Dissertations / Theses: 'Assessment health care'

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Bae, Crystal. "Emergency care assessment tool for health facilities." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20990.

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To date, health facilities in Africa have not had an objective measurement tool for evaluating essential emergency service provision. One major obstacle is the lack of consensus on a standardized evaluation framework, applicable across a variety of resource settings. The African Federation for Emergency Medicine has developed an assessment tool, specifically for low- and middle-income countries, via consensus process that assesses provision of key medical interventions. These interventions are referred to as essential emergency signal functions. A signal function represents the culmination of knowledge of interventions, supplies, and infrastructure capable for the management of an emergent condition. These are evaluated for the six specific clinical syndromes, regardless of aetiology, that occur prior to death: respiratory failure, shock, altered mental status, severe pain, trauma, and maternal health. These clinical syndromes are referred to as sentinel conditions. This study used the items deemed "essential", developed by consensus of 130 experts at the African Federation for Emergency Medicine Consensus Conference 2013, to develop a tool, the Emergency Care Assessment Tool (ECAT), incorporating these using signal functions for the specific emergency sentinel conditions. The tool was administered in a variety of settings to allow for the necessary refinement and context modifications before and after administering in each country. Four countries were chosen: Cameroon, Uganda, Egypt, and Botswana, to represent West/Central, East, North, and Southern Africa respectively. To enhance effectiveness, ECAT was used in varying facility levels with different health care providers in each country. This pilot precedes validation studies and future expansive roll out throughout the region.

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Roth, Nicholas Daniel. "Energy Assessment at a Health Care Facility." University of Toledo / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1288836702.

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Westman, Göran. "Planning primary health care provision : assessment of development work at a health centre." Doctoral thesis, Umeå universitet, Socialmedicin, 1986. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100557.

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At the Primary Health Care Centre in Vännäs (VPHCC), northern Sweden, a development work was implemented in 1976-1980. The overall purpose was to enhance primary health care planning. In trying to improve health care delivery cooperation with community members was initiated and some organizational changes like a new appointment system, a new medical record and local care programs for some common diseases were introduced. Official statistics were also used for comparative purposes. The aims of the work were postulated (increased accessibility, higher continuity, more equitable distribution and enhanced cooperation) and suitable methods were designed. From postal surveys, chartreviews and administrative data (from hospitals, out-patient clinics and health centres) figures and information were collected. Accessibility was studied by waiting room time which was reduced and continuity, analyzed with a new concept - visit based provider continuity - was improved. The question of equitable distribution was studied by the consultation rates at different out-patient clinics. It seemed as if the local development work changed the patterns of utilization but some important issues were not decisively answered. Repeated postal surveys reflected the question of equitable distribution and the cooperation between the VPHCC and the community members. Positive responses were recorded in aspects like telephone accessibility and health care information. In a tracer study of diabetes the quality of care was studied. The local care program was actually implemented in the daily practice but the question of care quality needs further penetration. Within the frames of the development work new methods in the health care planning were introduced. Our work started from the prerequisits of the VPHCC and other health centres might find other ways of planning for care provision. On a general level, however, the structure of our work - defining aims, means and evaluation methods - can be used by others.

Diss. (sammanfattning) Umeå : Umeå universitet, 1986, härtill 6 uppsatser.

digitalisering@umu

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Hartmann, Andre. "An assessment of telemedicine services within the Western Cape public health care system." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86225.

