yan, Gen
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.
Nguyen, T; Henderson, D; Stewart, D; Hlyva, O; Punthakee, Z; Gorter, J W
Recent evidence suggests that fostering strategies to enable youth with chronic health conditions to work towards gradual self-management of their health is key in successful transition to adult healthcare. To date, there is limited research on self-management promotion for youth. The purpose of this study is to explore self-management from the perspectives of youth, parents and healthcare providers in transition to adult healthcare. Part of a larger longitudinal transition (TRACE-2009-2013) study, interpretive phenomenology was used to explore the meaning of the lived experiences and perceptions of youth, parents, and healthcare providers about transition to adult healthcare. Purposeful sampling was utilized to select youth with a range of chronic health conditions from the TRACE cohort (spanning 20 diagnoses including developmental disabilities and chronic conditions), their parents and healthcare providers. The emerging three themes were: increasing independence of youth; parents as safety nets and healthcare providers as enablers and collaborators. The findings indicate that the experiences of transitioning youth, parents and service providers are interconnected and interdependent. Results support a dynamic and developmentally appropriate approach when working with transitioning youth and parents in practice. As youth depend on parents and healthcare providers for support in taking charge of their own health, parents and healthcare providers must work together to enable youth for self-management. At a policy level, adequate funding, institutional support and accreditation incentives are recommended to allow for designated time for healthcare providers to foster self-management skills in transitioning youth and parents. © 2016 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.
John Kuumuori Ganle
Full Text Available While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana.A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability.Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for
Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard
While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare
Feeg, Veronica D; Paraszczuk, Ann Marie; Çavuşoğlu, Hicran; Shields, Linda; Pars, Hatice; Al Mamun, Abdullah
Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation. Copyright © 2016 Elsevier Inc. All rights reserved.
Papadakaki, Maria; Lionis, Christos; Saridaki, Aristoula; Dowrick, Christopher; de Brún, Tomas; O'Reilly-de Brún, Mary; O'Donnell, Catherine A; Burns, Nicola; van Weel-Baumgarten, Evelyn; van den Muijsenbergh, Maria; Spiegel, Wolfgang; MacFarlane, Anne
Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants. To identify service providers' views on the barriers to migrant healthcare. Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare. Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population. The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.
Bergsten, Ulrika; Bergman, Stefan; Fridlund, Bengt; Arvidsson, Barbro
Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers' perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers' experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers' attitudes and patients' responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers' experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients' expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.
Lyn J. Haskins
Full Text Available Background: In South Africa, coverage of services for mothers and babies in the first year of life is suboptimal despite high immunisation coverage over the same time period. Integration of services could improve accessibility of services, uptake of interventions and retention in care.Aim: This study describes provision of services for mothers and babies aged under 1 year.Setting: Primary healthcare clinics in one rural district in KwaZulu-Natal, South Africa.Methods: All healthcare workers on duty and mothers exiting the clinic after attending well-child services were interviewed. Clinics were mapped to show the route through the clinic taken by mother–baby pairs receiving well-child services, where these services were provided and by whom.Results: Twelve clinics were visited; 116 health workers and 211 mothers were interviewed. Most clinics did not provide comprehensive services for mothers and children. Challenges of structural layout and deployment of equipment led to fragmented services provided by several different health workers in different rooms. Well-child services were frequently provided in public areas of the clinic or with other mothers present. In some clinics mothers and babies did not routinely see a professional nurse. In all clinics HIV-positive mothers followed a different route. Enrolled nurses led the provision of well-child services but did not have skills and training to provide comprehensive care.Conclusions: Fragmentation of clinic services created barriers in accessing a comprehensive package of care resulting in missed opportunities to provide services. Greater integration of services alongside immunisation services is needed.
Nogami, Kentaro; Taniguchi, Shogo; Ichiyama, Tomoko
The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.
... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.402 When are protective services provided? Protective services are provided when children or adults: (a) Are deprived temporarily... under the supervision of the Bureau in regard to the use and disbursement of funds in the child's or...
Ghazanfarpour, Masoumeh; Khadivzadeh, Talat; Latifnejad Roudsari, Robab; Mehdi Hazavehei, Seyed Mohammad
The aim of this study was to explore issues that challenge menopausal women in discussions of their sexual problems with a physician. This was done from the perspective of healthcare providers. In a descriptive exploratory qualitative study, using a semi-structured interview and purposive sampling, a sample set of 12 midwives and 13 general practitioners aged 25-70 years were selected in order to elicit meaning behind their experiences about the subject under study. Data analysis was carried out using qualitative content analysis. Results were used to identify a number of obstacles that hindered women from seeking help for sexual problems from GPs and midwives. These obstacles included the following: (1) traditional and cultural beliefs; (2) religious belief; (3) individuals' beliefs and (4) access to services. More research is needed to explore effective strategies to overcome these problems. Impact statement Current knowledge on the subject: In the literature, many reasons have been identified for the unwillingness of Iranian women to discuss their sexual problems with health providers. These include lack of time, feelings of shame and an expectation that a doctor cannot help. However, no qualitative study has addressed barriers held by menopausal women for seeking treatment for sexual problems. The contribution made by the results of this study: The results of this study add to the growing body of research on reasons that determine why most postmenopausal women rarely visit a doctor unless they were in tremendous physical or emotional pain. Also, menopausal women thought that an unmarried health provider would be less understanding about sexual and marital problems and they felt guilty about sharing such issues with them. Patients' opinions on the nature of menopause (a pathological vs. physiological process) affect the way in which the symptoms of menopause and sexual problems are handled by patient. The implications are of these findings for clinical
van de Schoot, Thijs; Pavlova, Milena; Atanasova, Elka; Groot, Wim
The aim of the study is to determine the preferences of Bulgarian citizens regarding the provision of healthcare services. A survey was carried out in Bulgaria among a nationally representative sample of 1003 respondents. Both a discrete choice experiment and a self-explicated ranking of outpatient and inpatient service attributes were included in the survey. The data are analyzed to elicit the preferences of Bulgarian healthcare consumers for service attributes and to compare them with previous studies in Bulgaria and other countries in Central and Eastern Europe. The reputation and skills of the care provider appear to be relatively most important to the respondents, followed by the state of the equipment, the condition of the facility and the attitude of the staff. The fee-level and access-related attributes (waiting and traveling time) emerged as less important. Overall, consumers in Bulgaria value the quality of healthcare provision very highly. Yet, there are some statistically significant differences between socio-demographic groups. In general, Bulgarian healthcare consumers are willing to accept higher prices for the services they use, when this comes with improved quality of services. These findings comply with findings in previous studies in Bulgaria and in the region. Given the quality problems in the Bulgarian healthcare sector, our findings indicate that priority has to be given to the improvement of healthcare quality when the Bulgarian government invests in this sector. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Mboineki, Joanes Faustine; Zhang, Weihong
The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.
Latten, Tom; Westra, Daan; Angeli, Federica; Paulus, Aggie; Struss, Marleen; Ruwaard, Dirk
Interactions between pharmaceutical companies and healthcare providers are increasingly scrutinized by academics, professionals, media, and politicians. Most empirical studies and professional guidelines focus on unilateral donor-recipient types of interaction and overlook, or fail to distinguish between, more reciprocal types of interaction. However, the degree of goal alignment and potential for value creation differs in these two types of interactions. Failing to differentiate between these two forms of interaction between pharmaceutical companies and healthcare providers could thus lead to biased conclusions regarding their desirability. This study reviews the empirical literature regarding the effects of bilateral forms of interactions between pharmaceutical companies and healthcare providers in order to explore their effects. We searched two medical databases (i.e. PubMed and Cochrane Library) and one business database (i.e. EBSCO) for empirical, peer-reviewed articles concerning any type of bilateral interaction between pharmaceutical companies and healthcare providers. We included quantitative articles which were written in English and published between January 1st, 2000 and October 31st, 2016, and where the title or abstract included a combination of synonyms of the following keywords: pharmaceutical companies, healthcare providers, interaction, and effects. Our search results yielded 10 studies which were included in our analysis. These studies focused on either research-oriented interaction or on education-oriented interaction. The included studies reported various outcomes of interaction such as prescribing behavior, ethical dilemmas, and research output. Regardless of the type of interaction, the studies either reported no significant effects or ambivalent outcomes such as affected clinical practice or ethical issues. The effects of bilateral interactions reported in the literature are similar to those reported in studies concerning unilateral
Muljadi, Eduard [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gevorgian, Vahan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Luo, Yusheng [Idaho National Laboratory; Mohanpurkar, M. [Idaho National Laboratory; Hovsapian, R. [Idaho National Laboratory; Koritarov, V. [Argonne National Laboratory
Supercapacitor technology has reached a level of maturity as a viable energy storage option available to support a modern electric power system grid; however, its application is still limited because of its energy capacity and the cost of the commercial product. In this paper, we demonstrate transient models of supercapacitor energy storage plants operating in coordination with run-of-the-river (ROR), doubly-fed induction generator hydropower plants (HPP) using a system control concept and architecture developed. A detailed transient model of a supercapacitor energy storage device is coupled with the grid via a three-phase inverter/rectifier and bidirectional DC-DC converter. In addition, we use a version of a 14-bus IEEE test case that includes the models of the supercapacitor energy storage device, ROR HPPs, and synchronous condensers that use the rotating synchronous generators of retired coal-powered plants. The purpose of the synchronous condensers is to enhance the system stability by providing voltage and reactive power control, provide power system oscillations damping, and maintain system inertia at secure levels. The control layer provides coordinated, decentralized operation of distributed ROR HPPs and energy storage as aggregate support to power system operations.
Marcinowicz, Ludmila; Chlabicz, Slawomir; Grebowski, Ryszard
Background Patient satisfaction is a complex and difficult concept to measure, thus precluding the use of exclusively quantitative methods for its description. The purpose of this survey was firstly to identify particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction; and secondly to attempt to typologise the patients' responses based on their evaluation of healthcare. Methods Using a qualitative research design, thirty-six in-depth interviews with patients of family physicians were conducted: four patients from each of 9 family practices in different regions of Poland were interviewed. The main outcome measure was factors associated with patient satisfaction/dissatisfaction. Results In their evaluations of their contacts with family doctors, the patients cited mostly issues concerning interpersonal relationships with the doctor. Nearly 40% of the statements referred to this aspect of healthcare, with nearly equal proportions of positive and negative comments. The second most frequent category of responses concerned contextual factors (21%) that related to conditions of medical service, with two-thirds of the evaluations being negative. Statements concerning the doctor's competencies (12.9%) and personal qualities (10.5%) were less common. Conclusion To improve the quality of healthcare, family doctors should take special care to ensure the quality of their interactions with patients. PMID:19371417
Full Text Available Abstract Background Patient satisfaction is a complex and difficult concept to measure, thus precluding the use of exclusively quantitative methods for its description. The purpose of this survey was firstly to identify particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction; and secondly to attempt to typologise the patients' responses based on their evaluation of healthcare. Methods Using a qualitative research design, thirty-six in-depth interviews with patients of family physicians were conducted: four patients from each of 9 family practices in different regions of Poland were interviewed. The main outcome measure was factors associated with patient satisfaction/dissatisfaction. Results In their evaluations of their contacts with family doctors, the patients cited mostly issues concerning interpersonal relationships with the doctor. Nearly 40% of the statements referred to this aspect of healthcare, with nearly equal proportions of positive and negative comments. The second most frequent category of responses concerned contextual factors (21% that related to conditions of medical service, with two-thirds of the evaluations being negative. Statements concerning the doctor's competencies (12.9% and personal qualities (10.5% were less common. Conclusion To improve the quality of healthcare, family doctors should take special care to ensure the quality of their interactions with patients.
Full Text Available We analyze risks and crises for healthcare providers and discuss the impact of cloud computing in such scenarios. The analysis is conducted in a holistic way, taking into account organizational and human aspects, clinical, IT-related, and utilities-related risks as well as incorporating the view of the overall risk management.
... from Bleeds – Talk to Your Healthcare Provider about Vitamin K Without enough vitamin K, your baby has a chance of bleeding into ... even death. Infants who do not receive the vitamin K shot at birth can develop VKDB up to ...
healthcare provider in the country would have had to apply to Matsoso for a CoN, whether they're setting up, modifying or buying a health establishment, increasing bed numbers, acquiring expensive tech nology, or simply continuing to practise where they are. The legal animal (hatched as provisions. 36 - 40 of the National ...
Santos Hercos, Benigno Vicente; Berezovsky, Adriana
To identify the perception of the ophthalmic service quality provided for outpatients of the public healthcare system as well as to detect which actions should be considered necessary and priority in order to improve its quality. A quantitative descriptive study was carried out on 100 outpatients of the public healthcare system which were submitted to ophthalmic tests at Fundação Hilton Rocha--Belo Horizonte-MG, from July 1st-July 30th 2004. Individual interviews were carried out by giving the interviewees two structured questionnaires adapted from the modified SERVQUAL. This scale is in agreement with the reality of the studied institute. The adapted SERVQUAL scale was submitted to statistical validation and it showed a suitable internal consistency index. In general terms, a slight general dissatisfaction was detected regarding ophthalmological service quality. The interviewees cared more about safety and reliability. A higher degree of dissatisfaction was detected mainly concerning fulfillment of procedures at scheduled appointments related to the execution of services within due time-limits. The institute is supposed to plan as well as carry out actions which lead to a general improvement in the patient's satisfaction regarding service quality and mainly reliability. Service quality monitoring through periodic use of the SERVQUAL scale will not only make it possible to plan highly precise and effective intervention strategies in these and in other healthcare services but it will also allow monitoring the responses to these actions. All these actions will contribute to the improvement of the service in the system as a whole.
Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard
Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and
Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes. © The Author(s) 2014.
Presser, Brynne E; Katz, Mira L; Shoben, Abigail B; Moore, Deborah; Ruffin, Mack T; Paskett, Electra D; Reiter, Paul L
Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet efforts to educate healthcare providers and staff about HPV self-testing are lacking. We report the findings of a brief education intervention about HPV self-testing for healthcare providers and staff. We conducted education sessions during 2015 with healthcare providers and staff (n = 33) from five federally qualified health centers located in Appalachian Ohio. Participants attended a one-time session and completed pre- and post-intervention surveys. Analyses for paired data assessed changes in knowledge and beliefs about HPV, HPV-related disease, and HPV self-testing. The intervention increased participants' knowledge and affected many of the beliefs examined. Participants answered an average of 4.67 of six knowledge items correctly on pre-intervention surveys and 5.82 items correctly on post-intervention surveys (p < 0.001). The proportion of participants who answered all six knowledge items correctly increased substantially (pre-intervention =9% vs. post-intervention =82%, p < 0.001). Compared to pre-intervention surveys, participants more strongly believed on post-intervention surveys that it is important to examine HPV self-testing as a potential cervical cancer screening strategy, that their female patients would be willing to use an HPV self-test at home by themselves, and that they have the knowledge to talk with their patients about HPV self-testing (all p < 0.05). A brief education intervention can be a viable approach for increasing knowledge and affecting beliefs about HPV self-testing among healthcare providers and staff. Findings will be valuable for planning and developing future HPV self-test interventions that include an education component for healthcare providers and staff.
Yoshida, Saran; Shimizu, Ken; Kobayashi, Mariko; Inoguchi, Hironobu; Oshima, Yoshio; Dotani, Chikako; Nakahara, Rika; Takahashi, Tomomi; Kato, Masashi
End-of-life discussions with patients can be one of the most difficult and stressful tasks for the oncologist. However, little is known about the discussions that healthcare providers have with patients in such situations and the difficulties they face. The primary end points of this study were to describe the contents of end-of-life discussion in the pediatric setting and the barriers to end-of-life discussion for pediatric patients, as perceived by pediatric healthcare providers. Participants were 10 healthcare providers. Semi-structured interviews were conducted, and the KJ method was performed to analyze the data. We found 23 barriers against end-of-life discussion with pediatric cancer patients. These barriers were classified as follows: healthcare provider factors, patient factors, parent factors and institutional or cultural factors. In addition to barriers found in previous studies, some unique barriers were uncovered such as, 'Lack of confidence to face the patient after the discussion', 'Uncertain responsibility for treatment decision-making' and 'No compelling reason to discuss'. Healthcare providers actively discussed the purpose of treatment and the patients' wishes and concerns; however, they were reluctant to deal with the patients' own impending death and their estimated prognosis. End-of-life discussion with pediatric patients differs from that with adult patients. Further studies are required to analyze pediatric cases associated with end-of-life discussion and carefully discuss its adequacy, pros and cons. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Feb 12, 2014 ... Eighteen years after apartheid, South Africa is still a country striving to build a nation and to be healed. Marches and protests against poor public service ... (Rm 5:13). A fundamental principle of the Christian faith is that man is saved through the grace of and by faith in the Triune God, not by deeds.
