Moore, Irene C; Coe, Jason B; Adams, Cindy L; Conlon, Peter D; Sargeant, Jan M
The objective of this qualitative study was to compare veterinarians' and Registered Veterinary Technicians' (RVT's) perceptions of the veterinary healthcare team with respect to the impact of toxic attitudes and a toxic environment. Focus group interviews using a semi-structured interview guide and follow up probes were held with four veterinarian groups (23 companion animal veterinarians) and four Registered Veterinary Technician groups (26 RVTs). Thematic analysis of the discussions indicated both veterinarian and RVT participants felt team members with manifestations of toxic attitudes negatively impacted veterinary team function. These manifestations included people being disrespectful, being resistant to change, always wanting to be the "go to person," avoiding conflict, and lacking motivation. When conflict was ignored, or when people with toxic attitudes were not addressed, a toxic environment often resulted. A toxic environment sometimes manifested when "broken communication and tension between staff members" occurred as a result of employees lacking confidence, skills, or knowledge not being managed properly. It also occurred when employees did not feel appreciated, when there was difficulty coping with turnover, and when there were conflicting demands. The presence of people manifesting a toxic attitude was a source of frustration for both veterinarian and RVT participants. Prompt and consistent attention to negative behaviors is recommended to reduce the development of a toxic environment.
Sharma, D R; Pradhan, B; Pathak, R P; Shrestha, S C
The management of healthcare liquid waste is an overlooked problem in Nepal with stern repercussions in terms of damaging the environment and affecting the health of people. This study was carried out to explore the healthcare liquid waste management practices in Kathmandu based central hospitals of Nepal. A descriptive prospective study was conducted in 10 central hospitals of Kathmandu during the period of May to December 2008. Primary data were collected through interview, observation and microbiology laboratory works and secondary data were collected by records review. For microbiological laboratory works,waste water specimens cultured for the enumeration of total viable counts using standard protocols. Evidence of waste management guidelines and committees for the management of healthcare liquid wastes could not be found in any of the studied hospitals. Similarly, total viable counts heavily exceeded the standard heterotrophic plate count (p=0.000) with no significant difference in such counts in hospitals with and without treatment plants (p=0.232). Healthcare liquid waste management practice was not found to be satisfactory. Installation of effluent treatment plants and the development of standards for environmental indicators with effective monitoring, evaluation and strict control via relevant legal frameworks were realized.
Nielsen, Anders Paarup; Edwards, Kasper
The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare....... The paper concludes by discussing the implications of hypothesis two, three, and four for the successful application of lean management within healthcare. Is it concluded that this requires a transformative and contingent approach to lean management where the universal principles of the lean philosophy...
.... The complaint alleged that the Army Healthcare Enterprise Management System was not properly competed, potential conflicts of interest existed, and possible contract performance problems existed...
Laderman-Jones, B E; Hurley, K F; Kass, P H
Veterinary services are increasingly used in animal shelters, and shelter medicine is an emerging veterinary specialty. However, little is known about working relationships between animal shelters and veterinarians. The aims of this survey were to characterize working relationships that shelter personnel have and want with veterinarians, identify opinions that shelter managers have regarding the veterinarians they work with, and determine areas for relationship growth between veterinarians and shelter managers. An electronic survey was distributed to 1373 managers of North American animal shelters; 536 (39.0%) responded. Almost all shelters had some veterinary relationship, and most had regular relationships with veterinarians. The proportion of shelters that used local clinics (73.9%) was significantly higher than the proportion that retained on-site paid veterinarians (48.5%). The proportion of respondents who did not have but wanted a paid on-site veterinarian (42%) was significantly higher than the proportion of respondents who did not use local clinics but wanted to (7.9%). These data suggest shelter managers valued veterinary relationships, and wished to expand on-site veterinary services. Almost all shelters in this study provided some veterinary care, and all respondents identified at least one common infectious disease, which, for most, had a substantial negative impact on shelter successes. Respondents indicated that the most important roles and greatest expertise of veterinarians were related to surgery, diagnosis and treatment of individual animals. Education of both veterinarians and shelter managers may help ensure that shelters benefit from the full range of services veterinarians can provide, including expertise in disease prevention and animal behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.
Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew
Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.
Ifende, V.I.; Derks, M.; Hooijer, G.A.; Hogeveen, H.
Veterinary herd health management (VHHM) programmes are meant to support herd health and farmers’ income (Brand and Guard 1996). They were introduced in the Netherlands in the 1970s (Sol and Renkema 1984) and at present many veterinarians provide them to farmers. VHHM comprises a basic structure of
Full Text Available Objective: This paper sets out to highlight the ongoing need for integrated teaching of business skills in the veterinary curriculum.Background: In response to the changing environment of the veterinary profession, it is important to understand the future needs of veterinary practitioners. While changes to the veterinary curriculum have been made in recent years, they have been highly varied across schools and little evidence is available on how these have improved students’ non-technical skills, knowledge, aptitudes, and attitudes. Evidentiary value: This literature review of 23 papers provides a solid basis for the further development of knowledge on business management issues in veterinary curricula. The impact on practice from our findings is substantial. The role of clinicians in academia is recognised as a primary source of engaging students with business management through their day-to-day teaching. Furthermore, the role of first-opinion vets who take on placement students (known as extra mural studies or ‘EMS’ in the UK cannot be underestimated as they play an essential role in ensuring that students perceive business skills with the same importance as clinical skills.Methods: This research draws on the findings of 23 papers that emerged as relevant from the structured literature search. The search yielded 124 papers but many were excluded because they focused on issues beyond the search strategy, did not report empirical findings so were based largely on discussion and conjecture, were not about the undergraduate veterinary curriculum, were not written in English or were not related to business teaching.Results: Employers of recent graduates highly value business skills, and often base their hiring decision on non-technical skills, rather than clinical skills. While changes to the veterinary curriculum have been made to include more non-technical training by individual veterinary schools, it is unclear how effective these
Full Text Available AbstractThe objective of this qualitative study was to compare veterinarians’ and Registered Veterinary Technicians’ (RVT’s perceptions of the veterinary health care team with respect to the impact of toxic attitudes and a toxic environment. Focus group interviews using a semi-structured interview guide and follow up probes were held with 4 veterinarian groups (23 companion animal veterinarians and 4 Registered Veterinary Technician groups (26 RVTs. Thematic analysis of the discussions indicated both veterinarian and RVT participants felt team members with toxic attitudes negatively impacted veterinary team function. These attitudes included people being disrespectful, being resistant to change, always wanting to be the go to person, avoiding conflict, and lacking motivation. When conflict was ignored, or when people with toxic attitudes were not addressed, a toxic environment often resulted. A toxic environment sometimes manifested when broken communication and tension between staff members occurred as a result of employees lacking confidence, skills, or knowledge not being managed properly. It also occurred when employees did not feel appreciated, when there was difficulty coping with turnover, and when there were conflicting demands.The presence of people with a toxic attitude was a source of frustration for both veterinarian and RVT participants. Prompt and consistent attention to negative behaviors is recommended to reduce the development of a toxic environment.
Prem Ananth, A.; Prashanthini, V.; Visvanathan, C.
The risks associated with healthcare waste and its management has gained attention across the world in various events, local and international forums and summits. However, the need for proper healthcare waste management has been gaining recognition slowly due to the substantial disease burdens associated with poor practices, including exposure to infectious agents and toxic substances. Despite the magnitude of the problem, practices, capacities and policies in many countries in dealing with healthcare waste disposal, especially developing nations, is inadequate and requires intensification. This paper looks upon aspects to drive improvements to the existing healthcare waste management situation. The paper places recommendation based on a 12 country study reflecting the current status. The paper does not advocate for any complex technology but calls for changes in mindset of all concerned stakeholders and identifies five important aspects for serious consideration. Understanding the role of governments and healthcare facilities, the paper also outlines three key areas for prioritized action for both parties - budget support, developing policies and legislation and technology and knowledge management.
Ananth, A Prem; Prashanthini, V; Visvanathan, C
The risks associated with healthcare waste and its management has gained attention across the world in various events, local and international forums and summits. However, the need for proper healthcare waste management has been gaining recognition slowly due to the substantial disease burdens associated with poor practices, including exposure to infectious agents and toxic substances. Despite the magnitude of the problem, practices, capacities and policies in many countries in dealing with healthcare waste disposal, especially developing nations, is inadequate and requires intensification. This paper looks upon aspects to drive improvements to the existing healthcare waste management situation. The paper places recommendation based on a 12 country study reflecting the current status. The paper does not advocate for any complex technology but calls for changes in mindset of all concerned stakeholders and identifies five important aspects for serious consideration. Understanding the role of governments and healthcare facilities, the paper also outlines three key areas for prioritized action for both parties - budget support, developing policies and legislation and technology and knowledge management.
Douglas, Jeffrey S.
Spiraling veterinary student debt and the lack of a sustainable and profitable business model for many private practices in the modern business environment threaten the future growth and stability of the veterinary profession.
Harris, Donna L; Lloyd, James W; Marrinan, Mike
The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs.
Full Text Available Objective: To highlight the importance of evidence-based research, not only for the consideration of clinical diseases and individual patient treatment, but also for investigating complex healthcare systems, as demonstrated through a focus on veterinary interprofessional working.Background:Evidence-Based Veterinary Medicine (EBVM was developed due to concerns over inconsistent approaches to therapy being delivered by individuals. However, a focus purely on diagnosis and treatment will miss other potential causes of substandard care including the holistic system. Veterinary services are provided by interprofessional teams; research on these teams is growing.Evidentiary value:This paper outlines results from four articles, written by the current authors, which are unique in their focus on interprofessional practice teams in the UK. Through mixed methods, the articles demonstrate an evidence base of the effects of interprofessional working on the quality of service delivery.Results:The articles explored demonstrate facilitators and challenges of the practice system on interprofessional working and the outcomes, including errors. The results encourage consideration of interprofessional relationships and activities in veterinary organisations. Interprofessional working is an example of one area which can affect the quality of veterinary services.Conclusion: The papers presented on veterinary interprofessional working are an example of the opportunities for future research on various topics within evidence-based healthcare.Application:The results are pertinent to members of veterinary teams seeking to improve their service delivery, to educators looking to enhance their students’ understanding of interprofessional working, and to researchers, who will hopefully be encouraged to consider evidence-based healthcare more holistically.
Cannas da Silva, J; Noordhuizen, J P T M; Vagneur, M; Bexiga, R; Gelfert, C C; Baumgartner, W
The nature of veterinary work in dairy health management in Europe has changed over the past years and will change even more dramatically in the near future. The consumers and the media show increasing concern about animal welfare, safety of products of animal origin and traceability of animal products. Farmers in Europe have to produce under strict, often expensive and laborious regulations, while still commercially competing with farmers outside the EU and not subject to the same rules. Veterinarians should adapt their knowledge and skills to the new challenges and developments of the dairy sector. Dairy farmers nowadays ask for support in areas that go beyond clinical activities: environmental protection, welfare, nutrition, grassland management, economics and business management. Bovine practitioners should be able to advise in many different areas and subjects--that is the challenge to our profession. Veterinary education with regards to cattle health management should start with individual animal clinical work, which constitutes the basis of herd health advisory programmes. The bovine practitioner should then look beyond that and regard the herd as the unit. Each diseased cow or group of cows should be detected early enough to avoid financial losses or such losses should be prevented altogether by detecting and managing risk factors contributing to disease occurrence. Herd health and production management programmes represent the first level to optimise dairy farm performance. Expansions to that should further be considered, comprising both animal health and welfare issues, as well as food safety and public health issues. The latter could be addressed by quality risk management programmes following the HACCP-principles. Cattle veterinarians should follow recent developments and invest in new skills and knowledge in order to maintain their usefulness to the modern dairy farmer. Finally we are convinced that the cattle practitioner should evolve into this
Ifende, V I; Derks, M; Hooijer, G A; Hogeveen, H
Veterinary herd health management (VHHM) programmes have been shown to be economically effective in the past. However, no current information is available on costs and benefits of these programmes. This study compared economics and farm performance between participants and non-participants in VHHM programmes in 1013 dairy farms with over 40 cows. Milk Production Registration (MPR) data and a questionnaire concerning VHHM were used. Based on the level of participation in VHHM (as indicated in the questionnaire), costs of the programmes were calculated using a normative model. The economic value of the production effects was similarly calculated using normative modelling based on MPR data. Participants in VHHM had a better performance with regard to production, but not with regard to reproduction. Over 90 per cent of the VHHM participants were visited at least once every six weeks and most participants discussed at least three topics. In most farms, the veterinarian did the pregnancy checks as part of the VHHM programmes. There was a benefit to cost ratio of about five per cow per year for VHHM participants, and a mean difference in net returns of €30 per cow per year after adjusting for the cost of the programme. This portrays that participation in a VHHM programme is cost-efficient. There is, however, much unexplained variation in the net returns, possibly due to diverse approaches by veterinarians towards VHHM or by other factors not included in this analysis, like nutritional quality or management abilities of the farmer. British Veterinary Association.
Cruz, Sofia Gaspar; Ferreira, Maria Manuela Frederico
Knowledge management imposes itself as a pressing need for the organizations of several sectors of the economy, including healthcare. to evaluate the perception of healthcare institution collaborators in relation to knowledge management in the institution where they operate and analyze the existence of differences in this perception, based on the institution's management model. a study conducted in a sample consisting of 671 collaborators from 10 Portuguese healthcare institutions with different models of management. In order to assess the knowledge management perception, we used a score designed from and based on items from the scores available in the literature. the perception of moderate knowledge management on the healthcare institutions and the statistically significant differences in knowledge management perception were evidenced in each management model. management knowledge takes place in healthcare institutions, and the current management model determines the way staff at these institutions manage their knowledge.
Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L
Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare.
Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun
Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.
Welton, William E
In early 2001, the community of educational programs offering master's-level education in healthcare management began an odyssey to modernize its approach to the organization and delivery of healthcare management education. The community recognized that cumulative long-term changes within healthcare management practice required a careful examination of healthcare management context and manpower requirements. This article suggests an evidence-based rationale for defining the distinctive elements of healthcare management, thus suggesting a basis for review and transformation of master's-level healthcare management curricula. It also suggests ways to modernize these curricula in a manner that recognizes the distinctiveness of the healthcare business enterprise as well as the changing management roles and careers within these complex organizations and systems. Through such efforts, the healthcare management master's-level education community would be better prepared to meet current and future challenges, to increase its relevance to the management practice community, and to allocate scarce faculty and program resources more effectively.
Svensson, C; Alvåsen, K; Eldh, A C; Frössling, J; Lomander, H
A preventive herd health approach will most likely reduce incidences of clinical and subclinical disease. Swedish veterinary organizations offer specific veterinary herd health management (HHM) programs, but these services are not used to a large extent. The aim of this study was to investigate dairy farmers' experience of HHM and the conditions for collaboration with veterinarians in HHM. Six focus group discussions were conducted in March 2015 in West Sweden. In total, 33 dairy farmers participated. The recordings were transcribed and coded using thematic analysis, and the transcripts were reviewed to identify potential factors indicating barriers for farmers to engage a veterinarian in HHM. The participants reported HHM to be important, but they had difficulty defining the actions included in the concept. They described a wide range of their work duties as preventive. The farmers' list of potential contributions by the veterinarians in HHM was strikingly short compared to the considerable number of preventive measures they performed themselves. Four main obstacles for farmers and farm managers to engage a veterinarian in HHM on their farm were identified in the analysis: "costs", "veterinary knowledge, skills, and organization", "farmer attitudes", and "veterinarian-farmer relationships". Costs were proposed as the main reason against engaging a veterinarian in HHM and included a high veterinary bill, low cost-benefit of veterinary services, and high costs to implement advice. Poor veterinary competence in HHM and poor knowledge about effective measures, practical farming, and farm economics were other important obstacles. Veterinarians were perceived to insufficiently describe their services and their benefits, and several participants felt they had never been offered veterinary HHM. Although veterinary HHM may be initiated by the farmer, the participants expected the veterinarian to have special responsibility for the initiation. A firm trust between farmer
Griffith, J R
Stakeholders will put increasing pressure on integrated health systems (IHS) for measured performance, demanding data on quality and patient satisfaction, while simultaneously pressing for lower cost. The changes to Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) and the growing importance of the National Committee on Quality Assurance (NCQA) are simply forerunners of an intensifying trend. Quality of care in particular will face increasing scrutiny. Achieving competitive targets in these areas will also require measures addressing demand and worker satisfaction. "Balanced scorecard" approaches will allow IHS and their accountable work groups to track performance on several dimensions and establish integrated goals or targets. Those with consistently good scores will be labeled "champions." Champions will support the multidimensional measures with improved decision processes. About eight major processes will be central--governance/strategic management, clinical quality, clinical organization, financial planning, planning and marketing, information services, human resources, and plant services. It is possible to map these processes to the criteria of the Joint Commission, NCQA, and Malcolm Baldrige Quality Award. The processes themselves can be measured and common weaknesses identified and corrected. Champions share some common characteristics that seem to arise from the combination of processes and measures. Among these characteristics are service line orientation, extensive partnering with other organizations, and the possibility of outsourcing organizational components.
Simeone, Cynthia L
The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.
Tarricone, Rosanna; Torbica, Aleksandra
This chapter describes and discusses the methods for cost analysis of healthcare services in order to assess and compare the economic value of health outputs at the level of healthcare organizations. The economic principles underpinning the assessment of the value of healthcare services – opportunity costs and shadow prices – are presented together with the management accounting approach to cost services. The key features of micro-costing and gross-costing are also discussed and their rele...
BACKGROUND: Despite the set guidelines on Healthcare Waste Management in Kenya, mixing of different categories of waste, crude dumping and poor incineration are still a common phenomenon in public health facilities in Thika Subcounty, Kenya. Thika Subcounty generates 560 Kilograms of healthcare waste daily, ...
Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna
Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used
Holt, Elsbeth; And Others
Reviews a course in Food Hygiene and Public Health at the University of Illinois College of Veterinary Medicine in which students are sequenced through a series of computer-based lessons or autotutorial slide-tape lessons, the computer also being used to route, test, and keep records. Since grades indicated mastery of the subject, the course will…
Full Text Available Healthcare institutions differ from other service businesses by their “matrix organizational structure” and “error-free output” requirement. However, the processes stay the same for all organizational activities at different levels. One of the post-modern management approach is to focus on basis of necessary processes and fundamental organizational changes. This case study aims to initially explain the characteristics of healthcare institutions and the basic conceptual properties of process and process management. Then the effect of the “management throughprocesses approach” over organization will be discussed. Finally; process management at healthcare institutions, scope of health care and examples of the other post-modern approaches will be examined with their outputs
Hewko, Sarah J; Cummings, Greta G
Purpose - The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals. Design/methodology/approach - PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas' theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words "performance" and "management" and of the term "performance management". Findings - Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced. Practical implications - At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance. Originality/value - In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.
Oriol, Mary David
Healthcare organizations continue their struggle to establish a culture of open communication and collaboration. Lessons are learned from the aviation industry, which long ago acknowledged that most errors were the result of poor communication and coordination rather than individual mistakes. The author presents a review of how some healthcare organizations have successfully adopted aviation's curriculum called Crew Resource Management, which promotes and reinforces the conscious, learned team behaviors of cooperation, coordination, and sharing.
Şükrü Kılıç; Cumhur Aydınlı
Healthcare institutions differ from other service businesses by their “matrix organizational structure” and “error-free output” requirement. However, the processes stay the same for all organizational activities at different levels. One of the post-modern management approach is to focus on basis of necessary processes and fundamental organizational changes. This case study aims to initially explain the characteristics of healthcare institutions and the ba...
The finding of the study shows that except Zewditu hospital, the rest use proper management to the hazardous waste. Lack of awareness about health hazards of healthcare waste, inadequate training, absence of waste management and disposal systems, insufficient financial and human resources, low priority given to the ...
Ilgen, Daniel R
Recent studies of veterinary practices and services have suggested that more attention must be focused on business practices and on the skills, knowledge, and abilities (SKAs) of veterinarians related to veterinary practice management (VPM). Responses to these concerns have been directed at the selection and education of veterinarians in veterinary school. While this position is supported in the present article, it is argued that the values and interests of persons who are likely to enter the field, as well as the nature of the experiences encountered across the career of veterinarians, will moderate the potential effectiveness of veterinary school practices and experiences regarding SKAs in VPM. The paper explores some potential implications of these moderators on the effectiveness of selection and education for increasing SKAs in VPM.
van Rossum, Lisa; Aij, Kjeld Harald; Simons, Frederique Elisabeth; van der Eng, Niels; Ten Have, Wouter Dirk
Purpose - Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the "toolbox lean" toward an actual transformation to lean healthcare. Design/methodology/approach - A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow. Findings - The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare. Originality/value - With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization's change capacity as crucial success factor for a sustainable transformation to lean healthcare.
... to buy the Enterprise Management System. The Information Technology Business Center provides information technology services to Fort Sam Houston tenants which include the Army Medical Command and the Army Medical Department Center and School...
Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P
There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format.
Experiences of healthcare providers managing sexual assault victims in the emergency unit Part 2: Discussion of results and literature control. ... It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault.
Full Text Available This article studies the type of leadership that managers are currently exercising in the Catalan health system in Catalonia. A questionnaire (MQL-5X was sent to 120 people occupying management positions in healthcare centers and hospitals as well as 14 others who also hold such positions in these healthcare centers and hospitals, were interviewed. The mixed methods research design attests that the Catalan health system is managed through a structure of simultaneous transformational and transactional leadership. However, the efficacy of this system is conditioned purely by the communicative competence that a manager may or may not possess, as the system itself makes no effort to encourage transformational leadership. Transformation leadership inspires positive change, conveys a clear vision and enhances morale, motivation and job performance. It galvanizes a team into changing their expectations and perceptions and motivates them to work towards common goals.
Hujala, Anneli; Rissanen, Sari
The aim of the paper is to understand and define how the polyphony of management is constructed in interaction and to describe this through concrete management meeting cases. Polyphony refers to the diverse voices of various organization members, and how these voices are present, disclosed and utilized in management. The study is based on the social constructionist and discursive perspectives of management, which question the traditional, individualistic approaches of management. The issue was examined through a qualitative case study by analysing the micro-level management discourse in three healthcare organizations. Discursive practices that enhance or inhibit polyphony are often unnoticed and unconscious. Key moments of management discourse are an example of unconscious mundane practices through which members of organizations construct the reality of management. The empirical results are locally contextual. In the future, research will be able to apply the approach to diverse contexts as well as link micro-level discourses to the construction of broader health and social management discourses. The paper increases the understanding of how to enhance participation and staff contribution, and how to utilize the knowledge of all members of the organization. Both managers and other staff members are fully involved in the social construction of management. Micro-level discourse should be paid attention to in management work as well as in the education of managers and staff. The study increases the understanding of micro-level issues of management and challenges the conventional, taken-for-granted assumptions behind organization and management theories.
D'Souza, Eva; Barraclough, Richard; Fishwick, David; Curran, Andrew
Small-animal work is a major element of veterinary practice in the UK and may be hazardous, with high levels of work-related injuries and ill-health reported in Australia and USA. There are no studies addressing the management of occupational health risks arising from small-animal work in the UK. To investigate the sources of health and safety information used and how health and safety and 12 specific occupational health risks are managed by practices. A cross-sectional postal survey of all small-animal veterinary practices in Hampshire. A response was mandatory as this was a Health & Safety Executive (HSE) inspection activity. A total of 118 (100%) practices responded of which 93 were eligible for inclusion. Of these, 99 and 86%, respectively, were aware of the Royal College of Veterinary Surgeons (RCVS) practice standards and had British Small Animal Veterinary Association (BSAVA) staff members, while only 51% had previous contact with HSE (publications, advice and visit). Ninety per cent had health and safety policies, but only 31% had trained responsible staff in health and safety. Specific health hazards such as occupational allergens and computer use were relatively overlooked both by practices and the RCVS/BSAVA guidance available in 2002. Failings in active health risk management systems could be due to a lack of training to ensure competence in those with responsibilities. Practices rely on guidance produced by their professional bodies. Current RCVS guidance, available since 2005, has remedied some previous omissions, but further improvements are recommended.
Robinson, Natalie J.; Dean, Rachel S.
Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare. PMID:29419766
Edwards, Kasper; Nielsen, Anders Paarup
still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...
Sun, Niuyun; Wang, Li; Zhou, Jun; Yuan, Qiang; Zhang, Zongjiu; Li, Youping; Liang, Minghui; Cheng, Lan; Gao, Guangming; Cui, Xiaohui
Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province, hospital, and non-governmental organization. The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an "NGO-led mode" represented by the United States and Canada and a "government-led mode" represented by the United Kingdom, Australia, and Taiwan. © 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.
Poock, Scott E; Payne, Craig A
Veterinarians play an important role in reproductive management of dairy herds across the United States; however, in many cases, their involvement in reproductive management of beef herds has been limited. The reasons for this vary; however, there are ways for veterinarians to become more actively involved in reproductive management of US beef herds. Veterinarians can have an impact on producers' profits by implementing their skills and knowledge to beef heifer development programs. This article provides an overview of the services veterinarians can provide to beef cattle producers that pertain to reproductive management of replacement beef heifers. Published by Elsevier Inc.
Lee, Chei Sian; Goh, Dion Hoe-Lian; Chua, Alton Y. K.
Healthcare portals are becoming increasingly popular with Internet users since they play an important role in supporting interaction between individuals and healthcare organizations with a Web presence. Additionally, many of these organizations make use of knowledge management mechanisms on their healthcare portals to manage the abundance of…
Aim: This study aims at ascertaining the current healthcare waste management practices in Anambra State. It highlights the sources of healthcare waste, its classification, the hazards associated with it and the gold standard in its management. The specific objectives are: to determine current practice of healthcare waste ...
that managers are able to incorporate those indicators they find useful in their department, and thus secure sufficient informational support for the department's decision-making processes. The Performance Account thereby eases the identification of areas suited for corrective actions, and provides the decision......; collectively, however, they pose a significant drawback. The vast selection of self-contained initiatives limits the overview for decision makers and imposes an escalating administrative burden on operational staff members. Contrary to the initial objective, the expanding informational burden limits...... the overview and transparency for healthcare decision makers; as a result, well-documented initiatives fail to become integrated support in operational decision-making processes. This research work has thus striven to design a holistic Management-By-Objectives framework that can enable managers and operational...
Birken Sarah A
Full Text Available Abstract Background Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations. Discussion Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. Summary Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation.
Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J
Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations. Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation.
Background Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations. Discussion Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. Summary Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation. PMID:22472001
Malekahmadi, Fariba; Yunesian, Masud; yaghmaeian, Kamyar; nadafi, Kazem
Background Considering the importance of healthcare waste management, following the ratification of the Waste Management law in 2005 and the subsequent approval of its executive bylaw in 2006 and finally the healthcare waste management criteria passing by the parliament in 2008, a review on the status of healthcare waste management is needed to implement the mentioned law properly. Findings In this retrospective study during six months period all public hospitals in Iran’s capital city, Tehra...
Full Text Available Background:This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers regarding bio-medical waste management.Methods:The study was conducted on 240 volunteers during June – August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions. A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups.Results:67.5% (162 of participants were female. 42.5% (102 are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test and others who had not (p<0.01. It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session.Conclusion:On the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.
Petrova, Gergana G; Popov, Teodor N
Organisation and management are factors of paramount importance in higher education for achieving higher quality of training, better professional adaptation, and more effective career pursuance of the students. The present study analyses the use of various teaching methods for the students in the major of Healthcare Management as they are employed in two medical universities. We conducted a detailed questionnaire survey which included the students in the Healthcare Management major in the Faculty of Public Health (FPH) at Sofia Medical University (SMU) and the Medical Faculty of Plovdiv Medical University (PMU). The students were surveyed for two consecutive academic years (2004/2005 and 2005/2006). The logical units of study were 198 students completing their baccalaureate programs in Healthcare Management: 145 (73.23+/-3.15%) in the FPH, SMU and 53 (26.77+/-3.15%) in the PMU (the greater number of students from the SMU was due to the greater number of students admitted into the Sofia Medical University). The technical units of study were the Faculty of Public Health in the Medical University in Sofia and the Medical faculty in the Medical University in Plovdiv. The survey was carried out using our own questionnaire form comprising 51 questions (open and closed), some of them allowing more than one answer. The collected sociological data were analysed using SPSS v. 13.0, and the diagrams were made using Microsoft Excel' 97. We used the alternative, non-parametric and graphic analyses to illustrate the processes and events at a level of significance P PMU and 26.32+/-1.91% for SMU). This format of teaching is also considered to be the easiest with regard to learning the study material by 22.75+/-3.25% of the PMU graduates and 27.56+/-2.38% of the SMU graduates. The PMU students regard seminars, individual work and discussions as the format that afford the easiest way to acquire knowledge (22.16+/-3.21%, 21.56+/-3.18%, (18.56+/-3.01%, respectively). The most
Healthcare units generate substantial amounts of hazardous or potentially hazardous wastes as by-products of their medical services. The inappropriate management of these wastes poses significant risks to people and the environment. In Portugal, as in other EU countries, the collection, storage, treatment and disposal of healthcare waste is regulated by law. Although legal provisions covering the safe management of healthcare waste date back to the 1990s, little is known about the compliance ...
Weijs, Cynthia A; Coe, Jason B; Muise, Amy; Christofides, Emily; Desmarais, Serge
From the Social media use by health professionals occurs in a digital environment where etiquette has yet to be solidly defined. The objectives of this study were to explore veterinarians' personal use of Facebook, knowledge of privacy settings, and factors related to sharing personal information online. All American Animal Hospital Association member veterinarians with a valid e-mail address (9469) were invited to complete an online survey about Facebook (e.g., time spent on Facebook, awareness of consequences, types of information posted). Questions assessing personality dimensions including trust, popularity, self-esteem and professional identity were included. The response rate was 17% (1594 of 9469); 72% of respondents (1148 of 1594) had a personal Facebook profile. Veterinarians were more likely to share information on Facebook than they would in general. Trust, need for popularity, and more time spent on Facebook predicted more disclosure of personal information on Facebook. Awareness of consequences and increased veterinary experience predicted lesser disclosure. As veterinary practices use Facebook to improve client services, they need also to manage risks associated with online disclosure by staff. Raising awareness of reputation management and consequences of posting certain types of information to Facebook is integral to protecting the individual, the practice, and the veterinary profession.
Weil, P; Haddock, C C; Barowsky, D
A 1990 study by ACHE and the University of Iowa compared the career attainments and attitudes of a group of male and female healthcare executives. The research showed that among men and women who had entered the field at the same time and had achieved similar educational levels, women did not fare as well as men in terms of salary, position level, or job satisfaction. A follow-up to this study, which consisted of two parts, was conducted in 1995 by ACHE, the University of Alabama at Birmingham, and Lamalie Amrop International to learn whether the gender gap had narrowed. The 1990 study divided respondents into groups according to the year they entered healthcare management: 1971-1975, 1976-1980, or 1981-1985. The first part of the 1995 project was a replication study that paralleled the 1990 study, dividing a new pool of respondents into three groups: 1976-1980, 1981-1985, and 1986-1990. The second part of the follow-up project was a panel study, in which respondents from the 1990 study were surveyed again. Following are highlights from the 1995 study.
Chen, Tzer-Shyong; Chen, Tzer-Long; Chung, Yu-Fang; Huang, Yao-Min; Chen, Tao-Chieh; Wang, Huihui; Wei, Wei
Pet markets involve in great commercial possibilities, which boost thriving development of veterinary hospital businesses. The service tends to intensive competition and diversified channel environment. Information technology is integrated for developing the veterinary hospital cloud service platform. The platform contains not only pet medical services but veterinary hospital management and services. In the study, QR Code andcloud technology are applied to establish the veterinary hospital cloud service platform for pet search by labeling a pet's identification with QR Code. This technology can break the restriction on veterinary hospital inspection in different areas and allows veterinary hospitals receiving the medical records and information through the exclusive QR Code for more effective inspection. As an interactive platform, the veterinary hospital cloud service platform allows pet owners gaining the knowledge of pet diseases and healthcare. Moreover, pet owners can enquire and communicate with veterinarians through the platform. Also, veterinary hospitals can periodically send reminders of relevant points and introduce exclusive marketing information with the platform for promoting the service items and establishing individualized marketing. Consequently, veterinary hospitals can increase the profits by information share and create the best solution in such a competitive veterinary market with industry alliance.
Ozder, Aclan; Teker, Bahri; Eker, Hasan Huseyin; Altındis, Selma; Kocaakman, Merve; Karabay, Oguz
This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management. The study was conducted on 240 volunteers during June - August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups. 67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (pnecessity for the safety of patients and important for its contribution to the economy of the country.
Despite the large number of women in the healthcare field, healthcare management resembles other industries in its severe lack of women in upper-management positions and in the "glass ceiling" that contributes to this dearth. Although not enough has been specifically written on women healthcare managers, the author reviews what is available, along with some of the general management literature.
Higgins, Helen M; Ferguson, Eamonn; Smith, Robert F; Green, Martin J
In the face of a steady decline in dairy cow fertility over several decades, using hormones to assist reproduction has become common. In the European Union, hormones are prescription-only medicines, giving veterinary practitioners a central role in their deployment. This study explored the clinical and ethical beliefs of practitioners, and provides data on their current prescribing practices. During 2011, 93 practitioners working in England completed a questionnaire (95% response rate). Of the 714 non-organic farms they attended, only 4 farms (0.6%) never used hormones to assist the insemination of lactating dairy cows. Practitioners agreed (>80%) that hormones improve fertility and farm businesses profitability. They also agreed (>80%) that if farmers are able to tackle management issues contributing to poor oestrus expression, then over a five year period these outcomes would both improve, relative to using hormones instead. If management issues are addressed instead of prescribing hormones, practitioners envisaged a less favourable outcome for veterinary practices profitability (p<0.01), but an improvement in genetic selection for fertility (p<0.01) and overall cow welfare (p<0.01). On farms making no efforts to address underlying management problems, long-term routine use at the start of breeding for timing artificial insemination or inducing oestrus was judged "unacceptable" by 69% and 48% of practitioners, respectively. In contrast, practitioners agreed (≥ 90%) that both these types of use are acceptable, provided a period of time has been allowed to elapse during which the cow is observed for natural oestrus. Issues discussed include: weighing quality versus length of cow life, fiscal factors, legal obligations, and balancing the interests of all stakeholders, including the increasing societal demand for food. This research fosters debate and critical appraisal, contributes to veterinary ethics, and encourages the pro-active development of professional
Helen M Higgins
Full Text Available In the face of a steady decline in dairy cow fertility over several decades, using hormones to assist reproduction has become common. In the European Union, hormones are prescription-only medicines, giving veterinary practitioners a central role in their deployment. This study explored the clinical and ethical beliefs of practitioners, and provides data on their current prescribing practices. During 2011, 93 practitioners working in England completed a questionnaire (95% response rate. Of the 714 non-organic farms they attended, only 4 farms (0.6% never used hormones to assist the insemination of lactating dairy cows. Practitioners agreed (>80% that hormones improve fertility and farm businesses profitability. They also agreed (>80% that if farmers are able to tackle management issues contributing to poor oestrus expression, then over a five year period these outcomes would both improve, relative to using hormones instead. If management issues are addressed instead of prescribing hormones, practitioners envisaged a less favourable outcome for veterinary practices profitability (p<0.01, but an improvement in genetic selection for fertility (p<0.01 and overall cow welfare (p<0.01. On farms making no efforts to address underlying management problems, long-term routine use at the start of breeding for timing artificial insemination or inducing oestrus was judged "unacceptable" by 69% and 48% of practitioners, respectively. In contrast, practitioners agreed (≥ 90% that both these types of use are acceptable, provided a period of time has been allowed to elapse during which the cow is observed for natural oestrus. Issues discussed include: weighing quality versus length of cow life, fiscal factors, legal obligations, and balancing the interests of all stakeholders, including the increasing societal demand for food. This research fosters debate and critical appraisal, contributes to veterinary ethics, and encourages the pro-active development of
Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam
Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.
Royer, Mathilde; Breton Marchand, Justine; Pons, David
The storage of temperature-sensitive healthcare products requires control of the cold chain. Healthcare facilities must have the appropriate equipment at their disposal and ensure the traceability and monitoring of temperatures. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Judith L. Stella
Full Text Available Understanding cat owners’ housing, care, and management practices is important for promoting cat welfare. A survey study was conducted on the housing and management practices used for cats by students, faculty, and staff of The Ohio State University and Purdue University veterinary colleges. Subjects were 138 cat-owner dyads. Most cats (74% were housed strictly indoors in keeping with common US veterinary recommendations. However, many did not implement best practices outlined for behavior and other welfare needs of indoor cats. The percentage of respondents placing resources where cats could be disrupted while using them was 31%, 53%, and 30% for resting areas, food/water dishes, and litter boxes, respectively. Many cats were not provided a litter box in a private area (35%, in multiple areas of the house (51%, or that was regularly washed (73%. Horizontal scratching opportunities were not provided to 38% of cats; 32% were not provided toys that mimic prey and 91% of cats were fed a diet consisting of >75% dry food. These findings suggest a need for more concerted efforts to educate owners about meeting their cats’ welfare needs so as to attenuate risks and improve cat physical and behavioral welfare outcomes.
Ban, van den A.W.; Sasidhar, P.V.K.
The changing nature of livestock outreach service delivery, manpower requirements and opportunities in the private sector provide both push and pull dynamics for veterinary graduates to engage in managerial, entrepreneurial, public and private service activities. The veterinary schools should
Pickens, Scott; Solak, Jamie
Many healthcare organization projects take more time and resources than planned and fail to deliver desired business outcomes. Healthcare IT is a major component of many projects and often undeservedly receives the blame for failure. Poor results are often not a result of faulty healthcare IT or poor project management or poor project execution alone. Many projects fail because of poor portfolio management--poor planning and management of the portfolio of initiatives designed to meet an organization's strategic goals. Because resources are limited, portfolio management enables organizations to more strategically allocate and manage their resources so care delivery, service delivery, and initiatives that advance organizations toward their strategic goals, including healthcare IT initiatives, can be accomplished at the levels of quality and service desired by an organization. Proper portfolio management is the essential foundation for program and project success and supports overall organization success. Without portfolio management, even programs and projects that execute flawlessly may not meet desired objectives. This article discusses the essential requirements for porfolio management. These include opportunity identification, return on investment (ROI) forecast, project prioritization, capacity planning (inclusive of human, financial, capital, and facilities resources), work scheduling, program and project management and execution, and project performance and value assessment. Portfolio management is essential to successful healthcare project execution. Theories are drawn from the Organizational Project Management Maturity Model (OPM3) work of the Project Management Institute and other leading strategy, planning, and organization change management research institutes.
Sánchez Ruiz, Lidia; Blanco Rojo, Beatriz; Simón, Rosa María
Nowadays due to the crisis, some government measures are aimed at reducing healthcare spending, affecting in some level or another the quality offered. Process management is said to be a useful tool for reducing healthcare costs by improving management without any additional economic investment. That is doing more with the same resources and without reducing the quality offered. In this study an empirical case of a Catalan hospital is presented. Overall, the usefulness of process management i...
Bossen, Claus; Danholt, Peter; Ubbesen, Morten Bonde
This paper describes the new kind of data-work involved in developing data-driven healthcare based on two cases from Denmark: The first case concerns a governance infrastructure based on Diagnose-Related Groups (DRG), which was introduced in Denmark in the 1990s. The DRG-system links healthcare...... activity and financing and relies of extensive data entry, reporting and calculations. This has required the development of new skills, work and work roles. The second case concerns a New Governance project aimed at developing new performance indicators for healthcare delivery as an alternative to DRG....... Here, a core challenge is select indicators and actually being able to acquire data upon them. The two cases point out that data-driven healthcare requires more and new kinds of work for which new skills, functions and work roles have to be developed....
Lee, James G
Adventist HealthCare offers the following lessons learned in improving the value of healthcare facilities, construction, and real estate management: Use an integrated approach. Ensure that the objectives of the approach align the hospital or health system's mission and values. Embrace innovation. Develop a plan that applies to the whole organization, rather than specific business units. Ensure commitment of senior leaders.
Mesdaghinia, Alireza; Naddafi, Kazem; Mahvi, Amir Hossein; Saeedi, Reza
The waste management practices in primary healthcare centres of Iran were investigated in the present study. A total of 120 primary healthcare centres located across the country were selected using the cluster sampling method and the current situation of healthcare waste management was determined through field investigation. The quantities of solid waste and wastewater generation per outpatient were found to be 60 g outpatient(-1) day(-1) and 26 L outpatient(-1) day(-1), respectively. In all of the facilities, sharp objects were separated almost completely, but separation of other types of hazardous healthcare solid waste was only done in 25% of the centres. The separated hazardous solid waste materials were treated by incineration, temporary incineration and open burning methods in 32.5, 8.3 and 42.5% of the healthcare centres, respectively. In 16.7% of the centres the hazardous solid wastes were disposed of without any treatment. These results indicate that the management of waste materials in primary healthcare centres in Iran faced some problems. Staff training and awareness, separation of healthcare solid waste, establishment of the autoclave method for healthcare solid waste treatment and construction of septic tanks and disinfection units in the centres that were without access to a sewer system are the major measures that are suggested for improvement of the waste management practices.