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Thesis (MEng)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Telemedicine is de ned as an electronic exchange of medical information and/or the delivery of clinical health care over a distance, by means of Information and Communication Technology (ICT). South Africa is faced with the problem of providing health care to a population in urban, as well as across vast rural areas. In addition to this, the South African health care system must deal with economical imbalances and a shortage of human resources to provide quality health care. Telemedicine services could provide a solution. Since the introduction of the rst national telemedicine services initiative in the late 1990s, a number of South African telemedicine services have been implemented in the public health care system. The majority of these telemedicine services have been prone to failure and many were prematurely terminated. The circumstances which in uence the failure or success of these services are not unknown. The lack of insight, and the high failure rate of telemedicine services implemented in the South Africa were the reasons for conducting this study. The purpose of the study is to assess telemedicine services implemented in the Western Cape public health care sector. The purpose is also to provide recommendations for improving the current and future telemedicine services in the Western Cape and other provinces. A telemedicine services assessment was conducted on a total of 26 telemedicine services identi ed at 6 health care facilities located in the Western Cape. The assessments were based on the TeleMedicine Services Maturity Model (TMSMM), which was developed speci cally for the purpose of assessing telemedicine services. The TMSMM capability statements were used as a yardstick to assess the maturity of each of the elements of telemedicine services in terms of the three service level groups (micro-,meso- and macro-level) and ve telemedicine domains (man, machine, material, method and money). The assessment process included: (i) the identi cation of telemedicine services at the selected health care facilities; (ii) the gathering of the relevant telemedicine service data by means of structured interviews; (iii) the transformation of the complex ow of information into Data Flow Diagrams (DFDs); (iv) the loading of telemedicine services data into a data warehouse; and (v) the analysis of data by means of On-Line Analytical Processing (OLAP), as well as box-and-whisker plots and statistical correlations. Based on the results of the TMSMM assessment, an electronic questionnaire was developed and administered amongst health care workers throughout the entire Western Cape. The questionnaire con rmed that the ndings from the TMSMM assessment are indeed representative of the entire Western Cape. The assessment of the telemedicine services provides information about the elements which a ect the success or failure of these services. This therefore addresses the initial research problem and ful ls the purpose of the study. These results were used as an input to the analysis of strengths, weaknesses, opportunities and threats (SWOT) of the delivery of telemedicine services in the Western Cape public health sector. For future references and studies, the SWOT analysis provides a point of departure for a strategic telemedicine services framework for a province like the Western Cape.
AFRIKAANSE OPSOMMING: Telegeneeskunde, per de nisie, behels die deel van mediese inligting en/of die lewering van kliniese gesondheidsdienste oor 'n afstand, deur middel van inligting en kommunikasie tegnologie (ICT). Telegeneeskunde dienste is moontlik een van die oplossings vir die lewering van gesondheidsdienste vir 'n bevolking wat versprei is oor 'n groot landelike gebied binne 'n publieke gesondheidsektor wat mense hulpbronne kort om kwaliteit gesondheidsorg te lewer. Die publieke gesondeheidstelsel van Suid Afrika het 'n drie-dubbele las van siektes, ekonomiese wanbalans and 'n tekort aan mediese praktisyns. Sedert die eerste nasionale inisiatief vir telegeneeskunde dienste in die laat 1990s bekend gestel is, is 'n paar telegeneeskunde dienste in die publieke gesondheidsektor van Suid Afrika geïmplementeer. Die meerderheid van hierdie dienste blyk onsuksesvol te wees. The faktore wat die implementeringsukses beïnvloed is nog nie goed nagevors nie. Die doel van hierdie studie is om telegeneeskunde dienste wat in die Wes- Kaap publieke gesondheidsektor geïmplementeer is te ondersoek. Die doel is verdermeer om aanbevelings te maak met die oog op die verbetering van bestaande en toekomstige dienste in die Wes-Kaap asook ander provinsies. Eerstens is 'n telegeneeskunde diens assessering uitgevoer op 'n totaal van 26 dienste 6 fasiliteite. Hierdie assesserings is gebasseer of the Telegeneeskunde Diens Volwassenheidsmodel (TMSMM), wat ontwikkel is spesi ek met die doel om telegeneeskunde dienste te assesseer. Dit word gedoen deur die dienste te meet in terme van drie vlakke (mikro-, meso- en macrovlak) en vyf domeine (man, masjien, materiaal, metode en geld). Die TMSMM vermoeë-stellings word as maatstaaf gebruik. Die assesseringsproses sluit in (i) die identi sering van telegeneeskunde dienste by die aangewese gesondheidsfasiliteite; (ii) die versameling van relevante telegeneeskunde data deur middel van gestruktureerde onderhoude; (iii) die transformasie van komplekse inligtings vloei na data vloeidiagramme (DFDs); (iv) die laai van telegeneeskundige dinste data in 'n databasis; and (v) die analyse van data deur middel van aanlyn analitiese verwerking (OLAP) sowel as boxen- snorbaard gra k en statistiese korrelasies. Gebasseer op die resultate van die TMSMM assesseringsproses, is 'n elektroniese vraelys ontwikkel en geadministreer onder gesondheidswerkers regoor die Wes-Kaap ten einde te bevestig of die gevolgtrekkings van die TMSMM assessering die hele provinsie verteenwoordig. Die assessering van die telegeneeskundige dienste verskaf inligting in terme van die faktore wat die sukses van telegeneeskundie dienste beïnvloed. Sodoende word die aanvanklike navorsingsprobleem aangespreek. Hierdie resultate is toe gebruik as inset vir die analise van die sterk punte, swak punte, geleenthede en bedreigings (SWOT) in die publieke gesondheidsektor van die Wes-Kaap in terme van telegeneeskundige dienste. Hierdie SWOT-analise kan in die toekoms gebruik word as vertrekpunt vir die ontwikkeling van strategiese raamwerk vir die implementering van telegeneeskundige dienste in 'n provinsie soos die Wes-Kaap.

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Buckley, Ernest Graham. "Health assessment of the elderly at home." Thesis, University of Edinburgh, 1989. http://hdl.handle.net/1842/19456.