In the United Arab Emirates, neuropsychiatric disorders are estimated to contribute to one-fifth of the global burden of disease. Studies show that the UAE citizens' apathy towards seeking professional mental health services is associated with the 'religious viewpoints' on the issue, societal stigma, lack of awareness of mental health and lack of confidence in mental health-care providers. Mental health expenditures by the UAE government health ministry are not available exclusively. The majority of primary health-care doctors and nurses have not received official in-service training on mental health within the last 5 years. Efforts are to be made at deconstructing the position of mental illness and its treatments in the light of Islamic Jurisprudence; drafting culturally sensitive and relevant models of mental health care for Emirati citizens; liaising between Imams of mosques and professional mental health service providers; launching small-scale pilot programs in collaboration with specialist institutions; facilitating mentoring in line with Science, Technology, Engineering and Math (STEM) outreach programmes for senior school Emirati students concerning mental health; and promoting mental health awareness in the wider community through participation in events open to public.
Introduction: The payment for health-care services is a major problem for many poor patients in developing nations. The aim of the study was to examine the cost of services and commodities and how these affect the patients who utilizes the primary health-care centers in Zaria, North western Nigeria. Methodology: A ...
Wang, Li; Mandell, David S.; Lawer, Lindsay; Cidav, Zuleyha; Leslie, Douglas L.
Healthcare costs and service use for autism spectrum disorder (ASD) were compared between Medicaid and private insurance, using 2003 insurance claims data in 24 states. In terms of costs and service use per child with ASD, Medicaid had higher total healthcare costs (22,653 vs. 5,254), higher ASD-specific costs (7,438 vs. 928), higher psychotropic…
the integration of telemedicine to the national healthcare services on a business logic (functional) integration level. In this paper, (1) we identify the lack of business logic (functional) level integration opportunities for patient oriented telemedical applications with national healthcare services; (2) we...
Legere, Laura E.; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn
Background Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of...
Casellas, Francesc; Vera, Isabel; Ginard, Daniel; Torrejón, Antonio
patient satisfaction with healthcare services provided for inflammatory bowel diseases (IBD) is essential due to high resources use. the study aimed to describe patient satisfaction with healthcare services using the CACHE questionnaire and to assess gastroenterologist and nurse perception on patients' satisfaction. observational multicentric prospective study in 35 Spanish hospitals. Patients included had Crohn's disease or ulcerative colitis. The study was approved by the Hospital Universitari Vall d'Hebron Ethics Committee. Scheduled study visits: baseline (patient sociodemographics and clinical data were collected), 2-4 and 6-months. Patient satisfaction with healthcare was assessed by CACHE questionnaire at each visit; it scores from 0-least satisfaction to 100-highest satisfaction.Gastroenterologists and nurses answered once an adapted questionnaire. participating 290 patients (54.2 % males, 41.3 years old), 62 gastroenterologists and 47 nurses. At baseline mean (SD) CACHE score was 81.7 (10.9); satisfaction with clinician care was the highest, patient information the lowest. Scores did not change across study. Gastroenterologist global score was 72.5 (9.8); Staff Care satisfaction was the highest, patient information the lowest. All scores were significantly lower than patients'. Nurses' global score was 82.2 (8.5), clinician care satisfaction was the highest, centre facilities the lowest. Scores on satisfaction with clinician care, centre facilities, and patient information scored statistically lower than patients'. No relationship was found between patients' satisfaction and patients characteristics. conclusions: IBD patients are satisfied with healthcare services provided, even though the information may be improved. Nurses' perception is similar to that of patients, physicians have a lower perception.
Fadi Abdelmuniem Abdelfattah
Full Text Available Purpose: This research aim to investigate the influence of service quality attributes towards customers’ loyalty on health insurance products. In addition, this research also tested the mediation role of perceived value in between service quality and customers’ loyalty on health insurance products. Design/methodology/approach: Based on the literature review, this research developed a conceptual model of customers loyalty embedded with service quality and perceived value. The study surveyed 342 healthcare insurance customers. Apart from assessing the reliability and validity of the constructs through confirmatory factor analysis, this research also used structural equation modelling (SEM approach to test the proposed hypothesis. Findings: The results from the inferential statistics revealed that the healthcare insurance customers are highly influenced by service quality followed by the perceived value in reaching their loyalty towards a particular health insurance service provider. Research limitations/implications: The sample for this study is based on health insurance customers only and it is suggested that future studies enlarge the scope to include others type of customers of different insurance products. Practical implications: In order to encourage the customers to more loyal towards their service providers, this research will add value for the mangers to understand the items of service quality and considering the perceived value of the target customers in order to optimize their loyalty. As whole, the outcome of this research will assist managers for better understanding of the customers’ loyalty antecedents under the perspective of healthcare insurance products. Originality/value: This paper has tried to provide a comprehensive understanding about customers’ loyalty under the perspective of service quality and perceived values context in the Malaysian health care insurance industry. Since there was a lack of such research in
MacLeod, Stephanie; Musich, Shirley; Hawkins, Kevin; Schwebke, Kay
Low-value healthcare services (LVHS) are defined as procedures delivered that provide little or no clinical benefit. Overuse of LVHS, or delivery when the risks exceed the benefits, contributes to excessive spending without improved outcomes. Furthermore, overuse contributes to healthcare waste. The primary purpose of this commentary is to (1) examine the problem of LVHS overuse and its impacts on quality care delivery and (2) propose factors to consider in developing quality measures to help reduce overuse and waste and thus improve patient outcomes. To inform and support this commentary, we conducted a limited review of the literature related to LVHS overuse, its consequences, and suggested solutions. Online search engines were used to identify research related to our primary areas of interest. This commentary demonstrates that overuse and associated healthcare waste is growing among selected LVHS. The factors of overuse are multidimensional and poorly understood. Meanwhile, overuse of LVHS has financial consequences and impacts quality of care and outcomes. Overuse of LVHS is common in the United States, leading to waste and suboptimal patient outcomes. Thus a need exists to address overuse and develop measures to capture a larger scope of services.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Rajah Rasiah; Nik Rosnah Wan Abdullah; Makmor Tumin
This paper examines the critical issues facing healthcare in Malaysia. It starts by reviewing the dominant arguments on ownership and healthcare provision, viz., neoclassical, evolutionary and heterodox and the politics of interest groups. Given the imperfections and asymmetries associated with healthcare, as well as its properties as a social good that should reach everyone, the paper adopts evolutionary and heterodox arguments, and the views of political scientists on civil society. It then...
Beja, Vanda; Leal, Isabel
To gain a deeper understanding of healthcare providers' perceptions on the abortion counselling they provide and its usefulness. We conducted in-depth interviews with 16 healthcare providers working in the Lisbon metropolitan area. The interviews were then subjected to content analysis. We identified the following themes on abortion counselling description: receiving the woman and understanding her request; providing information; supporting decision-making; managing emotional and psychological issues; addressing contraception; managing third-party involvement; offering psychological counselling; informing about the State's support and offering social counselling. All participants described counselling as useful but valued different aspects of it: information provision; addressing contraception to prevent future unplanned pregnancy/abortion; emotional support; decision-making support; addressing emotional issues beyond abortion; enticing women to seek healthcare in the future; preventing poor emotional post-abortion adjustment. Counselling was considered of no use to change the woman's abortion decision. The abortion counselling provided in Portugal is in tune with the latest literature on the subject, following a client-centred approach focused on the provision of information and emotional support. It can be improved, however, particularly in what concerns the staff's communication and counselling skills. Further research is needed to improve the provision of abortion care in Portugal.
Garbacz, Laure; Juillière, Yves; Alla, François; Jourdain, Patrick; Guyon, Gaëlle; Coudane, Henry; Hervé, Christian; Claudot, Frédérique
Care provider support for therapeutic patient education (TPE), its results and relationships with patients are factors in the setting up and sustainability of this practice. With a view to understanding the factors determining TPE care provider participation and favouring its development, the aim of this study was to describe the perception healthcare providers have of TPE in heart failure. A national survey by self-administered questionnaire was performed in 2013 in 61 Observatoire de l'INsuffisance cardiaque (ODIN; Heart Failure Observatory) centres participating in the I-CARE programme. The cardiologist in charge of each centre received five questionnaires: one for him/herself and four for other healthcare providers working with him/her. We received 116 responses out of the 305 questionnaires sent (38.0%). Almost all of the responders stated that the patients were more observant after TPE sessions (91.4%). According to the responders, patients were better informed thanks to TPE (53.9%); they stated that TPE had changed their relationships with patients (81.9%); they also felt that they were educating the patient's close family/friends at the same time as the patients (86.2%). The survey showed that TPE improves care relationships. Healthcare providers recognize that they have been working differently since the programme was set up, and want the patient's close family/friends to be involved in treatment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
This report documents the identification and assessment of external service providers to the National Security Technology Incubator (NSTI) program for southern New Mexico. The NSTI is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant to Arrowhead Center, New Mexico State University. This report contains 1) a summary of the services to be provided by NSTI; 2) organizational descriptions of external service providers; and 3) a comparison of NSTI services and services offered by external providers.
Full Text Available Abstract Background The purpose of this research is to understand the performance of home healthcare practice in the US. The relationships between home healthcare patient factors and agency characteristics are not well understood. In particular, discharge destination and length of stay have not been studied using a data mining approach which may provide insights not obtained through traditional statistical analyses. Methods The data were obtained from the 2000 National Home and Hospice Care Survey data for three specific conditions (chronic obstructive pulmonary disease, heart failure and hip replacement, representing nearly 580 patients from across the US. The data mining approach used was CART (Classification and Regression Trees. Our aim was twofold: 1 determining the drivers of home healthcare service outcomes (discharge destination and length of stay and 2 examining the applicability of induction through data mining to home healthcare data. Results Patient age (85 and older was a driving force in discharge destination and length of stay for all three conditions. There were also impacts from the type of agency, type of payment, and ethnicity. Conclusion Patients over 85 years of age experience differential outcomes depending on the condition. There are also differential effects related to agency type by condition although length of stay was generally lower for hospital-based agencies. The CART procedure was sufficiently accurate in correctly classifying patients in all three conditions which suggests continuing utility in home health care.
D.M.I.D. Duijmelinck (Daniëlle)
markdownabstractConsumer choice of health insurer is an essential precondition for achieving efficiency and consumer responsiveness in healthcare. In healthcare, consumer preferences are highly heterogeneous. This implies that if groups of consumers with specific preferences feel not free to switch
Gao, Fei; Kihal, Wahida; Le Meur, Nolwenn; Souris, Marc; Deguen, Séverine
Spatial accessibility indices are increasingly applied when investigating inequalities in health. Although most studies are making mentions of potential errors caused by the edge effect, many acknowledge having neglected to consider this concern by establishing spatial analyses within a finite region, settling for hypothesizing that accessibility to facilities will be under-reported. Our study seeks to assess the effect of edge on the accuracy of defining healthcare provider access by comparing healthcare provider accessibility accounting or not for the edge effect, in a real-world application. This study was carried out in the department of Nord, France. The statistical unit we use is the French census block known as 'IRIS' (Ilot Regroupé pour l'Information Statistique), defined by the National Institute of Statistics and Economic Studies. The geographical accessibility indicator used is the "Index of Spatial Accessibility" (ISA), based on the E2SFCA algorithm. We calculated ISA for the pregnant women population by selecting three types of healthcare providers: general practitioners, gynecologists and midwives. We compared ISA variation when accounting or not edge effect in urban and rural zones. The GIS method was then employed to determine global and local autocorrelation. Lastly, we compared the relationship between socioeconomic distress index and ISA, when accounting or not for the edge effect, to fully evaluate its impact. The results revealed that on average ISA when offer and demand beyond the boundary were included is slightly below ISA when not accounting for the edge effect, and we found that the IRIS value was more likely to deteriorate than improve. Moreover, edge effect impact can vary widely by health provider type. There is greater variability within the rural IRIS group than within the urban IRIS group. We found a positive correlation between socioeconomic distress variables and composite ISA. Spatial analysis results (such as Moran's spatial
McShea, Michael; Holl, Randy; Badawi, Omar; Riker, Richard R; Silfen, Eric
As the volume of data that is electronically available promliferates, the health-care industry is identifying better ways to use this data for patient care. Ideally, these data are collected in real time, can support point-of-care clinical decisions, and, by providing instantaneous quality metrics, can create the opportunities to improve clinical practice as the patient is being cared for. The business-world technology supporting these activities is referred to as business intelligence, which offers competitive advantage, increased quality, and operational efficiencies. The health-care industry is plagued by many challenges that have made it a latecomer to business intelligence and data-mining technology, including delayed adoption of electronic medical records, poor integration between information systems, a lack of uniform technical standards, poor interoperability between complex devices, and the mandate to rigorously protect patient privacy. Efforts at developing a health care equivalent of business intelligence (which we will refer to as clinical intelligence) remains in its infancy. Until basic technology infrastructure and mature clinical applications are developed and implemented throughout the health-care system, data aggregation and interpretation cannot effectively progress. The need for this approach in health care is undisputed. As regional and national health information networks emerge, we need to develop cost-effective systems that reduce time and effort spent documenting health-care data while increasing the application of knowledge derived from that data.
... CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Placement and Continued Services § 670.720 Who... graduates and former students in jobs. Job Corps placement agencies provide placement services under a...
Meadors, Patrick; Lamson, Angela; Swanson, Mel; White, Mark; Sira, Natalia
The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can be used interchangeably, the two most prominent measures utilized in the assessment of CF and STS are actually capturing at least some unique elements. Given these results, future researchers should examine and conceptualize the difference in etiology, prevalence, symptoms, and treatment efficacy for CF and STS as separate but related entities and then return their focus to understanding secondary traumatization in healthcare providers.
Newnham, Harvey; Barker, Anna; Ritchie, Edward; Hitchcock, Karen; Gibbs, Harry; Holton, Sara
To systematically review the available evidence about hospital discharge communication practices and identify which practices were preferred by patients and healthcare providers, improved patient and provider satisfaction, and increased patients' understanding of their medical condition. OVID Medline, Web of Science, ProQuest, PubMed and CINAHL plus. Databases were searched for peer-reviewed, English-language papers, published to August 2016, of empirical research using quantitative or qualitative methods. Reference lists in the papers meeting inclusion criteria were searched to identify further papers. Of the 3489 articles identified, 30 met inclusion criteria and were reviewed. Much research to date has focused on the use of printed material and person-based discharge communication methods including verbal instructions (either in person or via telephone calls). Several studies have examined the use of information technology (IT) such as computer-generated and video-based discharge communication practices. Utilizing technology to deliver discharge information is preferred by healthcare providers and patients, and improves patients' understanding of their medical condition and discharge instructions. Well-designed IT solutions may improve communication, coordination and retention of information, and lead to improved outcomes for patients, their families, caregivers and primary healthcare providers as well as expediting the task for hospital staff.
Efficient healthcare systems in developing economies are significant indicators of development. Health can either be optimised ... Region of Cameroon, a purposive sample of 300 households were collected and analysed using a multinomial logistic model. .... equitable income distribution in a bid to address the healthcare ...
Pessin, Hayley; Fenn, Natalie; Hendriksen, Ellen; DeRosa, Antonio P; Applebaum, Allison
Existential distress is well documented among patients at end of life (EOL) and increasingly recognized among informal caregivers. However, less information is known about existential concerns among healthcare providers working with patients at EOL, and the impact that such concerns may have on professionals. Recent literature documents five key existential themes for professionals working in EOL care: (1) opportunity for introspection; (2) death anxiety and potential to compromise patient care; (3) risk factors and negative impact of existential distress; (4) positive effects such as enhanced meaning and personal growth; and (5) the importance of interventions and self-care. EOL work can be taxing, yet also highly rewarding. It is critical for healthcare providers to make time for reflection and prioritize self-care in order to effectively cope with the emotional, physical, and existential demands that EOL care precipitates.