Roberts, Jess P; Fisher, Thomas R; Trowbridge, Matthew J; Bent, Christine
The business community has learned the value of design thinking as a way to innovate in addressing people's needs--and health systems could benefit enormously from doing the same. This paper lays out how design thinking applies to healthcare challenges and how systems might utilize this proven and accessible problem-solving process. We show how design thinking can foster new approaches to complex and persistent healthcare problems through human-centered research, collective and diverse teamwork and rapid prototyping. We introduce the core elements of design thinking for a healthcare audience and show how it can supplement current healthcare management, innovation and practice. Copyright © 2015 Elsevier Inc. All rights reserved.
This workshop was conducted with 20 Managers from Ceuta Healthcare to raise their awareness of the power of marketing and give them a set of marketing tools to improve the success rate of their business development activities
Fried, Bruce J; Harris, Dean M
The world is getting "flatter"; people, information, technology, and ideas are increasingly crossing national borders. U.S. healthcare is not immune from the forces of globalization. Competition from medical tourism and the rapid growth in the number of undocumented aliens requiring care represent just two challenges healthcare organizations face. An international workforce requires leaders to confront the legal, financial, and ethical implications of using foreign-trained personnel. Cross-border institutional arrangements are emerging, drawing players motivated by social responsibility, globalization of competitors, growth opportunities, or an awareness of vulnerability to the forces of globalization. Forward-thinking healthcare leaders will begin to identify global strategies that address global pressures, explore the opportunities, and take practical steps to prepare for a flatter world.
The purpose of this study was to understand how lean thinking and inventory management technology minimize expired medical supply waste in healthcare organizations. This study was guided by Toyota's theory of lean and Mintzberg's theory of management development to explain why the problem of medical supply waste exists. Government…
Joel Barker, a noted futurist, points out that the best ideas usually come from outside an industry or profession. As a management consultant, I often get new ideas from industries completely unrelated to my clients' industry. For example, companies interested in offering outstanding customer service might study Nordstrom's, L.L. Bean, or Lexus. Those interested in world class distribution might research Federal Express or United Parcel Service. Airlines, trying to minimize downtime of jets at the terminal, learn secrets from Indianapolis 500 pit crews. Similarly, in observing optometrists and dentists, there are valuable lessons for veterinarians. Dentists identified a business model or organizational structure that generates healthy profits. Independent optometrists experienced the onslaught of intense competition from huge corporate players and weathered the storm. The veterinary profession is not so unique. By studying other professions, we need not recreate the wheel.
Tietze, Mari F
Managed care has introduced changes, such as cost effectiveness, access to care, and quality of care, to many components of the U.S. healthcare delivery system. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on healthcare delivery practices. A survey was initiated to explore whether the perceptions of administrators differed from those of practitioners and to discover which organizational variables could explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrators and practitioners in high, moderate, and low managed-care-penetration markets. Two investigator-developed instruments--the Managed Care Perceptions Inventory (MCPI) and the MCPI-Demographic--and an intact centralization of decision-making assessment subscale were used for data collection. Administrators had a statistically significant, more positive perception of the impact of managed care on healthcare delivery than did practitioners. When the distinction between administrator and practitioner was not used as a grouping factor, managed care market penetration, nonprofit status, and years in current employment position were factors that had statistically significant associations with a more positive perception of managed care. Based on these findings, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should work collaboratively to address issues of concern. Similarly, promoting trust and commitment at the organizational level is important. Recommendations for further research are also provided.
Csupor, Éva; Kuna, Ágnes; Pintér, Judit Nóra; Kaló, Zsuzsa; Csabai, Márta
Efficient communication, conflict management and cooperation are the key factors of a successful patient care. This study is part of an international comparative research. The aim of this study is to unfold conflicts among healthcare workers. 73 healthcare workers were interviewed using a standardized interview protocol. The in-person interviews used the critical incident method. 30 interviews (15 doctors, 15 nurses) were analysed with the Atlas.ti 7 content analysis software. The sources, types, effects of conflicts and conflict management strategies were investigated. The content analysis unfolded the specificities of conflicts in healthcare based on personal experiences. Organizational hierarchy was a substantial source of conflict, especially among physicians, which originates from implicit rules. As a result of the avoiding conflict management the conflicts remain partly unresolved which has negative individual and group effect. Our conceptual framework helps to develop a proper intervention specific to healthcare. Orv. Hetil., 2017, 158(16), 625-632.
Full Text Available Veterinary education commenced in South Africa in 1920 at the Onderstepoort Veterinary Institute in South Africa in association with the Transvaal University College, now the University of Pretoria. Sir Arnold Theiler, Director of Veterinary Research and Education, was the first Dean. Today there are 46 veterinary training institutions in Africa of which 21 are in sub-Saharan Africa.Veterinary services are indispensable to the sustained health and wellbeing of animals and humans, and agricultural economies of countries worldwide. Veterinary education, postgraduate training, and research, and adequate numbers of veterinarians, are essential to satisfy the millennium development goals, the objectives of NEPAD and the African Union, and the agreements regulating international trade.
Mohamed, L.F.; Ebrahim, S.A.; Al-Thukair, A.A.
Hazardous healthcare waste has become an environmental concern for many developing countries including the Kingdom of Bahrain. There have been several significant obstacles facing the Kingdom in dealing with this issue including; limited documentation regarding generation, handling, management, and disposal of waste. This in turn hinders efforts to plan better healthcare waste management. In this paper, hazardous waste management status in the Kingdom has been investigated through an extensive survey carried out on selected public and private healthcare premises. Hazardous waste management practices including: waste generation, segregation, storage, collection, transportation, treatment, and disposal were determined. The results of this study along with key findings are discussed and summarized. In addition; several effective recommendations and improvements of hazardous waste management are suggested.
Malekahmadi, Fariba; Yunesian, Masud; Yaghmaeian, Kamyar; Nadafi, Kazem
Considering the importance of healthcare waste management, following the ratification of the Waste Management law in 2005 and the subsequent approval of its executive bylaw in 2006 and finally the healthcare waste management criteria passing by the parliament in 2008, a review on the status of healthcare waste management is needed to implement the mentioned law properly. In this retrospective study during six months period all public hospitals in Iran's capital city, Tehran, were selected to conduct the survey. Data collected through an expert-standardized questionnaire was analyzed by using SPSS software. The results of the current status of healthcare waste management in Tehran hospitals showed 5.6% of hospitals were ranked excellent, 50.7% good, 26.4% medium, and the 13.9% of hospitals were ranked weak and 3.5% ranked very poor. The findings showed that appropriate technologies should be used to have better disposal stage. As the ratified criteria were not fully observed by all the selected hospitals, training courses and comprehensive program conducting by each hospital could be enjoyed as practical tools to implement the all stages of healthcare waste management properly.
Oyekale, Abayomi Samuel; Oyekale, Tolulope Olayemi
Adequate management of healthcare waste (HCW) is a prerequisite for efficient delivery of healthcare services. In Nigeria, there are several constraints militating against proper management of HCW. This is raising some environmental concerns among stakeholders in the health sector. In this study, we analyzed the practices of HCW management and determinants of risky/safe indices of HCW disposal. The study used the 2013/2014 Service Delivery Indicator (SDI) data that were collected from 2480 healthcare facilities in Nigeria. Descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square (OLS) regression were used to analyze the data. The results showed that 52.20% and 38.21% of the sampled healthcare facilities from Cross River and Bauchi states possessed guidelines for HCW management, respectively. Trainings on management of HCW were attended by 67.18% and 53.19% of the healthcare facilities from Cross River and Imo states, respectively. Also, 32.32% and 29.50% of healthcare facilities from rural and urban areas previously sent some of their staff members for trainings on HCW management, respectively. Sharp and non-sharp HCW were burnt in protected pits in 45.40% and 45.36% of all the sampled healthcare facilities, respectively. Incinerators were reported to be functional in only 2.06% of the total healthcare facilities. In Bauchi and Kebbi states, 23.58% and 21.05% of the healthcare facilities respectively burnt sharp HCW without any protection. Using PCA, computed risky indices for disposal of sharp HCW were highest in Bayelsa state (0.3070) and Kebbi state (0.2172), while indices of risky disposal of non-sharp HCW were highest in Bayelsa state (0.2868) and Osun state (0.2652). The OLS results showed that at 5% level of significance, possession of medical waste disposal guidelines, staff trainings on HCW management, traveling hours from the facilities to local headquarters and being located in rural areas significantly influenced indices of
Abayomi Samuel Oyekale
Full Text Available Abstract Background Adequate management of healthcare waste (HCW is a prerequisite for efficient delivery of healthcare services. In Nigeria, there are several constraints militating against proper management of HCW. This is raising some environmental concerns among stakeholders in the health sector. In this study, we analyzed the practices of HCW management and determinants of risky/safe indices of HCW disposal. Methods The study used the 2013/2014 Service Delivery Indicator (SDI data that were collected from 2480 healthcare facilities in Nigeria. Descriptive statistics, Principal Component Analysis (PCA and Ordinary Least Square (OLS regression were used to analyze the data. Results The results showed that 52.20% and 38.21% of the sampled healthcare facilities from Cross River and Bauchi states possessed guidelines for HCW management, respectively. Trainings on management of HCW were attended by 67.18% and 53.19% of the healthcare facilities from Cross River and Imo states, respectively. Also, 32.32% and 29.50% of healthcare facilities from rural and urban areas previously sent some of their staff members for trainings on HCW management, respectively. Sharp and non-sharp HCW were burnt in protected pits in 45.40% and 45.36% of all the sampled healthcare facilities, respectively. Incinerators were reported to be functional in only 2.06% of the total healthcare facilities. In Bauchi and Kebbi states, 23.58% and 21.05% of the healthcare facilities respectively burnt sharp HCW without any protection. Using PCA, computed risky indices for disposal of sharp HCW were highest in Bayelsa state (0.3070 and Kebbi state (0.2172, while indices of risky disposal of non-sharp HCW were highest in Bayelsa state (0.2868 and Osun state (0.2652. The OLS results showed that at 5% level of significance, possession of medical waste disposal guidelines, staff trainings on HCW management, traveling hours from the facilities to local headquarters and being located in
Israel Deneke Haylamicheal; Mohamed Aqiel Dalvie; Biruck Desalegn Yirsaw; Hanibale Atsbeha Zegeye
Inadequate management of healthcare waste is a serious concern in many developing countries due to the risks posed to human health and the environment. This study aimed to evaluate healthcare waste management in Hawassa city, Ethiopia. The study was conducted in nine healthcare facilities (HCFs) including hospitals (four), health centres (two) and higher clinics (three) in two phases, first to assess the waste management aspect and second to determine daily waste generation rate. The result showed that the median quantity of waste generated at the facilities was 3.46 kg bed(-1) day(-1) (range: 1.48-8.19 kg bed(-1) day(-1)). The quantity of waste per day generated at a HCF increased as occupancy increased (p waste generated at government HCFs was more than at private HCFs (p waste (20-63.1%) generated at the different HCFs was much higher than the WHO recommendation (10-25%). There was no waste segregation in most HCFs and only one used a complete color coding system. Solid waste and wastewater were stored, transported, treated and disposed inappropriately at all HCFs. Needle-stick injuries were prevalent in 25-100% of waste handlers employed at these HCFs. Additionally, low levels of training and awareness of waste legislation was prevalent amongst staff. The study showed that management of healthcare waste at HCFs to be poor. Waste management practices need to be improved through improved legislation and enforcement, and training of staff in the healthcare facilities in Hawassa.
Sasidhar, P. V. K.; Van Den Ban, Anne W.
The changing nature of livestock outreach service delivery, manpower requirements and opportunities in the private sector provide both push and pull dynamics for veterinary graduates to engage in managerial, entrepreneurial, public and private service activities. The veterinary schools should support this transition by integrating Managerial,…
Catia M L Machado
Full Text Available The purpose of this research is to investigate the management models applied in the supply chain providing services in healthcare organizations, considering the lenses of lean. The aim of this is to develop a model of supply chain management focusing on the identification and minimization of waste, assisting in decision making and contributing to the quality of services and as a consequence the reduction of the costs involved in healthcare supply chain. The philosophies of continuous improvement and lean techniques have a role to play in helping healthcare to provide quality service and support to reduce costs in the current budget constraints. In the supply chain of hospitals the financial costs can be around 40% of its budget (MASOUMI et al. 2012; SOUZA et al., 2013. This article sheds light on the improvement in decision making and the effect of reducing costs in the healthcare supply chain. In this sense, the research intend to expand knowledge related to supply chain management in the area of provision of healthcare services through the use of the philosophy of continuous improvement and lean principles, helping healthcare to provide quality service within their current budget constraints.
Ahmad, Md Fauzi; Nee, Phoi Soo; Nor, Nik Hisyamudin Muhd; Wei, Chan Shiau; Hassan, Mohd Fahrul; Hamid, Nor Aziati Abdul
The aim of total quality management (TQM) is to achieve customer satisfaction. Healthcare industry is very important in Malaysia for providing good healthcare services to public. However, failure to improve quality and efficiency is a big challenge in a healthcare industry in order to increase quality healthcare services. The objectives of this research are to identify the extent level of TQM implementation; and to determine the impact of TQM implementation on business sustainable in healthcare industry. Quantitative approach has been chosen as the methodology of this study. The survey respondents targeted in this research are staffs in Malaysia private clinic. 70 respondents have participated in this research. Data were analysed by Statistical Package Social Science (SPSS). Analysis result showed that there was a positive significant relationship between TQM practices and business sustainable (r=0.774, Prelationship with business sustainable factors. The findings of this research will help healthcare industry to understand a better and deeper valuable information on the impact of TQM implementation towards business sustainable in Malaysia healthcare industry.
Pusa Tania Tapliga; Roxana Nicoleta Matei
Career management is a specialized activity that provides the relation between HRM and the individual and organizational career planning. The health system is changing, more than any other field. Career Management in the health care system involves a complex process of analysis and human resource planning at both the organizational and the individual level.
Full Text Available The waste management system in health care is a tool that allows to conduct reasonable steps to reduce their amount, collection, storage and transport, and provide a high level of utilization or disposal. Logistics solutions in waste management are intended to make full use of the infrastructure and technical resources, optimize costs, ensure the safety and health at work and meet legal requirements. The article discusses the elements of the logistics system of waste management in hospital, necessary to ensure the smooth flow of waste from its origin to landfilling. The following criteria were characterized: technical and technological, ecological and economic that can be used in the analysis and evaluation of solutions in waste management in the hospital. Finally, solutions to improve waste management system in the hospital on the example of the real object have been presented.
Modern healthcare facilities generate more and more waste, and their management is a significant constitutes a significant cost of their functioning. The undertakings aimed at lowering the costs of expenses in waste management may have a positive influence on budgetary accounts in the institutions rendering health care services. On the example of a hospital in Lublin the costs of waste management and the possibilities to lower these costs by intensifying segregation procedures were presented....
Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga
To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Nasrabad, Rafat Rezapour
Today, several studies in the field to identify key factors in the success and agility of health care organizations to improve their performance in the face of changes have taken place in the context of customer relationship management among them. The purpose of this study was to explore the concept of customer relationship management, goals and benefits by considering its relationship with value creation for clients and treatment. Results showed concern for organizations today, creating cust...
Nilsson, Petra; Blomqvist, Kerstin
Purpose The purpose of this paper is to explore how healthcare first-line managers think about and act regarding workplace survey processes. Design/methodology/approach This interview study was performed at a hospital in south Sweden. First-line healthcare managers ( n=24) volunteered. The analysis was inspired by phenomenography, which aims to describe the ways in which different people experience a phenomenon. The phenomenon was a workplace health promotion (WHP) survey processes. Findings Four main WHP survey process approaches were identified among the managers: as a possibility, as a competition, as a work task among others and as an imposition. For each, three common subcategories emerged; how managers: stated challenges and support from hospital management; described their own work group and collaboration with other managers; and expressed themselves and their situation in their roles as first-line managers. Practical implications Insights into how hospital management can understand their first-line managers' motivation for survey processes and practical suggestions and how managers can work proactively at organizational, group and individual level are presented. Originality/value Usually these studies focus on those who should respond to a survey; not those who should run the survey process. Focusing on managers and not co-workers can lead to more committed and empowered managers and thereby success in survey processes.
African Journal of Environmental Science and Technology ... Recommendations have been made for staff training to create awareness on wastes, their effects, importance of existing guidelines and the implementation of the waste management options for the different categories of wastes so that hospitals do not become ...
African Journal of Environmental Science and Technology Vol. 3 (12), pp. ... Full Length Research Paper ... practices in hospitals and compared same with international standards. ... recommended waste management practices as prescribed by World Health Organization and other ..... Lowering standards of clinical waste.
Healthcare waste generation and its management system: the case of health ... of an environmental risk to health care workers, the public and the environment at large. ... Only four out of ten health centers used local type of incinerators, while ...
Trevisani, M; Rosmini, R
Functions of veterinarians in the context of food safety assurance have changed very much in the last ten years as a consequence of new legislation. The aim of this review is to evaluate the management tools in veterinary public health that shall be used in response to the actual need and consider some possible key performance indicators. This review involved an examination of the legislation, guidelines and literature, which was then discussed to analyse the actual need, the strategies and the procedures with which the public veterinary service shall comply. The management of information gathered at different stages of the food chain, from both food production operators and veterinary inspectors operating in primary production, food processing and feed production should be exchanged and integrated in a database, not only to produce annual reports and plan national sampling plans, but also to verify and validate the effectiveness of procedures and strategies implemented by food safety operators to control risks. Further, the surveillance data from environmental agencies and human epidemiological units should be used for assessing risks and addressing management options.
Bader, Mazen S; Brooks, Annie A; Srigley, Jocelyn A
Healthcare personnel (HCP) are at risk of exposure to various pathogens through their daily tasks and may serve as a reservoir for ongoing disease transmission in the healthcare setting. Management of HCP exposed to infectious agents can be disruptive to patient care, time-consuming, and costly. Exposure of HCP to an infectious source should be considered an urgent medical concern to ensure timely management and administration of postexposure prophylaxis, if available and indicated. Infection control and occupational health departments should be notified for management of exposed HCP, identification of all contacts of the index case, and application of immediate infection control measures for the index case and exposed HCP, if indicated. This article reviews the main principles of postexposure management of HCP to infectious diseases, in general, and to certain common infections, in particular, categorized by their route of transmission, in addition to primary prevention of these infections.
Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F
Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.
Nault, Andre J.
Veterinary medical libraries and librarians are unique. There are now 33 veterinary colleges in North America, and in accordance with American Veterinary Medical Association accreditation, each has a library managed by an accredited librarian. Colleges with veterinary programs often maintain specialized branch libraries to support the degree,…
Full Text Available Modern healthcare facilities generate more and more waste, and their management is a significant constitutes a significant cost of their functioning. The undertakings aimed at lowering the costs of expenses in waste management may have a positive influence on budgetary accounts in the institutions rendering health care services. On the example of a hospital in Lublin the costs of waste management and the possibilities to lower these costs by intensifying segregation procedures were presented. Moreover, the article presents the influence of specific waste neutralisation on the costs of waste management.
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.
Jeffrey, M; Riley, J
Employers, in their search for cost containment and quality improvement, have driven the development of the behavioral health managed care vendor. More specifically, the behavioral health carve-out is an innovation that was developed to respond to employer and, more recently, health plan needs. Now that the product has matured, it is increasingly being asked to justify its existence. Costs have certainly been maintained, but improvements in quality have not always been evident. The issues the authors address include, as cost pressures continue, can the industry deliver on its promise to improve care? Will it need to evolve to yet another level, with new or different features?
Pastoret, P P
Veterinary vaccinology is a very interesting and rapidly developing field. In fact veterinary vaccines are not only used for the prevention of infectious diseases in the animal health sector, but also help to solve problems of public health, to reduce detrimental environmental impact of the use of some veterinary drugs and prevent the emergence of resistance of micro-organisms or parasites. After a short introduction, this paper will deal with the use of vaccines for animal health and welfare, including new developments in the veterinary field such as marker vaccines and vectored vaccines, the special case of equine influenza-inactivated vaccines and the use of veterinary vaccines in public health. The conclusions will analyse the reasons as to why develop veterinary vaccines and the obstacles to their development.
Andreatta, Pamela; Marzano, David
Interdisciplinary team factors are significant contributors to clinical performance and associated patient outcomes. Quality of care and patient safety initiatives identify human factors associated with team performance as a prime improvement area for clinical patient care. The majority of references to interdisciplinary teams in obstetrics and gynecology in the literature recommends the use of multidisciplinary approaches when managing complex medical cases. The reviewed literature suggests that interdisciplinary team development is important for achieving optimally efficient and effective performance; however, few reports provide specific recommendations for how to optimally achieve these objectives in the process of providing interdisciplinary care to patients. The absence of these recommendations presents a significant challenge for those tasked with improving team performance in the workplace. The prescribed team development programs cited in the review are principally built around communication strategies and simulation-based training mechanisms. Few reports provide descriptions of optimal team-based competencies in the various contexts of obstetric and gynecology teams. However, team-based evaluation strategies and empirical data documenting the transfer of team training to applied clinical care are increasing in number and quality. Our findings suggest that research toward determining team factors that promote optimal performance in applied clinical practice requires definition of specific competencies for the variable teams serving obstetrics and gynecology.
Pruess, A.; Giroult, E.; Rushbrook, P.
The waste produced in the course of health-care activities, from contaminated needles to radioactive isotopes, carries a greater potential for causing infection and injury than any other type of waste, and inadequate or inappropriate management is likely to have serious public health consequences and deleterious effects on the environment. This handbook - the result of extensive international consultation and collaboration - provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes. The various categories of waste are clearly defined and the particular hazards that each poses are described. Considerable prominence is given to the careful planning that is essential for the success of waste management; workable means of minimizing waste production are outlined and the role of reuse and recycling of waste is discussed. Most of the text, however, is devoted to the collection, segregation, storage, transport, and disposal of wastes. Details of containers for each category of waste, labelling of waste packages, and storage conditions are provided, and the various technologies for treatment of waste and disposal of final residues are discussed at length. Advice is given on occupational safety for all personnel involved with waste handling, and a separate chapter is devoted to the closely related topic of hospital hygiene and infection control. The handbook pays particular attention to basic processes and technologies that are not only safe but also affordable, sustainable, and culturally appropriate. For health-care settings in which resources are severely limited there is a separate chapter on minimal programmes; this summarizes all the simplest and least costly techniques that can be employed for the safe management of health-care wastes. The guide is aimed at public health managers and policy-makers, hospital managers, environmental health professionals, and all administrators with an
Full Text Available The purpose of this study is to explore how knowledge can be managed across boundaries when implementing innovations in the healthcare sector is desired, in this specific case a healthcare quality register. The research is based on a qualitative, case study approach and comprises methodologies such as semi-structured interviews and document analysis. The findings of this study describe knowledge transferred across boundaries on a syntactic, semantic, and pragmatic level. On the syntactic level, knowledge of the innovation was transferred by training sessions for healthcare staff and through information to patients. On the semantic level, knowledge was transferred by knowledge brokering in the professional community of rheumatologists, and by creating collective stories and encouraging rheumatologists to “try” the innovation to find added value. On the pragmatic level, there were explicit conflicts of interest between physicians and healthcare authorities, as well as resistance from some rheumatologists to share knowledge of patients and treatment. The paper is concluded with implications for innovation practice in healthcare drawn from the study and ends with remarks about challenges ahead.
The healthcare supply chain is a vast, disintegrated network of products and players, loosely held together by manual and people-intensive processes. Managing the flow of information, supplies, equipment, and services from manufacturers to distributors to providers of care is especially difficult in clinical supply chains, compared with more technology-intense industries like consumer goods or industrial manufacturing. As supplies move downstream towards hospitals and clinics, the quality and robustness of accompanying management and information systems used to manage these products deteriorates significantly. Technology that provides advanced planning, synchronization, and collaboration upstream at the large supply manufacturers and distributors rarely is used at even the world's larger and more sophisticated hospitals. This article outlines the current state of healthcare supply chain management technologies, addresses potential reasons for the lack of adoption of technologies and provides a roadmap for the evolution of technology for the future. This piece is based on both quantitative and qualitative research assessments of the healthcare supply chain conducted during the last two years.
von Knorring, Mia; Alexanderson, Kristina; Eliasson, Miriam A
Purpose - The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations. Design/methodology/approach - In total, 18 of Sweden's 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians' sickness certification practice. A discourse analysis approach was used for data analysis. Findings - Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes "physician" or "non-physician" to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of "yes, but […]" approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers. Research limitations/implications - Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians. Practical implications - The results suggest that there is a need to address the organisational conditions for managers' role taking in healthcare organisations. Originality/value - Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.
Clinical practice guidelines are key tools for the translation of scientific evidence into everyday patient care. Therefore guidelines can act as cornerstones of evidence based knowledge management in healthcare, if they are trustworthy, and its recommendations are not biased by authors' conflict of interests. Good medical guidelines should be disseminated by means of virtual (digital/electronic) health libraries - together with implementation tools in context, such as guideline based algorithms, check lists, patient information, a.s.f. The article presents evidence based medical knowledge management using the German experiences as an example. It discusses future steps establishing evidence based health care by means of combining patient data, evidence from medical science and patient care routine, together with feedback systems for healthcare providers.
Hu, Jun; Peyton, Liam
In order to manage performance and provide integrated services, health care data needs to be linked and aggregated across data sources from different organizations. The Internet and secure B2B networks offer the possibility of providing near real-time integration. However, there are three major stumbling blocks. One is to standardize and agree upon a common data model across organizations. The second is to match identities between different locations in order to link and aggregate records. The third is to protect identity and ensure compliance with privacy laws. In this paper, we analyze three main approaches to the problem and use a healthcare scenario to illustrate how each one addresses different aspects of the problem while failing to address others. We then present a systematic framework in which the different approaches can be flexibly combined for a more comprehensive approach to integrate identity management with federated healthcare data models.
Longe, Ezechiel O
A survey of healthcare waste management practices and their implications for health and the environment was carried out. The study assessed waste management practices in 20 healthcare facilities ranging in capacity from 40 to 600 beds in Ikorodu and metropolitan Lagos, Lagos State, Nigeria. The prevailing healthcare waste management status was analysed. Management issues on quantities and proportion of different constituents of waste, segregation, collection, handling, transportation, treatment and disposal methods were assessed. The waste generation averaged 0.631 kg bed(-1) day(-1) over the survey area. The waste stream from the healthcare facilities consisted of general waste (59.0%), infectious waste (29.7%), sharps and pathological (8.9%), chemical (1.45%) and others (0.95%). Sharps/pathological waste includes disposable syringes. In general, the waste materials were collected in a mixed form, transported and disposed of along with municipal solid waste with attendant risks to health and safety. Most facilities lacked appropriate treatment systems for a variety of reasons that included inadequate funding and little or no priority for healthcare waste management as well as a lack of professionally competent waste managers among healthcare providers. Hazards associated with healthcare waste management and shortcomings in the existing system were identified.
Youngjin Lee, RN, PhD
Conclusion: A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs.
Hulse, Nathan C.; Galland, Joel; Borsato, Emerson P.
In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs. PMID:23304309
Martin, Elliott B; Mazzola, Natalia M; Brandano, Jessica; Luff, Donna; Zurakowski, David; Meyer, Elaine C
To examine the most commonly reported emotions encountered among healthcare practitioners when holding difficult conversations, including frequency and impact on care delivery. Interprofessional learners from a range of experience levels and specialties completed self-report questionnaires prior to simulation-based communication workshops. Clinicians were asked to describe up to three emotions they experienced when having difficult healthcare conversations; subsequent questions used Likert-scales to measure frequency of each emotion, and whether care was affected. 152 participants completed questionnaires, including physicians, nurses, and psychosocial professionals. Most commonly reported emotions were anxiety, sadness, empathy, frustration, and insecurity. There were significant differences in how clinicians perceived these different emotions affecting care. Empathy and anxiety were emotions perceived to influence care more than sadness, frustration, and insecurity. Most clinicians, regardless of clinical experience and discipline, find their emotional state influences the quality of their care delivery. Most clinicians rate themselves as somewhat to quite capable of recognizing and managing their emotions, acknowledging significant room to grow. Further education designed to increase clinicians' recognition of, reflection on, and management of emotion would likely prove helpful in improving their ability to navigate difficult healthcare conversations. Interventions aimed at anxiety management are particularly needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Ullah, Junaid Habib; Ahmed, Rashid; Malik, Javed Iqbal; Khan, M Amanullah
To assess the present waste management system of healthcare facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training. Interventional quasi-experimental study. The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010. Mckinsey's 7-S, technique of TQM was applied to assess the 220 HCFs from Lahore, Gujranwala and Sheikhupura districts for segregation, collection, transportation and disposal (SCTD) of hospital waste. Direct interview method was applied. Trainings were provided in each institution. After one year action period, the status of four areas of concern was compared before and after training. The parameters studied were segregation, collection, transportation and disposal systems in the 220 HCFs. Each of these were further elaborated by strategy, structure, system, staff, skill, style and stakeholder/shared value factors. Standard error of difference of proportion was applied to assess significance using 95% confidence level. There was marked improvement in all these areas ranging from 20% to 77% following a training program of 3 months. In case of disposal of the waste strategy, structure and system an increase of 60%, 65% and 75% was observed after training. The 7-S technique played a vital role in assessing the hospital waste management system. Training for the healthcare workers played a significant role in healthcare facilities.
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…
Olden, Peter C
Organization theory (OT) provides a way of seeing, describing, analyzing, understanding, and improving organizations based on patterns of organizational design and behavior (Daft 2004). It gives managers models, principles, and methods with which to diagnose and fix organization structure, design, and process problems. Health care organizations (HCOs) face serious problems such as fatal medical errors, harmful treatment delays, misuse of scarce nurses, costly inefficiency, and service failures. Some of health care managers' most critical work involves designing and structuring their organizations so their missions, visions, and goals can be achieved-and in some cases so their organizations can survive. Thus, it is imperative that graduate healthcare management programs develop effective approaches for teaching OT to students who will manage HCOs. Guided by principles of education, three applied teaching/learning activities/assignments were created to teach OT in a graduate healthcare management program. These educationalmethods develop students' competency with OT applied to HCOs. The teaching techniques in this article may be useful to faculty teaching graduate courses in organization theory and related subjects such as leadership, quality, and operation management.
Chadderdon, Linda M; Lloyd, James W; Pazak, Helene E
Veterinary technology has generally established itself well in companion-animal and mixed-animal veterinary medical practice, but the career's growth trajectory is uncertain. Michigan State University (MSU) convened a national conference, "Creating the Future of Veterinary Technology-A National Dialogue," in November 2011 to explore ways to elevate the veterinary technician/technologist's role in the veterinary medical profession and to identify new directions in which the career could expand. Veterinary technicians/technologists might advance their place in private practice by not only improving their clinical skills, but by also focusing on areas such as practice management, leadership training, business training, conflict resolution, information technology, and marketing/communications. Some new employment settings for veterinary technicians/technologists include more participation within laboratory animal medicine and research, the rural farm industry, regulatory medicine, and shelter medicine. Achieving these ends would call for new training options beyond the current 2-year and 4-year degree programs. Participants suggested specialty training programs, hybrid programs of various types, online programs, veterinary technician residency programs of 12-18 months, and more integration of veterinary technician/technology students and veterinary medicine students at colleges of veterinary medicine.
Full Text Available The aim of this study was to evaluate health-care waste in the 18 districts of metropolitan municipality of the third biggest city in Turkey. This cross-sectional study was carried out with 825 health institutions established in the 18 districts of Izmir metropolitan municipality, in 2007. The total amount of health-care waste collected was 4841 tons and 621 kilograms per patient's bed in 2007. Most of the medical wastes were collected from Konak, Karsiyaka and Bornova districts and were 2308, 272 and 1020 tons, respectively. Regarding to overpopulation, the number of health institutions in these districts are more than the number of health institutions in the other administrative districts. There was a statistically significant, positive correlation between the amount of health-care waste collected and population of the 18 districts (r = 0.79, p < 0.001, and number of beds/patients (r = 0.83, p < 0.001. To provide a safe health-care waste management metropolitan municipality must provide hazardous waste separation in health institutions, establish sterilization units for infectious waste, and provide the last storage of medical waste in completely different, safe and special areas apart from the municipal waste storage areas.
Doukas, Charalampos; Pliakas, Thomas; Maglogiannis, Ilias
Cloud Computing provides functionality for managing information data in a distributed, ubiquitous and pervasive manner supporting several platforms, systems and applications. This work presents the implementation of a mobile system that enables electronic healthcare data storage, update and retrieval using Cloud Computing. The mobile application is developed using Google's Android operating system and provides management of patient health records and medical images (supporting DICOM format and JPEG2000 coding). The developed system has been evaluated using the Amazon's S3 cloud service. This article summarizes the implementation details and presents initial results of the system in practice.
Eva Buller Viqueira
Full Text Available Introduction Rural primary health centers frequently treat patients with tick bites. This study compares everyday clinical practice at our primary healthcare center to practices recommended by current scientific evidence. Purpose To describe the everyday management of tick bites by different healthcare professionals and to compare this management to evidence-based therapy guidelines. Design Cross-sectional, descriptive observational study. Methods Data was collected through an anonymous self-completed questionnaire. The form was filled out by a consecutive sample of nurses, physicians and pediatricians of the clinical management unit of Medina-Sidonia (Cádiz. Results Most nurses in the sample group use some type of product to facilitate the extraction of the tick (10 of the 11 surveyed nurses, 90.9%. The most frequently used products were chloroethyl and local anesthetic. In addition, nine nurses use gentle traction with tweezers (81.82% to remove the tick. In the physician sample group, 3 out of 12 respondents (25% prescribe antibiotics in all cases and nine stated that they knew which antibiotic should be used as first choice. In both cases, a high number of healthcare providers confirm giving post-extraction advice to patients: 11 in the medical community (91.66% and nine nurses (81.82%. Conclusions We conclude that the performance of the healthcare providers that integrate this study does not closely follow general recommendations for extraction, treatment and follow-up care in patients with tick bites. Therefore, there is a need to improve the level of knowledge to ensure quality care in these instances.
Derks, Marjolein; Hogeveen, Henk; Kooistra, Sake R; van Werven, Tine; Tauer, Loren W
This paper compares farm efficiencies between dairies who were participating in a veterinary herd health management (VHHM) program with dairies not participating in such a program, to determine whether participation has an association with farm efficiency. In 2011, 572 dairy farmers received a questionnaire concerning the participation and execution of a VHHM program on their farms. Data from the questionnaire were combined with farm accountancy data from 2008 through 2012 from farms that used calendar year accounting periods, and were analyzed using Stochastic Frontier Analysis (SFA). Two separate models were specified: model 1 was the basic stochastic frontier model (output: total revenue; input: feed costs, land costs, cattle costs, non-operational costs), without explanatory variables embedded into the efficiency component of the error term. Model 2 was an expansion of model 1 which included explanatory variables (number of FTE; total kg milk delivered; price of concentrate; milk per hectare; cows per FTE; nutritional yield per hectare) inserted into the efficiency component of the joint error term. Both models were estimated with the financial parameters expressed per 100 kg fat and protein corrected milk and per cow. Land costs, cattle costs, feed costs and non-operational costs were statistically significant and positive in all models (P<0.01). Frequency distributions of the efficiency scores for the VHHM dairies and the non-VHHM dairies were plotted in a kernel density plot, and differences were tested using the Kolmogorov-Smirnov two-sample test. VHHM dairies had higher total revenue per cow, but not per 100 kg milk. For all SFA models, the difference in distribution was not statistically different between VHHM dairies and non-VHHM dairies (P values 0.94, 0.35, 0.95 and 0.89 for the basic and complete model per 100 kg fat and protein corrected milk and per cow respectively). Therefore we conclude that with our data farm participation in VHHM is not related
Chen Yang; Li Peijun; Lupi, Carlo; Sun Yangzhao; Xu Diandou; Feng Qian; Fu Shasha
This paper discusses actions aimed at sustainable management of healthcare wastes (HCW) in China, taking into account the current national situation in this field, as well as the requirements deriving from the Stockholm Convention on Persistent Organic Pollutants and the WHO recommendations. By the end of 2005, there were 149 low-standard HCW disposal facilities in operation in China, distributed throughout different areas. According to the National Hazardous Waste and Healthcare Waste Disposal Facility Construction Plan, 331 modern, high-standard, centralized facilities will be built up in China in municipal level cities. Although incineration is still the main technical option for HCW disposal in China, it is expected that, especially for medium and small size facilities, non-incineration technologies will develop quickly and will soon become the main technical option. The basic management needs - both from the point of view of pollution control and final disposal - have been defined, and a system of technical and environmental standards has been formulated and implemented; however, there are still some shortages. This is particularly true when considering the best available techniques and best environmental practices developed under the Stockholm Convention, with which the present technological and managing situations are not completely compliant. In this framework, the lifecycle (from generation to final disposal of wastes) of HCW and holistic approaches (technology verification, facilities operation, environmental supervision, environmental monitoring, training system, financial mechanism, etc.) towards HCW management are the most important criteria for the sustainable and reliable management of HCW in China.
Dimitropoulos, Panagiotis E
Organizational performance can create and sustain competitive advantages for corporations and even improve their sustainability and future prospects. Health care organizations present a sector where performance management is structured by multiple dimensions. The scope of this study is to analyze the issue of performance management in healthcare organizations and specifically the implementation of the Balanced Scorecard (BSC) methodology on organizations providing health services. The study provides a discussion on the BSC development process, the steps that management has to take in order to prepare the implementation of the BSC and finally discusses a practical example of a scorecard with specific strategic goals and performance indicators. Managers of healthcare organizations and specifically those providing services to the elderly and the general population could use the propositions of the study as a roadmap for processing, analyzing, evaluating and implementing the balanced scorecard approach in their organizations' daily operations. BSC methodology can give an advantage in terms of enhanced stakeholder management and preservation within a highly volatile and competitive economic environment.
Hubbert, William T.
The program aims at training veterinarians, with interdepartmental faculty participation the rule rather than the exception. Included in the curriculum are: avian medicine, herd health management, veterinary public health, veterinary food hygiene, and regulatory veterinary medicine. (LBH)
Healthcare waste management and treatment is one of the national priority tasks of China's Tenth Five-Year Plan.Numerous installations disposing medical waste have already operated the project or under construction to the operation in 2006. This paper focuses on the assessment of existing and fu~re options to handle medical waste (MW). Internationally available and so far in China applied technologies and management practice are analysed, including the problems how to materials. Non-hazardous MW can be managed and treated in analogue to municipal solid waste (MSW). In most of the European countries decentralised hospital incinerators have been, because of high operation costs and pollution problems,widely banned and replaced by pre-treatment technologies at the source and centralised incineration plants for hazardous MW.Information for adapting and further developing MW management solutions and treatment technologies in China and applying the most appropriate MWM practice is provided.
Vanderbroeck, Paul; Wasserfallen, Jean-Blaise
Purpose Diversity, notably gender diversity, is growing in health care, both at the level of teams and the level of organizations. This paper aims to describe the challenges for team leaders and leaders of organizations to manage this diversity. The authors believe that more could be done to help leaders master these challenges in a way that makes diverse teams and organizations more productive. Design/methodology/approach Drawing on previously published research, using gender diversity as an example, the paper first describes how diversity can both have a positive and a negative influence on team productivity. Next, it describes the challenge of gender diversity at an organizational level, using Switzerland as an example. Findings The first part of the paper espouses the causes of gender diversity, undoes some of the myths surrounding diversity and presents a model for effective management of diversity in teams. The second part looks at gender diversity at an organizational level. Drawing from sources inside and outside healthcare, the effects of the "leaking pipeline", "glass wall" and "glass ceiling" that prevent health-care organizations from leveraging the potential of female talent are discussed. Practical implications The authors propose a model developed for intercultural teamwork as a framework for leveraging gender diversity for better team productivity. Proposals are offered to health-care organizations on how they can tip the gender balance at senior levels into their favor, so as to get the maximum benefit from the available talent. Originality/value Applying the "how to" ideas and recommendations from this general review will help leaders of health-care organizations gain a better return on investment from their talent development as well as to increase the productivity of their workforce by a better use of diverse talent.
Kim, Hun-Sung; Lee, Kye-Hwa; Kim, Hyunah; Kim, Ju Han
The increasing average life expectancy is simultaneously increasing the incidence of chronic diseases and the number of healthy elderly people, consequently leading to an increased demand for healthcare management methods that do not involve hospital visits. The development of health management services involving mobile phones will change the focus of medical services from hospital visits and treatments to managing the health decisions made by individuals in their daily lives. However, the elderly may experience specific difficulties in adapting to constantly evolving services. This study reviews various health-related devices such as mobile phones that are available for providing healthcare to the elderly, and the different ways of using them. As the use of mobile phone increases, it is expected that elderly mobile phone users will also be able to regularly check their health status at any time and place. The issues of an ageing population pertain to the entire society rather than only to the elderly, which make mobile-phone-based medical informatics as a health management service a worthy goal. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
VanVactor, Jerry D
This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively. It is worth remembering, however, that all disasters are local - under the auspice of tiered response involving federal agencies, the principal responsibility for responding to domestic disasters and emergencies rests with the lowest level of government equipped and able to deal with the incident effectively. As such, the findings are equally applicable to institutions outside the military. It also bears repeating that every crisis is unique: there is no such thing as a uniform response for every incident. The role of the US DoD in emergency preparedness and disaster planning is changing and will continue to do so as the need for roles in support of a larger effort also continues to change.
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.