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Grutters, Janneke Petronella Christina. "Health technology assessment of organizational innovation in health care the case of shared care in hearing aid provision /." Maastricht : Maastricht : Universiteit Maastricht ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=9519.

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Bjorn, Agnes Marie. "Community health assessment and nursing care needs of the elderly." Thesis, University of Manchester, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.237239.

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Hernandez, Cynthia Lynn. "Adapting the Lean Enterprise Self Assessment Tool for health care." Thesis, Massachusetts Institute of Technology, 2010. http://hdl.handle.net/1721.1/62768.

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Thesis (S.M. in Engineering and Management)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2010.
Cataloged from PDF version of thesis.
Includes bibliographical references (p. 61-63).
The Lean Enterprise Self Assessment Tool (LESAT) is a product of the Lean Advancement Initiative (LAI) and the Massachusetts Institute of Technology. This tool has been applied by many organizations to gage their progress toward lean enterprise management, however applying this tool in health care organizations has been inhibited by language and underlying assumptions from product manufacturing. An adaptation of the LESAT specifically for health care is proposed. Review of the literature and special reports on health care are used in determining the recommended changes. "Product life cycle" is reinterpreted as a health care service cycle and context specific enterprise level processes and practices are presented. Comparison to other industry measures shows the content the LESAT for health care to cover all key issues and practices for high quality health care delivery.
by Cynthia Lynn Hernandez.
S.M.in Engineering and Management

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Gerard, Karen M. "Economic aspects of consumer involvement in health care benefit assessment." Thesis, University of Southampton, 2005. https://eprints.soton.ac.uk/57928/.

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Anne, Ene Adah-Ogoh. "Assessment of job satisfaction among health care workers in primary health care centres in the Federal Capital Territory, Nigeria." University of the Western Cape, 2016. http://hdl.handle.net/11394/4888.

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Master of Public Health - MPH
Nigeria is experiencing shortages of health care workers within its national health services, especially with respect to doctors, nurses and pharmacists. These shortages are traceable to, among other factors, low job satisfaction, which leads to health care workers exiting the national health services, as well as reduced entry of health care workers into the health care system. Understanding the nature of job satisfaction and its causes is critical to informing strategies to halt attrition of the health workforce. The current study surveyed job satisfaction among 180 health care workers, employed in 20randomly selected primary health care centres in the Bwari Area Council of Abuja in the Federal Capital Territory, Nigeria. An observational, descriptive cross-sectional survey was conducted using the abbreviated form of the Minnesota Satisfaction Questionnaire. Descriptive and inferential statistics were calculated using Epi Info v3.1 statistical software. The results from the study revealed that more than half of the respondents (53.2%), were dissatisfied to varying degrees with their current employment. Out of the respondents that said they were dissatisfied, 33.3% stated that they were likely to leave their current employment. The most salient causes for job dissatisfaction were: (1) Institutional factors such as management support (69%); (2) Implementation of policies and procedures (66%); (3) Employee benefits including salaries and wages (33%) and other benefits (56%). It is pertinent to note that issues related to poor implementation of policies and procedures in the work place, and poor conditions of employment need to be addressed urgently to prevent the imminent loss of a third of the workforce to either private health institutions in the country or international migration.

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Karlsson, Staffan. "Older people`s public health care and social services : Functional ability, health complaints, agreement in needs assessment and care satisfaction." Doctoral thesis, Lund University, Lund, Sweden, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-30857.

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The overall aim was to describe and compare functional ability and health complaints of older people receiving municipal care in relation to housing and informal care, and factors associated with medical health care, municipal care and informal care. Further, the aim was to investigate agreement in needs assessments between personnel and older people and to investigate care satisfaction and health-related quality of life among older people receiving municipal care and services. Study I and II included 1958 persons aged 65 years and above, who were assessed for functional ability, health complaints, and level of informal and municipal care and service. Study II in addition included data from a register including medical health care. In study III (n=152), standardised needs assessments were performed by the staff. Later, the older person’s view was collected in a personal interview concerning functional ability, health complaints, public and informal care. In addition (Study IV, n=166), SF-12 was used for measuring health-related quality of life and for measuring care satisfaction. Cohabitation was a predictor of a combination of municipal and informal care at home (OR: 5.935), while assistance with Instrumental Activities of Daily Living (IADL) provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883), Personal Activities of Daily Living (PADL) (OR: 02.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. 35% of those with public care at home were admitted to hospital and 76% had contact with outpatient care by physician compared to 26% and 87% respectively of those in special accommodation. Living in special accommodation was associated with more contacts with primary health care (B=0.643) and fewer contacts with specialist care (B=-0.722). Informal care was associated with more contacts with primary health care (B=0.413), specialist care (B=0.787), admissions to (B=0.265) and days in hospital (B=1.573). Agreement for dependency in IADL and PADL varied between good (κ=0.78) and moderate (κ=0.43). Poor agreement was found for dizziness (κw=0.17) and fair agreement for impaired hearing, urinary incontinence, pain, anxiety and depressed mood (κw between 0.21 and 0.37). Older persons reported more health complaints than were found in the personnel’s assessments, although significantly lower estimation was found only for incontinence and vision. Agreement for provided public care at home was poor, while for informal care it varied between very good and moderate. Low care satisfaction was associated with dependency in IADL (B=-1.338 and B=-1.630), impaired mobility (B=-12.579), blindness (B=-26.143), faeces incontinence (B=-11.898 and B=-17.529) and anxiety (B=-6.105 and B=-27.197), while high care satisfaction was associated with dependency in PADL (B=2.109) and receiving informal care with IADL from spouse (B=8.738). In special accommodation, low care satisfaction had to do with continuity, timing, the staff’s personal characteristics and with their ability to give service. At home, the older people were the least satisfied with the staff’s ability to do housework and to give medical care, with the staff’s amount of time and with their own influence over their care.