Legere, Laura E; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn
Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of educational and professional development needs and strategies for health-care providers in perinatal depression. A systematic search of the literature was conducted in seven academic health databases using selected keywords. The search was limited to primary studies and reviews published in English between January 2006 and May/June 2015, with a focus on perinatal depression education and professional development for health-care providers. Studies were screened for inclusion by two reviewers and tie-broken by a third. Studies that met inclusion criteria were quality appraised and data extracted. Results from the studies are reported through narrative synthesis. Two thousand one hundred five studies were returned from the search, with 1790 remaining after duplicate removal. Ultimately, 12 studies of moderate and weak quality met inclusion criteria. The studies encompassed quantitative (n = 11) and qualitative (n = 1) designs, none of which were reviews, and addressed educational needs identified by health-care providers (n = 5) and strategies for professional development in perinatal mental health (n = 7). Consistently, providers identified a lack of formal education in perinatal mental health and the need for further professional development. Although the professional development interventions were diverse, the majority focused on promoting identification of perinatal depression and demonstrated modest effectiveness in improving various outcomes. This systematic review reveals a
Mariana de Sousa Dantas
Full Text Available This study was based on exploratory research and a qualitative approach within the framework of the Social Representations Theory. It aims to capture the social representations of healthcare providers in relation to HIV/AIDS by describing their structure. The Free Evocations technique was applied on 86 professionals of HIV/AIDS benchmark services in Recife, Pernambuco, Brazil, from 2011 to 2013. Analysis using EVOC 2005 software showed that the possible central core is prejudice in a negative attitude dimension; in the contrast zone, chronic disease translates living with the disease. In the first periphery, treatment and disease in a clinical/biometric conception; in the second periphery, death has a imagistic and negative nature. Positive and negative elements were observed, allowing healthcare personnel to construct meaning attributed to the phenomenon and reflect on their practices.
Jovanović Verica S.
Full Text Available Proper Healthcare Waste Management (HCWM was introduced in the Republic of Serbia in 2007 with the support of the European Union. Since then, the amounts of waste treated, prior to landfill, have steadily increased and more and more healthcare institutions adopted HCWM systems. In parallel large numbers of healthcare workers were trained in proper HCWM. This study quantifies the progress made. The study analyzed the period 2009 to 2012 using three methods of data collection. On basis of data collected, it has been established that with a population of just over seven million, Serbia generates between 4,500 and 5,000 tones of infectious waste on an annual basis of which some 20% originates from the treatment of out-patients, 75% from the treatment of in-patients and 5% from micro-biological laboratory tests. While in 2009 only one third of this waste was treated prior to disposal, this fraction has increased to two thirds in 2011. The data also show that more than 90% of healthcare facilities have developed individual healthcare waste management plans up from less than 20% in 2009. In every healthcare facility there are at least 2 people trained in healthcare waste management, and in total there are approximately 3000 staff members who received formal HCWM training provided through the Institute for Public Health. Healthcare waste management is continuously improving in the Republic of Serbia and is well established in more than 85% of healthcare facilities. There are still issues to be improved especially regarding treatment on healthcare waste other than infectious waste.
CyberPsychology and Behavior 8, 3 (2005), 187-211.  T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508  G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8...3 (2005), 220- 230.  F.D. Rose, B.M. Brooks & A.A. Rizzo, Virtual Reality in Brain Damage Rehabilitation: Review, CyberPsychology and Behavior
Chen, Po-Jui; Huang, Chien-Da; Yeh, San-Jou
The cultivation of empathy for healthcare providers is an important issue in medical education. Narrative medicine (NM) has been shown to foster empathy. To our knowledge, there has been no research that examines whether a NM programme affects multi-professional healthcare providers' empathy. Our study aims to fill this gap by investigating whether a NM programme effects multi-professional healthcare providers' empathy. A pre-post questionnaire method was used.142 participants (n = 122 females) who attended the NM programme were divided into single (n = 58) and team groups (n = 84) on the basis of inter-professional education during a period of 2 months. Perceptions of the NM programme were collected using our developed questionnaire. Empathy levels were measured using the Chinese version of Jefferson Scale of Empathy - Healthcare Providers Version (JSE-HP) - at three time points: prior to (Time 1), immediately after (T2), and 1.5 years (T3) after the programme. Participants' perceptions about the NM programme (n = 116; n = 96 females) suggested an in enhancement of empathy (90.5%). Empathy scores via the JSE-HP increased after the NM programme (T1 mean 111.05, T2 mean 116.19) and were sustainable for 1.5 years (T3 mean 116.04) for all participants (F(2297) = 3.74, p programme as an educational tool for empathy is feasible. However, further research is needed to examine gender difference as it might be that males and females respond differently to a NM programme intervention.
Koenig, Kristi L.; Shastry, Siri; Mzahim, Bandr; Almadhyan, Abdulmajeed; Burns, Michael J.
Mumps is a highly contagious viral infection that became rare in most industrialized countriesfollowing the introduction of measles-mumps-rubella (MMR) vaccine in 1967. The disease, however,has been re-emerging with several outbreaks over the past decade. Many clinicians have neverseen a case of mumps. To assist frontline healthcare providers with detecting potential casesand initiating critical actions, investigators modified the “Identify-Isolate-Inform” tool for mumpsinfection. The tool is...
The purpose of this study was to describe military healthcare providers adherence to nationally recognized hypertensive patient guidelines concerning lifestyle modifications and follow-up instructions...
Hughes, Anne K; Harold, Rena D; Boyer, Janet M
Very little research exists examining the interactions between community-based aging service providers and lesbian, gay, bisexual, and transgender (LGBT) older adults. It is unclear whether mainstream aging services acknowledge the needs of this community. We asked direct care providers and administrators in the Michigan aging services network to describe their work with LGBT older adults. We found there are very few services specific to the needs of older LGBT adults and very little outreach to this community. At the agency level, resistance to providing services was found.
Balyakina, Elizabeth; Fulda, Kimberly G; Franks, Susan F; Cardarelli, Kathryn M; Hinkle, Kollier
The primary purpose of this study was to determine the association between type of healthcare provider delivering prenatal care and intent to exclusively breastfeed. A self-report survey was administered to 455 expectant mothers. Logistic regression was performed to determine the association between prenatal care provider type [obstetrician; other primary care physician (family doctor/general practitioner/internist/or other physician); midwife/nurse midwife; more than one provider; and other] with intent to breastfeed (exclusive/non-exclusive). Having a midwife/nurse midwife as a prenatal care provider was associated with intent to breastfeed compared to having an obstetrician (OR 2.544, 95 % CI 1.385-4.675). There was no difference in intent between women with another primary care physician and an obstetrician. Women with another type of health care provider, no prenatal care from a health professional, or no knowledge of who is providing prenatal care were less likely to intend to breastfeed (OR 0.228, CI 0.068-0.766) as compared to those with an obstetrician. Provider type is associated with intent to breastfeed among pregnant women. Women's intent to breastfeed is an important predictor of breastfeeding initiation, continuation, and duration that may be assessed by healthcare providers during the prenatal period. A consideration of what features of provider care are associated with improved breastfeeding outcomes and characteristics of women seeking prenatal care with midwives may serve to formulate future prenatal care policies and education during prenatal care visits.
E. Nadi F. Zeraati
Full Text Available Poor inhaler technique is a common problem both in asthmatic patients and healthcare providers, which contributes to poor asthma control. This study was performed to evaluate the adequacy of metered-dose inhaler (MDI technique in a sample of physicians and nurses practicing in hospitals of Hamadan University of Medical Sciences. A total of 173 healthcare providers voluntary participated in this study. After the participants answered a questionnaire aimed at identifying their involvement in MDI prescribing and counseling, a trained observer assessed their MDI technique using a checklist of nine steps. Of the 173 participants, 35 (20.2% were physicians and 138 (79.8% were nurses. Only 12 participants (6.93% performed all steps correctly. Physicians performed essential steps significantly better than nurses (85.7% vs. 63.8%, P < 0.05. The majority of healthcare providers responsible for instructing patients on the correct MDI technique were unable to perform this technique correctly, indicating the need for regular formal training programs on inhaler techniques.
GÂRDAN, Daniel Adrian; Iuliana Petronela GÂRDAN
Healthcare services consumers’ behaviour represents an multidimensional concept, that implies the cumulative effects of different factors. The process of consumption is very different and complex in the case of healthcare services due to the nature of the needs and consumption motivations on one hand and because of the complexity of the services itself on the other hand. Amongst the factors that are influencing the consumer’s behaviour, the social ones represent a particular type. In the case...
Brett, Meghan E; Hinckley, Alison F; Zielinski-Gutierrez, Emily C; Mead, Paul S
Surveillance indicates that tick-borne diseases are a common problem in the United States. Nevertheless, little is known regarding the experience or management practices of healthcare providers who treat these conditions. The purpose of the present study was to characterize the frequency of tick-borne diseases in clinical practice and the knowledge of healthcare providers regarding their management. Four questions about tick-borne diseases were added to the 2009 Docstyles survey, a nationally representative survey of >2000 U.S. healthcare providers. Topics included diseases encountered, management of patients with early Lyme disease (LD), provision of tick-bite prophylaxis, and sources of information on tick-borne diseases. Overall, 51.3% of practitioners had treated at least one patient for a tick-borne illness in the previous year. Among these, 75.1% had treated one type of disease, 19.0% two types of disease, and 5.9% three or more diseases. LD was encountered by 936 (46.8%) providers; Rocky Mountain spotted fever was encountered by 184 (9.2%) providers. Given a scenario involving early LD, 89% of providers would prescribe antibiotics at the first visit, with or without ordering a blood test. Tick-bite prophylaxis was prescribed by 31.0% of all practitioners, including 41.1% in high-LD-incidence states and 26.0% in low-incidence states. Tick-borne diseases are encountered frequently in clinical practice. Most providers would treat early LD promptly, suggesting they are knowledgeable regarding the limitations of laboratory testing in this setting. Conversely, providers in low-LD-incidence states frequently prescribe tick-bite prophylaxis, suggesting a need for education to reduce potential misdiagnosis and overtreatment. Published by Elsevier GmbH.
Padela, Aasim I
The United Nations Educational, Scientific and Cultural Organization's (UNESCO) Declaration on Bioethics and Human Rights asserts that governments are morally obliged to promote health and to provide access to quality healthcare, essential medicines and adequate nutrition and water to all members of society. According to UNESCO, this obligation is grounded in a moral commitment to promoting fundamental human rights and emerges from the principle of social responsibility. Yet in an era of ethical pluralism and contentions over the universality of human rights conventions, the extent to which the UNESCO Declaration can motivate behaviors and policies rests, at least in part, upon accepting the moral arguments it makes. In this essay I reflect on a state's moral obligation to provide healthcare from the perspective of Islamic moral theology and law. I examine how Islamic ethico-legal conceptual analogues for human rights and communal responsibility, ḥuqūq al-'ibād and farḍ al-kifāyah and other related constructs might be used to advance a moral argument for healthcare provision by the state. Moving from theory to application, I next illustrate how notions of human rights and social responsibility were used by Muslim stakeholders to buttress moral arguments to support American healthcare reform. In this way, the paper advance discourses on a universal bioethics and common morality by bringing into view the concordances and discordances between Islamic ethico-legal constructs and moral arguments advanced by transnational health policy advocates. It also provides insight into applied Islamic bioethics by demonstrating how Islamic ethico-legal values might inform the discursive outputs of Muslim organizations. © 2016 John Wiley & Sons Ltd.
Nicolaidis, Christina; Raymaker, Dora; McDonald, Katherine; Kapp, Steven; Weiner, Michael; Ashkenazy, Elesia; Gerrity, Martha; Kripke, Clarissa; Platt, Laura; Baggs, Amelia
The healthcare system is ill-equipped to meet the needs of adults on the autism spectrum. Our goal was to use a community-based participatory research (CBPR) approach to develop and evaluate tools to facilitate the primary healthcare of autistic adults. Toolkit development included cognitive interviewing and test-retest reliability studies. Evaluation consisted of a mixed-methods, single-arm pre/post-intervention comparison. A total of 259 autistic adults and 51 primary care providers (PCPs) residing in the United States. The AASPIRE Healthcare toolkit includes the Autism Healthcare Accommodations Tool (AHAT)-a tool that allows patients to create a personalized accommodations report for their PCP-and general healthcare- and autism-related information, worksheets, checklists, and resources for patients and healthcare providers. Satisfaction with patient-provider communication, healthcare self-efficacy, barriers to healthcare, and satisfaction with the toolkit's usability and utility; responses to open-ended questions. Preliminary testing of the AHAT demonstrated strong content validity and adequate test-retest stability. Almost all patient participants (>94 %) felt that the AHAT and the toolkit were easy to use, important, and useful. In pre/post-intervention comparisons, the mean number of barriers decreased (from 4.07 to 2.82, p communication improved (from 30.9 to 32.6, p = 0.03). Patients stated that the toolkit helped clarify their needs, enabled them to self-advocate and prepare for visits more effectively, and positively influenced provider behavior. Most of the PCPs surveyed read the AHAT (97 %), rated it as moderately or very useful (82 %), and would recommend it to other patients (87 %). The CBPR process resulted in a reliable healthcare accommodation tool and a highly accessible healthcare toolkit. Patients and providers indicated that the tools positively impacted healthcare interactions. The toolkit has the potential to reduce barriers to
Stace, Laura Britton
Service dogs have been used in the adult population for decades. Recently, there has been a diversification in types of service dogs, specifically for the pediatric population. Although guide dogs and mobility dogs are accepted in society, autism assistance dogs, seizure alert and response dogs and diabetic alert dogs are relatively new. As pediatric service dogs attract more attention, pediatric providers need to be prepared to answer parental inquires regarding service dog use. The pediatric provider is well equipped to identify children who could benefit from a service dog intervention and should be able to make a referral to a reputable service dog provider. This article presents guidance on appropriate patient selection, making a service dog referral, and risks and benefits involved. Pediatric providers are ideally positioned to be leaders in implementing this evolving new assistive technology that can help to alleviate pediatric disabilities for both the patient and family. Copyright © 2016 Elsevier Ltd. All rights reserved.
Full Text Available Consumer’s perceptions about the health care services play an important role when choosing a hospital. The quality of service is crucial to both the outpatients and the service providers. The dimensions of the service quality are reliability, responsiveness, assurance, empathy, and tangibles. Customer’s expectations and experiences vary with services. When there is a shortfall between expectation of service level and perception of actual service delivery, it is called customer gap. The causes of customer gap include; not knowing what customers expect, not selecting the right service designs and standards, not delivering to service standards and not matching performance to promises. This paper focuses on the level of service quality rendered by SRM’s hospital, the patient-physicians’ relationship and to examine the pre and post service of outpatients in the SRM’s hospital. A structured questionnaires and interviews were constructed to provide answers to the research questions using a sample size of 50 [employees and outpatients]. It was found out that some outpatients were satisfied with the services rendered by the hospital with reservations for more improvement. It was also found out that, there were gaps between the outpatients’ expectation and perception about the service rendered by the hospital. It was recommended that a competent marketing executive should be employed since marketing is the voice of the healthcare industry.