Thakur, Vikas; Ramesh, A
The importance of healthcare waste management in preserving the environment and protecting the public cannot be denied. Past research has dealt with various issues in healthcare waste management and disposal, which spreads over various journals, pipeline research disciplines and research communities. Hence, this article analyses this scattered knowledge in a systematic manner, considering the period between January 2005 and July 2014. The purpose of this study is to: (i) identify the trends in healthcare waste management literature regarding journals published; (ii) main topics of research in healthcare waste management; (iii) methodologies used in healthcare waste management research; (iv) areas most frequently researched by researchers; and (v) determine the scope of future research in healthcare waste management. To this end, the authors conducted a systematic review of 176 articles on healthcare waste management taken from the following eight esteemed journals: International Journal of Environmental Health Research, International Journal of Healthcare Quality Assurance, Journal of Environmental Management, Journal of Hazardous Material, Journal of Material Cycles and Waste Management, Resources, Conservations and Recycling, Waste Management, and Waste Management & Research. The authors have applied both quantitative and qualitative approaches for analysis, and results will be useful in the following ways: (i) results will show importance of healthcare waste management in healthcare operations; (ii) findings will give a comparative view of the various publications; (c) study will shed light on future research areas. © The Author(s) 2015.
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.
Antia, Bassey E; Bertin, Fankep D A
Nigeria has a healthcare system that has been described as defective even by its managers. A year 2000 study by the World Health Organization (WHO) of health systems in 191 member countries ranked Nigeria 187th. These several evaluations consistently point to inadequate managerial skills. Regrettably, very little is known of the import of language and communication as management issues in healthcare delivery in this country of 400 languages. This article therefore proposes a language-driven audit of health management in Borno State (northeast Nigeria) as a means of sensitizing policy makers and implementers. Based largely on data from questionnaires completed by 129 health professionals belonging to various professional categories (physicians, nurses, pharmacy staff, laboratory staff, and medical and health workers) and drawn from four hospitals, the study explores the relationship between multilingualism and the following: (a) patients' rights; (b) staff recruitment, deployment and commitment; (c) human asset accounting; (d) physician-population ratio. This language-driven audit reveals a number of points, including: ethically questionable practices; distributional imbalance in personnel; commendable cases of employee commitment; and inequity in renumeration.
Angus Nnamdi Oli
Conclusions: The availability of material for waste segregation at point of generation, compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.
Bermúdez Tamayo, C; Olry de Labry Lima, A; García Mochón, L
To identify good practices in order to develop and implement indicators of health outcomes for clinical and healthcare management, as well as the characteristics for an indicator to be considered adequate. A scoping review was performed, with the following phases: 1) Search and identification of bibliography. 2) Selection of relevant documents. Including those studies that discussed issues related to good practices for the use of health indicators in the management field. Those published in a language other than English or Spanish or before 2006 were excluded. 3) Analysis and extraction of information. 4) Consultation with stakeholders, using a qualitative methodology through Concept Mapping, with the participation of 40 experts (decision-makers, scientific societies, and health professionals). The data collection process included an inductive and structured procedure, with prioritisation of ideas grouped into clusters, according to feasibility and importance criteria (0-10 scale). Good practices identified 2 levels: 1) macro-management: Define a framework for the evaluation of indicators and establish a benchmark of indicators. 2) meso-management: Establish indicators according to evidence and expert consensus, taking into account priority areas and topics, testing before final use, and communicate results adequately. The characteristics of a suitable indicator are: 1) Approach of an important issue, 2) Scientific validity, 3) Possibility of measurement with reliable data, 4) Meaning of useful and applicable measurement, and 5) Wide scope. The best practices for the use of indicators in clinical and healthcare management can make it easier to monitor performance and accountability, as well as to support the decision-making addressed at the development of initiatives for quality improvement. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine
To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Integrative literature review. CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. © 2016 John Wiley & Sons Ltd.
Full Text Available Most children in hospital have pain. Seeing your child in pain or discomfort is incredibly difficult. Pain in children is a public health concern of major significance in most parts of the world. We have learned that unrelieved pain causes the body to release certain chemicals that may actually delay healing, so it's important to work with child's nurses and doctors to help children for control the pain. On the other side, medication is not the only way to relieve pain. Pain in children should always be managed and pain expression is dependent on the child’s age, cognitive development, and socio cultural context and it is important to pay particular attention to developmental variations in any behavioural manifestations of pain. In this study to explain some ways for parents and healthcare team to manage pain in children.
Kerr, Karolyn A; Norris, Tony; Stockdale, Rosemary
This research extends and tests principles to establish good practice and overcome practical barriers in the strategic management of data quality. The research explores the issues that define and control data quality in national health data collections and the mechanisms and frameworks that can be developed to achieve and sustain good data quality. The aim is to make the strategic management of data quality, and the prevention of persistent errors, everyday, ;institutionalized' activities. Using action research methodology and a combination of interpretive and positivist data collection and analysis methods, this research provides the health informatics community with an understanding of the issues related to developing and implementing programmes to improve data quality. Healthcare is a complex system that is highly political and culturally diverse, and applied health informatics research is essential to improve outcomes and performance.
Révia Ribeiro Castro
Full Text Available It aimed to conduct a situational analysis of the production and management of waste generated in a small hospital in the interior of the state of Ceará, Brazil, in 2014. Data collection occurred through systematic observation using checklist to verify routine procedures and questionnaires applied with the manager and employees responsible for hospital sectors. In the waste, it were found biological materials, anatomical parts, product of fertilization without vital signs, laboratory samples leftovers, containers and materials resulting from the health care process, chemical, household and sharps waste. It was verified improperly discarded waste according to current regulations. It is concluded the need for information and training of professionals who handle and dispose of healthcare waste.
Thakur, Vikas; Anbanandam, Ramesh
Purpose - The World Health Organization identified infectious healthcare waste as a threat to the environment and human health. India's current medical waste management system has limitations, which lead to ineffective and inefficient waste handling practices. Hence, the purpose of this paper is to: first, identify the important barriers that hinder India's healthcare waste management (HCWM) systems; second, classify operational, tactical and strategical issues to discuss the managerial implications at different management levels; and third, define all barriers into four quadrants depending upon their driving and dependence power. Design/methodology/approach - India's HCWM system barriers were identified through the literature, field surveys and brainstorming sessions. Interrelationships among all the barriers were analyzed using interpretive structural modeling (ISM). Fuzzy-Matrice d'Impacts Croisés Multiplication Appliquée á un Classement (MICMAC) analysis was used to classify HCWM barriers into four groups. Findings - In total, 25 HCWM system barriers were identified and placed in 12 different ISM model hierarchy levels. Fuzzy-MICMAC analysis placed eight barriers in the second quadrant, five in third and 12 in fourth quadrant to define their relative ISM model importance. Research limitations/implications - The study's main limitation is that all the barriers were identified through a field survey and barnstorming sessions conducted only in Uttarakhand, Northern State, India. The problems in implementing HCWM practices may differ with the region, hence, the current study needs to be replicated in different Indian states to define the waste disposal strategies for hospitals. Practical implications - The model will help hospital managers and Pollution Control Boards, to plan their resources accordingly and make policies, targeting key performance areas. Originality/value - The study is the first attempt to identify India's HCWM system barriers and prioritize
Derks, Marjolein; van de Ven, Lindsay M A; van Werven, Tine; Kremer, Wim D J; Hogeveen, Henk
The importance of veterinary herd health management (VHHM) is increasing in both dairy farming and veterinary practice. Little is known, however, about how VHHM is perceived by farmers in terms of structure, content and satisfaction. In 2007 a questionnaire, containing questions about these three items was therefore sent to 800 Dutch dairy farmers. Farmers received two questionnaires, one for participants in VHHM and one for non-participants, allowing them to choose the appropriate one. Results were summarized and statistically analyzed. Farmers who were participating in VHHM had better farm performance. They were satisfied with the way VHHM was executed on their farm. However, there were some pressure points. Goal setting and evaluation was still not a regular part of VHHM, even though it is said to be effective in literature. Time spent on VHHM not visible to the farmer was often not charged or not clearly specified on the bill. The differences in opinions between participants and non-participants of VHHM indicated a lack of communication and/or product differentiation. Satisfaction with the way VHHM was executed on the farm had no significant influence on 305-day production. There was, however, some influence on calving interval and bulk milk somatic cell count (BMSCC). Copyright Â© 2012 Elsevier B.V. All rights reserved.
Dias, Ricardo Augusto; Baquero, Oswaldo Santos; Guilloux, Aline Gil Alves; Moretti, Caio Figueiredo; de Lucca, Tosca; Rodrigues, Ricardo Conde Alves; Castagna, Cláudio Luiz; Presotto, Douglas; Kronitzky, Yury Cezar; Grisi-Filho, José Henrique Hildebrand; Ferreira, Fernando; Amaku, Marcos
The present study aimed to compare different sterilization scenarios allowing the adoption of the most adequate strategy to control owned dog and cat population sizes as the official veterinary public policy for animal control in an urban area of Campinas municipality, Brazil. To achieve this goal, the vital parameters of the owned pet population were measured in a neighborhood of Campinas called Jardim Vila Olimpia through questionnaires used in two census studies performed in February 2012 and June 2013. Different hypothetical sterilization scenarios were compared with the scenario of a single sterilization campaign performed in the study area between the census studies. Using a deterministic mathematical model, population dynamics were simulated for these different scenarios. We have observed that for both owned dogs and cats, the impact on the population size achieved by a single sterilization campaign would be diluted over the years, equating to the impact achieved by the usual sterilization rate practiced before the sterilization campaign yearly. Moreover, using local and global sensitivity analyses, we assessed the relative influence on animal population evolution of each vital parameter used in the mathematical models. The more influential parameters for both species were the carrying capacity of the environment and sterilization rates of males and females (for both species). We observed that even with sterilizing 100% of the intact animals annually, it would not be possible to obtain proportions greater than 86% and 88% of sterilized dogs and cats, respectively, after 20 years due to the high introduction of new intact animals. There is no public dog and cat sterilization service in place in the city, and sporadic and local sterilization campaigns are performed with a prior communication to the owners to bring their animals to be sterilized in a selected veterinary facility. If a sterilization campaign was performed annually in the study area, it would
MacDonald, Jacqueline; Doshi, Ketan; Dussault, Marike; Hall, J Christopher; Holbrook, Larry; Jones, Ginny; Kaldis, Angelo; Klima, Cassidy L; Macdonald, Phil; McAllister, Tim; McLean, Michael D; Potter, Andrew; Richman, Alex; Shearer, Heather; Yarosh, Oksana; Yoo, Han Sang; Topp, Edward; Menassa, Rima
The production of recombinant vaccines in plants may help to reduce the burden of veterinary diseases, which cause major economic losses and in some cases can affect human health. While there is abundant research in this area, a knowledge gap exists between the ability to create and evaluate plant-based products in the laboratory, and the ability to take these products on a path to commercialization. The current report, arising from a workshop sponsored by an Organisation for Economic Co-operation and Development (OECD) Co-operative Research Programme, addresses this gap by providing guidance in planning for the commercialization of plant-made vaccines for animal use. It includes relevant information on developing business plans, assessing market opportunities, manufacturing scale-up, financing, protecting and using intellectual property, and regulatory approval with a focus on Canadian regulations. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
Lee, Youngjin; Choo, Jina; Cho, Jeonghyun; Kim, So-Nam; Lee, Hye-Eun; Yoon, Seok-Jun; Seomun, GyeongAe
This study aimed to develop a job description for healthcare managers of metabolic syndrome management programs using task analysis. Exploratory research was performed by using the Developing a Curriculum method, the Intervention Wheel model, and focus group discussions. Subsequently, we conducted a survey of 215 healthcare workers from 25 community health centers to verify that the job description we created was accurate. We defined the role of healthcare managers. Next, we elucidated the tasks of healthcare managers and performed needs analysis to examine the frequency, importance, and difficulty of each of their duties. Finally, we verified that our job description was accurate. Based on the 8 duties, 30 tasks, and 44 task elements assigned to healthcare managers, we found that the healthcare managers functioned both as team coordinators responsible for providing multidisciplinary health services and nurse specialists providing health promotion services. In terms of importance and difficulty of tasks performed by the healthcare managers, which were measured using a determinant coefficient, the highest-ranked task was planning social marketing (15.4), while the lowest-ranked task was managing human resources (9.9). A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs. Copyright © 2014. Published by Elsevier B.V.
Gelberg, H B; Gelberg, S
It is important for veterinary administrators to apply knowledge bases from other fields to their own unique administrative needs. For example, although some resources are written for business managers, the discussions of four key management competency areas, guidelines for mastering these skills, organizational assessment tools, and other self-help tools may provide interesting food-for-thought for veterinary administrators.(76) In developing their own administrative styles, administrators should seek to apply those principles that seem to intuitively fit with their personal research styles, work situations, managerial styles, administrative preferences, and unique organizational culture. Through strengthening their liaisons with community and university business programs, counseling agencies, employee assistance programs, and psychology researchers, administrators can continue to be exposed to and benefit from new paradigms for consideration in veterinary medical environments. Through these liaisons, the unique needs of veterinary medical environments are also communicated to individuals within the fields of psychology and business, thus stimulating new research that specifically targets veterinary medical environment leadership issues. Each field has unique contributions to help veterinary administrators work toward creating veterinary medical environments that are creative, energetic, visionary, pragmatic, and highly marketable in order to help administrators recruit and nurture the best and brightest veterinary researchers, teachers, and clinicians.
Shewchuk, Richard M; O'Connor, Stephen J; Fine, David J
Healthcare organizations, health management professional associations, and educational institutions have begun to examine carefully what it means to be a fully competent healthcare executive. As a result, an upsurge in interest in healthcare management competencies has been observed recently. The present study uses two critically important groups of informants as participants: health management practitioners and faculty. Using the nominal group process, health administrators identified critical environmental issues perceived to have an impact on healthcare executives today. These issues were employed in a card-sort assessment and a survey was administered to a nationwide sample of health administrators. These data were used to create a map and five clusters of the environmental landscape of healthcare management. These clusters of environmental issues provided a framework for having groups of administrators and faculty members generate and rank perceived behavioral competencies relative to each cluster. Implications for healthcare management practice, education, and research are discussed.
Angus Nnamdi Oli; Callistus Chibuike Ekejindu; David Ufuoma Adje; Ifeanyi Ezeobi; Obiora Shedrack Ejiofor; Christian Chibuzo Ibeh; Chika Flourence Ubajaka
Objective: To assess healthcare workers' involvement in healthcare waste management in public and private hospitals. Methods: Validated questionnaires (n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013. Results: Among the healthcare workers that participated in the study, 187 (28.33%) were medical doctors, 44 (6.67%) were pharmacists, 77 (11.67%) were medical laboratory scientist, 35 (5.30%) were waste handlers...
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.
Khammaneechan, Patthanasak; Okanurak, Kamolnetr; Sithisarankul, Pornchai; Tantrakarnapa, Kraichat; Norramit, Poonsup
This evaluative research study aimed to assess the effects of the central healthcare incinerator project on waste management in Yala Province. The study data were collected twice: at baseline and during the operational phase. A combination of structured interview and observation were used during data collection. The study covered 127 healthcare facilities: government hospitals, healthcare centres, and private clinics. The results showed 63% of healthcare risk waste (HCRW) handlers attended the HCRW management training. Improvements in each stage of the HCRW management system were observed in all groups of facilities. The total cost of the HCRW management system did not change, however; the costs for hospitals decreased, whereas those for clinics increased significantly. It was concluded that the central healthcare waste incinerator project positively affected HCRW management in the area, although the costs of management might increase for a particular group. However, the benefits of changing to a more appropriately managed HCRW system will outweigh the increased costs.
Advances in technology and digitalization have been widely adopted by Finnish healthcare organizations. This development has led to improvements in the efficiency and outcomes of patient care, but has also exposed healthcare providers to new kinds of risks. Cyber risks are becoming an increasingly common occurrence in the healthcare sector, and can lead to serious consequences for patients and organizations alike. The significance of cyber risks within healthcare has been projected to grow...
Mugambe, R.K.; Ssempebwa, J.C.; Tumwesigye, N.M.; Vliet, van B.J.M.; Adedimeji, A.
Aim The aim of this study was to assess the management, characteristics and generation of healthcare waste (HCW) in public and private hospitals in Kampala City, Uganda. Methods We employed mainly qualitative methods through the use of a waste inventory, observations, document review and key
Khamas, Wael A; Nour, Abdelfattah
Iraq is an agricultural country with a large population of animals: sheep, goats, cattle, water buffaloes, horses, donkeys, mules, and camels. In the 1980s, the successful poultry industry managed to produce enough table eggs and meat to satisfy the needs of the entire population; at one time, the thriving fish industry produced different types of fish for Iraqis' yearly fish consumption. There are four veterinary colleges in Iraq, which have been destroyed along with the veterinary services infrastructure. Understandably, improvements to the quality of veterinary education and services in Iraq will be reflected in a healthy and productive animal industry, better food quality and quantity, fewer zoonotic diseases, and more income-generating activities in rural areas. Thus, if undergraduate, graduate, and continuing education programs are improved, the veterinary medical profession will attract more competent students. This will satisfy the country's increased demand for competent veterinarians in both public and private sectors. Although Iraq has an estimated 5,000-7,000 veterinarians, there is a need for quality veterinary services and for more veterinarians. In addition, there is a need for the improvement of veterinary diagnostic facilities, as zoonotic diseases are always highly probable in this region. This article provides insight into the status of veterinary medical education and veterinary services in Iraq before and after the 1991 Gulf War and gives suggestions for improvement and implementation of new programs. Suggestions are also offered for improving veterinary diagnostic facilities and the quality of veterinary services. Improving diagnostic facilities and the quality of veterinary services will enhance animal health and production in Iraq and will also decrease the likelihood of disease transmission to and from Iraq. Threats of disease transmission and introduction into the country have been observed and reported by several international
Ferlie, Ewan; Ledger, Jean; Dopson, Sue; Fischer, Michael D.; Fitzgerald, Louise; McGivern, Gerry; Bennett, Christopher P.
Have generic management texts and associated knowledges now extensively diffused into public services organizations? If so, why? Our empirical study of English healthcare organizations detects an extensive presence of such texts. We argue that their ready diffusion relates to two macro-level forces: (i) the influence of the underlying political economy of public services reform and (ii) a strongly developed business school/management consulting knowledge nexus. This macro perspective theoreti...
Askarian, Mehrdad; Heidarpoor, Peigham; Assadian, Ojan
Healthcare waste comprises all wastes generated at healthcare facilities, medical research centers and laboratories. Although 75-90% of these wastes are classified as household waste posing no potential risk, 10-25% are deemed to be hazardous, representing a potential threat to healthcare workers, patients, the environment and even the general population, if not disposed of appropriately. If hazardous and non-hazardous waste is mixed and not segregated prior to disposal, costs will increase substantially. Medical waste management is a worldwide issue. In Iran, the majority of problems are associated with an exponential growth in the healthcare sector together with low- or non-compliance with guidelines and recommendations. The aim of this study was to reduce the amounts of infectious waste by clear definition and segregation of waste at the production site in Namazi Hospital in Shiraz, Iran. Namazi Hospital was selected as a study site with an aim to achieving a significant decrease in infectious waste and implementing a total quality management (TQM) method. Infectious and non-infectious waste was weighed at 29 admission wards over a 1-month period. Before the introduction of the new guidelines and the new waste management concept, weight of total waste was 6.67 kg per occupied bed per day (kg/occupied bed/day), of which 73% was infectious and 27% non-infectious waste. After intervention, total waste was reduced to 5.92 kg/occupied bed/day, of which infectious waste represented 61% and non-infectious waste 30%. The implementation of a new waste management concept achieved a 26% reduction in infectious waste. A structured waste management concept together with clear definitions and staff training will result in waste reduction, consequently leading to decreased expenditure in healthcare settings. Copyright © 2010 Elsevier Ltd. All rights reserved.
Karamitri, Ioanna; Talias, Michael A; Bellali, Thalia
Knowledge is an intangible asset in Organizations, and provides a comparative advantage to those who possess it. Hospitals are complex organizations with unique characteristics because of the heterogeneity of health professionals' orientation, the composite networking and the decision-making processes. A deeper understanding of knowledge management (KM) could streamline productivity and coordinate the use of resources more efficient. We conducted a systematic literature search of peer-reviewed papers that described key elements of KM using three databases (Medline, Cinahl and Health Source: nursing/academic edition) for a 10-year period (1/1/2004-25/11/2014). The included articles were subjected to qualitative content analysis. We retrieved 604 articles of which 20 articles were eligible for analysis. Most of the studies (n=13) used a qualitative methodology. The total sample size was 2155 participants. The key elements that arose were as follows: perceptions of KM, synthesis, dissemination, collaboration, means of KM and leadership. Moreover, this study identified barriers for KM implementation, like time restrictions and limited skills. Healthcare managers ought to cultivate a knowledge environment, operate as role models, provide the tools for KM and reward people who act as knowledge brokers. Opportunities for collaboration and knowledge sharing should be encouraged. Successful KM should be patient-centered to gain its maximum value. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Teich, Sorin T; Faddoul, Fady F
The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term "lean" was coined in 1990 following the exploration of the Toyota model that led to the "transference" thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of "essential few" and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States.
Kirshin, V.A.; Belov, A.D.; Budarkov, V.A.; Prochazka, Z.
The monograph summarizes the authors' experience and data from Soviet and foreign scientific literature. It consists of the following chapters: radioactive sources; utilization of ionizing radiation and radioactive isotopes; biological effects of ionizing radiation; radiation sickness in animals; combined post-irradiation syndromes; prophylaxis of radiation injury; therapy of irradiated animals; and veterinary radiation hygiene control of the environment, fodder, animals and animal products. (P.A.)
Bierbooms, J.J.P.A.; van Oers, J.A.M.; Bongers, I.M.B.
Purpose Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder)
Portrait, F.R.M.; van den Berg, B.
Background and objectives: The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare
Houngbo, T.; Zweekhorst, M.B.M.; Bunders- Aelen, J.G.F.; Coleman, H.L.S.; Medenou, D.; Dakpanon, L.Y.; de Cock Buning, Tjard
This study aims to identify the root causes and solutions of main problems facing Healthcare Technology Management in Benin׳s public health sector. Conducted in Benin from 2008 to 2010, two surveys were used with key actors in Healthcare Technology Management. The first survey was based on 377
...: strategic partnering with an equipment management firm. The objective of this study is to create a decision-model for selecting the optimal management strategy for a healthcare organization's facility maintenance program...
Kühling, Jan-Gerd; Pieper, Ute
In many Southeast Asian countries, significant challenges persist with regard to the proper management and disposal of healthcare waste. The amount of healthcare waste in these countries is continuously increasing as a result of the expansion of healthcare systems and services. In the past, healthcare waste, if it was treated at all, was mainly incinerated. In the last decade more comprehensive waste management systems were developed for Southeast Asian countries and implementation started. This also included the establishment of alternative healthcare waste treatment systems. The developments in the lower-middle-income countries are of special interest, as major investments are planned. Based upon sample projects, a short overview of the current development trends in the healthcare waste sector in Laos, Indonesia and Vietnam is provided. The projects presented include: (i) Lao Peoples Democratic Republic (development of the national environmental health training system to support the introduction of environmental health standards and improvement of healthcare waste treatment in seven main hospitals by introducing steam-based treatment technologies); (ii) Indonesia (development of a provincial-level healthcare waste-management strategy for Province Nanggroe Aceh Darussalam (NAD) and introduction of an advanced waste treatment system in a tertiary level hospital in Makassar); and (iii) Vietnam (development of a healthcare waste strategy for five provinces in Vietnam and a World Bank-financed project on healthcare waste in Vietnam).
Poku, Michael K; Behkami, Nima A; Bates, David W
As the U.S. healthcare system moves to value-based care, the importance of engaging patients and families continues to intensify. However, simply engaging patients and families to improve their subjective satisfaction will not be enough for providers who want to maximize value. True optimization entails developing deep and long-term relationships with patients. We suggest that healthcare organizations must build such a discipline of "patient relationship management" (PRM) just as companies in non-healthcare industries have done with the concept of customer relationship management (CRM). Some providers have already made strides in this area, but overall it has been underemphasized or ignored by most healthcare systems to date. As healthcare providers work to develop their dedicated PRM systems, tools, and processes, we suggest they may benefit from emulating companies in other industries who have been able to engage their customers in innovative ways while acknowledging the differences between healthcare and other industries.
Ratkovic, Branislava; Andrejic, Milan; Vidovic, Milorad
In 2007, the Serbian Ministry of Health initiated specific activities towards establishing a workable model based on the existing administrative framework, which corresponds to the needs of healthcare waste management throughout Serbia. The objective of this research was to identify the reforms carried out and their outcomes by estimating the efficiencies of a sample of 35 healthcare facilities engaged in the process of collection and treatment of healthcare waste, using data envelopment analysis. Twenty-one (60%) of the 35 healthcare facilities analysed were found to be technically inefficient, with an average level of inefficiency of 13%. This fact indicates deficiencies in the process of collection and treatment of healthcare waste and the information obtained and presented in this paper could be used for further improvement and development of healthcare waste management in Serbia.
Ciplak, Nesli; Barton, John R
Healthcare waste consists of various types of waste materials generated at hospitals, medical research centres, clinics and laboratories. Although 75-90% of this waste is classified as 'domestic' in nature, 20-25% is deemed to be hazardous, which if not disposed of appropriately, poses a risk to healthcare workers, patients, the environment and even the whole community. As long as healthcare waste is mixed with municipal waste and not segregated prior to disposal, costs will increase substantially. In this study, healthcare waste increases along with the potential to decrease the amounts by implementing effective segregation at healthcare facilities are projected to 2040. Our long-term aim is to develop a system to support selection and planning of the future treatment capacity. Istanbul in Turkey was used as the case study area. In order to identify the factors affecting healthcare waste generation in Istanbul, observations were made and interviews conducted in Istanbul over a 3 month period. A system dynamics approach was adopted to build a healthcare waste management model using a software package, Vensim Ple Plus. Based on reported analysis, the non-hazardous municipal fraction co-disposed with healthcare waste is around 65%. Using the projected waste generation flows, reducing a municipal fraction to 30% has the potential to avoid some 8000 t year(-1) of healthcare waste by 2025 and almost 10 000 t year(-1) by 2035. Furthermore, if segregation practices ensured healthcare waste requiring incineration was also selectively managed, 77% of healthcare waste could be diverted to alternative treatment technologies. As the throughput capacity of the only existing healthcare waste treatment facility in Istanbul, Kemerburgaz Incinerator, has already been exceeded, it is evident that improved management could not only reduce overall flows and costs but also permit alternative and cheaper treatment systems (e.g. autoclaving) to be adopted for the healthcare waste.
Shahmoradi, Leila; Safadari, Reza; Jimma, Worku
Background Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Methods Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: “Healthcar...
¹Department of Veterinary Anatomy, Faculty of Veterinary Medicine, ABU Zaria, Nigeria, ²Department of. Veterinary Physiology ... dogs, AGRs have a highly sensitive sense of smell. The rats ..... Gonadal Axis and thyroid Activity in. Male rats.
Kedrowicz, April A; Royal, Kenneth; Flammer, Keven
While social media has the potential to be used to make professional and personal connections, it can also be used inappropriately, with detrimental ramifications for the individual in terms of their professional reputation and even hiring decisions. This research explored students' and faculty members' perceptions of the acceptability of various social media postings. This cross-sectional study was conducted in 2015. All students and faculty members at the College of Veterinary Medicine were invited to participate. The sample size included 140 students and 69 faculty members who completed the Social Media Scale (SMS), a 7-point semantic differential scale. The SMS consisted of 12 items that measured the extent to which a variety of behaviors, using social media, constituted acceptable and unacceptable behaviors. Items appearing on the SMS were an amalgamation of modified items previously presented by Coe, Weijs, Muise et al. (2012) and new items generated specifically for this study. The data were collected during the spring semester of 2015 using Qualtrics online survey software and analyzed using t-tests and ANOVA. The results showed that statistically significant differences existed between the students' and faculty members' ratings of acceptable behavior, as well as gender differences and differences across class years. These findings have implications for the development of policy and educational initiatives around professional identity management in the social sphere.
APRIL A. KEDROWICZ
Full Text Available Introduction: While social media has the potential to be used to make professional and personal connections, it can also be used inappropriately, with detrimental ramifications for the individual in terms of their professional reputation and even hiring decisions. This research explored students’ and faculty members’ perceptions of the acceptability of various social media postings. Methods: This cross-sectional study was conducted in 2015. All students and faculty members at the College of Veterinary Medicine were invited to participate. The sample size included 140 students and 69 faculty members who completed the Social Media Scale (SMS, a 7-point semantic differential scale. The SMS consisted of 12 items that measured the extent to which a variety of behaviors, using social media, constituted acceptable and unacceptable behaviors. Items appearing on the SMS were an amalgamation of modified items previously presented by Coe, Weijs, Muise et al. (2012 and new items generated specifically for this study. The data were collected during the spring semester of 2015 using Qualtrics online survey software and analyzed using t-tests and ANOVA. Results: The results showed that statistically significant differences existed between the students’ and faculty members’ ratings of acceptable behavior, as well as gender differences and differences across class years. Conclusion: These findings have implications for the development of policy and educational initiatives around professional identity management in the social sphere.
Alzahrani, Ahmed; Qureshi, Muhammad Shuaib; Thayananthan, Vijey
This paper aims to analyze possible next generation of networked radio frequency identification (NGN-RFID) system for customer relationship management (CRM) in healthcare industries. Customer relationship and its management techniques in a specific healthcare industry are considered in this development. The key objective of using NGN-RFID scheme is to enhance the handling of patients' data to improve the CRM efficiency in healthcare industries. The proposed NGN-RFID system is one of the valid points to improve the ability of CRM by analyzing different prior and current traditional approaches. The legacy of customer relationship management will be improved by using this modern NGN-RFID technology without affecting the novelty.
Lee Carman Ka Man
Full Text Available The healthcare industry has been focusing efforts on optimizing inventory management procedures through the incorporation of Information and Communication Technology, in the form of tracking devices and data mining, to establish ideal inventory models. In this paper, a roadmap is developed towards a technological assessment of the Internet of Things (IoT in the healthcare industry, 2010–2020. According to the roadmap, an IoT-based healthcare asset management system (IoT-HAMS is proposed and developed based on Artificial Neural Network (ANN and Fuzzy Logic (FL, incorporating IoT technologies for asset management to optimize the supply of resources.
Bioethical courses were introduced in the curricula in medical universities in Bulgaria in 1990s. In the beginning, the courses were mainly theoretical, and systematic case analyses and discussions of movies were introduced later on. The benefits of using films to teach ethics have been previously analyzed in the literature; however, to our knowledge such studies in Bulgaria are yet lacking. The aim of this study was to survey the opinions of students and analyze the results from the application of movies in bioethics teaching in a medical university in the north of Bulgaria. A survey was carried out among 92 students in the management of healthcare. Two movies were used, and separate protocols for film discussion were developed. The study was conducted anonymously and with students' free informed consent. The students distinguished in total 21 different dilemmas and concepts in the first movie. The ethical dilemmas were classified into five groups: general ethical issues, deontological issues, special ethical issues, principles of bioethics, and theories of ethics. The second movie focused students' attention on the issues of death and dying. In total, 18 elements of palliative care were described by the students. The range of different categories was a positive indicator of an increased ethical sensitivity. The students evaluated the movies' discussions as a generally positive educational approach. They perceived the experience as contributing to their better understanding of bioethical issues. The innovative approach was well accepted by the students. The introduction of movies in the courses of bioethics had the potential to provide vivid illustrations of bioethical issues and to contribute to the exploration of specific theses and arguments. The presentation and discussion should be preceded by accumulation of theoretical knowledge. The future of effective bioethics education lays in the interactive involvement of students. © The Author(s) 2014.
Webb, Jonathan R
..., and $31 billion in excess general medical costs. The purpose of this study is to determine whether sustained hemoglobin HbA1c testing among patients is followed by reductions in healthcare utilization...
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.
DeFrancesco, Jennifer A.
Healthcare organizations strive to adapt to the continuous change in what has become a fast-paced, high technology environment. Many organizations are charged to find efficiencies to better manage medical device assets. Increasingly, healthcare leaders opt to adopt a standardized medical device nomenclature under the purview of a set of national…
Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…
Adebukola E. Oyewunmi
Full Text Available Purpose: Diversity is synonymous with difference. The diverse workforce presents an array of complexities which necessitates the deployment of specific managerial competencies. Empirical evidences have indicated the role of emotional intelligence in the enhancement of abilities. Thus, this study investigated the relationship between emotional intelligence and diversity management competency amongst healthcare managers in Southwest Nigeria. Design: The descriptive survey method was adopted for the study. A total of 360 respondents completed the structured questionnaire titled Emotional Intelligence and Diversity Management Competency Questionnaire (EIDMCQ. Data was analyzed using descriptive and inferential statistics such as, Multiple Regression Analyses and Pearson Product Moment Correlation Statistical methods. Findings: A positive correlation was found between emotional intelligence and diversity management competency. Gender, ethnicity, and age, did not moderate the relationship between emotional intelligence and diversity management competency. Practical Implications: As difference is the reality of modern organizations, it is important to conceptualize it as normal and positive. Emotional intelligence is recommended as a critical tool to normalize the individual perceptions of difference. The re-assessment of the functions of managers must be followed by total commitment to capacity building in emotional intelligence, as well as the re-engineering of organizational and national cultures to promote equal opportunities, inclusion and diversity leveraging. Originality/value: This study pioneers research on emotional intelligence and diversity management competency in Nigeria’s public healthcare sector. It conceptualizes diversity management on an individual- managerial level. Practical interventions are provided to enhance the application of specific competencies to optimize a diverse workplace.
Jennings, B M; Loan, L A
A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system. Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves. This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility. Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making. Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.
Naranjo-Gil, David; Ruiz-Muñoz, David
Healthcare supply expenses consume a large part of the financial resources allocated to public health. The aim of this study was to analyze the use of a benchmarking process in the management of hospital purchases, as well as its effect on product cost reduction and quality improvement. Data were collected through a survey conducted in 29 primary healthcare districts from 2010 to 2011, and through a healthcare database on the prices, quality, delivery time and supplier characteristics of 5373 products. The use of benchmarking processes reduced or eliminated products with a low quality and high price. These processes increased the quality of products by 10.57% and reduced their purchase price by 28.97%. The use of benchmarking by healthcare centers can reduce expenditure and allow more efficient management of the healthcare supply chain. It also facilitated the acquisition of products at lower prices and higher quality. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Full Text Available Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM by improving the decision making pertaining processes’ efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.
AbuKhousa, Eman; Al-Jaroodi, Jameela; Lazarova-Molnar, Sanja; Mohamed, Nader
Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM) by improving the decision making pertaining processes' efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM) has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.
Healthcare professionals working in the community setting have limited knowledge of the evidence-based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients \\'at risk\\' of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored.
Nilsson, Josefine; Pembe, Andrea B; Urasa, Miriam; Darj, Elisabeth
Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania. This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed. A total of 223 of 305 (73%) healthcare workers from different cadres were included in the study. The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital, however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes. However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.
Satink, T.J.; Cup, E.H.; Swart, B.J.M. de; Sanden, M.W. van der
PURPOSE: Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions.
Lin, Tzu-Yin; Rodriguez, Carlos O; Li, Yuanpei
Nanomedicine is an interdisciplinary field that combines medicine, engineering, chemistry, biology and material sciences to improve disease management and can be especially valuable in oncology. Nanoparticle-based agents that possess functions such as tumor targeting, imaging and therapy are currently under intensive investigation. This review introduces the basic concept of nanomedicine and the classification of nanoparticles. Because of their favorable pharmacokinetics, tumor targeting properties, and resulting superior efficacy and toxicity profiles, nanoparticle-based agents can overcome several limitations associated with conventional diagnostic and therapeutic protocols in veterinary oncology. The two most important tumor targeting mechanisms (passive and active tumor targeting) and their dominating factors (i.e. shape, charge, size and nanoparticle surface display) are discussed. The review summarizes published clinical and preclinical studies that utilize different nanoformulations in veterinary oncology, as well as the application of nanoparticles for cancer diagnosis and imaging. The toxicology of various nanoformulations is also considered. Given the benefits of nanoformulations demonstrated in human medicine, nanoformulated drugs are likely to gain more traction in veterinary oncology. Published by Elsevier Ltd.
Durmisevic, S; van der Voordt, Theo; Wagenaar, C.
Healthcare is in need of methods and sound research data to provide a better fit between supply and demand with regard to functionality, serviceability, architectural and perceptual qualities, technical aspects, economical issues and sustainability. This paper presents a
Angus Nnamdi Oli; Callistus Chibuike Ekejindu; David Ufuoma Adje; Ifeanyi Ezeobi; Obiora Shedrack Ejiofor; Christian Chibuzo Ibeh; Chika Flourence Ubajaka
Objective:To assess healthcare workers’ involvement in healthcare waste management in public and private hospitals.Methods:Validated questionnaires(n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013.Results:Among the healthcare workers that participated in the study,187(28.33%) were medical doctors,44(6.67%) were pharmacists,77(11.67%) were medical laboratory scientist,35(5.30%) were waste handlers and 317(48.03%) were nurses.Generally,the number of workers that have heard about healthcare waste disposal system was above average 424(69.5%).More health-workers in the government(81.5%) than in private(57.3%) hospitals were aware of healthcare waste disposal system and more in government hospitals attended training on it.The level of waste generated by the two hospitals differed significantly(P=0.0086) with the generation level higher in government than private hospitals.The materials for healthcare waste disposal were significantly more available(P=0.001) in government than private hospitals.There was no significant difference(P = 0.285) in syringes and needles disposal practices in the two hospitals and they were exposed to equal risks(P =0.8510).Fifty-six(18.5%) and 140(45.5%) of the study participants in private and government hospitals respectively were aware of the existence of healthcare waste management committee with 134(44.4%) and 19(6.2%) workers confirming that it did not exist in their institutions.The existence of the committee was very low in the private hospitals.Conclusions:The availability of material for waste segregation at point of generation,compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.
Stenner, Paul; Cross, Vinnette; McCrum, Carol; McGowan, Janet; Defever, Emmanuel; Lloyd, Phil; Poole, Robert; Moore, Ann P
A move towards self-management is central to health strategy around chronic low back pain, but its concept and meaning for those involved are poorly understood. In the reported study, four distinct and shared viewpoints on self-management were identified among people with pain and healthcare providers using Q methodology. Each construes self-management in a distinctive manner and articulates a different vision of change. Identification of similarities and differences among the viewpoints holds potential for enhancing communication between patients and healthcare providers and for better understanding the complexities of self-management in practice.
Full Text Available A move towards self-management is central to health strategy around chronic low back pain, but its concept and meaning for those involved are poorly understood. In the reported study, four distinct and shared viewpoints on self-management were identified among people with pain and healthcare providers using Q methodology. Each construes self-management in a distinctive manner and articulates a different vision of change. Identification of similarities and differences among the viewpoints holds potential for enhancing communication between patients and healthcare providers and for better understanding the complexities of self-management in practice.
Ferreira, Vera; Teixeira, Margarida Ribau
The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available Introduction: During their formal studies medical students acquire extensive medical expertise. However, the medical profession demands additional competencies, such as those involved in efficient resource allocation, business administration, development, organization, and process management in the healthcare system. At present students are not sufficiently prepared for the physician’s role as manager. In response, we designed the seminar course, MeCuM-SiGma, to impart basic knowledge about healthcare policy and management to students of medicine. This project report describes our teaching strategies and the initial evaluation of this educational project.Project description: In this semester-long, seminar course introduced in 2010, medical students gather experience with the competencies mentioned above as well as learn basic management skills. The course is offered each winter semester, and students sign up to attend voluntarily; course coordination and organization is done on a voluntary basis by physicians and employees of the Mentoring Office (MeCuM-Mentor at the Medical School of the Ludwig Maximilian University (LMU in Munich, Germany. The course is open to all students enrolled at the two medical schools in Munich.During the first part of this elective, students learn about the basic principles of the German political and healthcare systems in case-based, problem-based tutorials led by trained tutors and in lectures held by experts.In the second part of the course students take on the roles of the University Hospital’s executive board of directors and supervisory board to work on an existing hospital project as a group within the scope of a simulation. This phase of the course is accompanied by workshops conducted in cooperation with university-based and off-campus partners that address the procedural learning objectives (teamwork, project management, negotiation strategies, etc..A suitable, authentic issue currently facing the
Gradel, Maximilian; Moder, Stefan; Nicolai, Leo; Pander, Tanja; Hoppe, Boj; Pinilla, Severin; Von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos
During their formal studies medical students acquire extensive medical expertise. However, the medical profession demands additional competencies, such as those involved in efficient resource allocation, business administration, development, organization, and process management in the healthcare system. At present students are not sufficiently prepared for the physician's role as manager. In response, we designed the seminar course, MeCuM-SiGma, to impart basic knowledge about healthcare policy and management to students of medicine. This project report describes our teaching strategies and the initial evaluation of this educational project. In this semester-long, seminar course introduced in 2010, medical students gather experience with the competencies mentioned above as well as learn basic management skills. The course is offered each winter semester, and students sign up to attend voluntarily; course coordination and organization is done on a voluntary basis by physicians and employees of the Mentoring Office (MeCuM-Mentor) at the Medical School of the Ludwig Maximilian University (LMU) in Munich, Germany. The course is open to all students enrolled at the two medical schools in Munich. During the first part of this elective, students learn about the basic principles of the German political and healthcare systems in case-based, problem-based tutorials led by trained tutors and in lectures held by experts. In the second part of the course students take on the roles of the University Hospital's executive board of directors and supervisory board to work on an existing hospital project as a group within the scope of a simulation. This phase of the course is accompanied by workshops conducted in cooperation with university-based and off-campus partners that address the procedural learning objectives (teamwork, project management, negotiation strategies, etc.). A suitable, authentic issue currently facing the hospital is selected in advance by the course organizers
Minogue, Virginia; Wells, Bill
The NHS is under pressure to increase its effectiveness and productivity. Nurses are tasked with delivering effective and efficient care, as well as improving patient safety, experiences and results. The reduction of waste in service delivery, care and treatment can release time and resources for nurses to engage in direct patient care. Nurses have an important role in reducing waste and influencing other professionals in the healthcare environment to increase their efficiency and productivity.