Härtill 1 appendix och 4 uppsatser

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Oluyole, Alexander Bolarinwa. "Community involvement and needs assessment in primary health care in Nigeria." Thesis, Keele University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.261479.

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McClelland, Marleen Iannucci. "The discourse of interdisciplinary health care assessment : toward a biosocial model /." The Ohio State University, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487685204969396.

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Conrad, Michael Dean, and Anna Kampanartsanyakorn. "Advanced practice nursing health care needs assessment in an underserved community." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2336.

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The purpose of this study was to gain information about the community health care needs through a comprehensive assessment. This information will allow providers to identify services and groups of people where the biggest gap exists in receiving needed health care services. This may provide the basis for the design of an advanced practice preventative health intervention for the community.

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Talice, Kerlie W. "An Assessment of Veterans Affairs Healthcare Leadership Competencies." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10604903.

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The purpose of this study was to collaborate with one of the New England VA Healthcare Systems to conduct research to evaluate the current leadership competencies at the Department of Veterans Affairs (VA) to identified competencies essential for leadership by the VA. The researcher also assessed how VA front-line staff, first-line supervisors, mid-level managers, and senior/executive leadership rate their performance and that of their supervisors. Lastly, the researcher evaluated how these leaders are trained to assume their important roles at the VA and how much of a role are executive coaching and mentoring play in this training process. The research is a quantitative research study, and the competencies and specific behavior indicators were assessed using a web-based survey via a self-administered competency instrument designated to determine employee’s perceptions. The data collected comprised data from four different surveys/questionnaires for each position level within the organization including the demographic data. A total of 143 VA employees participated in the research study and completed surveys to measure the frequency of behaviors on a 10-point scale to answer the research questions. The results answered the key research questions asked in this study to measure leaders and emerging leader competence.

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Araya, Elsa Semere. "An assessment of kangaroo mother care among staff in a specialized neonatal intensive care unit, Asmara, Eritrea." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29346.

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Introduction: Preterm delivery remains the major cause of newborn infants’ morbidity and mortality globally and more so in low-income countries like Eritrea. Research has shown that the provision of Kangaroo mother care (KMC) can contribute to a reduction in morbidity and mortality among newborn infants. However, there is limited research on the practice of KMC in Eritrea. Methods: A mixed methods approach was adopted in a phenomenographic study to collect the data. Eleven participants with work experience of at least two years were recruited from the Specialised Neonatal Intensive Care Unit (SNICU) at Orotta Paediatric Hospital (OPH), Asmara, Eritrea. Data were collected via individual interviews and observations. Results: The results showed that participants had no prior KMC training and education. In addition, staff had limited knowledge and mixed attitudes about KMC practice. There were also no KMC guidelines and protocols. Furthermore, space was not adequate for full KMC practice except for implementation of the kangaroo position. The researcher’s observation confirmed similar evidence of a lack of availability of a KMC ward and lack of protocols and guidelines. Limited interaction and communication about KMC between participants and parents was also observed. Some of the most common hindrances to KMC practice were the perception that KMC increased staff work load and that it was time consuming. In addition, lack of regular KMC training for staff, lack of a convenient setup and too few staff members were among the hindrances. One staff members also perceived that KMC practice was not culturally accepted. 15 Conclusion: The results of this study showed that there were no proper KMC guidelines and protocols in the ward. In addition, only the kangaroo position was practiced, not the full KMC protocol. Furthermore, staff had limited knowledge and mixed attitudes. The observation component of the research highlighted the lack of space and KMC protocols and guidelines as key limitations for delivering KMC. Therefore, it is recommended that a programme to improve staff knowledge be implemented, that evidence-based KMC guidelines and polices be made available, that the KMC ward be expanded, and that health education about KMC practice be brought to the population through mass media

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Sundseth, Inger Beate Måren. "Global Mobility and the Right to Health : An assessment of migrant health care in Norway." Thesis, Norwegian University of Science and Technology, Department of Geography, 2009. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-5510.