Haishan, Huang; Hongjuan, Liu; Tieying, Zeng; Xuemei, Pu
The aim of this study is to find and compare the current situation between common people and healthcare providers' preferences for a good death in the context of Chinese culture. A cross-sectional anonymous questionnaire survey covering 190 ordinary Chinese people and 323 healthcare providers was conducted. An inventory of the good death was translated and the subjects were surveyed about their attitude toward it. Permission to conduct the study was granted by department chiefs, nurse managers and the participants themselves. The participants were informed that they took part on a voluntary and anonymous basis, that they could withdraw at any time, that they had the right to ignore questions they did not wish to answer, and that whatever they chose to do would not jeopardize their employment conditions. The attributes that were perceived as important by major respondents for a good death were maintaining hope and pleasure, good relationship with medical staff, good relationship with family, independence, environment comfort, being respected as an individual, preparation for death, physical and psychological comfort, dying in a favorite place, and not being a burden to others. And some relatively less important characteristics were life completion, receiving enough treatment, natural death, controlling over the future, unawareness of death, pride and beauty, feeling that one's life is worth living, and religious and spiritual comfort. We also found that healthcare providers were more likely than general out-patients to perceive "physical and psychological comfort," "dying in a favorite place," "good relationship with medical staff," and "natural death" as important for a good death. This study offers healthcare providers in China a fundamental understanding of the normal expectations of the general public for a good death. It is believed that these findings in our study are valuable to improve palliative care in China. We compared the attitudes of Chinese and
Clare, Camille A; Afzal, Omara; Knapp, Kenneth; Viola, Deborah
To determine whether a patient's level of assertiveness and other factors influences her comfort level in asking her provider to wash his or her hands. In this pilot study, we developed a survey to gather cross-sectional information on a variety of factors that might explain patient willingness to ask her health-care provider to wash his or her hands. Three primary predictor variables are analyzed: (1) patient assertiveness; (2) patient familiarity with her healthcare provider; and (3) whether the patient has observed hand-washing behavior. Fifty patients participated from the Obstetrics and Gynecology Department of Metropolitan Hospital Center. Less assertive patients are much less likely than assertive patients to ask physicians to wash hands (25% versus 68%; Fisher's exact test P = 0.0427). Among the 3 assertiveness questions included in the survey, the ability to ask physicians questions during visits is most strongly indicative of willingness to ask about hand washing. Familiarity with the names of regular health-care providers has a statistically significant impact on willingness to ask about hand washing. Evidence suggests that observing hand washing behavior affects willingness to ask, but differences are not statistically significant. Results by socioeconomic status such as age, education, income, and race/ethnicity are inconclusive. A patient's level of assertiveness alone is not sufficient to determine her willingness to inquire about the hand-washing behavior of her provider. A high percentage of patients did not see their provider engaging in adequate hand washing behavior. If patients feel comfortable with their provider to inquire about their care and request hand-washing behavior, health outcomes are affected by reducing the rates of health care-associated infections.
Freeman, Christopher R; Abdullah, Nabilah; Ford, Pauline J; Taing, Meng-Wong
This study investigated pharmacists' and pharmacy assistants' current practices and perspectives with regard to oral healthcare provision across Australian community pharmacies. Cross-sectional study. A questionnaire for each pharmacist and pharmacy assistant cohort was developed and administered by online or postal means. Pearson's χ(2) test was used to examine relationships between categorical variables. Pharmacists and pharmacy assistants working within 2100 randomly selected Australian community pharmacies. The overall response rate was 58.5% (644/1100) for the pharmacist cohort and 28% (280/1000) for the pharmacy assistant cohort. This represents pharmacy staff responses from 803 community pharmacies across Australia (approximately 14.6%, 803/5500 of community pharmacies nationally). Overall, the majority of pharmacists (80.2%; 516/644) and pharmacy assistants (83.6%; 234/280) reported providing oral health advice/consultations to health consumers up to five times each week. More than half of community pharmacists and pharmacy assistants were involved in identifying signs and symptoms for oral health problems; and the majority believed health consumers were receptive to receiving oral health advice. Additionally, more than 80% of pharmacists and 60% of pharmacy assistants viewed extended oral healthcare roles positively and supported integrating them within their workplace; extended roles include provision of prevention, early intervention and referral to oral healthcare services. The most commonly reported barriers to enhance pharmacy staff involvement in oral healthcare within Australian community pharmacies include lack of knowledge, ongoing training and resources to assist practice. This study highlights that Australian pharmacists have an important role in oral health and provides evidence supporting the need for growing partnerships/collaborations between pharmacy and dental healthcare professionals and organisations to develop, implement and evaluate
Emílio José Montero Arruda Filho
.... This study begins by giving the background to voice communication in the telecommunications sector and the misunderstanding of the competitive boundaries between technologies, service providers...
Joshua Mugambwa; George William Mugerwa; Wilson Williams Mutumba; Claire Muganzi; Bridget Namubiru; Yusuf Waswa; Isaac Newton Kayongo
.... This research took a case study of Nsamizi Training Institute of Social Development (NTISD) to determine the relationship between privately provided accommodation service quality and customer satisfaction...
Marin, Heimar F; Senne, Fabio; Barbosa, Alexandre
The potential offered by intensive and strategic adoption of information and communication technologies for obtaining advances in the health sector is worldwide recognized. In order to monitor the implementation of ICT in health policies in Brazil and to establish internationally comparable indicators, a nationwide survey was conducted to identify the current implementation of information and communication technologies in Healthcare facilities and its adoption by providers. Data collection was carried out from February to August 2013 using two structured questionnaires. The results obtained showed that the access to internet is nearly universal in the country but clinical information systems are still in its infancy when it comes to more complex functionalities and linked to clinical decision support. Healthcare professionals indicated that the main barrier to adopt is the lack of availability related to the patient information.
Stevens, Meriam; Berishaj, Kelly
Human trafficking is a major global public health concern. It is a grave crime that violates human rights. Contrary to healthcare providers' perceptions, victims of human trafficking come in contact with the healthcare system while being trafficked, with the emergency department being the most frequented setting for medical treatment. In this article, we explore the anatomy of human trafficking, including the scope of the problem, definitions, and types and elements of human trafficking. The roles of clinicians, particularly emergency department nurses and advanced practice nurses, in screening and identifying those at risk are examined. Clinical practice tools and guidelines that may be used by clinicians to guide the treatment of human trafficking victims are reviewed. Finally, current strategies and resources that address human trafficking are presented. For the purpose of this article, the terms "human trafficking" or "trafficking" will be used throughout.
Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.
Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…
Negulescu, Raluca-Anca; Catarino, Rosa; De Vuyst, Hugo; Undurraga-Malinverno, Manuela; Meyer-Hamme, Ulrike; Alec, Milena; Campana, Aldo; Vassilakos, Pierre; Petignat, Patrick
To validate a web-based instrument for assessing healthcare providers' skills in visual inspection with acetic acid or Lugol iodine (VIA/VILI) for the diagnosis and management of cervical intraepithelial neoplasia. An observational cross-sectional study enrolled healthcare providers in a web-based assessment of VIA/VILI skills between August and November 2014. Participants participated in a four-module training course, followed by a multiple-choice test with 70 questions based on cervical photographs of HPV-positive women participating in cervical screening. Logistic regression was used to identify relationships between independent variables and success on the test. Overall, 255 participants completed the test and 99 (38.8%) passed. No correlation was found between age or sex and test performance. Compared with other healthcare workers, physicians (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.01-3.63; P=0.048), and participants with more colposcopy experience (OR 3.62, 95% CI 1.91-6.85; P<0.001) and postgraduate VIA/VILI training (OR 1.95, 95% CI 1.16-3.29; P=0.012) were more likely to pass the test. Participants who repeated the test (31/255 [12.2%]) were five times more likely to succeed on their second repeat (OR 5.89, 95% CI 1.46-23.73; P=0.013). Web-based training for VIA/VILI is feasible and can identify healthcare workers who are proficient in this technique. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research.
Robertshaw, Luke; Dhesi, Surindar; Jones, Laura L
To thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries. Systematic review and qualitative thematic synthesis. Searches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs. Twenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes. A range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly
The article introduces a service-oriented architecture (SOA) governance framework for successful implementation in a healthcare organization. The proposed framework, based on a rigorous literature review, proposes nine governance elements that should be considered during the SOA implementation...... process. This proposal aims to pinpoint attributes and guidelines for each element required to successfully govern SOA and tackle longstanding healthcare information systems (HIS) implementation challenges. The framework was tested in a healthcare organization and valuable insights are presented herein...
Park, Yubin [Univ. of Texas, Austin, TX (United States); Shankar, Mallikarjun [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Park, Byung H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ghosh, Dr. Joydeep [Univ. of Texas, Austin, TX (United States)
Designing a database system for both efficient data management and data services has been one of the enduring challenges in the healthcare domain. In many healthcare systems, data services and data management are often viewed as two orthogonal tasks; data services refer to retrieval and analytic queries such as search, joins, statistical data extraction, and simple data mining algorithms, while data management refers to building error-tolerant and non-redundant database systems. The gap between service and management has resulted in rigid database systems and schemas that do not support effective analytics. We compose a rich graph structure from an abstracted healthcare RDBMS to illustrate how we can fill this gap in practice. We show how a healthcare graph can be automatically constructed from a normalized relational database using the proposed 3NF Equivalent Graph (3EG) transformation.We discuss a set of real world graph queries such as finding self-referrals, shared providers, and collaborative filtering, and evaluate their performance over a relational database and its 3EG-transformed graph. Experimental results show that the graph representation serves as multiple de-normalized tables, thus reducing complexity in a database and enhancing data accessibility of users. Based on this finding, we propose an ensemble framework of databases for healthcare applications.
Ahmed, Selim; Manaf, Noor H A; Islam, Rafikul
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.
Breskey, John D; Lacey, Steven E; Vesper, Benjamin J; Paradise, William A; Radosevich, James A; Colvard, Michael D
Photodynamic therapy (PDT) as a medical treatment for cancers is an increasing practice in clinical settings, as new photosensitizing chemicals and light source technologies are developed and applied. PDT involves dosing patients with photosensitizing drugs, and then exposing them to light using a directed energy device in order to manifest a therapeutic effect. Healthcare professionals providing PDT should be aware of potential occupational health and safety hazards posed by these treatment devices and photosensitizing agents administered to patients. Here we outline and identify pertinent health and safety considerations to be taken by healthcare staff during PDT procedures. Physical hazards (for example, non-ionizing radiation generated by the light-emitting device, with potential for skin and eye exposure) and chemical hazards (including the photosensitizing agents administered to patients that have the potential for exposure via skin, subcutaneous, ingestion, or inhalation routes) must be considered for safe use of PDT by the healthcare professional. Engineering, administrative, and personal protective equipment controls are recommendations for the safe use and handling of PDT agents and light-emitting technologies.
McGinn, Therese; Casey, Sara E
Background Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors? observations suggest that four reasons are typically given for this gap: ?There?s no need?; ?Abortion is too complicated to provide in crises?; ?Donors don?t fund abortion services?; and ?Abortion is illegal?. Discussion However, each of these reasons is based on false premises. Unsafe abortion is a...
Ivaschenko, A. V.; Sitnikov, P. V.; Tanonykhina, M. O.
The paper introduces a solution for IT services representation and management in the integrated information space of distributed enterprises. It is proposed to develop an Open Service Provider as a software platform for interaction between IT services providers and their users. Implementation of the proposed concept and approach is illustrated by an after-sales customer support system for a large manufacturing corporation delivered by SEC “Open Code”.
Sep 14, 2017 ... cross-sectional survey of six primary health-care facilities in Zaria metropolis, namely Baban dodo, Tudun ... Adegboyega and Abioye: Effect of Health-Care services and commodities cost in North western Nigeria. 1028. Nigerian ..... Integrating primary health care governance-primary health care under one.
Madhivanan, Purnima; Krupp, Karl; Kulkarni, Vinay; Kulkarni, Sanjeevani; Vaidya, Neha; Shaheen, Reshma; Philpott, Sean; Fisher, Celia
In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India's National AIDS Control Organization. While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.
Full Text Available , healthcare was then decentralised by shifting power from central offices to peripheral offices such as districts and municipalities. One of the strategies used by the government is to encourage healthcare service providers (private and/or public) to employ...
Harris, Cornelia A.
This research project examined the views and perceptions of healthcare provider staff regarding HIV testing and the implementation of HIV testing as a routine part of medical practice in a university student health center at a Historically Black College or University (HBCU). This study further explored whether healthcare provider staff promoted…
Stef Weijers; Reinder Pieters; Allan Woodburn; Hans-Heinrich Glöckner
In recent years, the transport industry has encountered numerous challenges. It experienced strong growth, but also many uncertainties. In many cases, logistics service providers were forced to change their strategy. So, the question for logistics service providers arises “how to deal best with
Background: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided.
Yang, Chih-Wei; Yen, Zui-Shen; McGowan, Jane E; Chen, Huiju Carrie; Chiang, Wen-Chu; Mancini, Mary E; Soar, Jasmeet; Lai, Mei-Shu; Ma, Matthew Huei-Ming
Advanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers. We retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention. Among 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills. There is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background: Family planning has been defined in the framework of mothers and children plan as one of Primary Healthcare (PHC details. Besides quantity, the quality of services, particularly in terms of ethics, such as observing individuals’ privacy, is of great importance in offering family planning services.Objective: A preliminary study to gather information about the degree of medical ethics offered during family planning services at Tehran urban healthcare centers.Materials and Methods: A questionnaire was designed for study. In the first question regarding informed consent, 47 clients who were advised about various contraception methods were asked whether advantages and disadvantages of the contraceptive methods have been discussed by the service provider. Then a certain rank was measured for either client or method in 2007. Finally, average value of advantage and disadvantage for each method was measured. In questions about autonomy, justice and beneficence, yes/no answers have been expected and measured accordingly.Results: Health care providers have stressed more on the advantages of pills and disadvantages of tubectomy and have paid less attention to advantages of injection ampoules and disadvantages of pills in first time clients. While they have stressed more on the advantages and disadvantages of tubectomy and less attention to advantages of condom and disadvantages of vasectomy in second time clients. Clients divulged their 100% satisfaction in terms of observing turns and free charges services.Observance degree of autonomy was 64.7% and 77.3% for first time and second- time clients respectively.Conclusion: Applying the consultant’s personal viewpoint for selecting a method will breach an informed consent for first and second time clients. System has good consideration to justice and no malfeasance
Chew, Boon-How; Cheong, Ai-Theng; Ismail, Mastura; Hamzah, Zuhra; A-Rashid, Mohd-Radzniwan; Md-Yasin, Mazapuspavina; Ali, Norsiah; Mohd-Salleh, Noridah; Bashah, Baizury
To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics. Cross-sectional study. This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS). PHCPs from three categories of health facility: hospitals, health clinics and health offices. Qualitative analyses of written comments of respondents' general impression of FMSs. The participants' response rate was 58.0% (780/1345), with almost equal proportions from each public healthcare facility. A total of 23 categories for each of the 648 impression comments were identified. The six emerging themes were: (1) importance of FMSs; (2) roles of FMSs; (3) clinical performance of FMSs; (4) attributes of FMSs; (5) FMS practice challenges; (6) misconception of FMS roles. Overall, FMS practice was perceived to be safe and able to provide effective treatments in a challenging medical discipline that was in line with the current standards of medical care and ethical and professional values. The areas of concern were in clinical performance expressed by PHCPs from some hospitals and the lack of personal attributes and professionalism among FMSs mentioned by PHCPs from health clinics and offices. FMSs were perceived to be capable of providing effective treatment and were considered to be important primary care physicians. There were a few negative impressions in some areas of FMS practice, which demanded attention by the FMSs themselves and the relevant authorities in order to improve efficiency and safeguard the fraternity's reputation. 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/
Sharek, Danika Burke; McCann, Edward; Sheerin, Fintan; Glacken, Michele; Higgins, Agnes
The specific healthcare needs and concerns for older lesbian, gay, bisexual and transgender (LGBT) persons have not been explored to any degree within Ireland. The aim of this paper, which is part of a larger study, is to detail older LGBT persons' usage, experiences and concerns with accessing healthcare services, disclosing their LGBT identity to professionals, preferences for care and their suggestions for improvement in services, including nursing services. A mixed methods research design combining quantitative survey and qualitative interview approaches of equal significance was used. 144 respondents completed an 84-item questionnaire concerning their use of healthcare services, experiences and needs. The qualitative phase involved in-depth interviews where 36 participants' experiences and concerns around health services were explored more in-depth. Quantitative data were analysed using descriptive statistics. Qualitative analysis employed the constant comparative process to generate the leading themes. Only one in three participants believed that healthcare professionals have sufficient knowledge of LGBT issues, and less than half (43%) felt respected as an LGBT person by healthcare professionals. Although 26% had chosen not to reveal their LGBT status for fear of a negative response, many positive encounters of coming out to healthcare professionals were relayed in the interviews. LGBT persons have specific concerns around residential care, particularly in relation to the perception that the Irish healthcare services emanate a heteronormative culture. Irish healthcare services need to reflect on how they currently engage with older LGBT persons at both an organisational and practitioner level. Consideration needs to be given to the specific concerns of ageing LGBT persons, particularly in relation to long-term residential care. Healthcare practitioners need to be knowledgeable of, and sensitive to, LGBT issues. © 2014 John Wiley & Sons Ltd.