Lippi, Giuseppe; Mattiuzzi, Camilla; Bovo, Chiara; Favaloro, Emmanuel J
Identification errors have emerged as critical issues in health care, as testified by the ample scientific literature on this argument. Despite available evidence suggesting that the frequency of misidentification in vitro laboratory diagnostic testing may be relatively low compared to that of other laboratory errors (i.e., usually comprised between 0.01 and 0.1% of all specimens received), the potential adverse consequences remain particularly worrying, wherein 10-20% of these errors not only would translate into serious harm for the patient, but may also erode considerable human and economic resources, so that the entire healthcare system should be re-engineered to act proactively and limiting the burden of this important problem. The most important paradigms for reducing the chance of misidentification in healthcare entail the widespread use of more than two unique patient identifiers, the accurate education and training of healthcare personnel, the delivery of more resources for patient safety (i.e., implementation of safer technological tools), and the use of customized solutions according to local organization and resources. Moreover, after weighing advantages and drawbacks, labeling blood collection tubes before and not after venipuncture may be considered a safer practice for safeguarding patient safety and optimizing phlebotomist's activity. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Vashist, Sandeep Kumar; Schneider, E Marion; Luong, John H T
Smartphone-based devices and applications (SBDAs) with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare). Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.
Sandeep Kumar Vashist
Full Text Available Smartphone-based devices and applications (SBDAs with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare. Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.
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.
Prenestini, Anna; Lega, Federico
Healthcare organizations are often characterized by diffuse power, ambiguous goals, and a plurality of actors. In this complex and pluralistic context, senior healthcare managers are expected to provide strategic direction and lead their organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the competing values framework, which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional performance evaluation system, which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and four teaching hospitals (THs). Usable responses were received from 80 senior managers of 11 different healthcare organizations (two THs and nine LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational, and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice, and public policy are discussed.
Palmeiro, Brian S
Cyclosporine is an immunomodulatory medication that is efficacious and approved for atopic dermatitis in dogs and allergic dermatitis in cats; it has also been used to successfully manage a variety of immune-mediated dermatoses in dogs and cats. This article reviews the use of cyclosporine in veterinary dermatology including its mechanism of action, pharmacokinetics, drug interactions, side effects, and relevant clinical updates. Dermatologic indications including atopic/allergic dermatitis, perianal fistulas, sebaceous adenitis, and other immune-mediated skin diseases are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.
Al-Khatib, Issam A
Medical waste management in primary and secondary healthcare centres in the occupied Palestinian territory was assessed. The overall monthly quantity of solid healthcare waste was estimated to be 512.6 tons. Only 10.8% of the centres completely segregated the different kinds of healthcare waste and only 15.7% treated their medical waste. In the centres that treated waste, open burning was the main method of treatment. The results indicate that Palestinians are exposed to health and environmental risks because of improper disposal of medical waste and steps are needed to improve the situation through the establishment and enforcement of laws, provision of the necessary infrastructure for proper waste management and training of healthcare workers and cleaners.
Kuziemsky, Craig E; Yazdi, Sara
Numerous studies and strategic plans are advocating more team based healthcare delivery that is facilitated by information and communication technologies (ICTs). However before we can design ICTs to support teams we need a solid conceptual model of team processes and a methodology for using such a model in healthcare settings. This paper draws upon success in the supply chain management domain to develop a reference ontology of healthcare teams and a methodology for modeling teams to instantiate the ontology in specific settings. This research can help us understand how teams function and how we can design ICTs to support teams.
Adebanjo, Dotun; Laosirihongthong, Tritos; Samaranayake, Premaratne
The objective of this study is to investigate the perceptions of practitioners/experts about the prioritisation of healthcare performance measures and their relationship with lean supply chain management (LSCM) practices. The study will also prioritise the drivers and resources required to implement LSCM in a healthcare operations context. The prioritisation is based on the relative weights of various initiatives on a range of performance measures. Twenty-four LSCM initiatives were identified...
Lefevre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger
AIMS AND OBJECTIVES: To investigate the experience and personal impact of a group leadership course for child healthcare nurses.BACKGROUND: During their child's first year, all parents in Sweden are invited to participate in parental groups within the child health service; however, only 49% choose to participate. Despite extensive experience, child healthcare nurses find managing parental groups challenging and express a need for training in group dynamics and group leadership.DESIGN: The stu...
Vanesh Mathur; S Dwivedi; M A Hassan; R P Misra
Background: The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Inadequate and inappropriate knowledge of handling of healthcare waste may have serious health consequences and a significant impact on the environment as well. Objective: The objective was to assess knowledge, attitude, and practices of doctors, nurses, laboratory technicians, and sanitary staff regarding biomedical waste management. Material...
Rubino, Louis; Freshman, Brenda
Recently, entrepreneurial behavior is becoming more accepted in the healthcare field. This article describes an attempt to foster development of positive entrepreneurial competencies in the undergraduate health administration classroom. Through a literature review on entrepreneurs, eight competency clusters are identified; decision making, strategic thinking, risk taking, confidence building, communicating ideas, motivating team members, tolerance of ambiguity, and internal locus of control. These clusters are used to promote entrepreneurial skills for students though identified learning-centered activities and supplement an instructional style that facilitates thoughtful reflection.
Healthcare associated infections (HAI) are the major complications of modern medical therapy. The most important HAIs are related to invasive devices including central line- associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and surgical-site infections (SSI). Excessive use of antibiotics has also led to the emergence and the global dissemination of antibiotic resistant bacteria over the last few decades. Reducing HAIs will involve a multi-modal approach to infection control practices as well as antibiotic stewardship program.
Masseroli, Marco; Marchente, Mario
We present X-PAT, a platform-independent software prototype that is able to manage patient referral multimedia data in an intranet network scenario according to the specific control procedures of a healthcare institution. It is a self-developed storage framework based on a file system, implemented in eXtensible Markup Language (XML) and PHP Hypertext Preprocessor Language, and addressed to the requirements of limited-dimension healthcare entities (small hospitals, private medical centers, outpatient clinics, and laboratories). In X-PAT, healthcare data descriptions, stored in a novel Referral Base Management System (RBMS) according to Health Level 7 Clinical Document Architecture Release 2 (CDA R2) standard, can be easily applied to the specific data and organizational procedures of a particular healthcare working environment thanks also to the use of standard clinical terminology. Managed data, centralized on a server, are structured in the RBMS schema using a flexible patient record and CDA healthcare referral document structures based on XML technology. A novel search engine allows defining and performing queries on stored data, whose rapid execution is ensured by expandable RBMS indexing structures. Healthcare personnel can interface the X-PAT system, according to applied state-of-the-art privacy and security measures, through friendly and intuitive Web pages that facilitate user acceptance.
Full Text Available Background/Aim. Over the recent years customer satisfaction program as a tool for patient satisfaction has been recognized as an important issue in healthcare services. The aim of this preliminary study was to explore an influence of healthcare institution managers' approach and attitudes to marketing and public relations activities (communication activities, in the context of implementation of customer satisfaction programs, on patient satisfaction. Methods. The study was conducted among managers from different state-owned healthcare institutions (healthcare centers, clinics, hospitals in Serbia. The structured questionnaire form, comprising both open and closed questions, was used as a main research tool. The total number of sent questionnaires was 120; 56 questionnaires were sent back, while 49 of them were valid. Results. It was shown that 42.9% of healthcare institutions apply proactive media approach, and that 35.7% of the organizations have a person who, besides his/her basic engagements, performs activities connected with marketing and public relations. Using Chi-square likelihood ratio test it is confirmed that these activities have a significant role in supporting customer satisfaction program implementation (p < 0.05. The results showed that in 69.4% cases, positive attitude of healthcare institutions managers toward marketing and public relations activities had positive influence on patient satisfaction (p < 0.05. Conclusion. Managers in healthcare sector in Serbia who used proactive approach toward media and who had already institutionalized communication activities with external stakeholders have a positive attitude to implementation of customer satisfaction program. Furthermore, managers' attitude toward communication activities has influence on patient satisfaction.
Alagoez, Aylin Zeren; Kocasoy, Guenay
Health-care waste management has been a significant problem in most economically developing countries as it is in Turkey. Most of the time, the main reason for the mismanagement of these wastes is the lack of appropriate legislation and effective control; other reasons are: financial strains and a lack of awareness. Being aware of the significance of the subject, in this paper the management of the health-care wastes in Istanbul, as a Metropolitan City of Turkey, was analyzed to create an integrated health-care waste management system in the city. Within the scope of the study, the existing situation and management practices such as the amount of the health-care wastes generated, segregation procedures, collection, temporary storage and transportation of the wastes within and outside of the institution were examined. Deficiencies, inconsistencies and improper applications were revealed. The existing Turkish Medical Wastes Control Regulation and institutional structure of the health-care waste management body were reviewed. After the evaluation and comparison with the requirements of other national and international organizations, items to be changed/added in the Regulation were identified. At the end of the study, the best management methods for the Istanbul City were determined and started to be applied at the institutions. After this study, the existing Regulation has been changed. The modified Regulation was published in 2005 and implementation has started. It is expected that by the application and implementation of the research outcomes, the management of health-care wastes in Istanbul and then in all over Turkey will be improved. The results obtained can also be used in most economically developing countries where there are similar environmental problems and strict budgets
Bierbooms, Joyce; Van Oers, Hans; Rijkers, Jeroen; Bongers, Inge
Purpose - Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder) management. Design/methodology/approach - The assessment was performed in two research parts: the steps described in the model were executed in a single case study at a mental healthcare organization in the Netherlands; and a process and effect evaluation was done to find the supporting and impeding factors with regard to the applicability of the model. Interviews were held with managers and directors to evaluate the effectiveness of the model with a view to stakeholder management. Findings - The stakeholder analysis resulted in the identification of eight stakeholder groups. Different expectations were identified for each of these groups. The analysis on performance gaps revealed that stakeholders generally find the collaboration with a mental healthcare provider "sufficient." Finally a prioritization showed that five stakeholder groups were seen as "definite" stakeholders by the organization. Practical implications - The assessment of the model showed that it generated useful knowledge for more evidence-based (stakeholder) management. Adaptation of the model is needed to increase its feasibility in practice. Originality/value - Provided that the model is properly adapted for the specific field, the analysis can provide more knowledge on stakeholders and can help integrate stakeholder management as a comprehensive process in policy planning.
Shahmoradi, Leila; Safadari, Reza; Jimma, Worku
Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.
Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira
Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.
Bushby, Philip; Woodruff, Kimberly; Shivley, Jake
Simple Summary First initiated in 1995 to provide veterinary students with spay/neuter experience, the shelter program at the Mississippi State University College of Veterinary Medicine has grown to be comprehensive in nature incorporating spay/neuter, basic wellness care, diagnostics, medical management, disease control, shelter management and biosecurity. Junior veterinary students spend five days in shelters; senior veterinary students spend 2-weeks visiting shelters in mobile veterinary units. The program has three primary components: spay/neuter, shelter medical days and Animals in Focus. Student gain significant hands-on experience and evaluations of the program by students are overwhelmingly positive. Abstract The shelter program at the Mississippi State University College of Veterinary Medicine provides veterinary students with extensive experience in shelter animal care including spay/neuter, basic wellness care, diagnostics, medical management, disease control, shelter management and biosecurity. Students spend five days at shelters in the junior year of the curriculum and two weeks working on mobile veterinary units in their senior year. The program helps meet accreditation standards of the American Veterinary Medical Association’s Council on Education that require students to have hands-on experience and is in keeping with recommendations from the North American Veterinary Medical Education Consortium. The program responds, in part, to the challenge from the Pew Study on Future Directions for Veterinary Medicine that argued that veterinary students do not graduate with the level of knowledge and skills that is commensurate with the number of years of professional education. PMID:26479234
Veterinary Microbiology, Third Edition is organized into four sections and begins with an updated and expanded introductory section on infectious disease pathogenesis, diagnosis and clinical management. The second section covers bacterial and fungal pathogens, and the third section describes viral d...
Macdonald, Jackie; Bath, Peter A; Booth, Andrew
Managers who work in publicly funded healthcare organizations are an understudied group. Some of the influences on their decisions may be unique to healthcare. This study considers how to integrate research knowledge effectively into healthcare managers' decision making, and how to manage and integrate information that will include community data. This first phase in a two-phase mixed methods research study used a qualitative, multiple case studies design. Nineteen semi-structured interviews were undertaken using the critical incident technique. Interview transcripts were analysed using the NatCen Framework. One theme represented ;information and decisions'. Cases were determined to involve complex multi-level, multi-situational decisions with participants in practical rather than ceremonial work roles. Most considered organizational knowledge in the first two decision phases and external knowledge, including research, in the third phase. All participants engaged in satisficing to some degree.
Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard
The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.
Veterinary Pathology, Faculty of Veterinary Medicine, University of Ilorin, Ilorin ... One of these mutations led to an amino acid exchange at position 544 ... organs such as comb, wattle, brain, heart, .... congestion in various tissues and edema of.
and Aji, T. G.. 1. 1Faculty of Veterinary Medicine, University of Maiduguri, Nigeria. ... limited nervous, muscle and skeletal systems development ... samples. Colloid area/volume and perimeter: This ..... BANKS, W. J., (1993): Applied Veterinary.
The Nigerian Veterinary Journal (NVJ) has been in existence since 1971. ... dogs diagnosed with parvovirus enteritis in some veterinary clinics in Nigeria · EMAIL ... Rabies vaccination status among occupationally exposed humans in Nigeria ...
... free client handout to share with them. Compounding Veterinary Compounding FDA has withdrawn its draft guidance for ... new guidance, the AVMA is working to ensure veterinary access and animal health are protected. NEWS & ALERTS ...
2Department of Veterinary Medicine, University of Nigeria, Nsukka. 3Veterinary. Teaching ... salivation, cornea opacity, haematuria and convulsion were observed in 20, 8, 2, 4, 1 and 3 of the patients ... intravenous fluid administration either for.
Kan, Yao-Chiang; Chen, Kai-Hong; Lin, Hsueh-Chun
Self-management in healthcare can allow patients managing their health data anytime and everywhere for prevention of chronic diseases. This study established a prototype of ubiquitous health management system (UHMS) with healthy diet control (HDC) for people who need services of metabolic syndrome healthcare in Taiwan. System infrastructure comprises of three portals and a database tier with mutually supportive components to achieve functionality of diet diaries, nutrition guides, and health risk assessments for self-health management. With the diet, nutrition, and personal health database, the design enables the analytical diagrams on the interactive interface to support a mobile application for diet diary, a Web-based platform for health management, and the modules of research and development for medical care. For database integrity, dietary data can be stored at offline mode prior to transformation between mobile device and server site at online mode. The UHMS-HDC was developed by open source technology for ubiquitous health management with personalized dietary criteria. The system integrates mobile, internet, and electronic healthcare services with the diet diary functions to manage healthy diet behaviors of users. The virtual patients were involved to simulate the self-health management procedure. The assessment functions were approved by capturing the screen snapshots in the procedure. The proposed system development was capable for practical intervention. This approach details the expandable framework with collaborative components regarding the self-developed UHMS-HDC. The multi-disciplinary applications for self-health management can support the healthcare professionals to reduce medical resources and improve healthcare effects for the patient who requires monitoring personal health condition with diet control. The proposed system can be practiced for intervention in the hospital. Copyright © 2017 Elsevier B.V. All rights reserved.
Shih, Stephen C; Rivers, Patrick A; Hsu, H Y Sonya
To gain and sustain competitive advantage, health-care providers have to continuously review and renovate their operational and information technology (IT) strategies through collaborative and cooperative endeavour with their supply chain channel members. This paper explores new ways of enhancing a health-care organization's responsiveness to changes and increasing its competitiveness through implementing strategic information technology alliances among channel members in a health-care supply chain network. An overview of issues and problems (e.g. bullwhip effect, negative externalities and free-riding phenomenon in multichannel supply chains) presented in the health-care supply chains is first delineated. This paper further goes over the issues of health-care supply chain coordination and integration for strategic IT alliances, followed by the discussion of the spillover effect of IT investments. A number of viable IT practices (such as information sharing and Internet-enabled supply chain portal) for effective health-care supply chain collaboration and coordination are then examined in this research. Finally, the paper discusses how strategic IT alliances can help improve the effectiveness of health-care supply chain management.
Krzeminski, M.; Lass, P.; Teodorczyk, J.; Krajka, J.
The veterinary use of radionuclide techniques dates back to the mid-sixties, but its more extensive use dates back to the past two decades. Veterinary nuclear medicine is focused mainly on four major issues: bone scintigraphy - with the majority of applications in horses, veterinary endocrinology - dealing mainly with the problems of hyperthyreosis in cats and hyperthyreosis in dogs, portosystemic shunts in small animals and veterinary oncology, however, most radionuclide techniques applied to humans can be applied to most animals. (author)
Pracht, Etienne E; Orban, Barbara L; Comins, Meg M; Large, John T; Asin-Oostburg, Virginia
Avoidable hospitalizations represent a key indicator for access to, and the quality of, primary care. Therefore, understanding their behavior is essential in terms of management of healthcare resources and costs. This analysis examines the affect of 2 healthcare strategies on the rate of avoidable hospitalization, managed care and the healthcare safety net. The avoidable hospitalizations definition developed by Weissman et al. (1992) was used to identify relevant inpatient episodes. A 2-stage simultaneous equations multivariate regression model with instrumental variables was used to estimate the relative influence of HMO penetration and the composition of local hospital markets on the rate of avoidable hospitalizations. Control variables in the model include healthcare supply and demand, demographic, socioeconomic, and health status characteristics. Increased market presence of public hospitals significantly reduced avoidable hospitalizations. HMO penetration did not influence the rate of avoidable hospitalizations. The results suggest that public investments in healthcare facilities and infrastructure are more effective in reducing avoidable hospitalizations. © 2011 National Association for Healthcare Quality.
Lefèvre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger
To investigate the experience and personal impact of a group leadership course for child healthcare nurses. During their child's first year, all parents in Sweden are invited to participate in parental groups within the child health service; however, only 49% choose to participate. Despite extensive experience, child healthcare nurses find managing parental groups challenging and express a need for training in group dynamics and group leadership. The study was designed as a controlled study with a pretest/post-test design where the participants form their own control group. A group leadership course was given to 56 child healthcare nurses and evaluated in a pre- and postintervention questionnaire, a course evaluation and an interview with the course leaders. The child healthcare nurses felt their group leadership skills were strengthened and the majority (96%) felt that the course had changed their way of leading parental groups. They felt that the group leader role had been clarified and that they had obtained several new tools to use in their groups. Clarifying the role of group leader and adding knowledge about group leadership and dynamics seems to have increased the self-confidence for child healthcare nurses in group leadership. Improved confidence in group management might motivate the child healthcare nurses to further develop parental groups to attract the parents who currently choose not to participate. © 2016 John Wiley & Sons Ltd.
Rebecca L Weintraub, MD; Keri Wachter, BA; Jennifer Goldsmith, MS; Marie J Teichman, BA; Eda Algur; Julie D Rosenberg, MPH
Background: Strong management is important for high-value health-care systems if returns on global health investments are to be delivered and the Sustainable Development Goals met by 2030. Managers are responsible for care delivery systems and strategies, making sure that health services benefit the population they intend to serve. Most managers in resource-limited settings work at the district level and below, with little training in non-clinical skills. They are often health care providers ...
Rahul S. Mor; Sarbjit Singh; Arvind Bhardwaj; Mohammad Osama
This study aims to investigate the awareness level of Biomedical waste managements in healthcare facilities, and their perception among hospital waste management team, doctors, nurses, lab techni-cians and waste handlers in Northwest Delhi region in India. The study has been conducted through a questionnaire survey followed by the descriptive statistical analysis method. Question-naire contains of 38 questions, where the first section deals with the hospital waste management team, the second ...
Childers, J R
Y2K raises challenges for healthcare risk managers that go beyond information technology issues. This article explains that (1) too little public attention is being paid to equipment which may well have Y2K faults and (2) few standards have been articulated for dealing with problems. Healthcare risk managers therefore must return to basic due diligence principles and develop their own standards and protocols. The article explains how to do due diligence and outlines suggested steps for dealing with the non-information technology side of compliance due diligence.
Full Text Available Purpose: to develop fundamental basis of science based healthcare management in social and economic instability. Public health state (1998-2008, selected region was characterized by cardiovascular health parameters (Code IX, ICD-10. Systematic review was performed according to PRISMA guidelines. Dynamic characteristics of major cardiovascular diseases in social and economic instability considered as a cause of a population system destabilization were reconstructed. Conclusion. Fundamentals of science based healthcare management in social and economic instability include long- and short-term prognosis of public health characteristics as the result of multifactor external influences on cardiovascular diseases prevalence.
Galimany-Masclans, Jordi; Torres-Egea, Pilar; Sancho-Agredano, Raúl; Girbau-García, Ma Rosa; Fabrellas, Núria; Torrens-Garcia, Ma Llum; Martínez-Estalella, Gemma
The sanitary waste represents a potential hazard for health workers. Given the high risk of infection in labor accidents, the correct management of sanitary waste minimizes this risk and improves labor and environment conditions. To identify risk perception with health professionals in relation to the advanced sorting and management of healthcare waste (HW). The current study is a descriptive, cross-sectional. The sample size was 177 health workers (nurse assistants, nurses, physicians, lab technicians) from three hospitals in Barcelona (Catalonia). Homemade questionnaire and questions with a free and spontaneous association and incomplete sentences were used to analyze labor variables, perception of risk and personal security through a Likert scale. Using a score from 1 (the lowest perception of risk) to 5 (the high perception of risk) to assess the risk perception, the average value for nurse assistants, nurses, physicians, and lab technicians was 3.71, 3.75, 3.83 and 4.03, respectively. Referring to items with free and spontaneous response association, 44.8% of workers consider HW as a biohazard, 29.6% consider it as waste material, 22.1% state that it must be managed properly and 3.5% described it as unknown residues. The results suggest that all health professionals generally have a perception of high risk. The lab technicians have a higher perception of the real risk of inadequate management of HW A 63.2% report that everyone has to make a proper management to preserve their occupational health; the 59% consider that the HW are a biological risk to the general population and only the 47.8% that are harmful to public health. Although it should be noted that only 44.8% think that HW are toxic and dangerous.
Guo, Ruiling; Berkshire, Steven D; Fulton, Lawrence V; Hermanson, Patrick M
Purpose The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics. Design/methodology/approach A cross-sectional study was conducted among US healthcare leaders. Spearman's correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0. Findings One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders' values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous "use of EBMgt" response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman's correlation indicated statistically significant relationships between healthcare leaders' use of EBMgt and healthcare organization bed size ( r s = 0.217, n = 152, p employees ( r s = 0.195, n = 152, p = 0.016). Originality/value This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.
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.
Trebble, Timothy M; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M
Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. The current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken. Six themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM. There is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and
Knowledge management has seen something of a resurgence in attention amongst health librarians recently. Of course it has never ceased to exist, but now many library staff are becoming more involved in organisational knowledge management, and positioning themselves as key players in the sphere. No single model of knowledge management is proliferating, but approaches that best fit the organisation's size, structure and culture, and a blending of evidence based practice and knowledge sharing. Whatever it is called and whatever models are used, it's clear that for librarians and information professionals, the importance of putting knowledge and evidence into practice, sharing knowledge well and capturing it effectively, are still what we will continue to do. © 2017 Health Libraries Group.
Full Text Available Healthcare organisations must improve their business practices and internal procedures in order to answer the increasing demand of health professionals and the general public for more and better information. Hospitals invest massively in information systems and technology (IS/IT in the hope that these investments will improve healthcare and meet patients’ demands. The main objective of our research is to study how organisational maturity, enhanced by investments in IS/IT, project management and best practices, leads to successful projects in public healthcare organisations. The rational of our model is that organisational maturity has a positive effect on IS/IT project success, and that this success is also positively enhanced by the use of project management practices. We emphasise that this combination of approaches can increase the effectiveness of projects. Furthermore, it can also improve the confidence that the results of investments will meet stakeholders’ expectations.
Busdicker, Mike; Upendra, Priyanka
This article discusses the role of healthcare technology management (HTM) in medical device cybersecurity and outlines concepts that are applicable to HTM professionals at a healthcare delivery organization or at an integrated delivery network, regardless of size. It provides direction for HTM professionals who are unfamiliar with the security aspects of managing healthcare technologies but are familiar with standards from The Joint Commission (TJC). It provides a useful set of recommendations, including relevant references for incorporating good security practices into HTM practice. Recommendations for policies, procedures, and processes referencing TJC standards are easily applicable to HTM departments with limited resources and to those with no resource concerns. The authors outline processes from their organization as well as best practices learned through information sharing at AAMI, National Health Information Sharing and Analysis Center (NH-ISAC), and Medical Device Innovation, Safety, and Security Consortium (MDISS) conferences and workshops.
Lin, Jen-Chiun; Su, Mei-Ju; Cheng, Po-Hsun; Weng, Yung-Chien; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei
This paper illustrates a sustained conceptual service quality improvement process for the management of software development within a healthcare enterprise. Our proposed process is revised from Niland's healthcare quality information system (HQIS). This process includes functions to survey the satisfaction of system functions, describe the operation bylaws on-line, and provide on-demand training. To achieve these goals, we integrate five information systems in National Taiwan University Hospital, including healthcare information systems, health quality information system, requirement management system, executive information system, and digital learning system, to form a full Deming cycle. A preliminary user satisfaction survey showed that our outpatient information system scored an average of 71.31 in 2006.
Koolivand, Ali; Mahvi, Amir Hossein; Alipoor, Vali; Azizi, Kourosh; Binavapour, Mohammad
The objective of this study was to identify the composition and production rate of healthcare waste and associated management practices in healthcare centres in Bandar Abbas, southern Iran. A total of 90 centres, including 30 physician offices, 30 dental offices and 30 clinics were selected in random way. Two samples in summer and two samples in winter were taken and weighed from each selected centre at the end of successive working day on Mondays and Tuesdays. Results showed that the mean of daily production rate for each clinic, dental and physician office were 2125.3, 498.3 and 374.9 g, respectively. Domestic-type and potentially infectious waste had the highest and chemical and pharmaceutical waste and sharps had the lowest percentages in all centres. Questionnaire results indicated that there were no effective activity for waste minimization, separation, reuse and recycling in healthcare centres and management of sharps, potentially infectious and other hazardous waste was poor.
Spanager, Lene; Østergaard, Doris; Lippert, Anne; Nielsen, Kurt; Dieckmann, Peter
Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.
Sadatsafavi, Hessam; Walewski, John
Purpose of the Paper: The purpose of this study is to provide healthcare organizations with a new perspective for developing strategies to enrich their human resource capabilities and improve their performance outcomes. The focus of this study is on leveraging the synergy between organizational management strategies and environmental design interventions. This paper proposes a framework for linking the built environment with the human resource management system of healthcare organizations. The framework focuses on the impact of the built environment regarding job attitudes and behaviors of healthcare workers. Research from the disciplines of strategic human resource management, resource-based view of firms, evidence-based design, and green building are utilized to develop the framework. The positive influence of human resource practices on job attitudes and behaviors of employees is one mechanism to improve organizational performance outcomes. Organizational psychologists suggest that human resource practices are effective because they convey that the organization values employee contributions and cares about their well-being. Attention to employee socio-emotional needs can be reciprocated with higher levels of motivation and commitment toward the organization. In line with these findings, healthcare environmental studies imply that physical settings and features can have a positive influence on job attitudes and the behavior of caregivers by providing for their physical and socio-emotional needs. Adding the physical environment as a complementary resource to the array of human resource practices creates synergy in improving caregivers' job attitudes and behaviors and enhances the human capital of healthcare firms. Staff, evidence-based design, interdisciplinary, modeling, perceived organizational supportPreferred Citation: Sadatsafavi, H., & Walewski, J. (2013). Corporate sustainability: The environmental design and human resource management interface in
Aguilar-Escobar, V G; Garrido-Vega, P
To study the applicability of the principles of Lean Production to manage the supply chain of a hospital. In particular, to determine which Lean practices and principles are applicable, the benefits obtained and the main barriers for its implementation. Managing the hospital supply chain is an important issue, both for its effect on the quality of care and its impact on costs. This study is based on a case study. 2005-10. Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technological investments. The implementation of the comprehensive plan has reduced inventory, decreased lead times and improved service quality. Also, there have been other important improvements: enhanced employee satisfaction and increased staff productivity, both dedicated to health and the logistics. The experience analysed has shown the applicability and appropriateness of Lean principles and some of its techniques in managing the logistics of hospitals. It also identifies some of the main difficulties that may arise. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.
AL Faresi, Ahmed
Current research in health care lacks a systematic investigation to identify and classify various sources of threats to information privacy when sharing health data. Identifying and classifying such threats would enable the development of effective information security risk monitoring and management policies. In this research I put the first step…
Chermin, B.; Frey, I.A.; Reijers, H.A.; Smeets, H.J.
Even though workflow management systems are currently not being applied on a wide scale in healthcare settings, their benefits with respect to operational efficiency and reducing patient risk seem enticing. The authors show how an approach that is rooted in simulation can be useful to predict the
Crooks, V.A.; Ormond, M.E.; Jin, Ki Nam
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short
Shivalli, Siddharudha; Sanklapur, Vasudha
The nurse's role in healthcare waste management is crucial. (1) To appraise nurses quantitatively and qualitatively regarding healthcare waste management; (2) to elicit the determinants of knowledge and attitudes of healthcare waste management. A cross-sectional study was undertaken at a tertiary care hospital of Mangalore, India. Self-administered pretested questionnaire and "nonparticipatory observation" were used for quantitative and qualitative appraisals. Percentage knowledge score was calculated based on their total knowledge score. Nurses' knowledge was categorized as excellent (>70%), good (50-70%), and poor (70% score). Most (86%) expressed the need of refresher training. No study variable displayed significant association (P > 0.05) with knowledge. Apt segregation practices were followed except in casualty. Patients and entourages misinterpreted the colored containers. Nurses' knowledge and healthcare waste management practices were not satisfactory. There is a need of refresher trainings at optimum intervals to ensure sustainability and further improvement. Educating patients and their entourages and display of segregation information board in local language are recommended.
Full Text Available Background. The nurse’s role in healthcare waste management is crucial. Objectives. (1 To appraise nurses quantitatively and qualitatively regarding healthcare waste management; (2 to elicit the determinants of knowledge and attitudes of healthcare waste management. Method. A cross-sectional study was undertaken at a tertiary care hospital of Mangalore, India. Self-administered pretested questionnaire and “nonparticipatory observation” were used for quantitative and qualitative appraisals. Percentage knowledge score was calculated based on their total knowledge score. Nurses’ knowledge was categorized as excellent (>70%, good (50–70%, and poor (70% score. Most (86% expressed the need of refresher training. No study variable displayed significant association (P>0.05 with knowledge. Apt segregation practices were followed except in casualty. Patients and entourages misinterpreted the colored containers. Conclusion. Nurses’ knowledge and healthcare waste management practices were not satisfactory. There is a need of refresher trainings at optimum intervals to ensure sustainability and further improvement. Educating patients and their entourages and display of segregation information board in local language are recommended.
Charalampos, Platis; Emmanouil, Zoulias; Dimitrios, Iracleous; Lappa, Evaggelia
The management of a healthcare organization is monitored using a suitably designed questionnaire to 271 nurses operating in Greek hospital. The data are fed to an automatic data mining system to obtain a suitable series of models to analyse, visualise and study the obtained information. Hidden patterns, correlations and interdependencies are investigated and the results are analytically presented.
This paper develops a conceptual framework for performance measurement as a pilot study on holistic hospital management in the Japanese healthcare context. We primarily used two data sources as well as expert statements obtained through interviews: a systematic review of literature and a questionnaire survey to healthcare experts. The systematic survey searched PubMed and PubMed Central, and 24 relevant papers were elicited. The expert questionnaire asked respondents to rate the degree of "usefulness" for each of 66 indicators on a three-point scale. Applying the theoretical framework, a minimum set of performance indicators was selected for holistic hospital management, which well fit the healthcare context in Japan. This indicator set comprised 35 individual indicators and several factors measured through questionnaire surveys. The indicators were confirmed by expert judgments from viewpoints of face, content and construct validities as well as their usefulness. A theoretical framework of performance measurement was established from primary healthcare stakeholders' perspectives. Performance indicators were largely divided into healthcare outcomes and performance shaping factors. Indicators in the former category may be applied for the detection of operational problems, while their latent causes can be effectively addressed by the latter category in terms of process, structure and culture/climate within the organization. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Singer, Judy; Adams, Jon
Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person
Mannion, Russell; Brown, Sally; Beck, Matthias; Lunt, Neil
The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care
Yoshioka, Jun; Nakane, Masaki; Kawamae, Kaneyuki
Mechanical ventilator failures expose patients to unacceptable risks, and maintaining mechanical ventilator safety is an important issue. We examined the usefulness of maintaining mechanical ventilators by clinical engineers (CEs) using a specialized calibrator. These evaluations and the ability to make in-house repairs proved useful for obviating the need to rent ventilators which, in turn, might prove faulty themselves. The CEs' involvement in maintaining mechanical ventilators is desirable, ensures prompt service, and, most importantly, enhances safe management of mechanical ventilators.
Subhas C. Misra
Full Text Available Biomedical engineering has grown as a vast field of research that includes many areas of engineering and technology also. Personalized Medicine is an emerging approach in today’s medicare system. It bears a very strong potential to consolidate modern e-health systems fundamentally. Scientists have already discovered some of the personalized drugs that can shift the whole medicare system into a new dimension. However, bringing the change in the whole medicare system is not an easy task. There are several factors that can affect the successful adoption of Personalized Medicine systems in the healthcare management sector. This paper aims at identifying the critical factors with the help of an empirical study. A questionnaire was distributed amongst some clinicians, clinical researchers, practitioners in pharmaceutical industries, regulatory board members, and a larger section of patients. The response data collected thereby were analyzed by using appropriate statistical methods. Based on the statistical analysis, an attempt is made to prepare a list of critical success factors in the adoption of personalized medicine in healthcare management. The study indicates that eight of the thirteen hypothesized factors have statistical relationship with “Success”. The important success factors detected are: data management, team work and composition, privacy and confidentiality, mind-set, return on investment, sufficient time, R&D and alignment. To the best of our knowledge, this is the first academic paper in which an attempt has been made to model the vital critical factors for the successful implementation of Personalized Medicine in healthcare management. The study bears the promise of important applications in healthcare engineering and technology. Keywords: Healthcare management, Personalized medicine, E-health, Success factors, Medicare systems, Regression analysis
Haylamicheal, Israel Deneke; Desalegne, Solomon Akalu
The management of healthcare waste (HCW) requires special attention due to the risk posed by the presence of hazardous waste. The first step towards this is the issuance of national legislation complemented by policy documents, regulations and technical guidelines. In Ethiopia there is no specific legislation for healthcare waste management (HCWM). However, there are various legislations which may provide a legal framework for the management of HCW. This review assesses the various legislations that are relevant to HCWM. It also looks into the institutional arrangements put in place and waste management practices that prevail in the country. It was found that, although the existing legislations have provisions that may provide a legal framework for the management of HCW in Ethiopia, they are not comprehensive and lack specificity in terms of defining hazardous HCW and its categories; in indicating legal obligations of healthcare facilities (HCFs) in handling, transporting, treating and disposing HCW, and record keeping and reporting. There is overlapping of mandates and lackof co-ordination among various government institutions that are responsible for HCWM. The HCWM practices also do not conform to the principles of waste management in general and HCWM in particular. Thus, to better manage HCW in Ethiopia, a specific and comprehensive legislation and policy document on HCWM with clear designation of responsibilities to various stakeholders should be issued immediately. Moreover, training and awareness raising activities on proper HCWM should be undertaken targeting medical staffs, HCF administrators, waste handlers, policy and decision makers and the general public.
Altmark, D; Sigal, M; Gelkopf, M
The clinical picture of Munchausen syndrome is that of feigned or self-induced illness with the aim of being hospitalized and/or receiving unnecessary medical interventions, peregrination from 1 hospital to another, and disruptive behavior when hospitalized. These patients are a danger to themselves and heavily burden inpatient facilities that care for them. We present a case that illustrates the problems of diagnosing and managing such patients. We stress the need for adequate centralization and distribution of the relevant information concerning these patients.
Weil, Peter A; Mattis, Mary C
We examined the findings of a recent national survey of healthcare executives that showed 90% of women but only 53% of men favoured efforts to increase the proportion of women in senior healthcare management positions. Using the theories of relative deprivation and social identity, we tested hypotheses to suggest the background, work characteristics and attitudes about existing discriminatory practices in their own organizations that correlate with respondents' views about affirmative action for women. Some support is evidenced for the two theories and explanations are suggested to account for apparent anomalies.
Hospitals represent a substantial market for pharmaceutical and medical device companies. The typical approach by healthcare manufacturers and suppliers to hospitals is to send representatives or detailers to hospitals and meet with representatives of hospital formularies and purchasing officials. Classic channels systems, and specifically, Category Captain Management ("CCM") may provide more of a sustainable competitive advantage than traditional hospital detailing. The purpose of this article is to discuss how CCM might apply as an approach for healthcare suppliers to truly partner with their hospital customers.
Tadesse, Menelik Legesse; Kumie, Abera
Healthcare wastes are hazardous organic and inorganic wastes. The waste disposal management in Addis Ababa city is seen unscientific manner. The waste management practice in the health facilities are poor and need improvement. This study will help different organizations, stakeholders and policy makers to correct and improve the existing situation of healthcare waste legislation and enforcement and training of staff in the healthcare facilities in Addis Ababa. The study aimed to assess the existing generation and management practice of healthcare waste in selected government health centers of Addis Ababa. The cross-sectional study was conducted to quantify waste generation rate and evaluate its management system. The study area was Addis Ababa. The sample size was determined by simple random sampling technique, the sampling procedure involved 10 sub-cities of Addis Ababa. Data were collected using both waste collecting and measuring equipment and check list. The Data was entered by EPI INFO version 6.04d and analyzed by and SPSS for WINDOW version15. The mean (±SD) healthcare waste generation rate was 9.61 ± 3.28 kg/day of which (38%) 3.64 ± 1.45 kg/day was general or non-hazardous waste and (62%) 5.97 ± 2.31 kg/day was hazardous. The mean healthcare waste generation rate between health centers was a significant different with Kurskal-Wallis test (χ2 = 21.83, p-value = 0.009). All health centers used safety boxes for collection of sharp wastes and all health centers used plastic buckets without lid for collection and transportation of healthcare waste. Pre treatment of infectious wastes was not practiced by any of the health centers. All health centers used incinerators and had placenta pit for disposal of pathological waste however only seven out of ten pits had proper covering material. Segregation of wastes at point of generation with appropriate collection materials and pre- treatment of infectious waste before disposal should be practiced
Kostagiolas, P.; Lappa, E.
Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services' contributions to hospital environment is presented.
Kostagiolas, P., E-mail: firstname.lastname@example.org [Assistant Professor Department of Archives, Library Science and Museology, Ionian University, CORFU 49100 (Greece); Lappa, E., E-mail: email@example.com [Director of Medical Library of General Hospital Attikis KAT, Nikis 2 str, 14564 KIFFISIA-ATHENS (Greece)
Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services’ contributions to hospital environment is presented.
Kostagiolas, P.; Lappa, E.
Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services’ contributions to hospital environment is presented
Cogin, Julie Ann; Ng, Ju Li; Lee, Ilro
We assess how human resource management (HRM) is implemented in Australian hospitals. Drawing on role theory, we consider the influence HRM has on job attitudes of healthcare staff and hospital operational efficiency. We adopt a qualitative research design across professional groups (physicians, nurses, and allied health staff) at multiple levels (executive, healthcare managers, and employee). A total of 34 interviews were carried out and analyzed using NVivo. Findings revealed a predominance of a control-based approach to people management. Using Snell's control framework (AMJ 35:292-327, 1992), we found that behavioral control was the principal form of control used to manage nurses, allied health workers, and junior doctors. We found a mix between behavior, output, and input controls as well as elements of commitment-based HRM to manage senior physicians. We observed low levels of investment in people and a concentration on transactional human resource (HR) activities which led to negative job attitudes such as low morale and frustration among healthcare professionals. While hospitals used rules to promote conformity with established procedures, the overuse and at times inappropriate use of behavior controls restricted healthcare managers' ability to motivate and engage their staff. Excessive use of behavior control helped to realize short-term cost-cutting goals; however, this often led to operational inefficiencies. We suggest that hospitals reduce the profusion of behavior control and increase levels of input and output controls in the management of people. Poor perceptions of HR specialists and HR activities have resulted in HR being overlooked as a vehicle to address the strategic challenges required of health reform and to build an engaged workforce.