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In this Master‟s thesis I have studied to what degree primary- and moral duty bearers in Norway maintain accountability and fulfil their obligations towards migrants and the right to health, as stated in the International Convention on Economic, Social and Cultural Rights (ICESCR) of 1966.

Theoretical perspectives on global mobility and Rights-based approaches, an outline of the HIV/AIDS epidemic, as well as empirical data provides a basis for the discussion addressing how the Norwegian Government maintain accountability with regards to health care of migrants, and seeking to identify the role of other duty bearers in offering health care services to migrants.

The research methods applied in order to generate data are analysis of text and interviews. I have studied legislation, treaties and official publications. In addition, I have performed two key informant interviews; one with Siv Limstrand, project manager of the Church City Mission in Trondheim‟s project „Living with HIV‟ („Leve med hiv‟), and another with nurse Tove Buchmann in Trondheim Municipality‟s refugee health team (flyktningehelseteamet).

The thesis concludes that there appears to be an embedded contradiction between legislation, policy and practice. Norway has stated a clear goal to protect, respect and fulfil human rights, both internationally and through the ratification and implementation of human rights treaties into Norwegian legislation. Based on this, they should to a larger extent fulfil their obligations and not restrict the access to medical attention on the part of asylum seekers and irregular migrants. On the part of the other duty bearers included in this thesis, namely the Church City Mission in Trondheim‟s project „Living with HIV‟ and Trondheim Municipality‟s refugee health team, the thesis finds that they play a vital role in guiding and informing, as well as in administering health care services to migrants in Trondheim

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Storms, Starr 1948. "An assessment of the mental health of mental health care workers in the public sector." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/291732.

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The mental and emotional well-being of mental health care professionals can be jeopardized by burnout, a syndrome similar to depression and other affective disorders in its symptomology and effects. A questionnaire designed to assess mental health and burnout was developed using various assessment tools from the mental health care community to obtain information about health habits, stressors, coping skills, personal history, and length of service. Forty-seven workers at a public mental health facility responded to the questionnaire. The results of this study suggest that approximately 20% of mental health care-givers are experiencing high degrees of burnout and mental disease. Neither personal history or long-term service appears to contribute to the burnout. Workers new to the field seem to be at greatest jeopardy. Control coping mechanisms were found to be more effective than escape coping mechanisms in combating stress and mental illness.

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Miller, Lesa. "Health Care Clinicians' Compliance with Conducting Spiritual Assessments and Providing Spiritual Care to Infertile Women." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/1790.

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Infertility is a disease that can cause psychological impairments in women, and the inability to achieve motherhood brings about cultural and social stigma. Spirituality is a protective element that may provide consolation to women experiencing infertility, yet the literature has shown that few clinicians conduct spirituality assessments or provide spiritual care to patients. The objectives of this scholarly project were to conduct an assessment to determine the needs of health care clinicians in regard to spirituality and spiritual patient care and to develop an educational module based on identified knowledge deficits. Guided by the knowledge-to-action cycle, a needs assessment was conducted in a small fertility clinic with 2 clinicians. The results of the assessment showed that the clinicians had not conducted spirituality assessments on their infertile patients and only sometimes provided spiritual care. An educational module and a posttest were developed and then validated by 3 doctorally-prepared nursing faculty members using a self-developed 10-question Likert-type evaluation scale. The materials were found to be clear, accurate, and easy to read by the nursing faculty. An implication of this scholarly project is that it will give clinicians the resources needed to create social change in health care by addressing the spirituality needs of women experiencing infertility. Future research includes a pilot study to implement the educational module with clinicians at the fertility clinic and to evaluate its effectiveness for enhancing spiritual care in practice.

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Gélinas, Isabelle. "Disability assessment in dementia of the Alzheimer's type." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=28756.