Dorton, LeighAnne H; Lintzenich, Catherine Rees; Evans, Adele K
We performed this study to evaluate the competency of health-care providers managing patients with tracheotomies, and assess the need for, and efficacy of, a multidisciplinary educational program incorporating patient simulation. The prospective observational study included 87 subjects who manage patients with tracheotomies within a tertiary-care hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course using patient simulation. The outcome measurements included pre-course and post-course questionnaire and test scores, as well as observational data collected during recorded patient simulation sessions. Before the education and simulation, the subjects reported an average comfort level of 3.3 on a 5-point Likert scale across 10 categories in the questionnaire, which improved to 4.4 after the training (p tracheotomy tube types, misunderstanding of speaking valve physiology, and delayed recognition and treatment of a plugged or dislodged tracheotomy tube. There is a significant need for improved tracheotomy education among primary health-care providers. Incorporating patient simulation into a comprehensive tracheotomy educational program was effective in improving provider confidence, increasing provider knowledge, and teaching the skills necessary for managing patients with a tracheotomy.
Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris
The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).
Lin, Chia-Jung; Lee, Chia-Kuei; Huang, Mei-Chih
Few articles in the literature identify and describe the instruments that are regularly used by scholars to measure cultural competence in healthcare providers. This study reviews the psychometric properties of the several instruments that are used regularly to assess the cultural competence of healthcare providers. Researchers conducted a systematic review of the relevant articles that were published between 1983 and 2013 and listed on academic and government Web sites or on one or more of the following databases: CINAHL, MEDLINE, ERIC, PsycINFO, Psyc ARTICLES, PubMed, Cochrane, Pro Quest, Google Scholar, CNKI (China), and the National Digital Library of Theses and Dissertations (Taiwan). This study included 57 articles. Ten instruments from these articles were identified and analyzed. These instruments included five that were presented in English and five that were presented in Chinese. All were self-administered and based on respondent perceptions. Five of the 10 instruments were designed to measure cultural competence, two were designed to measure cultural sensitivity, two were designed to measure transcultural self-efficacy, and one was designed to measure cultural awareness. The six cultural dimensions addressed by these instruments were attitudes, knowledge, skills, behaviors, desires, and encounters. An expert panel validated the content of the 10 instruments. The subscales explained 33%-90% of the variance in scores for eight of the instruments. The reliability of the 10 instruments was estimated based on the internal consistency, which ranged from .57 to .97. This systematic review may assist researchers to choose appropriate instruments to assess the cultural competence of healthcare providers. The findings of this review indicate that no single instrument is adequate to evaluate cultural competence in all contexts.
Nørredam, Marie Louise; Nielsen, Signe Smith; Krasnik, Allan
Background: Utilization of services is an important aspect of migrants' access to healthcare. The aim was to review the European literature on utilization of somatic healthcare services related to screening, general practitioner, specialist, emergency room and hospital by adult first......-generation migrants. Our study question was: ‘Are there differences in migrants' utilization of somatic healthcare services compared to non-migrants?' Methods: Publications were identified by a systematic search of PUBMED and EMBASE. Appropriateness of the studies was judged independently by two researchers based...... on the abstracts. Additional searches were conducted via the references of the selected articles. The final number of studies included was 21. Results: The results suggested a diverging picture regarding utilization of somatic healthcare services by migrants compared to non-migrants in Europe. Overall, migrants...
Hassali, Mohammed Azmi; Alrasheedy, Alian A; Ab Razak, Basyirah Afifah; Al-Tamimi, Saleh Karamah; Saleem, Fahad; Ul Haq, Noman; Aljadhey, Hisham
.... The study aimed to assess patients' level of satisfaction with public healthcare services and to explore the association between socio-demographic and other study variables and patient satisfaction level...
Coculescu, BI; Coculescu, EC; Radu, A; Petrescu, L; Purcărea, VL
The orientation towards one of the marketing policies with a major impact in organizations providing healthcare services, requires a careful analysis of the needs and aspirations of customers, targeting those patients whose needs the service organization can achieve through the existing resources at the respective health facility, finding the most effective way of achieving benefits associated with reduced costs to maximizing profits, placing the offers for medical services required by the patients on the market, as well as promptly reacting and acting to the changes of health services market which is constantly evolving through a flexible organizing and functioning structure, connected to the financial needs of the patients. PMID:26664466
Coculescu, B I; Coculescu, E C; Radu, A; Petrescu, L; Purcărea, V L
The orientation towards one of the marketing policies with a major impact in organizations providing healthcare services, requires a careful analysis of the needs and aspirations of customers, targeting those patients whose needs the service organization can achieve through the existing resources at the respective health facility, finding the most effective way of achieving benefits associated with reduced costs to maximizing profits, placing the offers for medical services required by the patients on the market, as well as promptly reacting and acting to the changes of health services market which is constantly evolving through a flexible organizing and functioning structure, connected to the financial needs of the patients.
Foreman, Joshua; Xie, Jing; Keel, Stuart; Taylor, Hugh R; Dirani, Mohamed
National data on eye health-care service utilization will inform Australia's eye health policy. To investigate the utilization of eye health-care services by Australians. Cross-sectional survey. Indigenous Australians aged 40 years and older and non-Indigenous Australians aged 50 years and older. One thousand seven hundred thirty-eight Indigenous Australians and 3098 non-Indigenous Australians were recruited from 30 randomly selected sites, stratified by remoteness. Sociodemographic, ocular history and eye health-care service utilization data were collected, and an eye examination was conducted. Recentness of eye examinations, types of providers used and associated risk factors. Approximately 67.0% of Indigenous Australians and 82.5% of non-Indigenous Australians underwent an eye examination within the previous 2 years. Indigenous status (P self-reported eye disease or diabetes were most likely to have been examined within the past year (P testing (P = 0.001). Those with retinal disease and cataract were more likely to see an ophthalmologist (P < 0.001), and those with refractive error were more likely to see an optometrist (P < 0.001). In Regional Australia, non-Indigenouspeople were more likely to see optometrists (P < 0.001), and Indigenous Australians were more likely to utilize other, non-specialistservices (P < 0.001). Eye examination frequency has improved in Indigenous and non-Indigenous Australians compared with previous population-based research. Further improvements are required in risk groups including Indigenous Australians and those living in Regional and Remote areas. © 2017 Royal Australian and New Zealand College of Ophthalmologists.
Rytkönen, Minna Maarit; Kaunisto, Merita Anneli; Pietilä, Anna-Maija K
Background and purpose: Participation is a crucial factor in primary healthcare and social services, enabling clients to maintain their own health and well-being. However, adolescents' participation in service provision may be compromised because they are often not understood or heard as equal clients in encounters with primary services. The aim…
Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee; Yoo, Sooyoung
To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.
Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee
Objectives To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. Methods We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. Results The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. Conclusions We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs. PMID:25995962
M. Ahsan Akhtar Hasin
Full Text Available Purpose - Healthcare service quality and customer satisfaction have been a major research issue over the decade. Customer satisfaction ha s been measured by different researchers under varied environment. A s environment varies, desires of customers and the perception of satisfaction vary. As a result, a major issue is to define the complex nature of customer satisfaction under varied environment. On the other hand, a compromising trade-off is required in operational cost in the wake of increase in cost t o uplift service quality. This research addressed the issue from the context o f Bangladesh. Design/methodology/approach - This research used SERVQUAL, which is a very powerful tool to measure service quality. The study utilized the benefit of hierarchical nature of satisfaction. Service quality was analyzed fro m customers' view point, as well as the service providers, such as doctor s nurses, etc. Finally hypothesis tests we re performed to investigate into the possibility of relationships among the affecting quality parameters and the output service. This analysis was based on customer's perception, as well a s expectation. Findings - The research found the values of service quality parameters, such as tangibles, doctoral service, nursing, infrastructure and management. Th e established fact of dependence of perception of quality on culture has bee n proved once again. The relationship among conflicting parameters were also found using hypothesis testing. Although the study was conducted in the context o f Bangladesh, the analysis procedure is well applicable to other countries. Originality/value - The study proved that the hierarchical nature o f satisfaction can well be analyzed using the powerful tool of SERVQUAL. Th e dependence of customer satisfaction on service quality has been assumed t o be a function of market segmentation and customer perception. This result can guide many of the future research works in further analysis of
There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369
Koenig, Kristi L; Shastry, Siri; Mzahim, Bandr; Almadhyan, Abdulmajeed; Burns, Michael J
Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR) vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the "Identify-Isolate-Inform" tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel.
Kristi L. Koenig
Full Text Available Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the “Identify-Isolate-Inform” tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel.
Lee, Jihyoun; Cho, Hyung Jung; Yoo, Han-Wook; Park, Sue K.; Yang, Jae Jeong; Kim, Sung-Won; Kang, Eunyoung; Ahn, Sei-Hyun; Lee, Soo-Jung; Suh, Young Jin; Kim, Sung Yong; Kim, Eun-Kyu; Moon, Nan Mo
Purpose Systematic educational programs and genetic counseling certification courses for hereditary breast/ovarian cancer (HBOC) have not yet been introduced in Korea. We provided and evaluated the effects of genetic counseling education on Korean healthcare providers' knowledge, awareness, and counseling skills for patients at high risk of HBOC. Methods A 3-day educational program was conducted for healthcare providers who were interested in genetic counseling for patients at high risk of HBOC. Participants who completed a knowledge test and satisfaction questionnaire were included in the present sample. Pre-post comparisons were conducted to determine the effects of the intervention. Results Significant differences between preprogram and postprogram knowledge scores were observed (p=0.002). Awareness (pcounseling significantly increased after the training. Doctors and participants with fewer years of work experience performed well on the knowledge test. Previous educational experience was correlated with increased confidence in knowledge and counseling skills. Conclusion Genetic counseling education regarding HBOC improved knowledge and awareness of HBOC and enhanced confidence in the counseling process. The effects varied according to occupation and participants' previous education. The implementation of systematic educational programs that consider participant characteristics may improve the effects of such interventions. PMID:24155764
El Tayeb, Sally; Abdalla, Safa; Van den Bergh, Graziella; Heuch, Ivar
Background Trauma care is an important factor in preventing death and reducing disability. Injured persons in low- and middle-income countries are expected to use the formal healthcare system in increasing numbers. The objective of this paper is to examine use of healthcare services after injury in Khartoum State, Sudan. Methods A community-based survey using a stratified two-stage cluster sampling technique in Khartoum State was performed. Information on healthcare utilisation was taken from injured people. A logistic regression analysis was used to explore factors affecting the probability of using formal healthcare services. Results During the 12 months preceding the survey a total of 441 cases of non-fatal injuries occurred, with 260 patients accessing formal healthcare. About a quarter of the injured persons were admitted to hospital. Injured people with primary education were less likely to use formal healthcare compared to those with no education. Formal health services were most used by males and in cases of road traffic injuries. The lowest socio-economic strata were least likely to use formal healthcare. Conclusions Public health measures and social security should be strengthened by identifying other real barriers that prevent low socio-economic groups from making use of formal healthcare facilities. Integration and collaboration with traditional orthopaedic practitioners are important aspects that need further attention. PMID:25205849
Alanazi, Mohammed R; Alamry, Ahmed; Al-Surimi, Khaled
One of the main purposes of healthcare organizations is to serve patients by providing safe and high-quality patient-centered care. Patients are considered the most appropriate source to assess the quality level of healthcare services. The objectives of this paper were to describe the translation and adaptation process of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for Arabic speaking populations, examine the degree of equivalence between the original English version and the Arabic translated version, and estimate and report the validity and reliability of the translated Arabic HCAHPS version. The translation process had four main steps: (1) qualified bilingual translators translated the HCAHPS from English to Arabic; (2) the Arabic version was translated back to English and reviewed by experts to ensure content accuracy (content equivalence); (3) both Arabic and English versions were verified for accuracy and validity of the translation, checking for the similarities and differences (semantic equivalence); (4) finally, two independent bilinguals reviewed and made the final revision of both the Arabic and English versions separately and agreed on one final version that is similar and equivalent to the original English version in terms of content and meaning. The study findings showed that the overall Cronbach's α for the Arabic HCAHPS version was 0.90, showing good internal consistency across the 9 separate domains, which ranged from 0.70 to 0.97 Cronbach's α. The correlation coefficient between each statement for each separate domain revealed a highly positive significant correlation ranging from 0.72 to 0.89. The results of the study show empirical evidence of validity and reliability of HCAHPS in its Arabic version. Moreover, the Arabic version of HCAHPS in our study presented good internal consistency and it is highly recommended to be replicated and applied in the context of other Arab countries. Copyright © 2017
Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin
Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy
Fahim, Muhammad; Lee, Sungyoung; Yoon, Yongik
Current generation smartphone can be seen as one of the most ubiquitous device for physical activity recognition. In this paper we proposed a physical activity recognizer to provide u-healthcare services in a cost effective manner by utilizing cloud computing infrastructure. Our model is comprised on embedded triaxial accelerometer of the smartphone to sense the body movements and a cloud server to store and process the sensory data for numerous kind of services. We compute the time and frequency domain features over the raw signals and evaluate different machine learning algorithms to identify an accurate activity recognition model for four kinds of physical activities (i.e., walking, running, cycling and hopping). During our experiments we found Support Vector Machine (SVM) algorithm outperforms for the aforementioned physical activities as compared to its counterparts. Furthermore, we also explain how smartphone application and cloud server communicate with each other.
Ramani, K V
Governments all over the world are getting increasingly concerned about their ability to meet their social obligations in the health sector. In this paper, we discuss the design and development of a management information system (MIS) to plan and monitor the delivery of healthcare services in government hospitals in India. Our MIS design is based on an understanding of the working of several municipal, district, and state government hospitals. In order to understand the magnitude and complexity of various issues faced by the government hospitals, we analyze the working of three large tertiary care hospitals administered by the Ahmedabad Municipal Corporation. The hospital managers are very concerned about the lack of hospital infrastructure and resources to provide a satisfactory level of service. Equally concerned are the government administrators who have limited financial resources to offer healthcare services at subsidized rates. A comprehensive hospital MIS is thus necessary to plan and monitor the delivery of hospital services efficiently and effectively.
Heaslip, Vanessa; Scammell, Janet; Mills, Anne; Spriggs, Ashley; Addis, Andrea; Bond, Mandy; Latchford, Carolyn; Warren, Angela; Borwell, Juliet; Tee, Stephen
Within the United Kingdom (UK) there is an increasing focus on Values Based Recruitment (VBR) of staff working in the National Health Service (NHS) in response to public inquiries criticising the lack of person-centred care. All NHS employees are recruited on the basis of a prescribed set of values. This is extended to the recruitment of student healthcare professionals, yet there is little research of how to implement this. Involving Service Users in healthcare educational practice is gaining momentum internationally, yet involvement of service users in VBR of 'would be' healthcare professionals remains at an embryonic phase. Adult nurses represent the largest healthcare workforce in the UK, yet involvement of service users in their recruitment has received scant attention. This paper is an evaluation of the inclusion of service users in a VBR of 640 adult student nurses. This study used a participatory mixed methods approach, with service users as co-researchers in the study. The study consisted of mixed methods design. Quantitative data via an online questionnaire to ascertain candidates' perspectives (n=269 response rate of 42%), and academic/clinical nurses (n=35 response rate 34.65%). Qualitative data were gathered using focus groups and one to one interviews with service users (n=9). Data analysis included descriptive statistics and thematic analysis. 4 overarching themes were identified; increasing sense of humanness, substantiating care values; impact of involvement; working together and making it work, a work in progress. The findings from the study highlight that involving service users in VBR of student healthcare professionals has benefits to candidates, service users and local health services. Appreciating the perceptions of healthcare professionals is fundamental in the UK and internationally to implementing service users' engagement in service enhancement and delivery. Findings from this study identify there may be a dissonance between the policy
... P value<0.001) were highly associated with access. Conclusion: Access to healthcare among the elderly in informal settlement is low. Availability and acceptability are major challenges. This calls for perception change among policy and health workers to elderly clients and qualitative research to ascertain the under lying ...