Funmilayo A. Okanlawon, RN, PhD, FWACN
Full Text Available Traditionally, nursing care has been identified as an integral part of human medicine but is not well recognised in veterinary medicine as practised in Nigeria. In caring for human beings, a nurse is expected to have the fundamental understanding of disease aetiology, manifestations, diagnosis, manage-ment, rehabilitation, prevention and control. This is equally applicable to the care of animals. The role of veterinary nursing in veterinary medicine is significant considering the multitude of issues involved in the care of animals. The keeping of domestic animals is becoming popular and consequently the spread of infectious diseases from animals to human beings is on the increase. It is vital for human beings and animals to coexist in a healthy environment. The authors examine the importance of nursing care in veterinary medicine, the current situation in Nigeria, the role of veterinary nurses, the inter-professional approach to veterinary medicine, preparedness for the emergence of infectious diseases and career opportunities for veterinary nurses. This premise falls within the context of the ‘One Health’ concept.
Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie
The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Thematic analysis review of CM studies. We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004-December 2015 period, then updated to July 2017, with the keywords 'CM' and 'frequent use'. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir's implementation of health innovations framework was used to organise results into four broad levels of factors: (1) ,environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. © 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
Craig, Kathy; Beichl, Lisa
This article explains the current state of the global healthcare market with respect to international medical travel (medical tourism) and worldwide provider sourcing. Emphasis is placed on the traditional twin pillars of oversight: program accreditation and branding affiliation. These are discussed for their main strength, which is their ability to operate at a system-strata level. This strength also represents a primary weakness from the international patient's perspective, which is the functional gap between systemic oversight and bedside surveillance. International case management (ICM) is identified as the right conduit of patient-level service delivery that fills the gap between system and bedside. The ICM professional is introduced and defined as the provider of patient-centered quality and safety improvements, who coordinates and collaborates using international network connections and culture-sensitive in-country communication skills. The article's information is useful for healthcare practitioners who want to learn about the global medical marketplace. Practitioners who are preparing to or who already have business enterprises associated with the global healthcare market will also find the information helpful. Explanations and content are useful to case management generalists, specialists, and business developers. The content is intended for uptake by interested parties within and outside the healthcare practice arena. All research and syntheses were executed by the authors. Sources included business correspondences, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. Clinical competencies stem from the international practice experiences of one author (K. Craig). International health insurance, economics, and financing expertise stems from other author (L. Beichl). This article launches the platform for development of checklists, tools, and guidelines for international case
Full Text Available Role players within the context of managed healthcare in Gauteng experience problems in the delivery of healthcare, which negatively affect their working relationships. This in turn, affects the quality of care provided to patients. The purpose of this study is to explore and describe the problem experienced by different role players within the context of managed healthcare in Gauteng, as well as the suggested solutions to counteract these problems. These results will be utilised as the basis of a conceptual framework to formulate a strategy to enhance the working relationships amongst these role players. The strategy will not be discussed in this article as the focus is on the problems experienced by the role players in the delivery of healthcare, as well as suggested solutions in the counteraction thereof. A qualitative, exploratory, descriptive and contextual study was followed to explore and describe the problems, as well as the suggested solutions to counteract these problems. Focus group interviews were conducted to collect data from three private hospitals, three managed care organisations and four general medical practitioners in Gauteng. The participants were purposively and conveniently selected. Content analysis as described by Tesch (1990 was followed to analyse the data. The main problems experienced were related to inadequate communication, inadequate staff competence, cost saving versus quality care, procedural complexity, perceived loss of power by doctors and patients and the system of accounts payment. The suggested solutions focused mainly on empowerment and standardisation of procedures. It is recommended that replication studies of this nature be conducted in other provinces and that ethical standards are formulated within the managed healthcare context.
Malvey, Donna M; Hamby, Eileen F; Fottler, Myron D
This paper proposes an innovation in service learning that we identify as e-service learning. By adding the "e" to service learning, we create a service learning model that is dynamic, mediated by technology, and delivered online. This paper begins by examining service learning, which is a distinct learning concept. Service learning furnishes students with opportunities for applied learning through participation in projects and activities in community organizations. The authors then define and conceptualize e-service learning, including the anticipated outcomes of implementation such as enhanced access, quality, and cost effectiveness of healthcare management education. Because e-service learning is mediated by technology, we identify state of the art technologies that support e-service learning activities. In addition, possible e-service learning projects and activities that may be included in healthcare management courses such as finance, human resources, quality, service management/marketing and strategy are identified. Finally, opportunities for future research are suggested.
Payne, Julianne; Leiter, Jeffrey
Since the 1970s, the healthcare industry has undergone significant changes. Using neo-institutional and resource dependency theories, the purpose of this paper is to explore how managers perceive constraint and enact agency amidst these historic challenges--perhaps most significantly, declining funding and increasing regulation. The data come from ten interviews with healthcare managers, spanning for-profit, non-profit, and government legal forms and hospital and nursing home sub-industries in both Queensland, Australia and North Carolina, USA. The authors look for patterns across the interviews. The paper shows that governments and umbrella "parent" organizations force managers to adhere to institutional expectations in exchange for resource investment. Managers navigate these environmental obstacles using a shared business-minded approach and competitive differentiation. Yet various interest groups--including front-line workers, physicians, and patients--challenge this paradigm, as they demand a focus on quality of care. Managers' efforts are likewise curbed by the very resource and institutional pressures they resist. The authors understand changes in the healthcare industry as resulting from an increasingly powerful managerial logic, at odds with traditional professional and societal values. Interest groups are best positioned to challenge this logic.
Khan, Sobia; Vandermorris, Ashley; Shepherd, John; Begun, James W; Lanham, Holly Jordan; Uhl-Bien, Mary; Berta, Whitney
Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here. We synthesized topics from this series into a set of six insights on how complexity thinking fosters a deeper understanding of accepted ideas in healthcare, applications of CAS to actors within the system, and paradoxes in applications of complexity thinking that may require further debate: 1) a complexity lens helps us better understand the nebulous term "context"; 2) concepts of CAS may be applied differently when actors are cognizant of the system in which they operate; 3) actor responses to uncertainty within a CAS is a mechanism for emergent and intentional adaptation; 4) acknowledging complexity supports patient-centred intersectional approaches to patient care; 5) complexity perspectives can support ways that leaders manage change (and transformation) in healthcare; and 6) complexity demands different ways of implementing ideas and assessing the system. To enhance our exploration of key insights, we augmented the knowledge gleaned from the series with key articles on complexity in the literature. Ultimately, complexity thinking acknowledges the "messiness" that we seek to control in healthcare and encourages us to embrace it. This means seeing challenges as opportunities for adaptation, stimulating innovative solutions to ensure positive adaptation, leveraging the social system to enable ideas to emerge and spread across the system, and even more important, acknowledging that these adaptive actions are part of system behaviour just as much as periods of stability are. By
Todorova, Irina; Alexandrova-Karamanova, Anna; Panayotova, Yulia; Dimitrova, Elitsa; Kotzeva, Tatyana
New preventive technologies such as vaccines offer insight into psychological, social, and cultural landscapes. Providers have a key role in parents' decisions for vaccinating their children. Yet, perspectives from providers regarding the human papillomavirus (HPV) vaccine, or vaccination in general, are rarely sought Our objective in this paper is to understand how the HPV vaccine is perceived by health care providers and the multiple contextual meanings it elicits. We conducted interviews with 20 health care professionals in Bulgaria about their attitudes and practices related to HPV vaccination and their recommendations for policies. The verbatim-transcribed interviews were analyzed through narrative analysis, with a special focus on language. We illustrate providers' contradictory and contextualized constructions of the vaccine and the narrative strategies they use to manage any uncertainty it elicits. These include being advocates and missionaries for preventive health, confirming their trust in the medical profession and professional organizations, challenging patients' concerns with rational explanations, normalizing the risk of medical innovations, and avoiding the sexual nature of HPV transmission. The introduction of a vaccine to prevent HPV infection, and by implication, possibly cervical and other cancers, created hope, and at the same time, intensified confusion and uncertainty. Providers have been frustrated for years with the rising mortality from cervical cancer in Bulgaria, and their perceived powerlessness in affecting this. HPV vaccination, on the other hand, seems relatively simple and "taming uncertainty" positions them as instrumental in limiting (or even eliminating) morbidity and mortality in future generations.
Richter, Anne; von Thiele Schwarz, Ulrica; Lornudd, Caroline; Lundmark, Robert; Mosson, Rebecca; Hasson, Henna
Leadership is a key feature in implementation efforts, which is highlighted in most implementation frameworks. However, in studying leadership and implementation, only few studies rely on established leadership theory, which makes it difficult to draw conclusions regarding what kinds of leadership managers should perform and under what circumstances. In industrial and organizational psychology, transformational leadership and contingent reward have been identified as effective leadership styles for facilitating change processes, and these styles map well onto the behaviors identified in implementation research. However, it has been questioned whether these general leadership styles are sufficient to foster specific results; it has therefore been suggested that the leadership should be specific to the domain of interest, e.g., implementation. To this end, an intervention specifically involving leadership, which we call implementation leadership, is developed and tested in this project. The aim of the intervention is to increase healthcare managers' generic implementation leadership skills, which they can use for any implementation efforts in the future. The intervention is conducted in healthcare in Stockholm County, Sweden, where first- and second-line managers were invited to participate. Two intervention groups are included, including 52 managers. Intervention group 1 consists of individual managers, and group 2 of managers from one division. A control group of 39 managers is additionally included. The intervention consists of five half-day workshops aiming at increasing the managers' implementation leadership, which is the primary outcome of this intervention. The intervention will be evaluated through a mixed-methods approach. A pre- and post-design applying questionnaires at three time points (pre-, directly after the intervention, and 6 months post-intervention) will be used, in addition to process evaluation questionnaires related to each workshop. In
Federal Laboratory Consortium — Mission:To provide quality veterinary medical care and environmental enrichment programs for all animals, representing nine different species.To provide guidance for...
Ahmed, Khaled E
Tooth wear is a condition that affects a substantial cohort of dental patients. It has a measurable impact on patients' satisfaction, and overall quality of life. Recently, with growing evidence, our understanding of the aetiology, progression, and management of tooth wear has evolved. The paper argues that pathological tooth wear should not be solely considered as a dental condition, but rather a dental manifestation of other mental and medical disorders. As such, successful management of tooth wear, and its underlying aetiology, requires a holistic, multidisciplinary management approach, involving dental, medical, and mental healthcare providers.
Santos, Maria Angelica Borges dos; Madeira, Fátima Carvalho; Passos, Sonia Regina Lambert; Bakr, Felipe; Oliveira, Klivia Brayner de; Andreazzi, Marco Antonio Ratzsch de
Autonomy in financial management is an advantage in public administration. A 2009 National Healthcare Facility Survey showed that 3.9% of Brazil's 52,055 public healthcare facilities had some degree of financial autonomy. Such autonomy was more common in inpatient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for resources in specific areas, relating to small outlays, consumables and capital goods, and outsourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facilities appears to be linked to local political decisions and not necessarily to the facility's specific legal and administrative status. However, legal status displays distinct scopes of autonomy - those under direct government administration tend to be less autonomous, and those under private businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.
Ana Maria Maniero Moreira
Full Text Available Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%, infectious-sharps (31-42% and recyclable (5-17%. The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services.
Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso
Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. PMID:27556874
Lornudd, Caroline; Bergman, David; Sandahl, Christer; von Thiele Schwarz, Ulrica
Purpose The purpose of this study is to investigate the relationship between leadership profiles and differences in managers' own levels of work stress symptoms and perceptions of work stressors causing stress. Design/methodology/approach Cross-sectional data were used. Healthcare managers ( n = 188) rated three dimensions of their leadership behavior and levels of work stressors and stress. Hierarchical cluster analysis was performed to identify leadership profiles based on leadership behaviors. Differences in stress-related outcomes between profiles were assessed using one-way analysis of variance. Findings Four distinct clusters of leadership profiles were found. They discriminated in perception of work stressors and stress: the profile distinguished by the lowest mean in all behavior dimensions, exhibited a pattern with significantly more negative ratings compared to the other profiles. Practical implications This paper proposes that leadership profile is an individual factor involved in the stress process, including work stressors and stress, which may inform targeted health promoting interventions for healthcare managers. Originality/value This is the first study to investigate the relationship between leadership profiles and work stressors and stress in healthcare managers.
Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa; Altemose, Jane K; Fox, Ellen
To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions.
Rahul S. Mor
Full Text Available This study aims to investigate the awareness level of Biomedical waste managements in healthcare facilities, and their perception among hospital waste management team, doctors, nurses, lab techni-cians and waste handlers in Northwest Delhi region in India. The study has been conducted through a questionnaire survey followed by the descriptive statistical analysis method. Question-naire contains of 38 questions, where the first section deals with the hospital waste management team, the second section is for doctors, nurses and lab technicians, and the third section is for the waste handlers. Out of 311 respondents, there were 16 hospital waste management teams, 81 doc-tors, 92 nurses, 49 lab technicians and 73 waste handlers. It was surprising that only 40% (n=10 hospitals had any kind of waste treatment & disposal facility onsite, only 10% hospitals were using the latest technology and 60% hospitals shred the Biomedical waste before disposal. It was good to see that none of the hospital waste managements disposed the waste with general waste, and 40% of them were exhausting through government agencies and the remaining 60% were using private agencies to dispose the waste. Finally, all the hospitals maintained the record of waste generated. It is concluded that there was a lack of awareness about the biomedical waste generation, legislation and management among healthcare personnel, and they all needed regular audits and training pro-grams at all levels, and a proper management starting from waste generation to its disposal at sites.
Quinn, P. J
"Veterinary Microbiology is one of the core subjects for veterinary students. Fully revised and expanded, this new edition covers every aspect of veterinary microbiology for students in both paraclinical and clinical years...
The Sahel Journal of Veterinary Sciences is the official journal of the Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Nigeria. The journal welcomes original research articles, short communications and reviews on all aspects of veterinary sciences and related disciplines.
Vezhnovets', T A
The aim of this work is to study the influence of the type of interpersonal relationships between executives and subordinates in healthcare institutions on their style of resolving management decision. It was established that indulgent and autonomous style are formed against background of liberal interpersonal relationship by the following criteria, as the absence of dominant traits, expressed benevolence among executives with autonomous style, uncertainty and inexperience among executives with indulgent style. Authoritarian and marginal styles are formed against empowerment and dominance in relationship with subordinates by expressed dominance criteria, as leadership qualities among executives with authoritarian style or as a manifestation of social maladjustment among executives with marginal style. Type of interpersonal relationships determines the style of resolving management decisions, that should be considered at conducting professional selection of candidates for senior positions in healthcare institutions.
Liu, Feng-Chuan; Cheng, Kai-Lin; Chao, Minston; Tseng, Hsu-Min
This paper aims to provide empirical evidence concerning the impact of team climate on knowledge sharing behavior and the mediating effects of individuals' altruistic intentions in the context of healthcare settings. Questionnaire data were collected from 212 administrators employed at a medical center in Taiwan. Team climate was assessed by the Team Climate Inventory composed of four factors, participative safety, support for innovation, vision, and task orientation. The proposed hypotheses were tested using structural equation modeling. The influence of the team innovation climate on knowledge sharing behavior was evident. Furthermore, individuals' altruistic intentions played a full mediating role in the relationship between team innovation climate and knowledge sharing behavior. These results contribute to the field of the people-orientated perspective in knowledge management. The full mediating effect of employees' altruistic intentions provides healthcare team managers the direction to accelerate knowledge sharing behavior.
Raila, Emilia Mmbando; Anderson, David O
Climate change remains one of the biggest threats to life on earth to date with black carbon (BC) emissions or smoke being the strongest cause after carbon dioxide (CO 2 ). Surprisingly, scientific evidence about black carbon emissions reduction in healthcare settings is sparse. This paper presents new research findings on the reduction of black carbon emissions from an observational study conducted at the UN Peacekeeping Operations (MINUSTAH) in Haiti in 2014. Researchers observed 20 incineration cycles, 30 minutes for each cycle of plastic and cardboard sharps healthcare waste (HCW) containers ranged from 3 to 14.6 kg. The primary aim was to determine if black carbon emissions from healthcare waste incineration can be lowered by mainstreaming the use of cardboard sharps healthcare waste containers instead of plastic sharps healthcare waste containers. Similarly, the study looks into whether burning temperature was associated with the smoke levels for each case or not. Independent samples t-tests demonstrated significantly lower black carbon emissions during the incineration of cardboard sharps containers (6.81 ± 4.79% smoke) than in plastic containers (17.77 ± 8.38% smoke); a statistically significant increase of 10.96% smoke (95% Confidence Interval ( CI) [4.4 to 17.5% smoke], p = 0.003). Correspondingly, lower bottom burner temperatures occurred during the incineration of cardboard sharps containers than in plastic (95% Cl [16 to 126°C], p = 0.014). Finally, we expect the application of the new quantitative evidence to form the basis for policy formulation, mainstream the use of cardboard sharps containers and opt for non-incineration disposal technologies as urgent steps for going green in healthcare waste management.
Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.
Crooks, Valorie A.; Ormond, Meghann; Jin, Ki Nam
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this...
Costa, Claudio; Roncoroni, Elisabetta; Saiani, Luisa; Stevanin, Simone; Fanton, Elena; Mantoan, Domenico
Presented here is the approach used by a multidisciplinary working group fo the drafting of the "core" competence profile of the healthcare professions manager in the Veneto Region. Defining a competence profile allows for specifying a standard for measuring the skills acquired by a professional and the gap level from what is expected by the organization, as well as orienting the preparatory education to carry out the related role.
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Open Veterinary Journal is a peer reviewed international open access online and printed journal that publishes high-quality original research articles, reviews, short communications and case reports dedicated to all aspects of veterinary sciences and its related subjects. Other websites associated with this journal: ...
'Central Diagnostic, National Veterinary Research Institute Vom, Plateau State, Nigeria, 'Department of Veterinary Medicine. Ahmadu Bello ..... environment as reported by (Olabode et al., 2009; Okwor and Eze, 2011;Jwander et al., 2013b). Farmers who had the same complaints of. Marek's disease from the same source of.
Full Text Available In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs responding to the survey (75.6% included 144 primary care pediatricians (38.1%, 98 hospital pediatricians (25.9%, 62 pediatric residents (16.4%, and 71 pediatric nurses (19.6%; the 464 responding parents (92.8% included 175 whose youngest (or only child was ≤5 years old (37.7%, 175 whose youngest (or only child was aged 6–10 years (37.7%, and 114 whose youngest (or only child was aged 11–14 years (24.6%. There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795–0.964. Among the parents, those of children aged 6–10 and 11–14 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.
Nuti, Sabina; Seghieri, Chiara
The Italian National Health System, which follows a Beveridge model, provides universal healthcare coverage through general taxation. Universal coverage provides uniform healthcare access to citizens and is the characteristic usually considered the added value of a welfare system financed by tax revenues. Nonetheless, wide differences in practice patterns, health outcomes and regional usages of resources that cannot be justified by differences in patient needs have been demonstrated to exist. Beginning with the experience of the health care system of the Tuscany region (Italy), this study describes the first steps of a long-term approach to proactively address the issue of geographic variation in healthcare. In particular, the study highlights how the unwarranted variation management has been addressed in a region with a high degree of managerial control over the delivery of health care and a consolidated performance evaluation system, by first, considering it a high priority objective and then by actively integrating it into the regional planning and control mechanism. The implications of this study can be useful to policy makers, professionals and managers, and will contribute to the understanding of how the management of variation can be implemented with performance measurements and financial incentives. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Nieto Pol, Enrique
The correct management of osteoarthritis requires an accurate diagnosis, evaluation of its spread and functional repercussions, and the application of comprehensive and effective individually-tailored treatment aimed at relieving pain and improving physical function with a consequent improvement in quality of life; treatment should also aim to prevent or delay disease progression and its effects. In the National Health Service, primary care is the basic level and the first point of access to healthcare; this level guarantees the continuity of care, coordinates patients, and regulates clinical workflow. Family physicians coordinate the healthcare processes related to chronic diseases and are responsible for the management, diagnosis, evaluation, treatment, and follow-up of patients with osteoarthritis. The clinical practice guidelines internationally accepted as the standard of care for the management of osteoarthritis should be adapted by both Spanish health planning strategies and clinical practice guidelines to the Spanish healthcare setting. The comprehensive assessment of osteoarthritis includes evaluation of its effects on the patient's physical function and quality of life; formulating a treatment plan in collaboration with the patient and adapted to his or her comorbidities; providing advice on basic treatments and their risks and benefits; and carrying out an individually-tailored periodic review. Referral criteria are based on diagnostic confirmation, poor treatment response, and surgical evaluation. Copyright © 2014 Elsevier España, S.L. All rights reserved.
Idowu, Ibijoke; Alo, Babajide; Atherton, William; Al Khaddar, Rafid
Proper management and safe disposal of medical waste (MW) is vital in the reduction of infection or illness through contact with discarded material and in the prevention of environmental contamination in hospital facilities. The management practices for MW in selected healthcare facilities in Lagos, Nigeria were assessed. The cross-sectional study involved the use of questionnaires, in-depth interviews, focused group discussions and participant observation strategies. It also involved the collection, segregation, identification and weighing of waste types from wards and units in the representative facilities in Lagos, Nigeria, for qualitative and quantitative analysis of the MW streams. The findings indicated that the selected Nigerian healthcare facilities were lacking in the adoption of sound MW management (MWM) practices. The average MW ranged from 0.01 kg/bed/day to 3.98 kg/bed/day. Moreover, about 30% of the domestic waste from the healthcare facilities consisted of MW due to inappropriate co-disposal practices. Multiple linear regression was applied to predict the volume of waste generated giving a correlation coefficient (R(2)) value of 0.99 confirming a good fit of the data. This study revealed that the current MWM practices and strategies in Lagos are weak, and suggests an urgent need for review to achieve vital reversals in the current trends.
Documet, Jorge; Tsao, Sinchai; Documet, Luis; Liu, Brent J.; Zhou, Zheng; Joseph, Anika O.
Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and Communications System) data. SMS is a flexible and mobile method for real-time access and control of Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or any other localized signal. It provides a simple, reliable yet flexible method to communicate with an information system. In addition, SMS services are widely available for low costs from cellular phone service providers and allows for more mobility than other services such as wireless internet. This paper aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.
Shanmugasundaram, Jothiganesh; Soulalay, Vongdeuane; Chettiyappan, Visvanathan
In Lao People's Democratic Republic (Lao PDR), a growth of healthcare centres, and the environmental hazards and public health risks typically accompanying them, increased the need for healthcare waste (HCW) management planning. An effective planning of an HCW management system including components such as the treatment plant siting and an optimized routeing system for collection and transportation of waste is deemed important. National government offices at developing countries often lack the proper tools and methodologies because of the high costs usually associated with them. However, this study attempts to demonstrate the use of an inexpensive GIS modelling tool for healthcare waste management in the country. Two areas were designed for this study on HCW management, including: (a) locating centralized treatment plants and designing optimum travel routes for waste collection from nearby healthcare facilities; and (b) utilizing existing hospital incinerators and designing optimum routes for collecting waste from nearby healthcare facilities. Spatial analysis paved the way to understand the spatial distribution of healthcare wastes and to identify hotspots of higher waste generating locations. Optimal route models were designed for collecting and transporting HCW to treatment plants, which also highlights constraints in collecting and transporting waste for treatment and disposal. The proposed model can be used as a decision support tool for the efficient management of hospital wastes by government healthcare waste management authorities and hospitals.
Kakyo, Tracy Alexis; Xiao, Lily Dongxia
Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.
Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J
Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.
Brusk, Amy M; White, Brad J; Goehl, Dan R; Dhuyvetter, Kevin C
To determine potential associations between demographic and business management factors and practice size and growth rate in rural mixed-animal veterinary practices. Cross-sectional survey. 54 mixed-animal practitioners. A cross-sectional survey (96 questions) was electronically disseminated. Responses were collected, and outcomes (number of veterinarians [NV], growth in number of veterinarians [NVG], gross practice income [GPI], growth in gross practice income [GPIG], gross practice income per veterinarian [GPIV], and growth in gross practice income per veterinarian [GPIVG]) were calculated. Bivariate analyses were performed and multivariable models created to determine associations between survey responses and outcomes of interest. Survey respondents were from mixed-animal practices, and most (46/54 [85.2%]) practiced in small communities (business manager. Typically, practices had positive mean growth in NVG (4.4%), GPIG (8.5%), and GPIVG (8.1%), but growth rate was highly variable among practices. Factors associated with growth rate included main species interest, frequency for adjusting prices, use of a marketing plan, service fee structure, and sending a client newsletter. Mixed-animal practices had a large range in size and growth rate. Economic indices were impacted by common business management practices.
Kerby, Erin E
The study investigated veterinary medicine librarians' experience with and perceptions of research data services. Many academic libraries have begun to offer research data services in response to researchers' increased need for data management support. To date, such services have typically been generic, rather than discipline-specific, to appeal to a wide variety of researchers. An online survey was deployed to identify trends regarding research data services in veterinary medicine libraries. Participants were identified from a list of contacts from the MLA Veterinary Medical Libraries Section. Although many respondents indicated that they have a professional interest in research data services, the majority of veterinary medicine librarians only rarely or occasionally provide data management support as part of their regular job responsibilities. There was little consensus as to whether research data services should be core to a library's mission despite their perceived importance to the advancement of veterinary research. Furthermore, most respondents stated that research data services are just as or somewhat less important than the other services that they provide and feel only slightly or somewhat prepared to offer such services. Lacking a standard definition of "research data" and a common understanding of precisely what research data services encompass, it is difficult for veterinary medicine librarians and libraries to define and understand their roles in research data services. Nonetheless, they appear to have an interest in learning more about and providing research data services.
Ciplak, Nesli; Kaskun, Songul
The need for proper healthcare waste management has been a crucial issue in many developing countries as it is in Turkey. The regulation regarding healthcare wastes in Turkey was updated in 2005 in accordance with the European Union (EU) waste directives, but it still falls behind meeting the requirements of current waste treatment technologies. Therefore, this study aims to reveal deficiencies, inconsistencies, and improper applications of healthcare waste management in the western part of the Turkish Black Sea Region. In this study, it was revealed that nearly 1 million people live in the region, resulting in 5 million hospital admissions annually. All the healthcare waste produced (1000 tons yr(-1)) is treated in an autoclave plant. However, treating some categories of healthcare wastes in autoclave units mismatches with the EU waste regulations, as alternative treatment technologies are not technically able to treat all types of healthcare wastes. A proper waste management system, therefore, requires an internal segregation scheme to divert these wastes from the main healthcare waste stream. The existing malpractice in the region could cause serious health problems if no measure is taken urgently. It is expected that healthcare waste management in the region and then all across Turkey will be improved with the significant deficiencies and inconsistencies pointed out in this research. In developed countries, specific rules and regulations have already been implemented along with the recommendations for handling of healthcare waste. However, in Turkey, these wastes are treated in autoclave units, which mismatches with the European Union waste regulations, as alternative treatment technologies are not technically capable to treat all types of healthcare wastes. The existing malpractice could cause serious health problems if no measure is taken urgently. The authors demonstrated the existing status of Turkish waste management and revealed deficiencies
Wramsten Wilmar, Maria; Ahlborg, Gunnar; Jacobsson, Christian; Dellve, Lotta
Over the last decade healthcare management and managers have increasingly been in focus in public debate. The purpose of the present study was to gain a deeper understanding of how prolonged, unfavorable media focus can influence both the individual as a person and his or her managerial practice in the healthcare organization. In-depth interviews (n = 49) with 24 managers and their superiors, or subordinate human resources/information professionals, and partners were analyzed using a grounded theory approach. The conceptual model explains how perceived uncertainties related to the managerial role influence personification and its negative consequences. The role ambiguities comprised challenges regarding the separation of individual identity from the professional function, the interaction with intra-organizational support and political play, and the understanding and acceptance of roles in society. A higher degree of uncertainty in role ambiguity increased both personification and the personal reaction to intense media pressure. Three types of reactions were related to the feeling of being infringed: avoidance and narrow-mindedness; being hard on self, on subordinates, and/or family members; and resignation and dejection. The results are discussed so as to elucidate the importance of support from others within the organization when under media scrutiny. The degree of personification seems to determine the personal consequences as well as the consequences for their managerial practice. Organizational support for managers appearing in the media would probably be beneficial for both the manager and the organization.
Full Text Available Background: The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Inadequate and inappropriate knowledge of handling of healthcare waste may have serious health consequences and a significant impact on the environment as well. Objective: The objective was to assess knowledge, attitude, and practices of doctors, nurses, laboratory technicians, and sanitary staff regarding biomedical waste management. Materials and Methods: This was a cross-sectional study. Setting: The study was conducted among hospitals (bed capacity >100 of Allahabad city. Participants: Medical personnel included were doctors (75, nurses (60, laboratory technicians (78, and sanitary staff (70. Results: Doctors, nurses, and laboratory technicians have better knowledge than sanitary staff regarding biomedical waste management. Knowledge regarding the color coding and waste segregation at source was found to be better among nurses and laboratory staff as compared to doctors. Regarding practices related to biomedical waste management, sanitary staff were ignorant on all the counts. However, injury reporting was low across all the groups of health professionals. Conclusion: The importance of training regarding biomedical waste management needs emphasis; lack of proper and complete knowledge about biomedical waste management impacts practices of appropriate waste disposal.
Evans, R; Rudd, P; Hemmila, U; Dobbie, H; Dreyer, G
Acute kidney injury (AKI) is a common but under-recognised disease process, which carries a high risk of mortality or chronic complications, such as chronic kidney disease and other organ dysfunction. Management of AKI, however, is suboptimal, both in developed settings and in Malawi. This is partly because of deficiencies in AKI education and training. To establish current levels of AKI education in a range of healthcare workers in Malawi. An AKI symposium was held in Blantyre in March 2015. Delegates were asked to complete a survey at the start of the symposium to assess their clinical experience and education in the management of AKI. From 100 delegates, 89 nurses, clinical officers, and physicians, originating from 11 different districts, responded to the survey. Twenty-two percent of healthcare workers (including 28% of district workers of the various cadres and 31% of nurses) had never received teaching on any aspect of renal disease, and 50% (including 63% of district workers and 61% of nurses) had never received teaching specifically on AKI. Forty-four percent did not feel confident managing AKI, and 98% wanted more support managing patients with renal disease. Thirty-four percent (including 55% of district workers) were unaware that haemodialysis was available at Queen Elizabeth Central Hospital (QECH) for the treatment of AKI and 53% (74% of district workers) were unaware that peritoneal dialysis was available for the treatment of AKI in children. Only 33% had ever referred a patient with AKI to QECH. There are deficiencies in education about, and clinical experience in, the management of AKI among Malawian healthcare workers, in addition to limited awareness of the renal service available at QECH. Urgent action is required to address these issues in order to prevent morbidity and mortality from AKI in Malawi.
Sapkota, Binaya; Gupta, Gopal Kumar; Mainali, Dhiraj
Healthcare waste is produced from various therapeutic procedures performed in hospitals, such as chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, autopsy, biopsy, injections, etc. These result in the production of non-hazardous waste (75-95%) and hazardous waste (10-25%), such as sharps, infectious, chemical, pharmaceutical, radioactive waste, and pressurized containers (e.g., inhaler cans). Improper healthcare waste management may lead to the transmission of hepatitis B, Staphylococcus aureus and Pseudomonas aeruginosa. This evaluation of waste management practices was carried out at gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards at Government of Nepal Civil Service Hospital, Kathmandu from February 12 to October 15, 2013, with the permission from healthcare waste management committee at the hospital. The Individualized Rapid Assessment tool (IRAT), developed by the United Nations Development Program Global Environment Facility project, was used to collect pre-interventional and post-interventional performance scores concerning waste management. The healthcare waste management committee was formed of representing various departments. The study included responses from focal nurses and physicians from the gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards, and waste handlers during the study period. Data included average scores from 40 responders. Scores were based on compliance with the IRAT. The waste management policy and standard operating procedure were developed after interventions, and they were consistent with the national and international laws and regulations. The committee developed a plan for recycling or waste minimization. Health professionals, such as doctors, nurses and waste handlers, were trained on waste management practices. The programs included segregation, collection, handling, transportation, treatment and disposal of waste, as well as occupational health and safety issues
Anozie, Okechukwu Bonaventure; Lawani, Lucky Osaheni; Eze, Justus Ndulue; Mamah, Emmanuel Johnbosco; Onoh, Robinson Chukwudi; Ogah, Emeka Onwe; Umezurike, Daniel Akuma; Anozie, Rita Onyinyechi
Awareness of appropriate waste management procedures and occupational safety measures is fundamental to achieving a safe work environment, and ensuring patient and staff safety. This study was conducted to assess the attitude of healthcare managers to medical waste management and occupational safety practices. This was a cross-sectional study conducted among 54 hospital administrators in Ebonyi state. Semi-structured questionnaires were used for qualitative data collection and analyzed with SPSS statistics for windows (2011), version 20.0 statistical software (Armonk, NY: IBM Corp). Two-fifth (40%) of healthcare managers had received training on medical waste management and occupational safety. Standard operating procedure of waste disposal was practiced by only one hospital (1.9%), while 98.1% (53/54) practiced indiscriminate waste disposal. Injection safety boxes were widely available in all health facilities, nevertheless, the use of incinerators and waste treatment was practiced by 1.9% (1/54) facility. However, 40.7% (22/54) and 59.3% (32/54) of respondents trained their staff and organize safety orientation courses respectively. Staff insurance cover was offered by just one hospital (1.9%), while none of the hospitals had compensation package for occupational hazard victims. Over half (55.6%; 30/54) of the respondents provided both personal protective equipment and post exposure prophylaxis for HIV. There was high level of non-compliance to standard medical waste management procedures, and lack of training on occupational safety measures. Relevant regulating agencies should step up efforts at monitoring and regulation of healthcare activities and ensure staff training on safe handling and disposal of hospital waste.
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…
Moore, Irene C; Coe, Jason B; Adams, Cindy L; Conlon, Peter D; Sargeant, Jan M
To determine the role of veterinary team effectiveness regarding job satisfaction and burnout in companion animal veterinary practice. Cross-sectional observational study. 48 companion animal veterinary health-care teams. 274 team members participated in an online survey. Overall job satisfaction was evaluated with a 1-item measure, and the 3 dimensions of burnout (exhaustion, cynicism, and professional efficacy) were measured with the Maslach Burnout Inventory-General Survey. Team effectiveness was assessed with a survey developed for this study. Demographic and team effectiveness factors (coordinated team environment, toxic team environment, team engagement, and individual engagement) associated with job satisfaction and burnout were evaluated. Overall mean job satisfaction score was 5.46 of 7 (median, 6.00); veterinary technicians and kennel attendants had the lowest scores. According to the Maslach survey results, 22.4% of participants were in the high-risk category for exhaustion, 23.2% were in the high-risk category for cynicism, and 9.3% were in the high-risk category for professional efficacy. A coordinated team environment was associated with increased professional efficacy and decreased cynicism. A toxic team environment was negatively associated with job satisfaction and positively associated with exhaustion and cynicism. Individual engagement was positively associated with job satisfaction and professional efficacy and negatively associated with exhaustion and cynicism. Results suggested the effectiveness of a veterinary team can significantly influence individual team members' job satisfaction and burnout. Practices should pay specific attention to the effectiveness with which their veterinary team operates.
Boonekamp, L C
The introduction of regulated competition in health care in several Western countries confronts health care providing organizations with changing relationships, with their environment and a need for knowledge and skills to analyse and improve their market position. Marketing receives more and more attention, as recent developments in this field of study provide a specific perspective on the relationships between an organization and external and internal parties. In doing so, a basis is offered for network management. A problem is that the existing marketing literature is not entirely appropriate for the specific characteristics of health care. After a description of the developments in marketing and its most recent key concepts, the applicability of these concepts in health-care organizations is discussed. States that for the health-care sector, dominated by complex networks of interorganizational relationships, the strategic marketing vision on relationships can be very useful. At the same time however, the operationalization of these concepts requires special attention and a distinct role of the management of health-care organizations, because of the characteristics of such organizations and the specific type of their service delivery.
Veterinary clinical oncology involves a multidisciplinary approach to the recognition and management of spontaneously occurring neoplasms of domestic animals. This requires some knowledge of the causes, incidence, and natural course of malignant disease as it occurs in domestic species. The purpose of this course is to acquaint you with the more common neoplastic problems you will encounter in practice, so that you can offer your clients an informed opinion regarding prognosis and possible therapeutic modalities. A major thrust will be directed toward discussing and encouraging treatment/management of malignant disease. Multimodality therapy will be stressed. 10 refs., 3 tabs.
Martin, Graham P.
Responding to Ruth McDonald’s editorial on the rise of leadership and leadership development programmes in healthcare, this paper offers three arguments. Firstly, care is needed in evaluating impact of leadership development, since achievement of organisational goals is not necessarily an appropriate measure of good leadership. Secondly, the proliferation of styles of leadership might be understood in part as a means of retaining control over public services while distributing responsibility for their success and failure. Thirdly, it makes a plea for the continued utility of good administrative skills for clinicians and managers, which are likely to become all-the-more important given recent developments in healthcare policy and governance. PMID:25584352
To determine the importance of strategy in nursing management and to establish if strategic management has entered the lexicon of nurses' vocabulary. Developing and managing strategy is a critical success factor for health care managers. It remains unclear if nurse managers view strategy development as their role. A review of scholarly International nursing and management literature, available through CINAHL and PUBMED Data Bases was undertaken. The titles of 1063 articles, published between 1997 and 2007 were examined in order to determine the profile of strategy in those titles. Documentary analysis was undertaken on a random sample of 250 of those articles and on the full text of a further 100. Less than 10% of journal titles contained the word strategy. What was presented as strategy was in the majority of cases describing policy, administration or management. Little formal strategy theory was evident. The nursing profession does not appear to have adopted the terms strategy or strategic management to any great extent. Nurse Managers could play a greater role in enhancing healthcare delivery if an understanding of, and acceptance of the importance of strategy in health care delivery was promoted.
Ojo, Temitope Olumuyiwa; Akinwumi, Adebowale Femi
Over the years, medical practice in Nigeria has evolved in scope and practice, in terms of changing disease patterns, patients' needs, and social expectations. In addition, there is a growing sentiment especially among the general public and some health workers that most doctors are bad managers. Besides drawing examples from some doctors in top management positions that have performed less creditably, critics also harp on the fact that more needs to be done to improve the training of doctors in health management. This article describes the role of doctors in this changing scene of practice and highlights the core areas where doctors' managerial competencies are required to improve the quality of healthcare delivery. Areas such as health care financing, essential drugs and supplies management, and human resource management are emphasized. Resources to be managed and various skills needed to function effectively at the different levels of management are also discussed. To ensure that doctors are well-skilled in managerial competencies, the article concludes by suggesting a curriculum review at undergraduate and postgraduate levels of medical training to include newer but relevant courses on health management in addition to the existing ones, whereas also advocating that doctors be incentivized to go for professional training in health management and not only in the core clinical specialties.
For many years, hospitals and other institutional healthcare providers used fund accounting as a basis for presenting their financial statements. Recently, authoritative literature has placed less emphasis on separate fund reporting. This is evidenced by the reduction of fund classifications specified in the literature. This trend seems to follow the recognition that institutional healthcare activities should be reported in a manner comparable to other businesses. The Principles and Practices Board (P&P Board) of the Healthcare Financial management Association believes that general purpose financial statements of institutional healthcare providers should be comparable to reporting by other businesses. That is, all assets, liabilities, and equity are presented in a single aggregated balance sheet without differentiation by fund. This form of presentation, referred to in this statement as single fund reporting, should be used by all institutional healthcare providers including those that are part of HMOs, universities, municipalities, and other larger entities when separate reports of the provider are issued. The P&P Board is studying other significant issues concerning the reporting of revenues and components of equity and changes therein. The conclusion in this statement can be implemented even though conclusions on these related subjects are not yet complete. The P&P Board recognizes that certain circumstances may require detailed records and reports for special purposes. This statement deals only with those general purpose financial statements on which an independent accountant's opinion is expressed.
Duerden, B I
The prevention and control of healthcare-associated infections (HCAIs) requires a tripartite partnership between clinicians and carers, managers and government/Department of Health (DoH) across the whole health and social care community. Mandatory surveillance of meticillin-resistant Staphylococcus aureus bacteraemia and Clostridium difficile infection has shown a significant fall from peak numbers in 2003/04 and 2006, respectively, and there is now a zero tolerance approach to preventable infections and poor practice. Success so far has been based on senior management commitment, enhanced real-time surveillance, implementation of clinical protocols (high impact interventions, prudent prescribing), improved hand hygiene and environmental cleaning, and training and audit, backed up by a heightened performance management focus through targets and legislation (Code of Practice). DoH improvement teams have supported National Health Service trusts in implementing change. Responsibility for managing HCAI is a combination of managerial responsibility based upon compliance assurance that procedures and protocols are being implemented and personal professional responsibility of all clinicians and other healthcare workers.