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Functional disability assessments are recognized as being important for the diagnosis of Dementia of the Alzheimer's type (DAT) as well as for monitoring the impact of intervention and determining the need for home assistance or institutionalization. Existing instruments designed for the assessment of functional disability with this population are generally unsatisfactory with regards to their content or psychometric properties. The objective of this research project was to develop a more appropriate French and English assessment of functional disability for use with proxy-respondents of community-dwelling individuals who have DAT. The Disability Assessment for Dementia (DAD) was developed in several stages using three panels composed of health care professionals and caregivers of individuals with DAT. Forward-backward translation procedures were performed at each stage to ensure that the French and English versions of the scale were comparable. Content validity was verified by a fourth panel of experts. The DAD was then administered to 59 community-dwelling DAT subjects and their caregivers to determine internal consistency and the need to eliminate items. The instrument developed, which consisted of 46 items, was reduced to 40 items, 17 related to basic self-care and 23 to instrumental activities of daily living, as a result of this process. The content validity of the final version was established by a majority of members from the panel of experts. It also demonstrated a high degree of internal consistency (Cronbach's alpha = 0.96) and excellent interrater (N = 31) and test-retest (N = 45) reliability (Intraclass correlation coefficients of 0.95 and 0.96 respectively). In addition, it was found not to have gender bias. Estimates of its validity were determined in another study. The DAD represents a valid and reliable instrument which is short and easy to administer. This instrument should have a positive impact on geriatric rehabilitation, and on clinical and

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Tabladillo, Mark Z. "Quality management climate assessment in healthcare." Diss., Georgia Institute of Technology, 1996. http://hdl.handle.net/1853/24162.

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Karichu, James K. "Assessment of Variability in Hospital Readmissions Among Medicare Beneficiaries in the United States." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1492820975133294.

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Steward, Jocelyn Louise. "Development and testing of the Primary Care Homeless Organizational Assessment Tool (PC-HOAT) to evaluate primary care services for the homeless." Thesis, The University of Alabama at Birmingham, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3634634.

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The purpose of this dissertation is to develop and test an organizational assessment tool that can used to evaluate primary care services for the homeless. The research evaluates the importance, feasibility, reliability, and validity of organizational processes and structures of primary care services for the homeless. The final product is the validated Primary Care Homeless Organizational Assessment Tool (PC-HOAT). This tool provides stakeholders with information regarding the organizational structures and processes associated with greater quality of primary care for the homeless. This tool will help managers better understand their organization's strengths and weaknesses, guide discussions regarding operations, and provide information to inform future strategies.

The researcher conducted a mixed-method study of key informants and organizations receiving federal health care for the homeless funding. The study used eight key informants to refine the initial PC-HOAT. The researcher distributed the final instrument through a web-based survey to determine reliability and validity of the PC-HOAT. Data analysis included descriptive statistics, factor analysis, and regression analysis.

The study yielded a 7-factor scale, 34-item tool focused on evaluation and delivery of primary care services, organizational structures relevant to effective delivery of care, and patient and family centeredness. In particular, the scale describing access and quality of care provided a positive statistical association with the proportion of patients with controlled hypertension. The study yielded results that provide a better understanding of the vital organizational characteristics that contribute most appropriately to the design of health care for the homeless organization.

Keywords: homeless, primary care, organizational assessment, reliability, validity, factor analysis

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Smith, Laura J. "Barriers to immigrant health care a needs assessment for Scott County, Minnesota /." Menomonie, WI : University of Wisconsin--Stout, 2005. http://www.uwstout.edu/lib/thesis/2005/2005smithl.pdf.

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Kim, Paul. "Emergency care assessment tool for health facilities: a validity study in Cameroon." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29865.

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Background To date, health facilities in Sub-Saharan Africa have not had an objective measurement tool for evaluating comprehensive emergency service provision. One major obstacle is the lack of consensus on a standardised evaluation framework, applicable across a variety of resource settings. The African Federation for Emergency Medicine (AFEM) developed an assessment tool specifically for these settings - the Emergency Care Assessment Tool (ECAT) - that assesses provision of key medical interventions. These interventions are referred to as signal functions for the six sentinel conditions that occur prior to death: respiratory failure, shock, altered mental status, severe pain/trauma, and dangerous fever. A signal function represents the culmination of knowledge of interventions, supplies, and infrastructure capable for the management of an emergent condition. Previous studies aimed at the refinement and context modification of the ECAT have already been performed in multiple African countries. We undertook a validation study to help determine the applicability of the tool in assessment of emergency services throughout the continent. Aims and Objectives The aim of this study was to determine the content, construct, and face validity of the AFEM Emergency Care Assessment Tool in Cameroon. To achieve this, the study had the following objectives: (1) Employ the ECAT in district, regional, and central hospitals in Cameroon. (2) Use direct observation to determine whether the signal functions can be performed in these facilities. Methods This was an observational study at a convenience sample of five hospitals in Cameroon: three district, one regional, and one central. The goal of this study was to validate the instrument, not the facility, and so the sample size was related to the number of signal functions witnessed rather than the number of facilities visited. The tool was administered with the Head of Emergency at each facility. This completed ECAT was then compared with direct observations of the signal functions, a process which was conducted by the partner local emergency care specialists accompanied by the ECAT researcher. Results In general, the higher the level of facility, the greater the emergency care capacity and the greater the number of signal functions that could be performed correctly and consistently. Discrepancies in funding, supplies, resource allocation, and care delivery ability were apparent through ECAT results, expounding on barriers to care delivery, and direct observation. McNemar tests on the ECAT results versus direct observation at each facility yielded statistically significant support for tool validation at the national level emergency unit as well as two of the district level emergency units. Concordance between reported and observed signal functions could not be achieved at the regional facility and one of the district facilities. Conclusions The ECAT has good potential for facility level assessment of emergency care provision, and collects meaningful information that can guide effective improvements in the delivery of emergency care.