Visse, M.A.; Widdershoven, G.A.; Abma, T.A.
The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear
Mosites, Emily; Carpenter, L Rand; McElroy, Kristina; Lancaster, Mary J; Ngo, Tue H; McQuiston, Jennifer; Wiedeman, Caleb; Dunn, John R
Tennessee has a high incidence of Rocky Mountain spotted fever (RMSF), the most severe tick-borne rickettsial illness in the United States. Some regions in Tennessee have reported increased illness severity and death. Healthcare providers in all regions of Tennessee were surveyed to assess knowledge, attitudes, and perceptions regarding RMSF. Providers were sent a questionnaire regarding knowledge of treatment, diagnosis, and public health reporting awareness. Responses were compared by region of practice within the state, specialty, and degree. A high proportion of respondents were unaware that doxycycline is the treatment of choice in children ≤ 8 years of age. Physicians practicing in emergency medicine, internal medicine, and family medicine; and nurse practitioners, physician assistants, and providers practicing for < 20 years demonstrated less knowledge regarding RMSF. The gaps in knowledge identified between specialties, designations, and years of experience can help target education regarding RMSF.
Jacobson, Stephanie; Eggert, Julie; Deluca, Jane; Speckhart, Dawn
With emerging technologies and genetic advancements in the field of oncology, ethical controversies and questions on how to approach them will continue to grow. Advancements in the field of hematopoietic stem cell transplantation have led to increased testing of transplantation recipients' children and parents as potential donors related to an increase in the use of haploidentical transplantations. This testing opens the door for an increased incidence of misattributed paternity findings. This article attempts to address the ethical conflicts and provide potential solutions to assist in the transition from individual-focused care to family-focused care. The principlist approach was used. Healthcare providers should be educated on methods of incidental finding disclosure and how to provide adequate support for those individuals.
Taylor, Jessica; Lamaro Haintz, Greer
Refugees in Australia are not fully utilising the healthcare system for several reasons and this may be affecting their overall health outcomes. This qualitative systematic review examined the influence of the social determinants of health on refugees' access to healthcare services in Australia. Electronic databases were searched using terms relating to refugees, social determinants, healthcare services, barriers, enablers and Australia. Only peer-reviewed studies published in English since 2006, which focused on refugees and specifically discussed social determinants influencing refugees' access to healthcare services in Australia, were included. The studies were critically analysed using standard Critical Appraisal Skills Programme Tools. Eight studies were included in the review. Findings reveal multiple factors influence refugees' access to healthcare in Australia, and these can be conceptualised within a social-ecological model of health; that is, they operate across individual, interpersonal, environmental, organisational and policy levels. The novel finding of this review was the re-occurrence of similar influences across multiple healthcare service settings in Australia. The prevalence and re-occurring nature of the social determinants of health suggests that refugees are experiencing multilayered barriers to accessing Australian healthcare. All levels of a social-ecological model must be addressed in any attempt to break down these barriers.
Chambers, Naomi; Sheaff, Rod; Mahon, Ann; Byng, Richard; Mannion, Russell; Charles, Nigel; Exworthy, Mark; Llewellyn, Sue
The direction of health service policy in England is for more diversification in the design, commissioning and provision of health care services. The case study which is the subject of this paper was selected specifically because of the partnering with a private sector organisation to manage whole system redesign of primary care and to support the commissioning of services for people with long term conditions at risk of unplanned hospital admissions and associated service provision activities. The case study forms part of a larger Department of Health funded project on the practice of commissioning which aims to find the best means of achieving a balance between monitoring and control on the one hand, and flexibility and innovation on the other, and to find out what modes of commissioning are most effective in different circumstances and for different services. A single case study method was adopted to explore multiple perspectives of the complexities and uniqueness of a public-private partnership referred to as the "Livewell project". 10 single depth interviews were carried out with key informants across the GP practices, the PCT and the private provider involved in the initiative. The main themes arising from single depth interviews with the case study participants include a particular understanding about the concept of commissioning in the context of primary care, ambitions for primary care redesign, the importance of key roles and strong relationships, issues around the adoption and spread of innovation, and the impact of the current changes to commissioning arrangements. The findings identified a close and high trust relationship between GPs (the commissioners) and the private commissioning support and provider firm. The antecedents to the contract for the project being signed indicated the importance of leveraging external contacts and influence (resource dependency theory). The study has surfaced issues around innovation adoption in the healthcare context
Full Text Available A systematic review of the literature was conducted to identify the barriers that prevent practitioners from identifying and counseling parents and caregivers of overweight or obese children. Once identified, barriers were organized into thematic categories (parental, provider, and professional barriers and recommendations were generated to facilitate discussion about childhood obesity between professionals and parents. Childhood obesity is a significant public health problem. Healthcare providers must be able to effectively communicate with caregivers and put childhood obesity at the front of healthcare discussions. This article provides a synthesis of the relevant literature and makes recommendations for healthcare providers to overcome the barriers allowing healthier outcomes for children.
Andersen, Lotte Bøgh; Bhatti, Yosef; Petersen, Ole Helby
Individual public service providers’ motivation can be conceptualized as either extrinsic, autonomous or prosocial, and the question is how we can best theoretically understand this complexity without losing too much coherence and parsimony. Drawing on Allison’s approach (1969), three perspectives...... are used to gain insight on the motivation of public service providers; namely principal-agent theory, self-determination theory and public service motivation theory. We situate the theoretical discussions in the context of public service providers being transferred to private organizations...... theoretical – to develop a coherent model of individual public service providers – but the empirical illustration also contributes to our understanding of motivation in the context of public sector outsourcing....
Luciana de Amorim Barros
Full Text Available OBJECTIVE To know the structure and functioning of healthcare services from the perspective of women who have suffered rape. METHOD A qualitative study conducted with 11 women who experienced rape, monitored in a maternity in the state of Alagoas, Brazil. Data were systematically based on content analysis. RESULTS It allowed for understanding the path taken by women in search of support from health services, as well as the limitations and capabilities of these services. CONCLUSION The assistance received in healthcare services leans towards a revictimization process of women who already carry trauma from the rape. It is necessary to reflect about care practices aimed at sexually victimized women.
Chronaki, Ce; Kontoyiannis, V; Mytaras, M; Aggourakis, N; Kostomanolakis, S; Roumeliotaki, T; Kavlentakis, G; Chiarugi, F; Tsiknakis, M
Ten years after primary, secondary, and tertiary healthcare facilities in Crete were connected in HYGEIAnet, one of the first regional health information networks worldwide, the Twister project addressed the practical challenge of delivering integrated eHealth services to remote healthcare facilities in Crete and the south Aegean. A hybrid network infrastructure comprising terrestrial broadband, wireless, and satellite segments provided connectivity among distributed healthcare organizations. A fast-track methodology of continuous training and evaluation was used to encourage the wide adoption of EHR services in primary healthcare centers and their remote community offices, eTraining in prehospital emergency management, and medical collaboration. For the evaluation of Twister, health professionals using EHRs and citizens visiting the healthcare facilities provided their attitudes and perceptions on eHealth. Although eHealth is viewed differently by citizens and health professionals, both groups consider the EHR as an important part of the daily medical practice. However, continuous training, practical incentives, and awareness initiatives are necessary to increase the use of EHRs and the social embedding of eHealth in rural areas.
Laverdure, Patricia A.; Rose, Deborah S.
As defined in the Individuals with Disabilities Education Improvement Act, occupational and physical therapists provide services to support students to access, participate, and progress in their educational program within the least restrictive educational environment. Educationally relevant occupational and physical therapy services in school…
Erickson, Chris D.; Al-Timimi, Nada R.
This paper presents background information on the cultural sociopathology of the Arab American experience. It discusses how, in order to effectively deliver services, mental health workers need to be aware of their own biases. It explores ways to provide culturally relevant mental health services to Arab Americans. (JDM)
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Selection of service providers. 631.52 Section 631.52 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE III OF THE JOB TRAINING PARTNERSHIP ACT Substate Programs § 631.52 Selection of service...
Indigenous perception on ecosystem services provided by honey bees and fruit bats were assessed in Bénin to find out whether the communities value these services and to appreciate if there is any chance to conserve them locally. Farmers were interviewed with questionnaire in three regions of Bénin to report their ...
Carnochan, Sarah; Austin, Michael J
The HUSK projects, involving collaboration between service users, providers, educators, and researchers, coincided with the reorganization of national government services (NAV). The NAV reorganization brought together employment services, social insurance, and municipal social service benefits, and called for a service model where users would be empowered to influence the provision of services. In this analysis of the HUSK cases the authors focus on the relationship between the service user and the service provider, identifying themes in two broad domains: concepts of the individual that included the service user and the service provider and concepts of the relationship that included power, role, activity, interaction, and communication. Within each theme, the analysis highlights the transition from a traditional or historical state to a new or desired state and draws upon some of the classic literature that frames the encounters between service users and providers.
Degrassi, Flori; Sopranzi, Cristina; Leto, Antonella; Amato, Simona; D'Urso, Antonio
Managing quality in health care whilst ensuring equity is a fundamental aspect of the provision of services by healthcare organizations. Measuring perceived quality of care is an important tool for evaluating the quality of healthcare delivery in that it allows the implementation of corrective actions to meet the healthcare needs of patients. The Rome B (ASL RMB) local health authority adopted the UNI EN 10006:2006 norms as a management tool, therefore introducing the evaluation of customer satisfaction as an opportunity to involve users in the creation of quality healthcare services with and for the citizens. This paper presents the activities implemented and the results achieved with regards to shared and integrated continuous improvement of services.
Full Text Available Privately provided accommodation is a growing service in Uganda’s higher education sector due to education liberalization and demand for education. This research took a case study of Nsamizi Training Institute of Social Development (NTISD to determine the relationship between privately provided accommodation service quality and customer satisfaction. Specifically, the objectives of the study were (a to find out the relationship between security and NTISD students’ satisfaction with privately provided accommodation, and (b to find out the hierarchical level of importance of NTISD student satisfaction of the three service quality dimensions (reliability, security, and tangibles with privately provided accommodation. Using quantitative and qualitative modes of data analysis and a sample of 300 students from 20 private hostels, this study established a strong positive significant relationship between security and satisfaction regarding privately provided accommodation. This implies that accommodation service providers should increase the quality of security so as to increase the satisfaction of students regarding privately provided accommodation. The study established the hierarchical order of importance from the most important service quality dimension, respectively, as follows: reliability, security, and tangibles. Therefore, private accommodation service managers should pay extra attention to the dimensions in the same order.
Mesabbah, Mohammed; Arisha, Amr
Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services. An extensive review of relevant HSE's publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented. PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals' management systems. The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE's PM framework, with a particular interest in acute hospitals and emergency services. This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.
Full Text Available Organisations that provide legal services to refugees and asylumseekers face the challenge of responding ethically to clients’ requeststo be assisted by foreigners as opposed to by nationals in countryoffices.
Onno Omta; Hans-Heinrich Glöckner; Reinder Pieters; Stef Weijers
As environmental concerns becoming increasingly important to logistics service providers, the question arises as to how they can achieve sustainable physical distribution practices while surviving the severe competition in freight transport. This issue is further complicated by the pressures from
It's available on personal computers with a CD or through Internet access. Assess instantly the accessibility of your provider network or the most promising areas to establish a health service with new GIS tools.
Paula, Elaine Amaral de; Costa, Mônica Barros; Colugnati, Fernando Antonio Basile; Bastos, Rita Maria Rodrigues; Vanelli, Chislene Pereira; Leite, Christiane Chaves Augusto; Caminhas, Márcio Santos; Paula, Rogério Baumgratz de
to assess the structure and results obtained by the "Chronic Renal Patients Care Program" in a Brazilian city. epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14 physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes. most units lacked sufficient offices for physicians and nurses to provide consultations, had incomplete staffing, and most professionals had not received proper qualification to provide care for chronic renal disease. Physicians from PHC units classified as capable more frequently referred patients to the secondary care service in the early stages of chronic renal disease (stage 3B) when compared to physicians of units considered not capable (58% vs. 36%) (p=0.049). Capable PHC units also more frequently presented stabilized glomerular filtration rates (51%) when compared to partially capable units (36%) and not capable units (44%) (p=0.046). patients cared for by primary healthcare units that scored higher in structure and process criteria presented better clinical outcomes. to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more
Dong Doan Van
Full Text Available Recently, Wireless Body Area Networks (WBANs have become an emerging technology in healthcare, where patients are equipped withwearable and implantable body sensor nodes to gather sensory information for remote monitoring. The increasing development of coordinator devices on patients enables the internetworking of WBANs in heterogeneous wireless networks to deliver physiological information that is collected at remote terminals in a timely fashion. However, in this type of network, providing a seamless handover with a guaranteed Quality of Service (QoS, especially emergency services, is a challenging task. In this paper, we proposed an effective Multi-Attribute Decision-Making (MADM handover algorithm that guarantees seamless connectivity. A patient’s mobile devices automatically connect to the best network that fulfills the QoS requirements of different types of applications. Additionally, we integrated a Content-Centric Networking (CCN processing module into different wireless networks to reduce packet loss, enhance QoS and avoid unnecessary handovers by leveraging in-network caching to achieve efficient content dissemination for ubiquitous healthcare. Simulation results proved that our proposed approach forthe model with CCN outperforms the model without CCN and Received Signal Strength Vertical Handoff (RSS-VHD in terms of the number of handovers, enhancing QoS, packet loss, and energy efficiency.
Schrooten, Iete; de Jong, Menno D T
This article investigates the relationship between healthcare providers' empathic and communicative competencies and clients' overall satisfaction with consultations. Two aspects of empathy were included: empathic attitude (sensitivity to the clients' perspective) and empathic skills (ability to estimate clients' evaluations). Communicative competencies were narrowed down to the clarity of the information provided. In the context of work disability examinations, 90 healthcare providers (44% physicians, 56% vocational experts) participated. For each provider, up to 20 dyads with clients were investigated. Within every dyad, clients rated their experiences and healthcare providers estimated clients' scores. The results show that both aspects of empathy and clarity of information significantly contribute to clients' overall satisfaction and as such confirm the importance of empathy and communication in medical consultations. Specifically, healthcare providers' empathic dispositions, in addition to their overt communicative behavior, appear to contribute to clients' overall satisfaction. Of the two aspects of empathy, only empathic attitude is significantly related to the clarity of information.
Bekas, Marcin; Gajewski, Antoni K; Pachocki, Krzysztof
Within the medical facilities provided by state healthcare services, a universally applied technique for patient diagnosis and treatment relies on ionising radiation; for example in radiotherapy and X-ray (ie. examination). Human exposure to such radiation is not however entirely free of associated health risks. To determine and estimate the numbers and types of X-ray based medical procedures that are performed in general and dental radiography, mammography and computer tomography on patients from the Mazovian province in Poland, which included children, women and men subjects. The numbers of patient subjects undergoing X-rays was estimated by surveying the patient intake in X-ray testing rooms within the healthcare facilities of the Mazovian province. Questionnaires were either dispatched by mail to such healthcare centres or were completed by the X-ray operating staff during the testing of quality control. Results so obtained from the latter, were compared to entries from the X-ray rooms' register During 2009, the number of X-rays performed were 7612046 equivalent to 1460 examinations per 1000 inhabitants. The majority were done on women ie. 3847961 (50.55%), followed by 3193781 (41.96%) on men and 570 304 (7.49%) for children. Results indicated that the predominating medical procedure used of this type, was for making general diagnoses; especially through using chest radiography. Others included, in descending order; dental X-ray (mainly intra-oral examination), computer tomography (mainly CT head examinations) and mammography procedures. It was also found that the annual numbers of having X-rays has increased compared to previous years.