Faez Firdaus Abdullah Jesse
Materials and methods: The Jamnapari cross goat aged two years and weighing 40 Kg was presented to the Universiti Veterinary Hospital, Universiti Putra Malaysia with the history of diarrhea and depression. The goat was examined physically. Blood and fecal samples were collected for complete blood count, serum biochemistry analysis and parasitological examination. Standard treatment plan was applied for the correction of the the problem. Results: Physical examination findings revealed the goat was in poor body condition, dull and depressed. Wet and dry fecal traces were observed around the groin region. The temperature was slightly elevated (39.5°C, the heart rate was increased (160 b/min while other parameters were within normal range. Upon auscultation of the thoracic region, moderate crackle lung sound was determined. Visual observation of the nasal cavity indicated a bilateral mucopurulent nasal discharge. The hemogram result revealed evidence of a normocytic normochromic anemia, leukocytosis, neutrophilia with left shift and monocytosis. Serum biochemistry revealed increases in gamma-glutamyl transferase (GGT, sodium, chloride, creatine kinase (CK, and hyperglobulinemia. Fecal examination revealed increased in Strongyle egg count of about 2,700 eggs per gram of feces using the Modified Mcmaster technique. From the history, physical examination and laboratory findings the goat was diagnosed with clinical parasitic gastroenteritis (PGE concurrent with moderate pneumonia infection. The therapeutic plan for this case were 45 mL of kaolin-pectin (30 mL/Kg body weight orally SID for 3 days as anti-diarrhea, 12 mL Levamisole (12 mg/Kg bwt was administered orally once as anthelminthic, fluid therapy was instituted using 1.5 L of Lactated Ringers solution once via intravenously. Trimethoprim-Sulfamethoxazole (1 mL/16 Kg bwt was administered intramuscularly SID for 3 days. Conclusion: Follow up examination of the goat a week post treatment indicated a good prognosis
Moreira, A.M.M., E-mail: firstname.lastname@example.org [Department of Environmental Health, School of Public Health, University of Sao Paulo, Avenida Doutor Arnaldo 715, Sao Paulo 01246-904 (Brazil); Guenther, W.M.R. [Department of Environmental Health, School of Public Health, University of Sao Paulo, Avenida Doutor Arnaldo 715, Sao Paulo 01246-904 (Brazil)
Highlights: Black-Right-Pointing-Pointer Assessment of medical waste management at health-care center before/after intervention. Black-Right-Pointing-Pointer Qualitative and quantitative results of medical waste management plan are presented. Black-Right-Pointing-Pointer Adjustments to comply with regulation were adopted and reduction of waste was observed. Black-Right-Pointing-Pointer The method applied could be useful for similar establishments. - Abstract: According to the Brazilian law, implementation of a Medical Waste Management Plan (MWMP) in health-care units is mandatory, but as far as we know evaluation of such implementation has not taken place yet. The purpose of the present study is to evaluate the improvements deriving from the implementation of a MWMP in a Primary Health-care Center (PHC) located in the city of Sao Paulo, Brazil. The method proposed for evaluation compares the first situation prevailing at this PHC with the situation 1 year after implementation of the MWMP, thus allowing verification of the evolution of the PHC performance. For prior and post-diagnosis, the method was based on: (1) application of a tool (check list) which considered all legal requirements in force; (2) quantification of solid waste subdivided into three categories: infectious waste and sharp devices, recyclable materials and non-recyclable waste; and (3) identification of non-conformity practices. Lack of knowledge on the pertinent legislation by health workers has contributed to non-conformity instances. The legal requirements in force in Brazil today gave origin to a tool (check list) which was utilized in the management of medical waste at the health-care unit studied. This tool resulted into an adequate and simple instrument, required a low investment, allowed collecting data to feed indicators and also conquered the participation of the unit whole staff. Several non-conformities identified in the first diagnosis could be corrected by the instrument utilized
Brewster, L; Tarrant, C; Dixon-Woods, M
Centrally led performance management regimes using standard setting, monitoring, and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. To characterize views and experiences of regulation and performance management relating to IPC in English hospitals. Two qualitative datasets containing 139 interviews with healthcare workers and managers were analysed. Data directly relevant to performance management and IPC were extracted. Data analysis was based on the constant comparative method. Participants reported that performance management regimes had mobilized action around specific infections. The benefits of establishing organizational structures of accountability were seen in empirical evidence of decreasing infection rates. Performance management was not, however, experienced as wholly benign, and setting targets in one area was seen to involve risks of 'tunnel vision' and the marginalization of other potentially important issues. Financial sanctions were viewed especially negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships. Centrally led performance management may have some important roles in IPC, but identifying where it is appropriate and determining its limits is critical. Persisting with harsh regimes may affect relationships and increase resistance to continued improvement efforts, but leaving all improvement to local teams may also be a flawed strategy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Ethiopian Veterinary Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 15, No 1 (2011) >. Log in or Register to get access to full text downloads.
Wagholikar, Amol S; Fung, Maggie; Nelson, Colleen C
Effective management of chronic diseases is a global health priority. A healthcare information system offers opportunities to address challenges of chronic disease management. However, the requirements of health information systems are often not well understood. The accuracy of requirements has a direct impact on the successful design and implementation of a health information system. Our research describes methods used to understand the requirements of health information systems for advanced prostate cancer management. The research conducted a survey to identify heterogeneous sources of clinical records. Our research showed that the General Practitioner was the common source of patient's clinical records (41%) followed by the Urologist (14%) and other clinicians (14%). Our research describes a method to identify diverse data sources and proposes a novel patient journey browser prototype that integrates disparate data sources.
The history of parasitology and the teaching of veterinary parasitology in South Africa are reviewed briefly. Courses in veterinary parasitology are presented at the faculties of veterinary science at the University of Pretoria and the Medical University of South Africa as well as at the Pretoria Technicon. At the University of Pretoria, the three disciplines of veterinary parasitology, entomology, helminthology and protozoology, are covered in 330 core lectures; from 13 to 40% of the contact time is devoted to practical classes. Teaching veterinary parasitology is both labour intensive and costly, viz. R1700 (US$570) per student per annum. Such costs are justified by the R148.8 million (US$49.6 million) spent every year in South Africa on anthelmintics, ectoparasiticides and vaccines to control parasites. Veterinary parasitology is a dynamic subject and the curriculum must be revised regularly to incorporate new information. Because the parasite faunas are so diverse no single textbook can satisfy the requirements of the various institutions worldwide which teach the subject, with the result that extensive use is made of notes. In Australia and in Europe, ticks and tick-borne diseases are less important than they are in Africa; consequently insufficient space is devoted to them in textbooks to satisfy the requirements of the subject in African countries. Parasite control under extensive and intensive conditions is dealt with adequately at the University of Pretoria, but increasing emphasis will be given to small-scale farming systems, particularly if alternative food animals are to be kept.
Harlos, Karen; Tetroe, Jacqueline; Graham, Ian D; Bird, Madeleine; Robinson, Nicole
We synthesized the management and health literatures for insights into implementing evidence-based change in healthcare drawn from industry-specific data. Because change principles based on evidence often fail to be translated into organizational practice or policy, we sought studies at the nexus of organizational change and knowledge translation. We reviewed five top management journals to identify an initial pool of 3,091 studies, which yielded a final sample of 100 studies. Data were abstracted, verified by the original authors and revised before entry into a database. We employed a systematic narrative synthesis approach using words and text to distill data and explain relationships. We categorized studies by varying levels of relevance for knowledge translation as (1) primary, direct; (2) intermediate; and (3) secondary, indirect. We also identified recurring categories of change-related organizational factors. The current analysis examines these factors in studies of primary relevance to knowledge translation, which we also coded for intervention readiness to reflect how readily change can be implemented. Preliminary Results centred on five change-related categories: Tailoring the Intervention Message; Institutional Links/Social Networks; Training; Quality of Work Relationships; and Fit to Organization. In particular, networks across institutional and individual levels appeared as prominent pathways for changing healthcare organizations. Power dynamics, positive social relations and team structures also played key roles in implementing change and translating it into practice. We analyzed journals in which first authors of these studies typically publish, and found evidence that management and health sciences remain divided. Bridging these disciplines through research syntheses promises a wealth of evidence and insights, well worth mining in the search for change that works in healthcare transformation. Copyright © 2012 Longwoods Publishing.
Townend, William K; Cheeseman, Christopher; Edgar, Jen; Tudor, Terry
Since the creation of the National Health Service (NHS) in the United Kingdom in 1948 there have been significant changes in the way waste materials produced by healthcare facilities have been managed due to a number of environmental, legal and social drivers. This paper reviews the key changes in legislation and healthcare waste management that have occurred in the UK between 1948 and the present time. It investigates reasons for the changes and how the problems associated with healthcare wastes have been addressed. The reaction of the public to offensive disposal practices taking place locally required political action by the UK government and subsequently by the European legislature. The relatively new UK industry of hazardous healthcare waste management has developed rapidly over the past 25 years in response to significant changes in healthcare practices. The growth in knowledge and appreciation of environmental issues has also been fundamental to the development of this industry. Legislation emanating from Europe is now responsible for driving change to UK healthcare waste management. This paper examines the drivers that have caused the healthcare waste management to move forward in the 60 years since the NHS was formed. It demonstrates that the situation has moved from a position where there was no overall strategy to the current situation where there is a strong regulatory framework but still no national strategy. The reasons for this situation are examined and based upon the experience gained; suggestions are made for the benefit of countries with systems for healthcare waste management still in the early stages of development or without any provisions at all.
Alejandro Baldominos Gómez
Full Text Available This paper presents DataCare, a solution for intelligent healthcare management. This product is able not only to retrieve and aggregate data from different key performance indicators in healthcare centers, but also to estimate future values for these key performance indicators and, as a result, fire early alerts when undesirable values are about to occur or provide recommendations to improve the quality of service. DataCare’s core processes are built over a free and open-source cross-platform document-oriented database (MongoDB, and Apache Spark, an open-source cluster-computing framework. This architecture ensures high scalability capable of processing very high data volumes coming at fast speed from a large set of sources. This article describes the architecture designed for this project and the results obtained after conducting a pilot in a healthcare center. Useful conclusions have been drawn regarding how key performance indicators change based on different situations, and how they affect patients’ satisfaction.
Ferlie, Ewan; Crilly, Tessa; Jashapara, Ashok; Peckham, Anna
The health policy domain has displayed increasing interest in questions of knowledge management and knowledge mobilisation within healthcare organisations. We analyse here the findings of a critical review of generic management and health-related literatures, covering the period 2000-2008. Using 29 pre-selected journals, supplemented by a search of selected electronic databases, we map twelve substantive domains classified into four broad groups: taxonomic and philosophical (e.g. different types of knowledge); theoretical discourse (e.g. critical organisational studies); disciplinary fields (e.g. organisational learning and Information Systems/Information Technology); and organisational processes and structures (e.g. organisational form). We explore cross-overs and gaps between these traditionally separate literature streams. We found that health sector literature has absorbed some generic concepts, notably Communities of Practice, but has not yet deployed the performance-oriented perspective of the Resource Based View (RBV) of the Firm. The generic literature uses healthcare sites to develop critical analyses of power and control in knowledge management, rooted in neo-Marxist/labour process and Foucauldian approaches. The review generates three theoretically grounded statements to inform future enquiry, by: (a) importing the RBV stream; (b) developing the critical organisational studies perspective further; and (c) exploring the theoretical argument that networks and other alternative organisational forms facilitate knowledge sharing. Copyright © 2012 Elsevier Ltd. All rights reserved.
D'Ettorre, Gabriele; Pellicani, Vincenza; Mazzotta, Mauro; Vullo, Annamaria
Healthcare workers (HCWs) employed in Emergency Departments (EDs) frequently face with patients becoming violent because of long wait or diseases or under the influence of alcohol or drugs. Globally, workplace violence (WPV) in EDs is a major challenge to safety for HCWs, involving significant consequences to the victims, patients, and healthcare organizations. We reviewed the current literature with the aim to explore the topics focused on and to detect new evidences about approaching the issue of WPV toward HCWs in EDs. A search for articles regarding WPV toward HCWs employed in EDs and published from January 2007 through December 2017 was performed; using predetermined criteria for inclusion, selected articles were reviewed and qualitatively assessed for the aims of the review. We found 60 papers which matched our inclusion criteria; the topics, discussed in order of frequency from highest to lowest, were: "Risk Assessment", "Occurrence Rates", "Risk Management", and "Physical/non Physical Consequences". Dementia, schizophrenia, anxiety, acute stress reaction, suicidal ideation, and alcohol and drug intoxication were found as predictors of physical violence perpetrated by patients against HCWs. A strategic way to the effective management of WPV should prioritize training courses focused on: constructing HCW-patient relationship, improving the workers' communication skills, accurate reporting of each violent incident, and improving the labor context through management commitment and employee involvement in WPV prevention programs. A special effort is required in implementing workplace design effective in minimizing stressful conditions in waiting rooms which turned out to be the most frequent site of assaults.
Full Text Available This paper provides a model for the use of ontology in e-learning systems for structuring educational content in the domain of healthcare human resources management (HHRM in Romania. In this respect we propose an effective method to improve the learning system by providing personalized learning paths created using ontology and advanced educational strategies to provide a personalized learning content for the medical staff. Personalization of e-learning process for the chosen target group will be achieved by setting up learning path for each user according to his profile. This will become possible using: domain ontology, learning objects, modeling student knowledge. Developing an ontology-based system for competence management allows complex interactions, providing intelligent interfacing. This is a new approach for the healthcare system managers in permanent training based on e-learning technologies and specific ontologies in a complex area that needs urgent modernization and efficiency to meet the public health economic, social and political context of Romania.
Almost, Joan M; VanDenKerkhof, Elizabeth G; Strahlendorf, Peter; Caicco Tett, Louise; Noonan, Joanna; Hayes, Thomas; Van Hulle, Henrietta; Adam, Ryan; Holden, Jeremy; Kent-Hillis, Tracy; McDonald, Mike; Paré, Geneviève C; Lachhar, Karanjit; Silva E Silva, Vanessa
In Ontario, Canada, approximately $2.5 billion is spent yearly on occupational injuries in the healthcare sector. The healthcare sector has been ranked second highest for lost-time injury rates among 16 Ontario sectors since 2009 with female healthcare workers ranked the highest among all occupations for lost-time claims. There is a great deal of focus in Ontario's occupational health and safety system on compliance and fines, however despite this increased focus, the injury statistics are not significantly improving. One of the keys to changing this trend is the development of a culture of healthy and safe workplaces including the effective utilization of leading indicators within Occupational Health and Safety Management Systems (OHSMSs). In contrast to lagging indicators, which focus on outcomes retrospectively, a leading indicator is associated with proactive activities and consists of selected OHSMSs program elements. Using leading indicators to measure health and safety has been common practice in high-risk industries; however, this shift has not occurred in healthcare. The aim of this project is to conduct a longitudinal study implementing six elements of the Ontario Safety Association for Community and Healthcare (OSACH) system identified as leading indicators and evaluating the effectiveness of this intervention on improving selected health and safety workplace indicators. A quasi-experimental longitudinal research design will be used within two Ontario acute care hospitals. The first phase of the study will focus on assessing current OHSMSs using the leading indicators, determining potential facilitators and barriers to changing current OHSMSs, and identifying the leading indicators that could be added or changed to the existing OHSMS in place. Phase I will conclude with the development of an intervention designed to support optimizing current OHSMSs in participating hospitals based on identified gaps. Phase II will pilot test and evaluate the tailored
Hansen, Ulla Møller; Jones, Allan; Zander, Mette
AIMS: The aim of this study was to benchmark the Danish sample of the second Diabetes, Attitudes, Wishes and Needs (DAWN2) study with the global average in order to determine Denmark's comparative position for health status, healthcare provision, self-management and social support from...... to be an untapped potential when it comes to converting education participation of FM into social support for PWD. CONCLUSIONS: Our findings suggest that PWD in Denmark rank above the global average on measures of psychological wellbeing, despite psychological wellbeing being under-prioritised by HCP. However...
Wills, Celia E; Polivka, Barbara J; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald
This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of "making do" decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. © The Author(s) 2015.
Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.
Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.
Pawlson, L G; Moy, E M; Kim, J I; Griner, P F
Most studies of managed care impact have used health maintenance organization (HMO) penetration or index of competition as the marker of managed care impact. However, little empirical evidence has been found to support the validity of these or other measures in current use. In addition, as managed care evolves to forms other than HMOs and managed care penetration in large metropolitan areas approaches 100% of commercially insured patients, the utility of the most commonly used measure, HMO penetration, will decrease still further. To provide a preliminary analysis of the use of premiums as a measure of market impact of managed care. Retrospective analysis (quartile, correlation, multiple-variable linear regression) of publicly available datasets. Labor market-adjusted HMO premiums from 3 publicly available sources, for the 56 largest metropolitan areas in the United States, were compared with penetration and index of competition as predictors of the dependent market variable, hospital bed-days per 1000 population. Health maintenance organization premiums in the Federal Employees Health Benefits Program emerged as the best predictor of HMO market impact. Average HMO premiums reported in the Interstudy database and for the Medicare+Choice program also outperformed penetration or index of competition in relating to several commonly available markers of competition such as bed-days per 1000. Premiums charged by HMOs are a useful measure of the impact of managed care on healthcare markets in large metropolitan areas.
Morgan, Carol A; McDonald, Michael
Veterinarians frequently encounter situations that are morally charged and potentially difficult to manage. Situation involving euthanasia, end-of-life care, economics, and inadequate provision of care create practical and moral dilemmas. Ethical tension may be attributable to differences in beliefs regarding the moral value of animals, client and veterinary responsibilities, and deciding what is best for an animal. Veterinarians can employ communication skills used in medical situations to explore the reasons underpinning ethical dilemmas and to search for solutions with clients, staff, and colleagues.
Lemieux, Valérie; Lévesque, Jean-Frédéric; Ehrmann-Feldman, Debbie
Our objective was to explore how individual and primary healthcare (PHC) organizational attributes influence patients' ability in chronic illness self-management. We conducted a cohort study, recruiting 776 adults with chronic disease from 33 PHC settings in the province of Quebec. Organizational data on the PHC clinics were obtained from a prior study. Participants were interviewed at baseline, 6 and 12 months, responding to questionnaires on self-efficacy, health status, socio-demographics, healthcare use and experience of care. Multilevel modelling showed that 52.5% of the variance in self-efficacy occurs at the level of the individual and 4.0% at the organizational level. Controlling for diagnosis, patient factors associated with self-efficacy were self-rated health (B coeff 0.76: CI 0.60; 0.92), concurrent depression (B coeff –1.41: CI 1.96; –0.86) and satisfaction with care (B coeff 0.27: CI 0.15; 0.39). None of the organizational attributes was significantly associated with self-efficacy after adjusting for lower-level variables. Patients generally reported receiving little self-management teaching across organizations. PMID:22548102
Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim
In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.
Lemieux, Valérie; Lévesque, Jean-Frédéric; Ehrmann-Feldman, Debbie
Our objective was to explore how individual and primary healthcare (PHC) organizational attributes influence patients' ability in chronic illness self-management. We conducted a cohort study, recruiting 776 adults with chronic disease from 33 PHC settings in the province of Quebec. Organizational data on the PHC clinics were obtained from a prior study. Participants were interviewed at baseline, 6 and 12 months, responding to questionnaires on self-efficacy, health status, socio-demographics, healthcare use and experience of care. Multilevel modelling showed that 52.5% of the variance in self-efficacy occurs at the level of the individual and 4.0% at the organizational level. Controlling for diagnosis, patient factors associated with self-efficacy were self-rated health (B coeff 0.76: CI 0.60; 0.92), concurrent depression (B coeff -1.41: CI 1.96; -0.86) and satisfaction with care (B coeff 0.27: CI 0.15; 0.39). None of the organizational attributes was significantly associated with self-efficacy after adjusting for lower-level variables. Patients generally reported receiving little self-management teaching across organizations.
Infante, Maria; dos Santos, Maria Angélica Borges
Despite their importance for hospital operations, discussions of healthcare organization logistics and supply and materials management are notably lacking in Brazilian literature. This paper describes a methodology for organizing the supply of medical materials in public hospitals, based on an action-research approach. Interventions were based on the assumption that a significant portion of problems in Brazil's National Health System (SUS) facilities derive from the fact that their clinical and administrative departments do not see themselves as belonging to the same production chain - neither the hospital nor the supply department is aware of what the other produces. The development of the methodology and its main steps are presented and discussed, against a background of recent literature and total quality and supply chain management concepts.
Haraway, Dana L; Haraway, William M
Conflict is inevitable and can be both positive and negative. Although it is impossible, and probably not wise, to eliminate conflict, it is prudent for healthcare organizations to provide direct instruction in conflict-management training. In this study, 23 supervisors and managers in a local healthcare organization participated in two 3-hour sessions designed to teach practical conflict-management strategies immediately applicable to their workplace duties and responsibilities. A comparison of pretest and posttest measures indicates statistically significant differences in four areas and suggests a positive influence of the brief intervention.
The pressure on healthcare systems rises as both demand for healthcare and expenditures are increasing steadily. As a result, healthcare professionals face the challenging task to design and organize the healthcare delivery process more effectively and efficiently. Designing and organizing processes
Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris
The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.
Cakici, Ozden Engin
This dissertation examines three issues on the effect of Radio Frequency Identification (RFID) on the management of healthcare supply chain performance within the context of inventory management. Motivated by a case study conducted in a radiology practice, the second chapter analyzes the incremental benefits of RFID over barcodes for managing…
Mills, Katie; Harte, Emma; Martin, Adam; MacLure, Calum; Griffin, Simon J; Mant, Jonathan; Meads, Catherine; Saunders, Catherine L; Walter, Fiona M; Usher-Smith, Juliet A
To synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice. A systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data. An electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers. Primary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice. Of 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues. The success of the NHS Health Check Programme relies on engagement by those responsible for its
Gwaltney-Brant, S M
Veterinary pathologists working in diagnostic laboratories are sometimes presented with cases involving animal poisonings that become the object of criminal or civil litigation. Forensic veterinary toxicology cases can include cases involving animal cruelty (malicious poisoning), regulatory issues (eg, contamination of the food supply), insurance litigation, or poisoning of wildlife. An understanding of the appropriate approach to these types of cases, including proper sample collection, handling, and transport, is essential so that chain of custody rules are followed and proper samples are obtained for toxicological analysis. Consultation with veterinary toxicologists at the diagnostic laboratory that will be processing the samples before, during, and after the forensic necropsy can help to ensure that the analytical tests performed are appropriate for the circumstances and findings surrounding the individual case. © The Author(s) 2016.
Hrusovsky, J.; Benes, J.
A textbook is presented for pregraduate and postgraduate students of veterinary medicine, offering an extensive review of all aspects of radiology as applied in veterinary sciences. Based on findings published in the literature and the authors' own research, the textbook familiarizes the reader with the problems of nuclear physics, biological effects of ionizing radiation on animals, the principles of biological cycles of radionuclides in the atmosphere, the fundamentals of radiochemistry, dosimetry, radiometry and nuclear medicine. Radiation protection of animals, raw materials, feeds, foodstuff and water, and the questions of the aplications of ionizing radiation and of radionuclides in veterinary medicine are discussed in great detail. The publication is complemented with numerous photographs, figures and graphs. (L.O.)
Camilla Kirketerp Nielsen
Full Text Available The overall objective of this project is research-based development, implementation and evaluation of a game-based learning concept to be used in the veterinary education. Herd visits and animal contact are essential for the development of veterinary competences and skills during education. Yet veterinary students have little occasion to reach/attain a proper level of confidence in their own skills/abilities, as they have limited “training-facilities” (Kneebone & Baillie, 2008. One possible solution mightbe to provide a safe, virtual environment (game-based where students could practise interdisciplinary clinical skills in an easily-accessible, interactive setting. A playable demo using Classical Swine Fever in a pig herd as an example has been produced for this purpose. In order totailor the game concept to the specific veterinary learning environment and to ensure compliance with both learning objectives and the actual learning processes/procedures of the veterinary students, the project contains both a developmental aspect (game development and an exploration of the academic (scholastic and profession (practice oriented learning context. The initial phase of the project was a preliminary exploration of the actual learning context, providing an important starting point for the upcoming phase in which I will concentrate on research-based development, implementation and evaluation of a game-based virtual environment in this course context. In the academic (scholastic and profession (practice oriented learning context of a veterinary course in Herd Health Management (Pig module,ethnographic studies have been conducted by using multiple data collection methods; participant observation, spontaneous dialogues and interviews (Borgnakke, 1996; Hammersley & Atkinson, 2007. All courserelated activities in the different learning spaces (commercial pig herds, auditoriums, post-mortem examinations, independent group work were followed.This paper will
de Rijk Angelique
Full Text Available Abstract Background This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Methods Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs in Sweden were subjected to qualitative analysis. Results The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1 they have high status and expertise; 2 they lack knowledge of the system; 3 they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Conclusions Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others in relation to the physician role. Further research is needed to elucidate how managers in healthcare
von Knorring, Mia; de Rijk, Angelique; Alexanderson, Kristina
This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs) in Sweden were subjected to qualitative analysis. The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1) they have high status and expertise; 2) they lack knowledge of the system; 3) they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others) in relation to the physician role. Further research is needed to elucidate how managers in healthcare organisations assume the manager role in relation to the medical
Raila, Emilia M; Anderson, David O
Despite growing effects of human activities on climate change throughout the world, and global South in particular, scientists are yet to understand how poor healthcare waste management practices in an emergency influences the climate change. This article presents new findings on climate change risks of healthcare waste disposal during and after the 2010 earthquake and cholera disasters in Haiti. The researchers analysed quantities of healthcare waste incinerated by the United Nations Mission in Haiti for 60 months (2009 to 2013). The aim was to determine the relationship between healthcare waste incinerated weights and the time of occurrence of the two disasters, and associated climate change effects, if any. Pearson product-moment correlation coefficient indicated a weak correlation between the quantities of healthcare waste disposed of and the time of occurrence of the actual emergencies (r (58) = 0.406, p = 0.001). Correspondingly, linear regression analysis indicated a relatively linear data trend (R 2 = 0.16, F (1, 58) = 11.42, P = 0.001) with fluctuating scenarios that depicted a sharp rise in 2012, and time series model showed monthly and yearly variations within 60 months. Given that the peak healthcare waste incineration occurred 2 years after the 2010 disasters, points at the need to minimise wastage on pharmaceuticals by improving logistics management. The Government of Haiti had no data on healthcare waste disposal and practised smoky open burning, thus a need for capacity building on green healthcare waste management technologies for effective climate change mitigation.
Kallfelz, F.A.; Comar, C.L.; Wentworth, R.A.
A brief review is presented of the expanding horizons of nuclear medicine, the equipment necessary for a nuclear medicine laboratory is listed, and the value of this relatively new field to the veterinary clinician is indicated. Although clinical applications to veterinary medicine have not kept pace with those of human medicine, many advances have been made, particularly in the use of in vitro techniques. Areas for expanded applications should include competitive protein binding and other in vitro procedures, particularly in connection with metabolic profile studies. Indicated also is more intensive application by the veterinarian of imaging procedures, which have been found to be of such great value to the physician. (U.S.)
Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela
Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.
Dube, Kudakwashe; Shoniregun, Charles A
The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu
Vaccari, Mentore; Tudor, Terry; Perteghella, Andrea
Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day -1 bed -1 ), paediatric and intensive care (3.37 kg day -1 bed -1 ) and gastroenterology-digestive endoscopy (3.09 kg day -1 bed -1 ). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg -1 , with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.
Haggerty, Jeannie L; Burge, Frederick; Pineault, Raynald; Beaulieu, Marie-Dominique; Bouharaoui, Fatima; Beaulieu, Christine; Santor, Darcy A; Lévesque, Jean-Frédéric
Management continuity, operationally defined as "the extent to which services delivered by different providers are timely and complementary such that care is experienced as connected and coherent," is a core attribute of primary healthcare. Continuity, as experienced by the patient, is the result of good care coordination or integration. To provide insight into how well management continuity is measured in validated coordination or integration subscales of primary healthcare instruments. Relevant subscales from the Primary Care Assessment Survey (PCAS), the Primary Care Assessment Tool - Short Form (PCAT-S), the Components of Primary Care Instrument (CPCI) and the Veterans Affairs National Outpatient Customer Satisfaction Survey (VANOCSS) were administered to 432 adult respondents who had at least one healthcare contact with a provider other than their family physician in the previous 12 months. Subscales were examined descriptively, by correlation and factor analysis and item response theory analysis. Because the VANOCSS elicits coordination problems and is scored dichotomously, we used logistic regression to examine how evaluative subscales relate to reported problems. Most responses to the PCAS, PCAT-S and CPCI subscales were positive, yet 83% of respondents reported having one or more problems on the VANOCSS Overall Coordination subscale and 41% on the VANOCSS Specialist Access subscale. Exploratory factor analysis suggests two distinct factors. The first (eigenvalue=6.98) is coordination actions by the primary care physician in transitioning patient care to other providers (PCAS Integration subscale and most of the PCAT-S Coordination subscale). The second (eigenvalue=1.20) is efforts by the primary care physician to create coherence between different visits both within and outside the regular doctor's office (CPCI Coordination subscale). The PCAS Integration subscale was most strongly associated with lower likelihood of problems reported on the VANOCSS
Grönlund, Catarina Fischer; Dahlqvist, Vera; Zingmark, Karin; Sandlund, Mikael; Söderberg, Anna
Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support (CES) inspired by Habermas' theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved.
The concept of evidence-based medicine (EBM) has promulgated among healthcare professionals in recent years, on the other hand, the problem of underuse of useful clinical evidence is coming to be important. This is called as evidence-practice gap. The major concern about evidence-practice gap is insufficient implementation of evidence-based effective treatment, however, the perspective can be extended to measures to improve drug safety and prevention of drug related adverse events. First, this article reviews the characteristics of the database of receipt (healthcare claims) and the usefulness for research purpose of pharmacoepidemiology. Second, as the real example of the study on evidence-practice gap by using the receipt database, the case of ergot-derived anti-Parkinson drugs, of which risk of valvulopathy has been identified, is introduced. The receipt analysis showed that more than 70% of Parkinson's disease patients prescribed with cabergoline or pergolide did not undergo echocardiography despite the revision of the product label recommendation. Afterwards, the issues of pharmaceutical risk management and risk communication will be discussed.
Kamel Boulos, Maged N.; Lou, Ricardo Castellot; Anastasiou, Athanasios; Nugent, Chris D.; Alexandersson, Jan; Zimmermann, Gottfried; Cortes, Ulises; Casas, Roberto
Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in), CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be. PMID:19742164
Full Text Available Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in, CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be.
Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing. Whether these potential outcomes are realized within the relevant budget is a function of the healthcare system and the interaction of benefit design and clinical processes-not just individually vetted components. Efficiencies and values achieved in price discounts and cost sharing can be nullified if there is irrational prescribing (over-utilization, under-utilization and mis-utilization), variable patient adherence to medication regimens, ineffective formulary processes, or fraud, waste and abuse. Rising prescription drug costs and the increasing prevalence of 'high deductible health plans', which require much greater patient out-of-pocket costs, is creating a crisis for PBM efforts towards an affordable pharmacy benefit. Since PBM rebate and incentive contracts are opaque to the public, whether they add value by restraining higher drug prices or benefit from them is debatable.
Törneke, K; Torren-Edo, J; Grave, K; Mackay, D K J
Antimicrobials are essential medicines for the treatment of many microbial infections in humans and animals. Only a small number of antimicrobial agents with new mechanisms of action have been authorized in recent years for use in either humans or animals. Antimicrobial resistance (AMR) arising from the use of antimicrobial agents in veterinary medicine is a concern for public health due to the detection of increasing levels of resistance in foodborne zoonotic bacteria, particularly gram-negative bacteria, and due to the detection of determinants of resistance such as Extended-spectrum beta-lactamases (ESBL) in bacteria from animals and in foodstuffs of animal origin. The importance and the extent of the emergence and spread of AMR from animals to humans has yet to be quantified. Likewise, the relative contribution that the use of antimicrobial agents in animals makes to the overall risk to human from AMR is currently a subject of debate that can only be resolved through further research. Nevertheless, risk managers have agreed that the impact on public health of the use of antimicrobials in animals should be minimized as far as possible and a variety of measures have been introduced by different authorities in the EU to achieve this objective. This article reviews a range of measures that have been implemented within European countries to reduce the occurrence and the risk of transmission of AMR to humans following the use of antimicrobial agents in animals and briefly describes some of the alternatives to the use of antimicrobial agents that are being developed. © 2015 John Wiley & Sons Ltd.
Smith, Donald F
The future of veterinary medicine is best understood in the context of history. What began as a profession rooted in urban centers in proximity to horses, physicians, and medical schools, was transformed into a land grant-based agricultural profession with the arrival of the internal combustion engine in the early twentieth century. Most of the United States' current veterinary colleges are still located in towns or small cities in the middle section of the country, outside the largest metropolitan areas where most veterinarians practice companion-animal medicine. Throughout veterinarian history, substantial numbers of US students have been educated in foreign colleges and this continues today, creating an even greater geographic imbalance between the veterinary educational process and US population centers and major medical schools. Three themes deserve special attention as we celebrate the profession's 150th anniversary. We must first move beyond the land-grant culture and develop a more geographically balanced approach to establishing new veterinary colleges that are also in closer association with schools of medicine and public health. We must also facilitate more opportunities for women leadership in organized veterinary medicine, in practice ownership, in academia, and in the corporate structures that educate, hire, and interface with veterinarians. Finally, we need to expand our understanding of One Health to include the concept of zooeyia (the role of animals in promoting human health), as well as continue to emphasize veterinarians' special roles in the control and management of zoonotic diseases and in advancing comparative medicine in the age of the genome.
Johan van der Zwart
Full Text Available Recent deregulation of laws on hospital real estate in the Netherlands implies that healthcare institutions have more opportunities to make independent accommodation choices, but at the same time have themselves become responsible for the risks associated with the investment. In addition, accommodation costs have become an integral part of the costs of healthcare. This sheds new light on the alignment between the organisation of healthcare and accommodation: care institutions themselves bear the risk of recouping their investment in real estate and high accommodation costs lead to higher rates for healthcare compared to competing institutions. In this thesis, the ideas and concepts of Corporate Real Estate Management (CREM are examined in terms of the contribution they could make to the process of accommodation decision by using recent cases in Dutch hospitals. CREM can be defined as the management of the real estate portfolio of a corporation by aligning the portfolio and services with the needs of the core business in order to obtain maximum added value for the business and an optimal contribution to the overall performance of the organisation. This definition assumes that accommodation can add value to the organisation and contribute to its overall achievement. Elaborating on the added value of real estate in addition to quantifying these added values and making them applicable to hospital real estate management is therefore central to this study. The added values determine the transition between the different phases in the cycle of the initiation, design, construction and occupancy of the accommodation. In addition, the added value of real estate functions as a common language between the disciplines involved in the design and construction of hospital accommodation, such as the healthcare institution, healthcare manager, real estate manager and architect. In four sub-studies (1 Context, (2 Management, (3 Value and, (4 Design several
Hudak, R.; Zivcak, J.; Sevcik, A.; Danko, J.
The use of infrared thermography in veterinary medicine has been practiced since at least the 1960's, but it is only now, in approximately the last 5 years, that it has been viewed with a reasonably open mind in the veterinary community at large. One of the reasons is progress in sensors technology, which contributed for an outstanding improvement of the thermal imager parameters. Paper deals with veterinary thermography and with description of applications at the University of Veterinary Medicine in Kosice. (authors)
Mercer, Danielle; Russell, Elizabeth; Arnold, Kara A
This study examined healthcare managers' perceptions of flexible working arrangements and implementation barriers. Work-life conflict can lead to negative health implications, but flexible working arrangements can help manage this conflict. Little research has examined its implementation in 24/7/365 healthcare organizations or within groups of employees working 9 AM to 5 PM (9-5) versus shift-work hours. Questionnaires regarding perceptions to, benefits of, and barriers against flexible working arrangements were administered to managers of 9-5 workers and shift workers in an Atlantic Canadian healthcare organization. Few differences in perceptions and benefits of flexible working arrangements were found between management groups. However, results indicate that the interaction with patients and/or the immediacy of tasks being performed are barriers for shift-work managers. The nature of healthcare presents barriers for managers implementing flexible working arrangements, which differ only based on whether the job is physical (shift work) versus desk related (9-5 work).
Mitton, Craig; Dionne, Francois; Donaldson, Cam
Given limited resources, priority setting or choice making will remain a reality at all levels of publicly funded healthcare across countries for many years to come. The pressures may well be even more acute as the impact of the economic crisis of 2008 continues to play out but, even as economies begin to turn around, resources within healthcare will be limited, thus some form of rationing will be required. Over the last few decades, research on healthcare priority setting has focused on methods of implementation as well as on the development of approaches related to fairness and legitimacy and on more technical aspects of decision making including the use of multi-criteria decision analysis. Recently, research has led to better understanding of evaluating priority setting activity including defining 'success' and articulating key elements for high performance. This body of research, however, often goes untapped by those charged with making challenging decisions and as such, in line with prevailing public sector incentives, decisions are often reliant on historical allocation patterns and/or political negotiation. These archaic and ineffective approaches not only lead to poor decisions in terms of value for money but further do not reflect basic ethical conditions that can lead to fairness in the decision-making process. The purpose of this paper is to outline a comprehensive approach to priority setting and resource allocation that has been used in different contexts across countries. This will provide decision makers with a single point of access for a basic understanding of relevant tools when faced with having to make difficult decisions about what healthcare services to fund and what not to fund. The paper also addresses several key issues related to priority setting including how health technology assessments can be used, how performance can be improved at a practical level, and what ongoing resource management practice should look like. In terms of future
Focus and Scope. The Tanzania Veterinary Journal (The Tropical Veterinarian) is a biannual Journal, which publishes original contribution to knowledge on Veterinary Science, Animal Science and Production, and allied sciences including new techniques and developments in Veterinary Medicine. The target readers of the ...
Fowlpox Virus from Backyard Poultry in Plateau State Nigeria: Isolation and Phylogeny of the P4b Gene Compared to a Vaccine Strain. Meseko, C. A.. 1. ; Shittu, I. 1. ; Bwala, D. G.. 2. ; Joannis, T. M.. 1 and Nwosuh, C. I.. 2. 1Regional Laboratory For Animal Influenza and Transboundary Animal Diseases, National Veterinary ...
Journal Homepage Image. Zimbabwe Veterinary Journal contains original and review papers on all aspects of animal health in Zimbabwe and SADC countries, including articles by non-veterinarians. This journal did not publish any issues between 2002 and 2015 but has been revived and and it actively accepting papers ...
Roest, H.I.J.; Engelsma, M.Y.; Weesendorp, E.; Bossers, A.; Elbers, A.R.W.
In veterinary molecular diagnostics, samples originating from animals are tested. Developments in the farm animals sector and in our societal attitude towards pet animals have resulted in an increased demand for fast and reliable diagnostic techniques. Molecular diagnostics perfectly matches this
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Sacchini, Federico; Freeman, Kathleen P
An increasing number of veterinary laboratories worldwide have obtained or are seeking certification based on international standards, such as the International Organization for Standardization/International Electrotechnical Commission 17025. Compliance with any certification standard or quality management system requires quality documentation, an activity that may present several unique challenges in the case of veterinary laboratories. Research specifically addressing quality documentation is conspicuously absent in the veterinary literature. This article provides an overview of the quality system documentation needed to comply with a quality management system with an emphasis on preparing written standard operating procedures specific for veterinary laboratories. In addition, the quality documentation challenges that are unique to veterinary clinical pathology laboratories are critically evaluated against the existing quality standards and discussed with respect to possible solutions and/or recommended courses of action. Documentation challenges include the establishment of quality requirements for veterinary tests, the use or modification of human analytic methods for animal samples, the limited availability of quality control materials satisfactory for veterinary clinical pathology laboratories, the limited availability of veterinary proficiency programs, and the complications in establishing species-specific reference intervals.
Hunt, Katherine J; May, Carl R
Balancing the normative expectations of others (accountabilities) against the personal and distributed resources available to meet them (capacity) is a ubiquitous feature of social relations in many settings. This is an important problem in the management of long-term conditions, because of widespread problems of non-adherence to treatment regimens. Using long-term conditions as an example, we set out middle range theory of this balancing work. A middle-range theory was constructed four stages. First, a qualitative elicitation study of men with heart failure was used to develop general propositions about patient and care giver experience, and about the ways that the organisation and delivery of care affected this. Second, these propositions were developed and confirmed through a systematic review of qualitative research literature. Third, theoretical propositions and constructs were built, refined and presented as a logic model associated with two main theoretical propositions. Finally, a construct validation exercise was undertaken, in which construct definitions informed reanalysis of a set of systematic reviews of studies of patient and caregiver experiences of heart failure that had been included in an earlier meta-review. Cognitive Authority Theory identifies, characterises and explains negotiation processes in in which people manage their relations with the expectations of normative systems - like those encountered in the management of long-term conditions. Here, their cognitive authority is the product of an assessment of competence, trustworthiness and credibility made about a person by other participants in a healthcare process; and their experienced control is a function of the degree to which they successfully manage the external process-specific limiting factors that make it difficult to otherwise perform in their role. Cognitive Authority Theory assists in explaining how participants in complex social processes manage important relational aspects of
Mogre, Victor; Wanaba, Peter; Apala, Peter; Nsoh, Jonas A.
Background Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional?s weight management counselling and the weight management behaviours of type 2 diabetes patients. Methods This cross-sectional study was conducted among 378 type 2 ...
Full Text Available Including current published evidence is vital as part of evidence-based decision making in veterinary practice. Sometimes there is no published evidence which is relevant or applicable to the clinical situation.This can be either because it refers to patients with experimentally induced conditions, from a referral population or who lack the co-morbities often seen outside of the experimental context. The Veterinary Clinical Trials Network is unique. It is a rapidly expanding network of veterinary practices, with whom we are working to establish methods for running prospective, pragmatic, practical clinical trials in veterinary practice.Data is extracted from the patient record using an XML Schema. The data extracted is already captured by the Practice Management Software (PMS system as part of the consultation, no extra information is required, and the extraction method is automated. This improves participation as it minimises the time input required from vets and vet nurses. Other data is obtained directly from owners of the animals involved.By working with a large number of first opinion veterinary practices we are able to include enough patients to ensure that our trials are suitably powered, and the participants will be representative of the wider vet-visiting pet population. The research generated from this clinical trials network will help strengthen the evidence base to aid decision making by veterinary practitioners.