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McEvers, Sara Elizabeth, and Sara Elizabeth McEvers. "Adolescent Mental Health in Primary Care: A Needs Assessment for Improving Practice." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/624513.

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Background: Youth and young adults have the highest incidence and prevalence of mental health issues, and most do not receive the services they need. Mental health is an essential component of wellness, and primary care providers (PCPs) serve a critical role in promoting mental well-being, identifying problems, facilitating and coordinating services, and managing and monitoring mental health outcomes. Many barriers exist to incorporating mental health into routine primary care for adolescents, and little is known about the specific nature of the obstacles that impede the quality improvement process related to integrating mental and physical health and how to overcome them. Objectives: The purpose of this DNP project was to gain insight into the PCP role, exploring perceptions, current practices, and barriers related to screening, identifying, and managing adolescent mental health needs, understand the challenges and opportunities, and guide future quality improvement projects that reflect and respond to the needs of adolescents in the local community in effective and sustainable ways. Methods: The project was designed as a needs assessment, and conducted as an anonymous 20 question survey that was distributed to 13 local PCPs that routinely provide primary care services to the community’s adolescent population. Results: Nine of the surveys were completed and returned. Time constraints and competing demands were dominant concepts, reported as primary barriers to screening, collaboration with mental health professionals, and addressing mental health in general. The participants articulated the need for high-quality professional mental health involvement, improved collaboration, inter-professional development, and inter-agency cooperation to successfully promote mental health and provide excellent care that improves outcomes. They also displayed an interest in innovative solutions and organizational restructuring to better coordinate mental health services. Conclusion: This project offered preliminary insight into the challenges faced by PCPs addressing adolescent mental health in primary care, and generated ideas for further exploration to guide quality improvement initiatives designed to support the providers' capacity to incorporate mental health into routine care, and contribute to the community’s efforts in promoting mental health for local youth. PCPs occupy esteemed roles in the community, and their perspectives and insight are invaluable.

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Hanna, Elizabeth Gayle. "Environmental health and primary health care : towards a new workforce model /." Access full text, 2005. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20061110.152550/index.html.

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Thesis (Ph.D.) -- La Trobe University, 2005.
Research. "A Thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy [to the] School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria". Includes bibliographical references (leaves 255-293). Also available via the World Wide Web.

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Crawford, Kathryn J. "Assessment of noise in a medical intensive care unit." Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/2061.

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Exposure to noise in hospital intensive care units (ICUs) can disrupt patients’ sleep and delay their recovery. In this intervention study, noise levels were measured in eight patient rooms of a medical ICU (MICU) every minute with sound level meters for eight weeks before and after an intervention. Implemented over six weeks, the intervention was designed to educate nurses and other staff members to reduce noise levels through behavior modification, including instituting a “quiet time” in the afternoons, encouraging patients to keep televisions off or at lower volumes, and speaking more quietly during conversations. Sound equivalent levels (Leq) were calculated from one-minute measurements for each hour in each room. These hourly Leq (Leq-H) values were compared by pod (group of rooms within the MICU), room position (in proximity to a central nurses’ station), occupancy status, and time of day. Days with more than ten hours of one-minute noise levels above 60 dBA were flagged as the loudest time periods and compared to MICU activity logs. The intervention was ineffective with Leq-H values always above World Health Organization guidelines for ICUs (35 dBA in day; 30 dBA at night) before and after the intervention. Leq-H values frequently exceeded more modest project goals during the day regardless of the intervention (50% of Leq-H > 55 dBA both pre- and post-intervention) and at night (68% and 62% of Leq-H > 50 dBA pre- and post-intervention). Statistical analysis of the Leq-H suggests a general source is contributing to the high baseline noise in the MICU, most likely the heating, ventilation, and air-conditioning (HVAC) system. Our analysis of one-minute data indicated that high noise was often associated with high-volume respiratory-support devices. We concluded that our intervention focusing on administrative controls (e.g., education and training) was not enough to reduce noise in the MICU but that an intervention designed with engineering controls (e.g., shielding, substitution) would be more effective.

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Mattila, Marja-Leena. "Quality-related outcome of pediatric dental health care." Turku : Turun Yliopisto, 2001. http://catalog.hathitrust.org/api/volumes/oclc/48714198.html.