Liu, Ling; Zhang, Jianjun; Han, Wei; Pu, Calton; Caverlee, James; Park, Sungkeun; Critchlow, Terence J.; Buttler, David; Coleman, Matthew A.
Dynamic Web data sources – sometimes known collectively as the Deep Web – increase the utility of the Web by providing intuitive access to data repositories anywhere that Web access is available. Deep Web services provide access to real-time information, like entertainment event listings, or present a Web interface to large databases or other data repositories. Recent studies suggest that the size and growth rate of the dynamic Web greatly exceed that of the static Web, yet dynamic content is often ignored by existing search engine indexers owing to the technical challenges that arise when attempting to search the Deep Web. To address these challenges, we present DYNABOT, a service-centric crawler for discovering and clustering Deep Web sources offering dynamic content. DYNABOT has three unique characteristics. First, DYNABOT utilizes a service class model of the Web implemented through the construction of service class descriptions (SCDs). Second, DYNABOT employs a modular, self-tuning system architecture for focused crawling of the Deep Web using service class descriptions. Third, DYNABOT incorporates methods and algorithms for efficient probing of the Deep Web and for discovering and clustering Deep Web sources and services through SCD-based service matching analysis. Our experimental results demonstrate the effectiveness of the service class discovery, probing, and matching algorithms and suggest techniques for efficiently managing service discovery in the face of the immense scale of the Deep Web.
Full Text Available It is of theoretical and practical significance to understand what factors influence the sustainable development of home healthcare services in China. Based on a face-to-face survey, we find that the location planning, which is decisive for the improvement of patient satisfaction, can effectively reduce the risks, as well as the costs of redundant construction and re-construction of service centers for home healthcare and, thus, helps ensure the sustainability of health and the environment. The purposes of this paper are to investigate the existing problem of home healthcare in Shanghai and to find the optimum location planning scheme under several realistic constraints. By considering differentiated services provided by the medical staff at different levels and the degrees of patient satisfaction, a mixed integer programming model is built to minimize the total medical cost. The IBM ILOGCPLEX is used to solve the above model. Finally, a case study of Putuo district in Shanghai is conducted to validate the proposed model and methodology. Results indicate that the model used in this paper can effectively reduce the total medical cost and enhance the medical sustainability, and therefore, the results of the model can be used as a reference for decision makers on the location planning problem of home healthcare services in China.
Koponen, Anne M; Laamanen, Ritva; Simonsen-Rehn, Nina; Sundell, Jari; Brommels, Mats; Suominen, Sakari
To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated. A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis. Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM. Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.
Calderón Espinosa, Emmanuel; Becerril Montekio, Víctor; Alcalde Rabanal, Jacqueline; García Bello, Luis
The search for efficient answers to strengthen maternal health care has included various sources of evidence for decision making. In this article, we present a systematic mapping of the scientific literature on the use of tacit knowledge in relation to maternal healthcare. A systematic mapping was conducted of scientific articles published in Spanish and English between 1971 and 2014 following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Of 793 articles, 30 met the inclusion criteria; 60% were from high-income countries and 66.7% were focused on health professionals. We identified a predominance of qualitative methodologies (62%). Four categories regarding the use of tacit knowledge were generated: proposals to improve the organization of the maternal care system (30%) and to improve the care provided to women during the continuum of pregnancy, childbirth and postpartum (26.7%), determination of health workers' perception and skill levels (26.7%) and the interactions between tacit and explicit knowledge in clinical decision making (16.7%). This mapping shows that tacit knowledge is an emerging, innovative and versatile research approach used primarily in high-income countries and that includes interesting possibilities for its use as evidence to improve maternal healthcare, particularly in middle- and low-income countries, where it needs to be strengthened. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
Full Text Available Abstract Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i Telecollaboration and teleconsultation services between remotely located healthcare providers, ii telemedicine services in emergencies, iii home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G, and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances
Mougiakakou, Stavroula G; Kyriacou, Efthyvoulos; Perakis, Kostas; Papadopoulos, Homer; Androulidakis, Aggelos; Konnis, Georgios; Tranfaglia, Riccardo; Pecchia, Leandro; Bracale, Umberto; Pattichis, Constantinos; Koutsouris, Dimitrios
Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of the southeast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens.These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. The
Thi Thu Ha, Bui; Mirzoev, Tolib; Morgan, Rosemary
accountability of service providers and better utilization of information on complaints.
Lukasczik, Matthias; Ahnert, Jutta; Ströbl, Veronika; Vogel, Heiner; Donath, Carolin; Enger, Ilka; Gräßel, Elmar; Heyelmann, Lena; Lux, Heidemarie; Maurer, Jochen; Özbe, Dominik; Spieckenbaum, Stefanie; Voigtländer, Elzbieta; Wildner, Manfred; Zapf, Andreas; Zellner, Angela; Hollederer, Alfons
Background Healthcare professionals are confronted with specific work-related demands that influence work-family relations and might indirectly affect the quality of healthcare. This paper seeks to provide an overview of the current state of research on this topic of relevance to health services research. The overview may serve as a starting point for modifying structures in the healthcare system (especially in rural regions) with the aim of improving work-family compatibility. Methods A systematic national and international literature search was conducted in terms of a scoping review. The following criteria/contents to be covered in publications were defined: work-family compatibility; work-family interface and work-family conflict in employees working in healthcare; healthcare professions in rural areas and links with work-family issues; interventions to improve work-family compatibility. 145 publications were included in the overview. Results The available literature focuses on physicians and nursing staff while publications on other professions are largely lacking. The methodological quality of existing studies is mostly low, including a lack of meta-analyses. Several studies document dissatisfaction in physicians and nursing staff regarding reconciliation of work and family life. Only few intervention studies were found that seek to improve work-life compatibility; few of them focus on employees in healthcare. There are also deficits with respect to linking work-family issues with aspects of healthcare in rural areas. Conclusions There is a shortage of systematic national and international research regarding work-family compatibility, especially when it comes to the evaluation of interventions. The overview provides starting points for improving work-family compatibility in healthcare. © Georg Thieme Verlag KG Stuttgart · New York.
Lonial, Subash; Raju, P S
The purpose of this paper is to examine the role of perceived service attributes in the development of overall customer satisfaction (OCS) and customer loyalty (CL) in a health-care setting. This paper also sheds light on the role of hospitalist physicians (HPs) and offers suggestions to improve patient satisfaction and loyalty. A telephone survey was used to collect data from recently hospitalized patients with respect to their HP. Structural equations modeling (SEM) was used to confirm the overall relationships between perceived service quality (PSQ), OCS and CL. The sample was then divided into customer relationship groups (CRGs) based on satisfaction and loyalty measures. Discriminant analysis was used to determine which attributes differentiated most between high and low satisfaction and loyalty groups. Overall relationships among PSQ, OCS and CL were in conformity with the conceptual model. Findings also revealed that service attributes played an important role in distinguishing between high and low satisfaction and loyalty groups, although some attributes were more important than others and different attributes emerged as being key influencers for satisfaction and loyalty. The conceptual model used is a fairly straight forward model, and we have not considered the impact of individual factors such as expectations and value perceptions or involvement levels and demographic characteristics on service quality and overall satisfaction. The data for this study were provided by a major health maintenance organization (HMO), and there is room for improvement in the manner in which certain constructs were measured. For example, OCS, recommendation and retention all used single item measures, and it might have been preferable to use multiple item measures for these constructs. The study shows that organizations can benefit by identifying and focusing on critical attributes as part of their customer relationship management program. The SEM results provide strong
Flores, Glenn; Lin, Hua; Walker, Candice; Lee, Michael; Currie, Janet M; Allgeyer, Rick; Portillo, Alberto; Henry, Monica; Fierro, Marco; Massey, Kenneth
Of the 4.8 million uninsured children in America, 62-72% are eligible for but not enrolled in Medicaid or CHIP. Not enough is known, however, about the impact of health insurance on outcomes and costs for previously uninsured children, which has never been examined prospectively. This prospective observational study of uninsured Medicaid/CHIP-eligible minority children compared children obtaining coverage vs. those remaining uninsured. Subjects were recruited at 97 community sites, and 11 outcomes monitored monthly for 1 year. In this sample of 237 children, those obtaining coverage were significantly (P health (27% vs. 46%); no PCP (7% vs. 40%); experienced never/sometimes getting immediate care from the PCP (7% vs. 40%); no usual source of preventive (1% vs. 20%) or sick (3% vs. 12%) care; and unmet medical (13% vs. 48%), preventive (6% vs. 50%), and dental (18% vs. 62%) care needs. The uninsured had higher out-of-pocket doctor-visit costs (mean = $70 vs. $29), and proportions of parents not recommending the child's healthcare provider to friends (24% vs. 8%) and reporting the child's health caused family financial problems (29% vs. 5%), and lower well-child-care-visit quality ratings. In bivariate analyses, older age, birth outside of the US, and lacking health insurance for >6 months at baseline were associated with remaining uninsured for the entire year. In multivariable analysis, children who had been uninsured for >6 months at baseline (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.4-10.3) and African-American children (OR, 2.8; 95% CI, 1.1-7.3) had significantly higher odds of remaining uninsured for the entire year. Insurance saved $2886/insured child/year, with mean healthcare costs = $5155/uninsured vs. $2269/insured child (P = .04). Providing health insurance to Medicaid/CHIP-eligible uninsured children improves health, healthcare access and quality, and parental satisfaction; reduces unmet needs and out-of-pocket costs; and saves
This research investigates how intrinsic and extrinsic motivation factors contribute to employee motivation in providers of Product-Service Systems (PSS). Employee motivation determines the quality of the delivered service and is thus an area of great importance for PSS providers. We present rich...... case-based data collected through semi-structured interviews, a survey and secondary sources. The analysis showed the particularly high importance of intrinsic and individual motivation factors such as the fulfilling nature of the work and skill development showing the ownership and pride service...... employees took in their work. Further, the organisation needs to set the context of high employee motivation by enabling flexibility and performance feedback. Our research contributes to the literature by providing a first empirical study of employee motivation in PSS providers and thus providing important...
Shetty, Gina; Sanchez, Julian A; Lancaster, Johnathan M; Wilson, Lauren E; Quinn, Gwendolyn P; Schabath, Matthew B
There are limited data on lesbian, gay, bisexual, and transgender (LGBT) healthcare experiences and interactions with the providers. This study assessed knowledge, attitudes, and practice behaviors of oncology providers regarding LGBT health. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. 108 providers participated in the survey (28% response rate). LGBT cultural competency at the institution. Results from the open comments section identified multiple misconceptions. This study revealed knowledge gaps about LGBT health risks. Cultural competency training may aid oncology providers to understand the need to inquire about patients' gender identity and sexual orientation. Health care providers who incorporate the routine collection of gender identity and sexual orientation (SOGI) in their patient history taking may improve patient care by offering tailored education and referrals. While identifying as LGBT does not in itself increase risk for adverse health outcomes, this population tends to have increased risk behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Plaisime, Marie V; Malebranche, David J; Davis, Andrea L; Taylor, Jennifer A
We explored health providers' formative personal and professional experiences with race and Black men as a way to assess their potential influence on interactions with Black male patients. Utilizing convenience sampling with snowballing techniques, we identified healthcare providers in two urban university hospitals. We compared Black and White providers' experiences based on race and level of training. We used the Gardener's Tale to conceptualize how racism may lead to racial health disparities. A semi-structured interview guide was used to conduct in-person interviews (n = 16). Using the grounded theory approach, we conducted three types of coding to examine data patterns. We found two themes reflective of personally mediated racism: (1) perception of Black males accompanied by two subthemes (a) biased care and (b) fear and discomfort and (2) cognitive dissonance. While this latter theme is more reflective of Jones's internalized racism level, we present its results because its novelty is compelling. Perception of Black males and cognitive dissonance appear to influence providers' approaches with Black male patients. This study suggests the need to develop initiatives and curricula in health professional schools that address provider racial bias. Understanding the dynamics operating in the patient-provider encounter enhances the ability to address and reduce health disparities.
Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank
The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.
Full Text Available Background: Disease burden of malaria in Papua New Guinea (PNG is the highest in Asia and the Pacific, and prompt access to effective drugs is the key strategy for controlling malaria. Despite the rapid economic growth, primary healthcare services have deteriorated in rural areas; the introduction of non-professional health workers [village health volunteers (VHVs] is expected to improve antimalarial drug deliveries. Previous studies on PNG suggested that distance from households negatively affected the utilization of health services; however, price effect on healthcare demand decisions has not been explored. Empirical studies on household’s affordability as well as accessibility of healthcare services contribute to policy implications such as efficient introduction of out-of-pocket costs and effective allocation of health facilities. Therefore, we investigate price responsiveness and other determinants of healthcare provider choice for febrile children in a malaria endemic rural area wherein VHVs were introduced.Methods: Cross-sectional surveys were conducted using a structured questionnaire distributed in a health center’s catchment area of East Sepik Province in the 2011/2012 rainy seasons. Caretakers were interviewed and data on fever episodes of their children in the preceding two weeks were collected. Mixed logit model was employed to estimate the determinants of healthcare provider choice.Results: Among 257 fever episodes reported, the main choices of healthcare providers were limited to self-care, VHV, and a health center. Direct cost and walking distance negatively affected the choice of a VHV and the health center. An increase of VHV’s direct cost or walking distance did not much affect predicted probability of the health center, but rather that of self-care. While, drug availability and illness severity increased the choice probability of a VHV and the health center. Conclusion: The results suggest that the net healthcare demand
Law, James; McCann, Dolly; O'May, Fiona
This paper is a report of a descriptive qualitative study of the role and activities of nursing and allied health professionals caring for children with complex needs in a community setting. Health care is changing in terms of service provision and delivery, with an increased focus on person-centred care, prevention and community-based services. The role of nursing and allied health professionals is central to these changes but is not well described in terms of capacity, or the knowledge and skills required to meet increasing demand. Within four Health Boards, semi-structured telephone interviews were conducted in 2007 with three nursing and four allied health managers, followed by four focus groups with 15 nursing and 11 allied health practitioners; in addition, three nurses and one speech therapist were interviewed by telephone. Respondents identified challenges related to communication and information systems, equity of service provision, family-centred care and partnership working. Generic and specialized knowledge and skills are needed, although providing the right skills in the right place can often prove problematic with potential implications for service provision. Findings support the adoption of integrated partnership working, going beyond the identification of key professionals, to developing a set of criteria against which future service provision could be judged. Research priorities were identified; comparative evaluation of services, better understanding of the transition process and a clearer sense of the individual's response to the increasing customization of services. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Kaji, Tadashi; Fujishiro, Takahiro; Susaki, Seiichi; Kawai, Eri; Hoshino, Kazuyoshi; Higashino, Teruo
In these days, telecom operators in the world have been constructing Next Generation Network (NGN). NGN can provide QoS and security guaranteed communication to its users. However, the protection of communication is limited inside NGN. Therefore, when the interconnection between NGN and the Internet will be widely used in near future, it will become an important problem to solve how it protects the communications crossing over NGN and the Internet. This paper proposes a secure communication provider service that protects the confidentiality and integrity of communications crossing over NGN and the Internet by setting up and controlling the IPsec session in cooperation with NGN's call session control function (CSCF). In this service, the secure session control provider (sSCP) server and CSCF authenticate its user as Trusted Third Party on behalf of service providers. In addition, this service provides the ability of fast session establishment because sSCP distributes a security association for IPsec session between the user and service provider via the SIP session protected by NGN.
Piper, Llewellyn E; Tallman, Erin
This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.
Katz, Mira L; Reiter, Paul L; Heaner, Sarah; Ruffin, Mack T; Post, Douglas M; Paskett, Electra D
To assess HPV vaccine acceptability, focus groups of women (18-26 years), parents, community leaders, and healthcare providers were conducted throughout Ohio Appalachia. Themes that emerged among the 23 focus groups (n=114) about the HPV vaccine were: barriers (general health and vaccine specific), lack of knowledge (cervical cancer and HPV), cultural attitudes, and suggestions for educational materials and programs. Important Appalachian attitudes included strong family ties, privacy, conservative views, and lack of trust of outsiders to the region. There are differences in HPV vaccine acceptability among different types of community members highlighting the need for a range of HPV vaccine educational materials/programs to be developed that are inclusive of the Appalachian culture.