Guardabassi, Luca; Damborg, Peter; Stamm, Ivonne; Kopp, Peter A; Broens, Els M; Toutain, Pierre-Louis
BACKGROUND: The microbiology laboratory can be perceived as a service provider rather than an integral part of the healthcare team. OBJECTIVES: The aim of this review is to discuss the current challenges of providing a state-of-the-art diagnostic veterinary microbiology service including the
Gulnara R. Khamidullina
Full Text Available Objective to offer a solution to the problem of statistical accounting in health care on the basis of stationary medical institutions which will serve as the basis for solving many of the challenges facing the management of health institutions. Method systematic logical analysis was used. Scientific novelty solution to the issues of collecting recording and using statistical indicators necessary for the medical institution functioning is proposed. The possibility is proved of using this approach for solving problems of healthcare management. Practical value the use of research results for the processing of statistical information will reduce the risk of losing information. It will allow health care managers to use both statistical information and data on availability and consumption of materials thus ensuring the timeliness and correctness of managerial decisions. Results the problem of collecting processing and recording statistical information in a stationary medical institution is discussed. On the basis of the conducted research a solution is proposed to the problem of errors in the collecting processing transferring and keeping statistical information in health care. The necessity of these implementations is proved. The economic efficiency is proved which is associated with the timely managerial decisions on the basis of the offered variant of statistical accounting.
Wawrzyniak, Zbigniew M.; Martínez Santolaya, Sara
The paper aims to discuss data mining techniques based on statistical tools in medical data management in case of long-term diseases. The data collected from a population survey is the source for reasoning and identifying disease processes responsible for patient's illness and its symptoms, and prescribing a knowledge and decisions in course of action to correct patient's condition. The case considered as a sample of constructive approach to data management is a dependence of allergic diseases of chronic nature on some symptoms and environmental conditions. The knowledge summarized in a systematic way as accumulated experience constitutes to an experiential simplified model of the diseases with feature space constructed of small set of indicators. We have presented the model of disease-symptom-opinion with knowledge discovery for data management in healthcare. The feature is evident that the model is purely data-driven to evaluate the knowledge of the diseases` processes and probability dependence of future disease events on symptoms and other attributes. The example done from the outcomes of the survey of long-term (chronic) disease shows that a small set of core indicators as 4 or more symptoms and opinions could be very helpful in reflecting health status change over disease causes. Furthermore, the data driven understanding of the mechanisms of diseases gives physicians the basis for choices of treatment what outlines the need of data governance in this research domain of discovered knowledge from surveys.
Tudor, T.L.; Noonan, C.L.; Jenkin, L.E.T.
This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of 'waste management', to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%
Olsson, Silas; Hofmann, Isa; Brambilla, Piero Maria; Jacobsson, Ulf; Kennedy, Paul; Roca, Josep; Schmitt, Karl-Jürgen; Wyke, Alexandra
The aim with the round table was to give additional inputs and views to the specific technology oriented presentations focusing on issues dealing with the need, patients' view, the use and the business opportunities relating to wearable eHealth systems for personalised health management. Wearable eHealth systems for personalised health management are targeting citizens, patients at health risks and patients enrolled in open care or home care for monitoring, treatment or follow up. The developments so far show promises for these group categories, and in addition, could support developments in health care organisations and systems. However, the ethical issues and data privacy nature have to be seriously taken into account. The market is not yet developed, and this is the situation both in Europe and in the US. To be able to give the customers solid product information a standardised test bed for new equipment and services might speed up the market development. In the round table discussion it was highlighted that one has to differ between needs and demands. Needs are related to the prevalence of the diseases, the health risks, etc. Demands are more related to market developments and customers' willingness to pay for the new products and services. Further, technical interoperability was seen as a fundamental prerequisite for market acceptance. As wearable eHealth systems for personalised health management differ completely from traditional way of deliver healthcare, new reimbursement systems have to be developed and implemented.
Townend, William K; Cheeseman, Christopher R
This paper presents guidelines that can be used by managers of healthcare facilities to evaluate and assess the quality of resources and waste management at their facilities and enabling the principles of sustainable development to be addressed. The guidelines include the following key aspects which need to be considered when completing an assessment. They are: (a) general management; (b) social issues; (c) health and safety; (d) energy and water use; (e) purchasing and supply; (f) waste management (responsibility, segregation, storage and packaging); (g) waste transport; (h) recycling and re-use; (i) waste treatment; and (j) final disposal. They identify actions required to achieve a higher level of performance which can readily be applied to any healthcare facility, irrespective of the local level of social, economic and environmental development. The guidelines are presented, and the characteristics of facilities associated with sustainable (level 4) and unsustainable (level 0) healthcare resource and wastes management are outlined. They have been used to assess a major London hospital, and this highlighted a number of deficiencies in current practice, including a lack of control over purchasing and supply, and very low rates of segregation of municipal solid waste from hazardous healthcare waste.
Hospital cleaning and healthcare associated infections (HCAIs) continue to attract adverse media attention and consumer concern. Parallels exist with similar publicity relating to cleaning and food safety in the food industry almost 13 years earlier. This paper examines some of the management solutions developed in the food industry, and discusses their application to healthcare delivery. The food industry is managing food safety by adopting a dual approach based on pre-requisite programmes and Hazard Analysis Critical Control Points (HACCP). How these differ is described and how the approaches and terminology can be adapted for use in healthcare is discussed. The food industry is moving towards external certification of safety using national and international standards. The HACCP approach, a management tool and a central requirement of these standards, is evolving and there is interest worldwide from the healthcare community. Its application to the decontamination of endoscopes, using conventional HACCP, is presented, as well as suggestions for a simplified format for managing patient-related procedures. Taking this type of approach to the management of HCAIs could provide greater transparency, reduce infection rates and increase consumer confidence. Potential problems in adopting HACCP, including cost and human resource, are discussed. The HACCP method/approach has previously been mentioned in the medical literature but this paper is one of the few to examine, from basic principles, its infection control application within a broader approach to quality assurance.
van der Zwart, J.; van der Voordt, Theo; Arkesteijn, M.H.
Since 2008, after 35 years of a publicly supported healthcare real estate budget system, Dutch healthcare organisations have become financially responsible for the profits and risks of their real estate investment. Furthermore the Dutch healthcare system is in transition towards a regulated market
Nilsson, Kerstin; Sandoff, Mette
The purpose of this study is to gain better understanding of the roles and functions of process managers by describing Swedish process managers' experiences of leading processes involving patient care and treatment when working in a hierarchical health-care organization. This study is based on an explorative design. The data were gathered from interviews with 12 process managers at three Swedish hospitals. These data underwent qualitative and interpretative analysis with a modified editing style. The process managers' experiences of leading processes in a hierarchical health-care organization are described under three themes: having or not having a mandate, exposure to conflict situations and leading process development. The results indicate a need for clarity regarding process manager's responsibility and work content, which need to be communicated to all managers and staff involved in the patient care and treatment process, irrespective of department. There also needs to be an emphasis on realistic expectations and orientation of the goals that are an intrinsic part of the task of being a process manager. Generalizations from the results of the qualitative interview studies are limited, but a deeper understanding of the phenomenon was reached, which, in turn, can be transferred to similar settings. This study contributes qualitative descriptions of leading care and treatment processes in a functional, hierarchical health-care organization from process managers' experiences, a subject that has not been investigated earlier.
Full Text Available Abstrak Latar belakang: Dalam memberikan pelayanan kesehatan, rumah sakit maupun sarana pelayanan kesehatan lainnya menghasilkan limbah medik yang mempunyai risiko menularkan penyakit-penyakit tular darah dan penyakit lainnya apabila tidak dikelola secara aman. Tujuan:Diperolehnya gambaran tentang kondisi dan praktik Pengelolaan Limbah Layanan Kesehatan (PLLK di beberapa rumah sakit umum (RSU di Indonesia, agar dapat digunakan oleh RSU dan sarana pelayanan kesehatan lainnya untuk melaksanakan PLLK secara aman. Bahan dan Cara: Kajian berupa survei dilakukan oleh Direktorat Penyehatan Lingkungan dengan cara mengirimkan kuesioner terstruktur di100 RSU pada tahun 2004. Hanya 76 RSU yang mengisi kuesioner. Lingkup survei meliputi aspek sanitasi RSU, di antaranya PLLK yang meliputi variabel ketersedian unit organisasi yang bertanggungjawab dalam PLLK, rencana pengelolaan limbah medik , ketersediaan pedoman PLLK, praktik pemilahan dan teknologi pengolahan limbah medik. Hasil: Sebagian besar RSU telah mempunyai unit yang bertanggungjawab dalam PLLK, namun hanya sekitar 33% yang mempunyai rencana PLLK. Demikian pula hanya sekitar 30% RSU yang memilah limbahnya menjadi tiga kategori sesuai pedomanPLLK, walaupun lebih dari 60% RSU telah mempunyai buku pedoman PLLK sesuai dengan Keputusan Menteri Kesehatan No. 1204/2004. Insinerasi merupakan cara pemusnahan limbah yang dipilih oleh mayoritas RSU. Kesimpulan: Masih banyak RSU yang disurvei belum mengelola limbahnya sesuai dengan Keputusan Menteri Kesehatan No. 1204/2004 seperti diamanatkan oleh Peraturan Pemerintah tentang Pengelolaan Limbah Berbahaya dan Beracun termasuk limbah layanan kesehatan. Kata kunci: fasilitas kesehatan, pengelolaan limbah layanan kesehatan, kebijakan, risiko kesehatan Abstract Background: In providing healthcare services, hospitals and other healthcare facilities generate medical wastes which can spread blood-borne diseases and other waste diseases if they do not manage their
To provide sufficient information about the Manchester Patient Safety Framework (MaPSaF) to allow healthcare professionals to assess its potential usefulness. The assessment of safety culture is an important aspect of risk management, and one in which there is increasing interest among healthcare organizations. Manchester Patient Safety Framework offers a theory-based framework for assessing safety culture, designed specifically for use in the NHS. The framework covers multiple dimensions of safety culture, and five levels of safety culture development. This allows the generation of a profile of an organization's safety culture in terms of areas of relative strength and challenge, which can be used to identify focus issues for change and improvement. Manchester Patient Safety Framework provides a useful method for engaging healthcare professionals in assessing and improving the safety culture in their organization, as part of a programme of risk management.
Lin, Hsueh-Chun; Chiang, Li-Chi; Wen, Tzu-Ning; Yeh, Kuo-Wei; Huang, Jing-Long
Many regional programs of the countries educate asthmatic children and their families to manage healthcare data. This study aims to establish a Web-based self-management system, eAsthmaCare, to promote the electronic healthcare (e-Healthcare) services for the asthmatic children in Taiwan. The platform can perform real time online functionality based upon a five-tier infrastructure with mutually supportive components to acquire asthma diaries, quality of life assessments and health educations. We have designed five multi-disciplinary portions on the interactive interface functioned with the analytical diagrams: (1) online asthma diary, (2) remote asthma assessment, (3) instantaneous asthma alert, (4) diagrammatical clinic support, and (5) asthma health education. The Internet-based asthma diary and assessment program was developed for patients to process self-management healthcare at home. In addition, the online analytical charts can help healthcare professionals to evaluate multi-domain health information of patients immediately. eAsthmaCare was developed by Java™ Servlet/JSP technology upon Apache Tomcat™ web server and Oracle™ database. Forty-one voluntary asthmatic children (and their parents) were intervened to examine the proposed system. Seven domains of satisfiability assessment by using the system were applied for approving the development. The average scores were scaled in the acceptable range for each domain to ensure feasibility of the proposed system. The study revealed the details of system infrastructure and developed functions that can help asthmatic children in self-management for healthcare to enhance communications between patients and hospital professionals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Söderberg, Johan; Brulin, Christine; Grankvist, Kjell; Wallin, Olof
Most errors in laboratory medicine occur in the preanalytical phase and are the result of human mistakes. This study investigated information search procedures, test request management and test tube labelling in primary healthcare compared to the same procedures amongst clinical laboratory staff. A questionnaire was completed by 317 venous blood sampling staff in 70 primary healthcare centres and in two clinical laboratories (response rate = 94%). Correct procedures were not always followed. Only 60% of the primary healthcare staff reported that they always sought information in the updated, online laboratory manual. Only 12% reported that they always labelled the test tubes prior to drawing blood samples. No major differences between primary healthcare centres and clinical laboratories were found, except for test tube labelling, whereby the laboratory staff reported better practices. Re-education and access to documented routines were not clearly associated with better practices. The preanalytical procedure in the surveyed primary healthcare centres was associated with a risk of errors which could affect patient safety. To improve patient safety in laboratory testing, all healthcare providers should survey their preanalytical procedures and improve the total testing process with a systems perspective.
Sánchez-Martínez, Fernando I; Abellán-Perpiñán, José María; Oliva-Moreno, Juan
It is often asserted that public management of healthcare facilities is inefficient. On the basis of that unproven claim, it is argued that privatization schemes are needed. In this article we review the available evidence, in Spain and other countries, on the application of private management mechanisms to publicly funded systems similar to the Spanish national health system. The evidence suggests that private management of healthcare services is not necessarily better than public management, nor vice versa. Ownership-whether public or private-of health care centers does not determine their performance which, on the contrary, depends on other factors, such as the workplace culture or the practice of suitable monitoring by the public payer. Promoting competition among centers (irrespective of the specific legal form of the management arrangements), however, could indeed lead to improvements under some circumstances. Therefore, it is advisable to cease the narrow-minded debate on the superiority of one or other model in order to focus on improving healthcare services management per se. Understanding that good governance affects health policies, the management of health care organizations, and clinical practice is, undoubtedly, an essential requirement but may not necessarily lead to policies that stimulate the solvency of the system. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
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).
Peter, W.F.; Hurkmans, E.J.; Wees, P.J. van der; Hendriks, E.J.; Bodegom-Vos, L. van; Vlieland, T.P.
OBJECTIVES: The aim of the present study was to develop healthcare quality indicators (HCQIs) for the physiotherapy (PT) management of patients with hip or knee osteoarthritis (HKOA) or rheumatoid arthritis (RA) in the Netherlands. METHODS: Two multidisciplinary expert panels, including patients,
J.K. Oostrom (Janneke); H. van Mierlo (Heleen)
textabstractWorkplace violence is a major occupational hazard for healthcare workers, generating a need for effective intervention programs. The purpose of this study was to evaluate the effectiveness of an aggression management training program. The evaluation design was based on the internal
Tabak, Monique; Flierman, I.; van Schooten, B.W.; Hermens, Hermanus J.
Introduction: In chronic disease management, such as in chronic obstructive pulmonary disease (COPD), technology can play an important role to increase the quality and efficiency of care. In the THeCS project, which is part of the large Dutch COMMIT programme, we aim to develop a trusted healthcare
Full Text Available There is increasing interest in – and debate about – the extent to which key concepts from the resource-based view (RBV of the Firm school of strategic management can be usefully applied to study knowledge mobilization (KM processes in healthcare and other public services settings.
Stahl, Scott J
The reptile veterinarian should approach the breeder with a comprehensive plan involving a review of proper husbandry, nutrition, record keeping, and a thorough prebreeding evaluation of the snakes. In addition, an evaluation of the reproductive strategy, assistance with confirming and monitoring gestation, and a review of potential reproductive complications will help to prepare the snake owner for a successful breeding season.
Gustavsson, Catharina; Nordqvist, Maria; Bröms, Kristina; Jerdén, Lars; Kallings, Lena V; Wallin, Lars
The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare. Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis. We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling. The study provides knowledge
Rogers, Andy; Chapple, Claire-Louise; Murray, Maria; Platton, David; Saunderson, John
There has been concern expressed by the UK regulator, the Health & Safety Executive, regarding the management of occupation dose for healthcare radiation workers who work across multiple organizations. In response to this concern, the British Institute of Radiology led a working group of relevant professional bodies to develop guidance in this area. The guidance addresses issues of general system management that would apply to all personal dosimetry systems, regardless of whether or not the workers within that system work across organizational boundaries, along with exploring efficient strategies to comply with legislation where those workers do indeed work across organizational boundaries. For those specific instances, the guidance discusses both system requirements to enable organizations to co-operate (Ionising Radiation Regulations 1999 Regulation 15), as well as specific instances of staff exposure. This is broken down into three categories-low, medium and high risk. A suggested approach to each is given to guide employers and their radiation advisers in adopting sensible strategies for the monitoring of their staff and the subsequent sharing of dosimetry data to ensure overall compliance with both dose limits and optimization requirements.
Enrique Jiménez-Rodríguez; José Manuel Feria-Domínguez; Alonso Sebastián-Lacave
Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identificati...
Rosen, A.C.; Dexter, F.
Foglia et al. (in press) describe tension in two veteran's hospitals among managers, clinicians, and patients over allocating appropriate resources to support care and inefficiencies in care delivery. Ultimately ethical healthcare in a system which is committed to caring for an entire population of patients must use its limited resources effectively while not compromising patient safety. This discussion gives examples from operating room management in which systematic analyses of existing dat...
Houngbo, P.T.; de Cock Buning, J.T.; Bunders- Aelen, J.G.F.; Medenou, D.; Dakpanon, L.Y.; Zweekhorst, M.B.M.; Coleman, H.L.S.
Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of
Vockeroth, W G
Complementary and alternative therapies, including homeopathy, have a definite place in veterinary medicine today. The public is demanding access to a full range of conventional and complementary therapies, and the best scenario is to have all therapies available, for there is a place and a need for all of them in the right situation. In my own practice, I use both alternative and conventional therapies, as well as referring patients to specialists, for services such as ultrasound and surgery...
Full Text Available Bio-medical waste has a higher potential of infection and injury to the healthcare worker, patient and the surrounding community. Awareness programmes on their proper handling and management to healthcare workers can prevent the spread of infectious diseases and epidemics. This study was conducted in a tertiary care hospital to assess the impact of training, audits and education/implementations from 2009 to 2012 on awareness and practice of biomedical waste segregation. Our study reveals focused training, strict supervision, daily surveillance, audits inspections, involvement of hospital administrators and regular appraisals are essential to optimise the segregation of biomedical waste.
Joseph, L; Paul, H; Premkumar, J; Paul, R; Michael, J S
Bio-medical waste has a higher potential of infection and injury to the healthcare worker, patient and the surrounding community. Awareness programmes on their proper handling and management to healthcare workers can prevent the spread of infectious diseases and epidemics. This study was conducted in a tertiary care hospital to assess the impact of training, audits and education/implementations from 2009 to 2012 on awareness and practice of biomedical waste segregation. Our study reveals focused training, strict supervision, daily surveillance, audits inspections, involvement of hospital administrators and regular appraisals are essential to optimise the segregation of biomedical waste.
Brennan, David M; Mawson, Sue; Brownsell, Simon
Telerehabilitation refers to the use of Information and Communication Technologies (ICT) to provide rehabilitation services to people remotely in their homes or other environments. By using ICT, client access to care can be improved and the reach of clinicians can extend beyond the physical walls of a traditional healthcare facility, thus expanding continuity of care to persons with disabling conditions. The concept of telecare, when telerehabilitation is used to deliver services to clients in their homes or other living environments, empowers and enables individuals to take control of the management of their medical needs and interventions by enabling personalized care, choice and personal control. A wide variety of assessment and treatment interventions can be delivered to clients using remote monitoring systems, robotic and virtual reality technologies, and synchronized collaboration with online material. This chapter will present a brief history of telerehabilitation and telecare and offer an overview of the technology used to provide remote rehabilitation services. Emphasis will be given to the importance of human factors and user-centered design in the planning, development, and implementation of telerehabilitation systems and programs. The issue of self-care in rehabilitation and self-management will be discussed along with the rationale for how telerehabilitation can be used to promote client self-care and self-management. Two case studies of real-world telerehabilitation systems will be given, with a focus on how they were planned and implemented so as to maximize their potential benefits. The chapter will close with a discussion of obstacles and challenges facing telerehabilitation and suggestions for ways to promote its growth in use and acceptance.
Control of the development and prevalence of antimicrobial resistance in bacteria of food animal origin in Japan: a new approach for risk management of antimicrobial veterinary medicinal products in Japan.
Asai, Tetsuo; Hiki, Mototaka; Ozawa, Manao; Koike, Ryoji; Eguchi, Kaoru; Kawanishi, Michiko; Kojima, Akemi; Endoh, Yuuko S; Hamamoto, Shuichi; Sakai, Masato; Sekiya, Tatsuro
Antimicrobial agents are essential for controlling bacterial disease in food-producing animals and contribute to the stable production of safe animal products. The use of antimicrobial agents in these animals affects the emergence and prevalence of antimicrobial resistance in bacteria isolated from animals and animal products. As disease-causing bacteria are often transferred from food-producing animals to humans, the food chain is considered a route of transmission for the resistant bacteria and/or resistance genes. The Food Safety Commission of Japan (FSC) has been assessing the risk posed to human health by the transmission of antimicrobial-resistant bacteria from livestock products via the food chain. In addition to the FSC's risk assessments, the Japanese Ministry of Agriculture, Forestry and Fisheries has developed risk-management guidelines to determine feasible risk-management options for the use of antimicrobial veterinary medicinal products during farming practices. This report includes information on risk assessment and novel approaches for risk management of antimicrobial veterinary medicinal products for mitigating the risk of development and prevalence of antimicrobial resistance in bacteria originating from food-producing animals in Japan.
The Hospital Information System (HIS) has been positioned as the hub of the healthcare information management architecture. In Japan, the billing system assigns an "insurance disease names" to performed exams based on the diagnosis type. Departmental systems provide localized, departmental services, such as order receipt and diagnostic reporting, but do not provide patient demographic information. The system above has many problems. The departmental system's terminals and the HIS's terminals are not integrated. Duplicate data entry introduces errors and increases workloads. Order and exam data managed by the HIS can be sent to the billing system, but departmental data cannot usually be entered. Additionally, billing systems usually keep departmental data for only a short time before it is deleted. The billing system provides payment based on what is entered. The billing system is oriented towards diagnoses. Most importantly, the system is geared towards generating billing reports rather than at providing high-quality patient care. The role of the application server is that of a mediator between system components. Data and events generated by system components are sent to the application server that routes them to appropriate destinations. It also records all system events, including state changes to clinical data, access of clinical data and so on. Finally, the Resource Management System identifies all system resources available to the enterprise. The departmental systems are responsible for managing data and clinical processes at a departmental level. The client interacts with the system via the application server, which provides a general set of system-level functions. The system is implemented using current technologies CORBA and HTTP. System data is collected by the application server and assembled into XML documents for delivery to clients. Clients can access these URLs using standard HTTP clients, since each department provides an HTTP compliant web
Sockalingam, Sanjeev; Tehrani, Hedieh; Kacikanis, Anna; Tan, Adrienne; Hawa, Raed; Anderson, Ruthie; Okrainec, Allan; Abbey, Susan
The high incidence of delirium in surgical units is a serious quality concern, given its impact on morbidity and mortality. While successful delirium management depends upon interdisciplinary care, training needs for surgical teams have not been studied. A needs assessment of surgical units was conducted to determine perceived comfort in managing delirium, and interprofessional training needs for team-based care. We administered a survey to 106 General Surgery healthcare professionals (69% response rate) with a focus on attitudes towards delirium and team management. Although most respondents identified delirium as important to patient outcomes, only 61% of healthcare professionals indicated that a team-based approach was always observed in practice. Less than half had a clear understanding of their role in delirium care, while just over half observed team communication of delirium care plans during handover. This is the first observation of clear gaps in perceived team performance in a General Surgery setting.
Posadzki, Pawel; Mastellos, Nikolaos; Ryan, Rebecca; Gunn, Laura H; Felix, Lambert M; Pappas, Yannis; Gagnon, Marie-Pierre; Julious, Steven A; Xiang, Liming; Oldenburg, Brian; Car, Josip
Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention. To assess the effects of ATCS for preventing disease and managing long-term conditions on behavioural change, clinical, process, cognitive, patient-centred and adverse outcomes. We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled-trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015. Randomised, cluster- and quasi-randomised trials, interrupted time series and controlled before-and-after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible. We used standard Cochrane methods to select and extract data and to appraise eligible studies. We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty-one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long-term conditions, and seven studies for appointment reminders
Armitage-Chan, Elizabeth; Jackson, Elizabeth
Improving Student Engagement in Veterinary Business StudiesIn a densely packed veterinary curriculum, students may find it particularly challenging to engage in the less overtly clinical subjects, yet pressure from industry and an increasingly competitive employment market necessitate improved veterinary student education in business and management skills. We describe a curriculum intervention (formative reflective assignment) that optimizes workplace learning opportunities and aims to provide better student scaffolding for their in-context business learning. Students were asked to analyze a business practice they experienced during a period of extra-mural studies (external work placement). Following return to the college, they were then instructed to discuss their findings in their study group, and produce a group reflection on their learning. To better understand student engagement in this area, we analyzed individual and group components of the assignment. Thematic analysis revealed evidence of various depths of student engagement, and provided indications of the behaviors they used when engaging at different levels. Interactive and social practices (discussing business strategies with veterinary employees and student peers) appeared to facilitate student engagement, assist the perception of relevance of these skills, and encourage integration with other curriculum elements such as communication skills and clinical problem solving.
Crooks, Valorie A; Ormond, Meghann; Jin, Ki Nam
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple venues, including this very journal. Key questions for future research emerging from the forum include: who should be meaningfully involved in identifying and defining categories of those travelling across borders for health services and what risks exist if certain voices are underrepresented in such a process; who does and does not 'count' as a medical tourist and what are the implications of such quantitative assessments; why have researchers not been able to address pressing knowledge gaps regarding the health equity impacts of medical tourism; and how do national-level polices and initiatives shape the ways in which medical tourism is unfolding in specific local centres and clinics? This short report as an important time capsule that summarises the current state of medical tourism research knowledge as articulated by the thought leaders in attendance at the forum while also pushing for research growth.
Wireless Sensor Network (WSN) can be deployed to monitor the health of patients suffering from critical diseases. Also a wireless network consisting of biomedical sensors can be implanted into the patient's body and can monitor the patients' conditions. These sensor devices, apart from having an enormous capability of collecting data from their physical surroundings, are also resource constraint in nature with a limited processing and communication ability. Therefore we have to integrate them with the Grid technology in order to process and store the collected data by the sensor nodes. In this paper, we proposed the SEnsor Grid Enhancement Data Management system, called SEGEDMA ensuring the integration of different network technologies and the continuous data access to system users. The main contribution of this work is to achieve the interoperability of both technologies through a novel network architecture ensuring also the interoperability of Open Geospatial Consortium (OGC) and HL7 standards. According to the results, SEGEDMA can be applied successfully in a decentralized healthcare environment.
Smith, Alan D; Flanegin, Frank R
The concepts of automated e-procurement, or electronic B2B (business-to-business) trade, are grounded in the strategic leveraging of both tangible/intangible assets for successful implementation and execution of electronic trade, resulting in significant financial benefits for firms. Some of the major reasons for this growth include significant process savings from automation, compliance, and purchasing advantage; and reduced costs that organisations can experience by conducting transactions electronically. Although these are the basic benefits associated with generic e-commerce strategies, a majority of these B2B transactions have focused on the purchase of indirect materials (especially office products and travel services). In fact, more than 93% of medical supplies on hospital shelves appear to have universal product numbers on them--at least while still in their boxes and there is a great potential for huge savings in e-procurement in the healthcare field. However, other types of supply chain-related purchases, including maintenance, repair, and operating and replacement parts, and direct material purchases, are becoming more important operational management considerations. In addition, several other key considerations are: existing procurement strategy, the vendor, technology, suppliers, and total costs of ownership. Companies need to analyse their current procurement strategy before developing an e-procurement plan.
Benaissa, M; Malik, B; Kanakis, A; Wright, N P
In this paper, a telemedicine system for managing diabetic patients with better care is presented. The system is an end to end solution which relies on the integration of front end (patient unit) and backend web server. A key feature of the system developed is the very low cost automated approach. The front-end of the system is capable of reading glucose measurements from any glucose meter and sending them automatically via existing networks to the back-end server. The back-end is designed and developed using n-tier web client architecture based on model-view-controller design pattern using open source technology, a cost effective solution. The back-end helps the health-care provider with data analysis; data visualization and decision support, and allows them to send feedback and therapeutic advice to patients from anywhere using a browser enabled device. This system will be evaluated during the trials which will be conducted in collaboration with a local hospital in phased manner.
Wheelton, R.; McCaffery, A.
This brief article discusses radiation protection for diagnostic radiography in veterinary practices. It includes aspects such as a radiation protection adviser, personal dosimetry but in particular a Veterinary Monitoring Service, developed by the NRPB, which offers veterinary practitioners the convenience of making simple but essential measurements for themselves using photographic films contained in a 'vet pack' to determine the operating condition of their X-ray machine. (U.K.)
Sandefer, Ryan Heath
The use of health information and health information technology by consumers is a major factor in the current healthcare systems' effort to address issues related to quality, cost, and access. Patient engagement in the healthcare process through access to information related to diagnoses, procedures, and treatment has the potential to improve…
Velthuijsen, Hugo; Balje, Jan; Carter, Anke
Although many pilots with new eHealth products have been developed, only very few of these products reach widespread adoption within healthcare organisations. The literature mentions a wide range of bottlenecks for the acceptance of new technology in the healthcare industry, among which insufficient
van Rossum, L.; Aij, K.H.; Simons, F.; van der Eng, N.; ten Have, W.D.
Purpose – Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change
Meng, Weizhi; Choo, Kim-Kwang Raymond; Furnell, Steven
experts that the security of Internet-enabled medical devices is crucial, and an ongoing threat vector is insider attacks. In this paper, we focus on the identification of insider attacks in healthcare SDNs. Specifically, we survey stakeholders from 12 healthcare organizations (i.e., two hospitals and two...
Hopkins, Robert Borden; Campbell, Kaitryn; O'Reilly, Daria; Tarride, Jean-Eric; Bowen, Jim; Blackhouse, Gord; Goerre, Ron
To summarize and then assess with a pilot study the use of published best practice recommendations for priority setting during management of multiple healthcare research projects, in a resource-constrained environment. Medical, economic, business, and operations literature was reviewed to summarize and develop a survey to assess best practices for managing multiple projects. Fifteen senior healthcare research project managers, directors, and faculty at an urban academic institution were surveyed to determine most commonly used priority rules, ranking of rules, characteristics of their projects, and availability of resources. Survey results were compared to literature recommendations to determine use of best practices. Seven priority-setting rules were identified for managing multiple projects. Recommendations on assigning priorities by project characteristics are presented. In the pilot study, a large majority of survey respondents follow best practice recommendations identified in the research literature. However, priority rules such as Most Total Successors (MTS) and Resource Scheduling Method (RSM) were used "very often" by half of the respondents when better performing priority rules were available. Through experience, project managers learn to manage multiple projects under resource constraints. Best practice literature can assist project managers in priority setting by recommending the most appropriate priority given resource constraints and project characteristics. There is room for improvement in managing multiple projects.
The cons and pros of veterinary education in Iraq are described. Started as a small institution, with few students and with foreign staffs, then expanded to enroll more than hundred students each year, with all Iraqi staff. The graduates of the Veterinary College played an important role in monitoring animal health, supervising research projects involving animal welfare, some served as educators of various veterinary science specializations, others worked as private practitioners or recruited in the army. Veterinary education was very vital, as other sciences for progress of the country.
Full Text Available Abstract Background In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention. Methods A qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation. Results The stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations. Conclusion This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the
Kim, Younghee; Jung, Jinyong; Kim, Myunghyun; Park, Jeongim; Boxall, Alistair B A; Choi, Kyungho
Pharmaceutical residues may have serious impacts on nontarget biological organisms in aquatic ecosystems, and have therefore precipitated numerous investigations worldwide. Many pharmaceutical compounds available on the market need to be prioritized based on their potential ecological and human health risks in order to develop sound management decisions. We prioritized veterinary pharmaceuticals in Korea by their usage, potential to enter the environment, and toxicological hazard. Twenty compounds were identified in the top priority class, most of which were antibiotics. Among these compounds, 8 were identified as deserving more immediate attention: amoxicillin, enramycin, fenbendazole, florfenicol, ivermectin, oxytetracycline, tylosin, and virginiamycin. A limitation of this study is that we initially screened veterinary pharmaceuticals by sales tonnage for veterinary use only. However, this is the first attempt to prioritize veterinary pharmaceuticals in Korea, and it provides important concepts for developing environmental risk management plans for such contaminants in aquatic systems. Copyright © 2008 Elsevier B.V. All rights reserved.
Tabash, M I; Hussein, R A; Mahmoud, A H; El-Borgy, M D; Abu-Hamad, B A
To assess knowledge, attitude and practice (KAP) of healthcare staff regarding pharmaceutical waste management; and to determine the impact of an educational programme on the KAP survey items. Pre-post-test intervention study. The pre-intervention phase was performed using a sample of 530 out of 1500 healthcare workers. A predesigned interview questionnaire was used to assess KAP. Next, an educational programme was designed and offered to a subsample of 69 healthcare workers. KAP were re-assessed for the programme attendees using the same interview questionnaire, both immediately (post-test) and six months after the end of the programme (follow-up test). The parametric paired sample t-test was used to assess the difference between pre-test and follow-up test results. Poor knowledge and poor practice levels (scores 50%) detected in the pre-intervention phase were found to improve to satisfactory levels (scores ≥75%) in the follow-up phase. Attitude was found to be positive (score ≥75%) in all phases of the study. The educational programme led to a significant improvement in KAP of healthcare staff regarding pharmaceutical waste management (P<0.001). Copyright © 2016. Published by Elsevier Ltd.
Bergman, Philip J
The ideal cancer immunotherapy agent should be able to discriminate between cancer and normal cells, be potent enough to kill small or large numbers of tumor cells, and be able to prevent recurrence of the tumor. Tumor immunology and immunotherapy are among the most exciting and rapidly expanding fields; cancer immunotherapy is now recognized as a pillar of treatment alongside traditional modalities. This article highlights approaches that seem to hold particular promise in human clinical trials and many that have been tested in veterinary medicine. Copyright © 2017 Elsevier Inc. All rights reserved.
Holistic veterinary medicine treats the whole patient including all physical and behavioral signs. The root cause of disease is treated at the same time as accompanying clinical signs. Herbal and nutritional supplements can help support tissue healing and proper organ functioning, thereby reducing the tendency of disease progression over time. Proper selection of homeopathic remedies is based on detailed evaluation of clinical signs. Herbal medicines are selected based on organ(s) affected and the physiologic nature of the imbalance. Many herbal and nutraceutical companies provide support for veterinarians, assisting with proper formula selection, dosing, drug interactions, and contraindications. Copyright © 2014 Elsevier Inc. All rights reserved.
Khan, Nadia; Bacon, Simon L; Khan, Samia; Perlmutter, Sara; Gerlinsky, Carline; Dermer, Mark; Johnson, Lonni; Alves, Finderson; McLean, Donna; Laupacis, Andreas; Pui, Mandy; Berg, Angelique; Flowitt, Felicia
Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care. ©2017 Wiley Periodicals, Inc.
Purchasing Value: Purchasing and Supply Management's Contribution to Health Service Performance: Address delivered at the occasion of accepting the appointment of endowed professor of Purchasing & Supply Management in Healthcare on behalf of the Vereniging Trustfonds, Erasmus University Rotterdam, at Rotterdam School of Management and the institute of Health Policy & Management, Erasmus University, on Friday, 14 October 2016
textabstractMany countries across the globe face the challenge of increasing healthcare costs, often increasing faster than GDP or personal income. In an effort to manage these costs, but also to improve the quality and accessibility of healthcare, governments have introduced a purchaser-provider split in the healthcare system. Healthcare financers, such as local governments, employers and health insurers exercise the role of healthcare purchasers. They select and contract providers, and mana...
Devitt, Rob; Klassen, Wolf; Martalog, Julian
One of the historical challenges in the healthcare system has been the identification and collection of meaningful data to measure an organization's progress towards the achievement of its strategic goals and the concurrent alignment of internal operating practices with this strategy. Over the last 18 months the Toronto East General Hospital (TEGH) has adopted a strategic management system and organizing framework that has led to a metric-based strategic plan. It has allowed for formal and measurable linkages across a full range of internal business processes, from the annual operating plan to resource allocation decisions, to the balanced scorecard and individual performance evaluations. The Strategic Management System (SMS) aligns organizational planning and performance measurement, facilitates an appropriate balance between organizational priorities and resolving "local" problems, and encourages behaviours that are consistent with the values upon which the organization is built. The TEGH Accountability Framework serves as the foundation for the entire system. A key tool of the system is the rolling three-year strategic plan for the organization that sets out specific annual improvement targets on a number of key strategic measures. Individual program/department plans with corresponding measures ensure that the entire organization is moving forward strategically. Each year, all plans are reviewed, with course adjustments made to reflect changes in the hospital's environment and with re-calibration of performance targets for the next three years to ensure continued improvement and organizational progress. This system has been used through one annual business cycle. Results from the past year show measurable success. The hospital has improved on 12 of the 15 strategic plan metrics, including achieving the targeted 1% operating surplus while operating in an environment of tremendous change and uncertainty. This article describes the strategic management system used
Vezhnovets', T A
The aim of our study was to examine the influence of age and management experience of executives in healthcare institutions at the style of decision-making. The psychological study of 144 executives was conducted. We found out that the age of executives in healthcare institutions does not affect the style of managerial decision making, while experience in leadership position does. Also it was established that the more experienced leader is, the more often he will make decision in authoritative, autonomous, marginal style and the less management experience is, the more likely is the usage of indulgent and situational style. Moreover, the authoritarian style is typical for younger executives, marginal and autonomous is typical for elder executives.
Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso
to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. propor instrumento para facilitar diagnóstico, elaboração e avaliação de Plano de Gerenciamento de Resíduos em Unidades Básicas de Saúde e apresentar os resultados da aplicação em quatro unidades selecionadas. pesquisa descritiva que contemplou as etapas de construção/aplicação do instrumento proposto e a avaliação de desempenho do gerenciamento de resíduos nas unidades estudadas. geração de instrumento composto por cinco formulários; proposta de indicadores específicos de geração de resíduos para unidades assistenciais de saúde sem
Guardabassi, Luca; Damborg, Peter; Stamm, Ivonne
the identification (ID) and antimicrobial susceptibility testing (AST) of key pathogens in veterinary dermatology. Methods The Study Group for Veterinary Microbiology (ESGVM) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) identified scientific, technological, educational...... not adequately equipped to run up-to-date clinical microbiologic diagnostic tests. Conclusions and clinical importance ESGVM recommends the use of laboratories employing mass spectrometry for ID and broth micro-dilution for AST, and offering assistance by expert microbiologists on pre- and post-analytical issues......Background The microbiology laboratory can be perceived as a service provider rather than an integral part of the healthcare team. Objectives The aim of this review is to discuss the current challenges of providing a state-of-the-art diagnostic veterinary microbiology service including...
Kinnison, Tierney; Lumbis, Rachel; Orpet, Hilary; Welsh, Perdi; Gregory, Sue; Baillie, Sarah
Interprofessional education (IPE) has received little attention in veterinary education even though members of the veterinary and nursing professions work closely together. The present study investigates veterinary and veterinary nursing students' and practitioners' experiences with interprofessional issues and the potential benefits of IPE. Based on stakeholder consultations, two teaching interventions were modified or developed for use with veterinary and veterinary nursing students: Talking Walls, which aimed to increase individuals' understanding of each other's roles, and an Emergency-Case Role-Play Scenario, which aimed to improve teamwork. These interventions were piloted with volunteer veterinary and veterinary nursing students who were recruited through convenience sampling. A questionnaire (the Readiness for Interprofessional Learning Scale [RIPLS]) was modified for use in veterinary education and used to investigate changes in attitudes toward IPE over time (pre-intervention, immediately post-intervention, and four to five months afterward). The results showed an immediate and significant positive change in attitude after the intervention, highlighting the students' willingness to learn collaboratively, their ability to recognize the benefits of IPE, a decreased sense of professional isolation, and reduced hierarchical views. Although nearly half of the students felt concerned about learning with students from another profession before the intervention, the majority (97%) enjoyed learning together. However, the positive change in attitude was not evident four to five months after the intervention, though attitudes remained above pre-intervention levels. The results of the pilot study were encouraging and emphasize the relevance and importance of veterinary IPE as well as the need for further investigation to explore methods of sustaining a change in attitude over time.
... become essential tools in almost every field of research and applied technology. ... Computers in veterinary medicine have been used for veterinary education; ... agro-veterinary project design, monitoring and implementation; preparation of ...
Doyle, J D
The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relations...
Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun
Objective To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60?years) who have a high risk of falling. Research design The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. Partici...
This Code of Practice is designed to give guidance to veterinary surgeons in ensuring that workers and members of the public are adequately protected from the hazards of ionising radiation arising from the use of x-ray equipment in veterinary practice. (author)
Journal Homepage Image. The Journal publishes original research articles related to veterinary sciences, including livestock health and production, diseases of wild life and fish, preventive veterinary medicine and zoonoses among others. Case reports, review articles and editorials are also accepted. Other sites related to ...
Stockdale, David; McFerran, Don; Brazier, Peter; Pritchard, Clive; Kay, Tony; Dowrick, Christopher; Hoare, Derek J
There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness. Current treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained. The average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies. NHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology.
de Ruijter, P.; Ferreira, G.; Parsons, R.
We discuss a collaboration between Health Partners International, HEART and the Open University (OpenLearn) to develop a short open access course for the purpose of improving policy making and practice in healthcare technology in developing countries.
Navin Sewberath Misser; Johan Versendaal; Pascal Ravesteijn; Joris Mens; Koen Smit
In the dynamic environment of increasing regulations, increasing patient demand, decentralization of budgets and enforcement of efficiency, small sized healthcare institutions in the Netherlands are having a difficult time. Although these service providers are usually capable of flexibly delivering
Geer-Rutten-Rijswijk, van der E.; Tuijl, van H.F.J.M.; Rutte, C.G.
In healthcare, performance indicators are increasingly used to measure and control quality and efficiency of care-providing teams. This article demonstrates that when controllability is emphasized during indicator development, the level of task uncertainty influences the type of resulting
Gwyther, Holly; Shaw, Rachel; Jaime Dauden, Eva-Amparo; D'Avanzo, Barbara; Kurpas, Donata; Bujnowska-Fedak, Maria; Kujawa, Tomasz; Marcucci, Maura; Cano, Antonio; Holland, Carol
To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. Thematic analysis of semistructured qualitative interviews. European healthcare policy departments. Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role. Seven themes were identified. Our findings reveal a 'knowledge gap', around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care , the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management. There is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the
Konishi, Emiko; Tabara, Takashi; Kusama, Tomoko.
To propose measures for radiological protection of veterinary workers in Japan, X-ray exposure of workers in typical conditions in veterinary clinics was assessed. Dose rates of useful beam and scattered radiation, worker exposure doses at different stations, and effectiveness of protective clothing were determined using TLD and ion chambers. As precausions against radiation, the following practices are important: (1) use of suitable and properly maintained X-ray equipment, (2) proper selection of safe working stations, (3) use of protective clothing. Regulations are necessary to restrict the use of X-rays in the veterinary field. Because the use of X-rays in the veterinary field is not currently controlled by law, the above precautions are essential for minimizing exposure of veterinary staff. (author)
Mostafa, Gehan M A; Shazly, Mona M; Sherief, Wafaa I
Good healthcare waste management in a hospital depends on a dedicated waste management team, good administration, careful planning, sound organization, underpinning legislation, adequate financing, and full participation by trained staff. Hence, waste management protocols must be convenient and sensible. To assess the knowledge and practice related to waste management among doctors, nurses, and housekeepers in the surgical departments at Al-Mansoura University Hospital, and to design and validate a waste management protocol for the health team in these settings. This cross-sectional study was carried out in the eight surgical departments at Al-Mansoura University Hospital. All health care personnel and their assistants were included: 38 doctors, 106 nurses, and 56 housekeepers. Two groups of jury were included for experts' opinions validation of the developed protocol, one from academia (30 members) and the other from service providers (30 members). Data were collected using a self-administered knowledge questionnaire for nurses and doctors, and an interview questionnaire for housekeepers. Observation checklists were used for assessment of performance. The researchers developed the first draft of the waste management protocol according to the results of the analysis of the data collected in the assessment phase. Then, the protocol was presented to the jury group for validation, and then was implemented. Only 27.4% of the nurses, 32.1% of the housekeepers, and 36.8% of the doctors had satisfactory knowledge. Concerning practice, 18.9% of the nurses, 7.1% of the housekeepers, and none of the doctors had adequate practice. Nurses' knowledge score had a statistically significant weak positive correlation with the attendance of training courses (r=0.23, pwaste management. The knowledge among nurses is positively affected by attendance of training programs. Based on the findings, a protocol for healthcare waste management was developed and validated. It is recommended to
Guardabassi, Luca; Damborg, Peter; Stamm, Ivonne; Kopp, Peter A; Broens, Els M; Toutain, Pierre-Louis
The microbiology laboratory can be perceived as a service provider rather than an integral part of the healthcare team. The aim of this review is to discuss the current challenges of providing a state-of-the-art diagnostic veterinary microbiology service including the identification (ID) and antimicrobial susceptibility testing (AST) of key pathogens in veterinary dermatology. The Study Group for Veterinary Microbiology (ESGVM) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) identified scientific, technological, educational and regulatory issues impacting the predictive value of AST and the quality of the service offered by microbiology laboratories. The advent of mass spectrometry has significantly reduced the time required for ID of key pathogens such as Staphylococcus pseudintermedius. However, the turnaround time for validated AST methods has remained unchanged for many years. Beyond scientific and technological constraints, AST methods are not harmonized and clinical breakpoints for some antimicrobial drugs are either missing or inadequate. Small laboratories, including in-clinic laboratories, are usually not adequately equipped to run up-to-date clinical microbiologic diagnostic tests. ESGVM recommends the use of laboratories employing mass spectrometry for ID and broth micro-dilution for AST, and offering assistance by expert microbiologists on pre- and post-analytical issues. Setting general standards for veterinary clinical microbiology, promoting antimicrobial stewardship, and the development of new, validated and rapid diagnostic methods, especially for AST, are among the missions of ESGVM. © 2017 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the ESVD and ACVD.
de Branco, Freitas Maia L M
Quality assurance of services provided by veterinary diagnostics laboratories is a fundamental element promoted by international animal health organizations to establish trust, confidence and transparency needed for the trade of animals and their products at domestic and international levels. It requires, among other things, trained personnel, consistent and rigorous methodology, choice of suitable methods as well as appropriate calibration and traceability procedures. An important part of laboratory quality management is addressed by ISO/IEC 17025, which aims to facilitate cooperation among laboratories and their associated parties by assuring the generation of credible and consistent information derived from analytical results. Currently, according to OIE recommendation, veterinary diagnostics laboratories are only subject to voluntary compliance with standard ISO/IEC 17025; however, it is proposed here that OIE reference laboratories and collaboration centres strongly consider its adoption.
Öberg, Ulrika; Orre, Carl Johan; Isaksson, Ulf; Schimmer, Robyn; Larsson, Håkan; Hörnsten, Åsa
Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self-management for people with chronic conditions, it is important to highlight nurses' experiences. This study is part of a larger project aimed at implementing person-centred interactive self-management support (iSMS) in primary health care. The aim of this study was to describe Swedish primary healthcare nurses' perceptions of using digital eHealth systems and services to support patient self-management. Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis. Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes. The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self-management support as well as giving the primary healthcare nurses adequate resources to support patients' self-management while still maintaining the values associated with person-centred care. © 2017 Nordic College of Caring Science.
McGuckin, Maryanne; Govednik, John
Healthcare-associated infections (HAIs) in U.S. acute care hospitals lead to a burden of $96-$147 billion annually on the U.S. health system and affect 1 in 20 hospital patients (Marchetti & Rossiter, 2013). Hospital managers are charged with reducing and eliminating HAIs to cut costs and improve patient outcomes. Healthcare worker (HCW) hand hygiene (HH) practice is the most effective means of preventing the spread of HAIs, but compliance is at or below 50% (McGuckin, Waterman, & Govednik, 2009). For managers to increase the frequency of HCW HH occurrences and improve the quality of HH performance, companies have introduced electronic technologies to assist managers in training, supervising, and gathering data in the patient care setting. Although these technologies offer valuable feedback regarding compliance, little is known in terms of capabilities in the clinical setting. Less is known about HCW or patient attitudes if the system allows feedback to be shared. Early-adopting managers have begun to examine their experiences with HH technologies and publish their findings. We review peer-reviewed research on infection prevention that focused on the capabilities of these electronic systems, as well as the related research on HCW and patient interactions with electronic HH systems. Research suggests that these systems are capable of collecting data, but the results are mixed regarding their impact on HH compliance, reducing HAIs, or both and their costs. Research also indicates that HCWs and patients may not regard the technology as positively as industry or healthcare managers may have intended. When considering the adoption of electronic HH monitoring systems, hospital administrators should proceed with caution.
Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun
To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling. The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. 20 HCPs who managed falls in older people. This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia. Four categories of barriers emerged-these were related to perceived barriers for older people, HCPs' barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs. This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs. 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/
Background Effective human resources management plays a vital role in the success of health-care sector reform. Leaders are selected for their clinical expertise and not their management skills, which is often the case at the middle-management level. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level. Methods The study included eight state-owned hospitals in Slovenia. A cross-sectional study included 119 middle managers and 778 employees. Quota sampling was used for the subgroups. Structured survey questionnaires were administered to leaders and employees, each consisting of 24 statements in four content sets evaluated on a 5-point Likert-type scale. Respondents were also asked about the type and number of training or education programmes they had participated in over the last three years. Descriptive statistics, two-way analysis of variance, Pearson’s correlation coefficient and multiple linear regression were used. The study was conducted from March to December 2008. Results Statistically significant differences were established between leaders and employees in all content sets; no significant differences were found when comparing health-care providers and health-administration workers. Employment position was found to be a significant predictor for employee development (β = 0.273, P employee relationship (β = 0.291, P motivation (β = 0.258, P motivation: respondents with a higher level of education were rated with a lower score (β = -0.117, P = 0.024). Health-care providers participate in management programmes less frequently than do health-administration workers. Conclusion Employee participation in change-implementation processes was low, as was awareness of the importance of employee development. Education of employees in Slovenian hospitals for leadership roles is still not perceived as a necessary investment for improving work processes
Diana L. Eubanks
Full Text Available Periodontal disease is among the most prevalent canine dis-eases affecting over 75% of dogs. Strengthening of the human-animal bond and the increasing education of the aver-age pet owner, have fostered a heightened awareness of periodontal care in dogs and cats. Industry support has further assisted the small animal veterinarian in providing quality dental treatments and prevention. As recently as the 1990’s, veterinary curriculums contained little or no dental training. That trend is changing as nearly every one of the 28 US Colleges of Veterinary Medicine offers some level of small animal dentistry during the four-year curriculum. Primary areas of focus are on client education, the treatment of periodontal disease, dental prophylaxis, dental radiology, endodontics, exodontics and pain control. Students receive instruction in dental anatomy during their di-dactic curriculum and later experience clinical cases. Graduate DVMs can attend a variety of continuing education courses and even choose to specialize in veterinary dentistry in both small animals and horses. Through the efforts of organizations such as the American Veterinary Dental So-ciety, The American Veterinary Dental College and The Academy of Veterinary Dentistry, many veterinarians have been able to advance their skills in dentistry and improve animal welfare. Increasing ex-pectations of the pet-owning public coupled with the recent advancements of training opportunities available for vete-rinary students, graduate DVMs and certified veterinary technicians make veterinary dentistry an emerging practice-builder among the most successful small animal hospitals.
Campbell, Norm R C; Dashdorj, Naranjargal; Baatarsuren, Uurtsaikh; Myanganbayar, Maral; Dashtseren, Myagmartseren; Unurjargal, Tsolmon; Zhang, Xin-Hua; Veiga, Eugenia Velludo; Beheiry, Hind Mamoun; Mohan, Sailesh; Almustafa, Bader; Niebylski, Mark; Lackland, Daniel
To assist hypertension control programs and specifically the development of training and education programs on hypertension for healthcare professionals, the World Hypertension League has developed a resource to assess knowledge, attitudes, and practices on hypertension management. The resource assesses: (1) the importance of hypertension as a clinical and public health risk; (2) education in national or international hypertension recommendations; (3) lifestyle causes of hypertension; (4) measurement of blood pressure, screening, and diagnosis of hypertension; (5) lifestyle therapy counseling; (6) cardiovascular risk assessment; (7) antihypertensive drug therapy; and (8) adherence to therapy. In addition, the resource assesses the attitudes and practices of healthcare professionals for task sharing/shifting, use of care algorithms, and use of registries with performance reporting functions. The resource is designed to help support the Global Hearts Alliance to provide standardized and enhanced hypertension control globally. ©2017 Wiley Periodicals, Inc.
Computers have been used to automate complex and repetitive tasks in veterinary hospitals since the 1960s. Early systems were expensive, but their use was justified because they performed jobs which would have been impossible or which would have required greater resources in terms of time and personnel had they been performed by other methods. Systems found in most veterinary hospitals today are less costly, magnitudes more capable, and often underused. Modern multitasking operating systems and graphical interfaces bring many opportunities for automation. Commercial and custom programs developed and used in a typical multidoctor mixed species veterinary practice are described.
Kiplagat, Augustine; Musto, Richard; Mwizamholya, Damas; Morona, Domenica
Integrated Management of Childhood Illness (IMCI) was developed by the World Health Organization (WHO) and the United Nations International Children's Fund (UNICEF) and aims at reducing childhood morbidity and mortality in resource-limited settings including Tanzania. It was introduced in 1996 and has been scaled up in all districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza, Tanzania since reports indicates that the guidelines are not full adhered to by the healthcare workers. A cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza city were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the 2 facilitators. Data were analyzed using SPSS and presented using figures and tables. Only 51% of healthcare workers interviewed had been trained. 69% of trained Healthcare workers expressed understanding of the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illnesses especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, lack of onsite mentoring and lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through training, onsite mentoring, supportive supervision and strengthening the healthcare system through increasing access to essential medicines, vaccines, strengthening supply chain management, increasing healthcare financing, improving leadership & management were the major interventions that could assist in IMCI implementation. The healthcare workers can implement better IMCI through the
Van der Zwart, J.
Recent deregulation of laws on hospital real estate in the Netherlands implies that healthcare institutions have more opportunities to make independent accommodation choices, but at the same time have themselves become responsible for the risks associated with the investment. In addition,
Though patient satisfaction initiatives exist in healthcare, they rarely fall under the CRM moniker. Some subscription software can help hospitals track patient demographics. Building brand loyalty begins with improving patient experience. Report cards are often used to measure and improve the patient experience.
van den Broek, Judith; Boselie, J.P.P.E.F.; Paauwe, J.
In recent years, the Dutch healthcare sector has been confronted with increased competition. Not only are financial resources scarce, Dutch hospitals also need to compete with other hospitals in the same geographic area to attract and retain talented employees due to considerable labour shortages.
de Korte, D.; van Schayck, O.C.P.; van Spiegel, P.; Kaptein, A.A.; Sachs, A.; Rutten-van Mölken, M.; Chavannes, N.; Tromp-Beelen, T.; Bes, R.; Allard, R.; Peeters, G.; Kliphuis, L.; Schouten, J.W.; van Gennip, L.; van Ommen, R.; Asin, J.
Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps
Moreira, A.M.M.; Günther, W.M.R.
Highlights: ► Assessment of medical waste management at health-care center before/after intervention. ► Qualitative and quantitative results of medical waste management plan are presented. ► Adjustments to comply with regulation were adopted and reduction of waste was observed. ► The method applied could be useful for similar establishments. - Abstract: According to the Brazilian law, implementation of a Medical Waste Management Plan (MWMP) in health-care units is mandatory, but as far as we know evaluation of such implementation has not taken place yet. The purpose of the present study is to evaluate the improvements deriving from the implementation of a MWMP in a Primary Health-care Center (PHC) located in the city of São Paulo, Brazil. The method proposed for evaluation compares the first situation prevailing at this PHC with the situation 1 year after implementation of the MWMP, thus allowing verification of the evolution of the PHC performance. For prior and post-diagnosis, the method was based on: (1) application of a tool (check list) which considered all legal requirements in force; (2) quantification of solid waste subdivided into three categories: infectious waste and sharp devices, recyclable materials and non-recyclable waste; and (3) identification of non-conformity practices. Lack of knowledge on the pertinent legislation by health workers has contributed to non-conformity instances. The legal requirements in force in Brazil today gave origin to a tool (check list) which was utilized in the management of medical waste at the health-care unit studied. This tool resulted into an adequate and simple instrument, required a low investment, allowed collecting data to feed indicators and also conquered the participation of the unit whole staff. Several non-conformities identified in the first diagnosis could be corrected by the instrument utilized. Total waste generation increased 9.8%, but it was possible to reduce the volume of non
Full Text Available Nowadays, young women and their children are the most important migrant users of health-care services. In particular, these people may encounter different cultural constructions of health, disease, therapy, and motherhood. The observed difficulties in intercultural communication encourage healthcare systems to promote mediation. Mediation consists of the intervention of a third person, who promotes reciprocal understanding and acceptance between participants. The research presented in this article focuses on the intercultural communication that is produced in these services between health-care personnel and migrant patients. To achieve this goal, the research aims at integrating different theoretical and methodological approaches: conversation analysis, in order to observe the interaction between healthcare personnel and patients, pointing out the cues of the participants’ turn-taking sequences; analysis of the cultural presuppositions of the healthcare system as a communication system with a specific function in society, by highlighting contextualization cues, that is, cultural presuppositions that steer the interaction system, which result from the wider social context and are cues of the cultural identities that characterize it. It was observed that the patients in most cases have very few opportunities to answer the physicians’ questions or to pose questions or doubts. Substituting the patients as the main participants in interactions, the mediator never refuses the physicians’ indications, never expresses doubts, and never asks the patients if they have some reason to doubt or refuse. In these cases, interlinguistic and intercultural mediation de-emphasizes the importance of the larger social context, of the durability of relationships between the parties, and of their social and political recognition.
Weese, J Scott; Jack, Douglas C
Needlestick injuries are an inherent risk of handling needles during the course of veterinary practice. While significant effort has been expended to reduce needlestick injuries in human medicine, a relatively lax approach seems to be prevalent in veterinary medicine. It appears that needlestick injuries are very common among veterinary personnel and that serious adverse effects, while uncommon, do occur. Clients may also receive injuries in clinics during the course of animal restraint, and at home following prescription of injectable medications or fluids. Because of occupational health, personal health, and liability concerns, veterinary practices should review the measures they are taking to reduce the likelihood of needlestick injuries and develop written needlestick injury avoidance protocols.
Federal Laboratory Consortium — As seen on the center's logo, the mission statement for FDA's Center for Veterinary Medicine (CVM) reads: "Protecting Human and Animal Health." To achieve this broad...
Enticott, Gareth; Donaldson, Andrew; Lowe, Philip; Power, Megan; Proctor, Amy; Wilkinson, Katy
This paper analyses how the changing governance of animal health has impacted upon veterinary expertise and its role in providing public health benefits. It argues that the social sciences can play an important role in understanding the nature of these changes, but also that their ideas and methods are, in part, responsible for them. The paper begins by examining how veterinary expertise came to be crucial to the regulation of the food chain in the twentieth century. The relationship between the veterinary profession and the state proved mutually beneficial, allowing the state to address the problems of animal health, and the veterinary profession to become identified as central to public health and food supply. However, this relationship has been gradually eroded by the application of neoliberal management techniques to the governance of animal health. This paper traces the impact of these techniques that have caused widespread unease within and beyond the veterinary profession about the consequences for its role in maintaining the public good of animal health. In conclusion, this paper suggests that the development of the social sciences in relation to animal health could contribute more helpfully to further changes in veterinary expertise.
Full Text Available This study examines the organizational climate and looking at gender differences in professional roles within healthcare organizations. Data came from organizational-climate questionnaires administered in 2010 to 1498 health managers and 19,616 health staff in the Tuscany Region (Italy. An exploratory factor analysis was performed to verify the validity and internal consistency between items and Student t-test to compare mean perceptions regarding the dimensions across different groups of respondents. Five dimensions were measured: “training opportunities”, “communication and information processing”, “managerial tools”, “organization”, and “management and leadership style”, and overall job satisfaction. Significant gender differences were found in the perception of professional roles between managers and staff.
Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore
Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.
Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai
This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time. Copyright © 2012 John Wiley & Sons, Ltd.
Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E
Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.
Macinati, Manuela S; Anessi-Pessina, E
Reforms of the public health-care sector have emphasised the role of management accounting (MA). However, there is little systematic evidence on its use and benefits. To fill this gap, we propose a contingency-based model which addresses three related issues, that is, whether: (i) MA use is influenced by contextual variables and MA design; (ii) top-management satisfaction with MA mediates the relationship between MA design and MA use; and (iii) financial performance is influenced by MA use. A questionnaire was mailed out to all Italian public health-care organisations. Structural equation modelling was performed to validate the research hypotheses. The response rate was 49%. Our findings suggest that: (i) cost-containment strategies encourage more sophisticated MA designs; (ii) MA use is directly and indirectly influenced by contingency, organisational, and behavioural variables; (iii) a weakly significant positive relationship exists between MA use and financial performance. These findings are relevant from the viewpoint of both top managers and policymakers. The former must make sure that MA is not only technically advanced, but also properly understood and appreciated by users. The latter need to be aware that MA may improve performance in ways and along dimensions that may not fully translate into better financial results. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Jiménez-Rodríguez, Enrique; Feria-Domínguez, José Manuel; Sebastián-Lacave, Alonso
Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData ® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.
Full Text Available Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE. The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs. Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR concept in combination to the Loss Distribution Approach (LDA is proved to be a proactive tool, within the frame of balanced scorecard (BSC, in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.
Jiménez-Rodríguez, Enrique; Sebastián-Lacave, Alonso
Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls. PMID:29601529
González Sánchez, María José; Framiñán Torres, José Manuel; Parra Calderón, Carlos Luis; Del Río Ortega, Juan Antonio; Vigil Martín, Eduardo; Nieto Cervera, Jaime
We present a methodology based on Business Process Management to guide the development of a speech recognition system in a hospital in Spain. The methodology eases the deployment of the system by 1) involving the clinical staff in the process, 2) providing the IT professionals with a description of the process and its requirements, 3) assessing advantages and disadvantages of the speech recognition system, as well as its impact in the organisation, and 4) help reorganising the healthcare process before implementing the new technology in order to identify how it can better contribute to the overall objective of the organisation.
Kanamori, Shogo; Shibanuma, Akira; Jimba, Masamine
The 5S management method (where 5S stands for sort, set in order, shine, standardize, and sustain) was originally implemented by manufacturing enterprises in Japan. It was then introduced to the manufacturing sector in the West and eventually applied to the health sector for organizing and standardizing the workplace. 5S has recently received attention as a potential solution for improving government health-care services in low- and middle-income countries. We conducted a narrative literature review to explore its applicability to health-care facilities globally, with a focus on three aspects: (a) the context of its application, (b) its impacts, and (c) its adoption as part of government initiatives. To identify relevant research articles, we researched public health databases in English, including CINAHL, PubMed, ScienceDirect, and Web of Science. We found 15 of the 114 articles obtained from the search results to be relevant for full-text analysis of the context and impacts of the 5S application. To identify additional information particularly on its adoption as part of government initiatives, we also examined other types of resources including reference books, reports, didactic materials, government documents, and websites. The 15 empirical studies highlighted its application in primary health-care facilities and a wide range of hospital areas in Brazil, India, Jordan, Senegal, Sri Lanka, Tanzania, the UK, and the USA. The review also found that 5S was considered to be the starting point for health-care quality improvement. Ten studies presented its impacts on quality improvements; the changes resulting from the 5S application were classified into the three dimensions of safety, efficiency, and patient-centeredness. Furthermore, 5S was adopted as part of government quality improvement strategies in India, Senegal, Sri Lanka, and Tanzania. 5S could be applied to health-care facilities regardless of locations. It could be not only a tool for health workers and
Wong Eliza LY
condition to participate in self-management in order to prevent health deterioration and to save healthcare costs. The role of pharmacists should not be limited to drugs and should be extended in the primary healthcare system. Pharmacist-led patient self-management could be developed gradually with the support of government by enhancing pharmacists' responsibilities in health services and developing public-private partnership with community pharmacists. Developing facilitating measures to enhance the implementation of the pharmacist-led approach should also be considered, such as allowing pharmacists to access electronic health records, as well as deregulation of more prescription-only medicines to pharmacy-only medicines.
Bitsaki, Marina; Koutras, George; Heep, Hansjoerg; Koutras, Christos
Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.
de Bruin, Simone R; Heijink, Richard; Lemmens, Lidwien C; Struijs, Jeroen N; Baan, Caroline A
Evaluating the impact of disease management programs on healthcare expenditures for patients with diabetes, depression, heart failure or COPD. Systematic Pubmed search for studies reporting the impact of disease management programs on healthcare expenditures. Included were studies that contained two or more components of Wagner's chronic care model and were published between January 2007 and December 2009. Thirty-one papers were selected, describing disease management programs for patients with diabetes (n=14), depression (n=4), heart failure (n=8), and COPD (n=5). Twenty-one studies reported incremental healthcare costs per patient per year, of which 13 showed cost-savings. Incremental costs ranged between -$16,996 and $3305 per patient per year. Substantial variation was found between studies in terms of study design, number and combination of components of disease management programs, interventions within components, and characteristics of economic evaluations. Although it is widely believed that disease management programs reduce healthcare expenditures, the present study shows that evidence for this claim is still inconclusive. Nevertheless disease management programs are increasingly implemented in healthcare systems worldwide. To support well-considered decision-making in this field, well-designed economic evaluations should be stimulated. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Njue, P Mwaniki; Cheboi, K Solomon; Shadrak, Oiye
Despite the set guidelines on Healthcare Waste Management in Kenya, mixing of different categories of waste, crude dumping and poor incineration are still a common phenomenon in public health facilities in Thika Subcounty, Kenya. Thika Subcounty generates 560 Kilograms of healthcare waste daily, which is risk to the many patients (admission rate of 26%). This may pose a potential environmental risk and be a source of disease diffusion. This research explored the adherence to healthcare waste management waste guidelines in health care facilities among the nurses and waste handlers. This was a cross sectional survey in which mixed methods were applied. A census and proportionate random sampling method were used. Quantitative data was analyzed using Statistical Package for Social Science (SPSS) version 20.0, while qualitative data was analyzed manually into themes. Full adherence to the seven waste disposal guidelines was low (16.3%). Knowledge on waste segregation, waste separation then disposal and means of transports were statistically significant in relation to adherence. The type of incinerator and burning status, protection maintenance and supply of adequate waste bins were also important to adherence level. Adherence level was low (16.3%,) and insignificantly different among nurses and waste handlers. From this finding, compliance remains a key challenge. Strategies targeted at contextualizing waste regulations and guidelines into local settings are necessary and important. Policy makers may design and implement standard incinerators across all the health facilities. This study is not exhaustive; therefore, it is necessary to carry out a study linking poor treatment and disposal of clinical waste to purported health outcomes in Kenya.
In this overview of success stories in veterinary clinical nutrition topics in cats and dogs reviewed include the dietary management of chronic kidney disease, dissolution of urinary tract uroliths by dietary modification, the recognition that taurine and L-carnitine deficiencies can cause dilated cardiomyopathy; that clinical signs associated with feline hyperthyroidism (caused by a benign adenoma) can be controlled by a low-iodine diet alone; that dietary management of canine osteoarthritis can also reduce non-steroidal anti-inflammatory drug doses; and that disease-free intervals and survival times can be statistically longer in dogs with Stage III lymphoma managed with diet. As we discover more about nutrigenetics and nutrigenomics, and as we expand our basic understanding of idiopathic diseases we are bound to identify more nutritionally related causes, and be able to develop novel dietary strategies to manage disease processes, including the formulation of diets designed to alter gene expression to obtain beneficial clinical outcomes.
Responsibilising managers and clinicians, neglecting system health? What kind of healthcare leadership development do we want?: Comment on "Leadership and leadership development in healthcare settings - a simplistic solution to complex problems?".
Martin, Graham P
Responding to Ruth McDonald's editorial on the rise of leadership and leadership development programmes in healthcare, this paper offers three arguments. Firstly, care is needed in evaluating impact of leadership development, since achievement of organisational goals is not necessarily an appropriate measure of good leadership. Secondly, the proliferation of styles of leadership might be understood in part as a means of retaining control over public services while distributing responsibility for their success and failure. Thirdly, it makes a plea for the continued utility of good administrative skills for clinicians and managers, which are likely to become all-the-more important given recent developments in healthcare policy and governance.
Oostrom, Janneke K; van Mierlo, Heleen
Workplace violence is a major occupational hazard for healthcare workers, generating a need for effective intervention programs. The purpose of this study was to evaluate the effectiveness of an aggression management training program. The evaluation design was based on the internal referencing strategy, an unobtrusive and applicable evaluation method that rules out some major threats to internal validity without the need for a control group. On three occasions, training participants completed a questionnaire containing experimental and control variables. As hypothesized, there was a significant improvement in the experimental variables that was larger than the non-significant change in the control variable. We conclude that aggression management training may be an effective instrument in the fight against workplace violence. 2008 Wiley Periodicals, Inc
Lees, P.; Pelligand, L.; Whiting, M.; Chambers, D.; Toutain, P-L.; Whitehead, M. L.
For many years after its invention around 1796, homeopathy was widely used in people and later in animals. Over the intervening period (1796-2016) pharmacology emerged as a science from Materia Medica (medicinal materials) to become the mainstay of veterinary therapeutics. There remains today a much smaller, but significant, use of homeopathy by veterinary surgeons. Homeopathic products are sometimes administered when conventional drug therapies have not succeeded, but are also used as alternatives to scientifically based therapies and licensed products. The principles underlying the veterinary use of drug-based and homeopathic products are polar opposites; this provides the basis for comparison between them. This two-part review compares and contrasts the two treatment forms in respect of history, constituents, methods of preparation, known or postulated mechanisms underlying responses, the legal basis for use and scientific credibility in the 21st century. Part 1 begins with a consideration of why therapeutic products actually work or appear to do so. PMID:28801498
Maria Antonieta P. de Moraes
Full Text Available OBJECTIVE: To assess the effectiveness of healthcare team guidance in the implementation of a glycemic control protocol in the non-intensive care unit of a cardiology hospital. METHODS: This was a randomized clinical trial comparing 9 months of intensive guidance by a healthcare team on a protocol for diabetes care (Intervention Group, n = 95 with 9 months of standard care (Control Group, n = 87. Clinicaltrials.gov: NCT01154413. RESULTS: The mean age of the patients was 61.7±10 years, and the mean glycated hemoglobin level was 71±23 mmol/mol (8.7±2.1%. The mean capillary glycemia during hospitalization was similar between the groups (9.8±2.9 and 9.1±2.4 mmol/l for the Intervention Group and Control Group, respectively, p = 0.078. The number of hypoglycemic episodes (p = 0.77, hyperglycemic episodes (47 vs. 50 in the Intervention Group and Control Group, p = 0.35, respectively, and the length of stay in the hospital were similar between the groups (p = 0.64. The amount of regular insulin administered was 0 (0-10 IU in the Intervention Group and 28 (7-56 IU in the Control Group (p<0.001, and the amount of NPH insulin administered was similar between the groups (p = 0.16. CONCLUSIONS: While guidance on a glycemic control protocol given by a healthcare team resulted in a modification of the therapeutic strategy, no changes in glycemic control, frequency of episodes of hypoglycemia and hyperglycemia, or hospitalization duration were observed.
Nardo, Bruno; Cannistrà, Marco; Diaco, Vincenzo; Naso, Agostino; Novello, Matteo; Zullo, Alessandra; Ruggiero, Michele; Grande, Raffaele; Sacco, Rosario
Smartphones changed the method by which doctors communicate with each other, offer modern functionalities sensitive to the context of use, and can represent a valuable ally in the healthcare system. Studies have shown that WhatsApp™ application can facilitate communication within the healthcare team and provide the attending physician a constant oversight of activities performed by junior team members. The aim of the study was to use WhatsApp between two distant surgical teams involved in a program of elective surgery to verify if it facilitates communication, enhances learning, and improves patient care preserving their privacy. We conducted a focused group of surgeons over a 28-month period (from March 2013 to July 2015), and from September 2014 to July 2015, a group of selected specialists communicated healthcare matters through the newly founded "WhatsApp Surgery Group." Each patient enrolled in the study signed a consent form to let the team communicate his/her clinical data using WhatsApp. Communication between team members, response times, and types of messages were evaluated. Forty six (n = 46) patients were enrolled in the study. A total of 1,053 images were used with an average of 78 images for each patient (range 41-143). 125 h of communication were recorded, generating 354 communication events. The expert surgeon had received the highest number of questions (P, 0.001), while the residents asked clinical questions (P, 0.001) and were the fastest responders to communications (P, 0.001). Our study investigated how two distant clinical teams may exploit such a communication system and quantifies both the direction and type of communication between surgeons. WhatsApp is a low cost, secure, and fast technology and it offers the opportunity to facilitate clinical and nonclinical communications, enhance learning, and improve patient care preserving their privacy.
Jones, Fiona; Pöstges, Heide; Brimicombe, Lucinda
Programmes providing self-management support for patients and families are gaining attention and have shown promising outcomes with regards to reducing long-term unmet needs post stroke. However, notions of what good self-management support looks like can differ depending on professional opinion, individual preferences, skills and experiences of patients and their families as well as on how care and rehabilitation is organised in a particular healthcare setting. This resonates with the perspective of patient-centred care, according to which the meaning of good care is not universal, but rather jointly shaped between healthcare professionals and patients in everyday interactions. While self-management support is continuously co-produced in care and rehabilitation practices, most self-management programmes are typically provided as an 'add-on' to existing statutory care. This paper aims to deepen the understanding of how self-management support can be made an integral part of everyday care and rehabilitation using Bridges methodology. The authors provide a self-reflective account on 'Bridges' an integrated approach to self-management support, which is used by healthcare professionals within acute and community stroke rehabilitation across the UK, and in some parts of New Zealand and Australia. Bridges is based on self-efficacy principles, but has a central aim of professionals sharing decision-making and expertise with patients and families in every healthcare interaction. Methodologically, the co-production of a Bridges support package with local healthcare professionals and patients is critical. The authors present the values articulated by the support package and how it engages professionals, patients and Bridges training facilitators in a continuous process of adjusting and re-adjusting situated self-management support practices. Our reflections reveal the need to consider development and implementation of self-management support as one and the same on
Peltz, Rami; Ashkenazi, Issac; Schwartz, Dagan; Shushan, Ofer; Nakash, Guy; Leiba, Adi; Levi, Yeheskel; Goldberg, Avishay; Bar-Dayan, Yaron
Quarantelli established criteria for evaluating the effectiveness of disaster management. The objectives of this study were to analyze the response of the healthcare system to the Tsunami disaster according to the Quarantelli principles, and to validate these principles in a scenario of a disaster due to natural hazards. The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research team to study the response of the Thai medical system to the disaster. The analysis of the disaster management was based on Quarantelli's 10 criteria for evaluating the management of community disasters. Data were collected through personal and group interviews. The three most important elements for effective disaster management were: (1) the flow of information; (2) overall coordination; and (3) leadership. Although pre-event preparedness was for different and smaller scenarios, medical teams repeatedly reported a better performance in hospitals that recently conducted drills. In order to increase effectiveness, disaster management response should focus on: (1) the flow of information; (2) overall coordination; and (3) leadership.
Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff
The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...
Memon, M.A.; Shmalberg, J.; Adair, H.S.; Allweiler, S.; Bryan, J.N.; Cantwell, S.; Carr, E.; Chrisman, C.; Egger, C.M.; Greene, S.; Haussler, K.K.; Hershey, B.; Holyoak, G.R.; Johnson, M.; Jeune, S. Le; Looney, A.; McConnico, R.S.; Medina, C.; Morton, A.J.; Munsterman, A.; Nie, G.J.; Park, N.; Parsons-Doherty, M.; Perdrizet, J.A.; Peyton, J.L.; Raditic, D.; Ramirez, H.P.; Saik, J.; Robertson, S.; Sleeper, M.; Dyke, J. Van; Wakshlag, J.
Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative. PMID:27200270
Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard
A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...
Cairns-Haylor, Theodora; Fordyce, Peter
This study maps communication between veterinary surgeons and dog owners on obesity management in four first-opinion practices in the UK. A total of 74 dog owners who met the study's inclusion criteria and 24 veterinary surgeons were interviewed using oral questionnaires between November 2013 and May 2014. The dog owner questionnaire was based on potential discussion areas that could influence an owner's intention to act (initiate a weight loss regime) based on Ajzen's Theory of Planned Behaviour. The veterinary surgeons' questionnaires assessed perception of canine obesity, their personal communication strategies and current practice-level interventions. The findings identify opportunities for more proactive approaches to obesity management by veterinary surgeons and their practices. British Veterinary Association.
Lees, P; Pelligand, L; Whiting, M; Chambers, D; Toutain, P-L; Whitehead, M L
For many years after its invention around 1796, homeopathy was widely used in people and later in animals. Over the intervening period (1796-2016) pharmacology emerged as a science from Materia Medica (medicinal materials) to become the mainstay of veterinary therapeutics. There remains today a much smaller, but significant, use of homeopathy by veterinary surgeons. Homeopathic products are sometimes administered when conventional drug therapies have not succeeded, but are also used as alternatives to scientifically based therapies and licensed products. The principles underlying the veterinary use of drug-based and homeopathic products are polar opposites; this provides the basis for comparison between them. This two-part review compares and contrasts the two treatment forms in respect of history, constituents, methods of preparation, known or postulated mechanisms underlying responses, the legal basis for use and scientific credibility in the 21st century. Part 1 begins with a consideration of why therapeutic products actually work or appear to do so. British Veterinary Association.
de Andrés-Nogales, F; Vivancos Mora, J; Barriga Hernández, F J; Díaz Otero, F; Izquierdo Esteban, L; Ortega-Casarrubios, M Á; Castillo Moreno, L; Ximénez-Carrillo Rico, Á; Martín Torres, M P; Gómez-Escalonilla Escobar, C I; Torres González, C; de Salas-Cansado, M; Casado Gómez, M Á; Soto Álvarez, J; Gil-Núñez, A
Stroke is the main cause of admission to Neurology departments and cardioembolic stroke (CS) is one of the most common subtypes of stroke. A multicentre prospective observational study was performed in 5 Neurology departments in public hospitals in the Region of Madrid (Spain). The objective was to estimate the use of healthcare resources and costs of acute CS management. Patients with acute CS at<48h from onset were recruited. Patients' socio-demographic, clinical, and healthcare resource use data were collected during hospitalisation and at discharge up to 30 days after admission, including data for rehabilitation treatment after discharge. During an 8-month recruitment period, 128 patients were recruited: mean age, 75.3±11.25; 46.9% women; mortality rate, 4.7%. All patients met the CS diagnostic criteria established by GEENCV-SEN, based on medical history or diagnostic tests. Fifty per cent of the patients had a history of atrial fibrillation and 18.8% presented other major cardioembolic sources. Non-valvular atrial fibrillation was the most frequent cause of CS (33.6%). Data for healthcare resource use, given a mean total hospital stay of 10.3±9.3 days, are as follows: rehabilitation therapy during hospital stay (46.9%, mean 4.5 days) and after discharge (56.3%, mean 26.8 days), complications (32%), specific interventions (19.5%), and laboratory and diagnostic tests (100%). Head CT (98.4%), duplex ultrasound of supra-aortic trunks (87.5%), and electrocardiogram (85.9%) were the most frequently performed diagnostic procedures. Average total cost per patient during acute-phase management and rehabilitation was €13,139. Hospital stay (45.0%) and rehabilitation at discharge (29.2%) accounted for the largest part of resources used. Acute CS management in the Region of Madrid resulted consumes large amounts of resources (€13,139), mainly due to hospital stays and rehabilitation. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier Espa
Donnellan, John J
Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.
Sfregola, Gianfranco; Laganà, Antonio Simone; Granese, Roberta; Sfregola, Pamela; Lopinto, Angela; Triolo, Onofrio
Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy. Based on our results, we strongly suggest a change of direction of healthcare policy, oriented to increase the number of employed midwives, in order to let them fulfil their duties according to the international guidelines (especially one-to-one care). On the other hand, we encourage the adoption of standardised protocols in each work setting.
Dixon, William H R; Kinnison, Tierney; May, Stephen A
At a time where high levels of stress are reported in the veterinary profession, this study explores the challenges that veterinary graduates encounter when they enter general (first opinion) practice. Participants had written reflective accounts of their 'Most Puzzling Cases' for the postgraduate Professional Key Skills module of the Certificate in Advanced Veterinary Practice, offered by the Royal Veterinary College. Reasons that a case was puzzling, or became challenging, were thematically analysed. Fifteen summaries were analysed. Three core themes were identified: 'clinical reasoning', centred on the limitations of pattern recognition and the methods used to overcome this; the 'veterinary healthcare system', focusing on the need for continuity of care, time pressure and support in the transition to practice; and the 'owner', looking at the broader clinical skills needed to succeed in general practice. Clinical reasoning was raised as an issue; discussion of when pattern recognition is not appropriate and what to do in these cases was common. A lack of experience in general practice case types, and how to best operate in the resource-constrained environment in which they present, is the likely cause of this, suggesting that a greater focus on the primary care paradigm is needed within veterinary education. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Currie, Kay; King, Caroline; Nuttall, Tim; Smith, Matt; Flowers, Paul
Antimicrobial resistance (AMR) is a global challenge facing both human and animal healthcare professionals; an effective response to this threat requires a 'One-Health' approach to antimicrobial stewardship (AMS) to preserve important antibiotics for urgent clinical need. However, understanding of barriers and enablers to effective AMS behaviour in companion animal veterinary practice is currently limited. We conducted a Delphi study of 16 nationally recognised experts from UK-based veterinary policymakers, university academics and leaders of professional bodies. This Delphi study sought to identify veterinary behaviours which experts believe contribute to AMR and form vital aspects of AMS. Analysis of Delphi findings indicated a perceived hierarchy of behaviours, the most influential being antibiotic prescribing behaviours and interactions with clients. Other veterinary behaviours perceived as being important related to interactions with veterinary colleagues; infection control practices; and the use of diagnostic tests to confirm infection. Key barriers and enablers to AMS within each of these behavioural domains were identified. Specific interventions to address important barriers and enablers are recommended. To the authors' knowledge, this is the first study to establish expert consensus at a national level about which 'behaviours' (aspects of veterinarian practice) should be targeted in relation to AMR and AMS in companion animal veterinary practice. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.