Abbyad, Christine; Robertson, Trina Reed
Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women's birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women's mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women's preparation for birthing.
Tharaldsen, Kjersti Balle; Stallard, Paul; Cuijpers, Pim; Bru, Edvin; Bjaastad, Jon Fauskanger
The aim of this study is to investigate adolescents' perspectives on mental healthcare services. Based on theoretical perspectives concerning barriers for help-seeking, individual interviews were carried out in order to obtain the adolescents' perspectives on knowledge of services for mental health problems, potential barriers for help-seeking,…
McKinnon, Cole; Friberg, Laura; McKillop, Linda; Walsh, Marsha
With an increasingly smaller base of potential employees in long-term care facilities, especially Certified Nursing Assistants (CNAs), and an increasingly larger population of elderly persons needing their services, Salter Healthcare Services in Massachusetts has developed plans for retaining CNAs. Although the Salter Corporation has been…
Marital quality is well established as a determinant of health in Western contexts, yet the importance of relationship quality to health in non-Western contexts is largely limited to a focus on domestic violence. Using the Women's Reproductive Histories Survey, this study examines whether women with higher-quality family relationships are more likely than others to use maternal health-care services in Madhya Pradesh, India. Results show that among nuclear families, women with better marital relationships are more likely than others to use antenatal care services and to deliver in a health-care facility. Among joint families, women who have better relationships with their in-laws are more likely to use antenatal care services. The results further suggest that women's agency mediates some, but not all, of the effect of relationship quality on use of maternal health-care services.
Daniel Adrian GÂRDAN
Full Text Available Healthcare services consumers’ behavior represents an multidimensional concept, that implies the cumulative effects of different factors. The process of consumption is very different and complex in the case of healthcare services due to the nature of the needs and consumption motivations on one hand and because of the complexity of the services itself on the other hand. Amongst the factors that are influencing the consumer’s behaviour, the social ones represent a particular type. In the case of healthcare services this is because the social interactions of the patients can contribute to their own perception regarding the post consumption satisfaction, or can influence the buying decision in the first place. The influence of social factors can be analysed on multiple layers – from the effect of the affiliation and adhesion groups to the effect of social norms and regulations.
Anitha E. Mathew
Full Text Available Introduction: This study assessed whether Georgia Senate Bill 360, a statewide law passed in August 2010, that prohibits text messaging while driving, resulted in a decrease in this behavior among emergency medicine (EM and general surgery (GS healthcare providers. Methods: Using SurveyMonkey, we created a web-based survey containing up to 28 multiple choice and free-text questions about driving behaviors. EM and GS healthcare providers at a southeastern medical school and its affiliate county hospital received an email inviting them to complete this survey in February 2011. We conducted all analyses in SPSS (version 19.0, Chicago, IL, 2010, using chisquared tests and logistic regression models. The primary outcome of interest was a change in participant texting or emailing while driving after passage of the texting ban in Georgia. Results: Two hundred and twenty-six providers completed the entire survey (response rate 46.8%. Participants ranged in age from 23 to 71 years, with an average age of 38 (SD¼10.2; median¼35. Only three-quarters of providers (n¼173, 76.6% were aware of a texting ban in the state. Out of these, 60 providers (36.6% reported never or rarely sending texts while driving (0 to 2 times per year, and 30 engaged in this behavior almost daily (18.9%. Almost two-thirds of this group reported no change in texting while driving following passage of the texting ban (n¼110, 68%, while 53 respondents texted less (31.8%. Respondents younger than 40 were more than twice as likely to report no change in texting post-ban compared to older participants (OR¼2.31, p¼0.014. Providers who had been pulled over for speeding in the previous 5 years were about 2.5 times as likely to not change their texting while-driving behavior following legislation passage compared to those without a history of police stops for speeding (OR¼2.55, p¼0.011. Each additional ticket received in the past 5 years for a moving violation lessened the odds of
Nielsen, Signe S; Hempler, Nana F; Waldorff, Frans B
were linked to registries on healthcare utilisation. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies......BACKGROUND: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilisation in immigrants, their descendents, and ethnic Danes could...... groups. CONCLUSIONS: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared...
Nielsen, Signe Smith; Hempler, Nana Folmann; Waldorff, Frans Boch
Background: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilization in immigrants, their descendents, and ethnic Danes could...... were linked to registries on healthcare utilization. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies...... groups. Conclusion: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared...
Edwards, Elizabeth J; Stapleton, Peta; Williams, Kelly; Ball, Lauren
Obesity related health problems affect individuals, families, communities and the broader health care system, however few healthcare providers (e.g., doctors, nurses, social workers, psychologists, counselors) receive formal training in obesity prevention interventions. We examined the effectiveness of training healthcare providers in brief motivational interviewing (brief MI) targeting eating and exercise behavior change. 163 healthcare providers participated. 128 participants completed a one-day experiential brief MI training workshop followed by electronic peer-support and a further 35 matched controls did not receive the training. Participant's knowledge of brief MI and confidence in their ability to counsel patients using brief MI significantly improved following training (pskills assessed during the simulated patient interactions indicated a significant improvement across two practical training blocks (pskills and knowledge quickly and confidence in their counseling abilities improves and is sustained. Healthcare providers may consider brief MI as an obesity prevention intervention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Yli-Uotila, Tiina; Kaunonen, Marja; Pylkkänen, Liisa; Suominen, Tarja
To describe the phases of the cancer trajectory when social support, in the form of electronic counselling services, as provided by the non-profit cancer societies, is needed, as well as how these services are integrated into the cancer care in public healthcare. In this descriptive qualitative study a purposive sample of patients with cancer (n = 12) were interviewed. The data were content analysed inductively. Social support was needed when emotional well-being was weakened, when the body broke, when the care pathway induced unawareness, and when empowerment needed strengthening. There was no need for social support when well-being was considered in balance. The electronic counselling services were integrated into cancer care by supporting the patient with cancer emotionally, developing the informational expertise of the patient with cancer, expanding the opportunities for support, and supporting public healthcare. Integration required improvements to the actions of the patients and various actors involved in the healthcare system. There was no integration due to the health status of the patient and the sufficiency of the primary support sources. The received social support was not integrated into the actual cancer treatment process of the patient with cancer in the public healthcare system. The phases of support needed in the cancer trajectory as defined by the patient differ from the traditional biomedical phases of treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Full Text Available Although male circumcision (MC is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs about adult MC as an HIV prevention option in India.This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC/non-circumcising communities (NCC; including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision.Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for 'religious identity/privilege/sacrifice' or 'hygiene'; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting 'foreign' evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence.HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance especially among the NCC. Feasibility
Ebtissam Z. Murshid
Full Text Available Objectives: To evaluate dental knowledge and attitudes toward oral health care among healthcare providers and educators working with children with autism spectrum disorders (ASD in central Saudi Arabia. Methods: There were 305 questionnaires distributed to 7 special-needs centers between September and November 2014. A total of 217 questionnaires were collected with a response rate of 71.1%. The study took place in the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. Results: Approximately 50.2% of the participants did not offer any toothbrushing advice, and 73.3% never recommended dental checkup visits to parents, and 75.6% never performed dental examinations to children under their care. Ten percent thought that children should have their first dental visit after 6 years of age. Almost all participants agreed that children should practice oral hygiene, and 60.4% think they should brush twice per day. In general, the participants choose toothbrushes and toothpaste as the main tools to perform oral hygiene. There were 35% of participants who believed that parents should be responsible for the children’s oral hygiene, and a few participants mentioned teachers and therapists to be responsible. Most of the participants (71.4% did not receive any dental information from dental professional resources, only 14.3% of participants believed bacteria to be the cause of dental cavities. Conclusion: There is a clear lack of dental knowledge and attitudes, and its practical application among the participating group of healthcare providers working with children with ASD in Riyadh.
Murshid, Ebtissam Z.
Objectives: To evaluate dental knowledge and attitudes toward oral health care among healthcare providers and educators working with children with autism spectrum disorders (ASD) in central Saudi Arabia. Methods: There were 305 questionnaires distributed to 7 special-needs centers between September and November 2014. A total of 217 questionnaires were collected with a response rate of 71.1%. The study took place in the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. Results: Approximately 50.2% of the participants did not offer any toothbrushing advice, and 73.3% never recommended dental checkup visits to parents, and 75.6% never performed dental examinations to children under their care. Ten percent thought that children should have their first dental visit after 6 years of age. Almost all participants agreed that children should practice oral hygiene, and 60.4% think they should brush twice per day. In general, the participants choose toothbrushes and toothpaste as the main tools to perform oral hygiene. There were 35% of participants who believed that parents should be responsible for the children’s oral hygiene, and a few participants mentioned teachers and therapists to be responsible. Most of the participants (71.4%) did not receive any dental information from dental professional resources, only 14.3% of participants believed bacteria to be the cause of dental cavities. Conclusion: There is a clear lack of dental knowledge and attitudes, and its practical application among the participating group of healthcare providers working with children with ASD in Riyadh. PMID:26620991
Klinedinst, N. Jennifer; Clark, Patricia C.; Dunbar, Sandra B.
Purpose The purposes of this study were to examine the relationship between the post-stroke depressive symptoms, older adult stroke survivors’ perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the healthcare provider with whether or not older stroke survivors discussed their depressive symptoms with a healthcare provider. Method A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the healthcare provider via one time interview. Results Thirty-seven percent (n=16) of all older stroke survivors reported depressive symptoms to their healthcare provider. Of the stroke survivors who had high levels of depressive symptoms (CESD≥16; n=11), seven reported the depressive symptoms to their healthcare provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. Conclusions High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a healthcare provider. PMID:23855380
Liu, Zhaoxi; Wu, Qiuwei
This report covers the analysis of the electric vehicle (EV) and heat pump (HP) providing ancillary services to the power system of the Nordic region including Denmark, Finland, Norway and Sweden. The analysis is to investigate the feasibility of EVs and HPs to serve as demand as frequency reserve...... (DFR) providers in the distribution power system in the four mentioned Nordic countries....
Caldwell, Leon D.; Tarver, Dolores D.; Iwamoto, Derek K.; Herzberg, Sarah E.; Cerda-Lizarraga, Patricia; Mack, Tabethah
In this qualitative study, the authors explored definitions of multicultural competence given by 99 frontline human service providers. The providers had no formal training in counseling but served in a helping role. Seven thematic definitions emerged: color blindness, client focused, acknowledgment of cultural differences, textbook consistent,…
Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin
Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.
Full Text Available This methodological article investigates practical challenges that emerge when conducting customer satisfaction surveys (CSS for financial service providers such as banks, insurance or leasing companies, and so forth. It displays methodological recommendations in reference with: (a survey design, (b sampling, (c survey method, (d questionnaire design, and (e data acquisition. Article provides appropriate explanations that usage of: two-stage survey design, SRS method, large samples, and rigorous fieldwork preparation can enhance the overall quality of CSS in financial services. Proposed methodological recommendations can primarily be applied to the primary quantitative marketing research in retail financial services. However, majority of them can be successfully applied when conducting primary quantitative marketing research in corporate financial services as well. .
Filippon, Jonathan; Giovanella, Ligia; Konder, Mariana; Pollock, Allyson M
The recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS.
Flood, Jeanie L
Background. In the state of Hawaii, breastfeeding initiation rates are higher than the national average but fall below target rates for duration. Accessing breastfeeding support services is challenging for mothers living in rural areas of the state. Healthcare workers (HCWs) working with mothers and infants are in a key position to encourage and support breastfeeding efforts. The purpose of this study is to gain a better understanding of a Hawaiian community's (specifically Hilo, Hawai'i) breastfeeding service and support issues. Method. The qualitative study design utilized was a focused ethnography. This approach was used to gather data from participant HCWs (N = 23) about their individual or shared experience(s) about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Results. Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment, Coexisting Messages, and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. A number of implications for practice and further research were suggested within the results and are discussed.
Jeanie L. Flood
Full Text Available Background. In the state of Hawaii, breastfeeding initiation rates are higher than the national average but fall below target rates for duration. Accessing breastfeeding support services is challenging for mothers living in rural areas of the state. Healthcare workers (HCWs working with mothers and infants are in a key position to encourage and support breastfeeding efforts. The purpose of this study is to gain a better understanding of a Hawaiian community’s (specifically Hilo, Hawai‘i breastfeeding service and support issues. Method. The qualitative study design utilized was a focused ethnography. This approach was used to gather data from participant HCWs (N=23 about their individual or shared experience(s about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Results. Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment, Coexisting Messages, and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. A number of implications for practice and further research were suggested within the results and are discussed.
Lai, Angel Hor-Yan; Kuang, Zoey; Yam, Carrie Ho-Kwan; Ayub, Shereen; Yeoh, Eng-Kiong
Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services. This qualitative study explored the experiences of EHCVS recipients (n = 55, aged 61-94) with eight focus group interviews in Hong Kong in the year 2016. Convenience sampling was used. Research questions were: (1) Why do older people choose not to use EHCVS for preventive as well as disease management services among older people in Hong Kong? (2) What are the barriers to reallocating demand from the public to private sector? (3) In what ways did EHCVS improve the quality of primary care services for older people? Using a deductive and inductive approach, eight qualitative themes were identified. Findings suggested that the non-targeted services and inadequate knowledge on EHCVS deterred older people from using the vouchers for disease management and prevention. The relatively expensive private services, lack of trust in the private sector, low public clinic fees and good services quality of the public sector, together with inadequate private practitioners in the healthcare market were barriers that hinder demand reallocation. Nevertheless, the quality of primary care services had been improved after the implementation of EHCVS with shortened wait times and opportunities to discuss health-related issues with private practitioners. Findings were discussed with practice, policy and research implications. © 2017 John Wiley & Sons Ltd.
Results: The findings reveal different modes money was made available for payment for health services. On the whole, about 98% of payment was through out-of pocket spending (user-charges) with most respondents using their own money. Although this financing method shown to be associated with good quality service ...
Background: Although, antenatal care (ANC) attendance in sub Saharan Africa is high, however this does not always translate into quality ANC care service utilization. Aim: This study therefore is aimed at exploring pattern of maternal health (MH) services utilization and the socio‑demographic factors influencing it in ...
Helen L Zhang
Full Text Available Zoonoses are common causes of human and livestock illness in Tanzania. Previous studies have shown that brucellosis, leptospirosis, and Q fever account for a large proportion of human febrile illness in northern Tanzania, yet they are infrequently diagnosed. We conducted this study to assess awareness and knowledge regarding selected zoonoses among healthcare providers in Moshi, Tanzania; to determine what diagnostic and treatment protocols are utilized; and obtain insights into contextual factors contributing to the apparent under-diagnosis of zoonoses.We conducted a questionnaire about zoonoses knowledge, case reporting, and testing with 52 human health practitioners and 10 livestock health providers. Immediately following questionnaire administration, we conducted semi-structured interviews with 60 of these respondents, using the findings of a previous fever etiology study to prompt conversation. Sixty respondents (97% had heard of brucellosis, 26 (42% leptospirosis, and 20 (32% Q fever. Animal sector respondents reported seeing cases of animal brucellosis (4, rabies (4, and anthrax (3 in the previous 12 months. Human sector respondents reported cases of human brucellosis (15, 29%, rabies (9, 18% and anthrax (6, 12%. None reported leptospirosis or Q fever cases. Nineteen respondents were aware of a local diagnostic test for human brucellosis. Reports of tests for human leptospirosis or Q fever, or for any of the study pathogens in animals, were rare. Many respondents expressed awareness of malaria over-diagnosis and zoonoses under-diagnosis, and many identified low knowledge and testing capacity as reasons for zoonoses under-diagnosis.This study revealed differences in knowledge of different zoonoses and low case report frequencies of brucellosis, leptospirosis, and Q fever. There was a lack of known diagnostic services for leptospirosis and Q fever. These findings emphasize a need for improved diagnostic capacity alongside healthcare
Bodkin, Kate; Delahunty-Pike, Alannah; O'Shea, Tim
Providing services for street level sex workers requires a multidisciplinary approach, addressing both health and safety concerns typical of their age and gender and