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Sharma, Devika. "Effects of Meaningful Use Requirements| Performance Assessment of Acute Care Hospitals Based on the Clinical Outcomes of Care." Thesis, Central Michigan University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10743509.

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The medical literature is replete with studies on the issues of quality of care and patient safety. Several initiatives have been undertaken nationally to improve the quality of care and reduce the incidence of in-hospital adverse events. The report Crossing the Quality Chasm: Building a Healthcare System for the 21^st Century, posited to transform the healthcare system and improve the quality of care required a paradigm shift from a paternalistic to a patient-centric healthcare delivery model. It was further reiterated in the report that safety is a systems property and patients should be safe from harms and injuries caused by the system. The report envisioned a retooled, realigned and a coordinated health care delivery system where health information technology (HIT) would provide new and improved channels for information flow and communication between all stakeholders involved in healthcare delivery. To accelerate the adoption of health information technology, the American Recovery and Reinvestment Act (ARRA) of 2009 included a Health Information Technology for Economic and Clinical Health (HITECH) component and $27 billion in incentives for eligible providers and eligible hospitals through the Centers for Medicare and Medicaid Services (CMS). Beginning in 2011, the CMS has paid a total of $35,663,068,148 in incentives to eligible providers and hospitals. Hence, it is essential to evaluate whether this investment in incentives for meeting the requirements for meaningful use has translated into improved outcomes of care in acute care hospitals, which have met the requirements for meaningful use of electronic health record (EHRs). The purpose of this study is to determine the effects of meeting the requirements for meaningful use on clinical outcomes of care in acute care hospitals and to examine if there is a statistically significant difference in the clinical outcomes of care between acute care hospitals, which have met the requirements for meaningful use (MU) and acute care hospitals, which have not met the requirements for meaningful use.

A cross-sectional descriptive study was conducted to determine the effects of meeting the requirements for meaningful use on the quality and safety of patient care delivered in acute care hospitals in the all fifty states and the District of Columbia. The data, for the study, was obtained from 2014–2015 CMS Hospital Compare database, CMS EHR Incentive Program, CMS Inpatient Prospective Payment System (IPPS) database, and American Hospital Association (AHA) database. The unit of analysis for the study was acute care hospital.

Principal Findings: There is a positive association between acute care hospital meeting the requirements for meaningful use and its clinical outcome measures for common conditions (AMI, CHF, &PN) as measured by 30-day readmission and 30-day mortality rates, when controlling for organizational characteristics (size, type, teaching status, and location) and case mix index (CMI). There is also a positive association between an acute care hospital meeting the requirements for MU and patient safety as measured by PSI-90 and hospital-acquired infections (HAI). Two one-way ANOVA test was conducted to measure the difference between groups. The results of the one-way ANOVA did not reveal a main effect of meeting the requirements for meaningful use on quality of care between hospitals, which have met the requirements for meaningful use and acute care hospitals which have not met the requirements for meaningful use. The main effect, MUSTAGE was not significant at the 95% confidence level, F(2, 1647) = 0.94, p = .389, indicating there were no significant differences in Quality by MUSTAGE levels. However, the results of one-way ANOVA for safety were significant, F(2, 2019) = 5.24, p = .005, indicating there were significant differences in patient safety among the levels of MUSTAGE. The eta squared was 0.01 indicating MUSTAGE explains approximately 1% of the variance in patient safety between acute care hospital which has met the requirements for meaningful use, and acute care hospital that has not met the requirements for meaningful use. Conclusions: The HITECH Act and the incentives included for meeting the requirements for meaningful use has promoted increased adoption of advanced capabilities of EHRs to meet the requirements for MU2 as the majority of the hospitals in the United States had met the requirements for MU2 in 2016. This increase in the adoption and use of EHRs had a positive effect on quality of care and patient safety. The increase in the adoption and use of EHRs has also led to the increased creation of structured and standardized medical records which will be easier to exchange with providers involved in care. (Abstract shortened by ProQuest.)

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Cao, Xinyuan. "Assessment of Clinical Engineering Departments in developing countries." Thesis, University of Ottawa (Canada), 2004. http://hdl.handle.net/10393/26594.

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This study was to evaluate the development level of Clinical Engineering Departments (CEDs) in hospitals in developing countries. The method of data collection was a survey done by structured questionnaire sent by Email and Listserv. In total, 61 responses (9% response rate) were grouped into two regions: Latin America (27 from Venezuela, Mexico, Brazil) and Asia (34 from India, Bangladesh, P.R. China, Indonesia, Saudi Arabia, South Africa); The responses from those developing countries were compared with those from developed countries acquired in previous studies done by Frize and Glouhova. In this study, results indicate that CEDs that responded to the survey from developing countries have similar organizational structure as developed countries, but there are differences in personnel educational levels, responsibilities, and resources. We also identified differences in the level of development of CEDs in respondents from Asia and those from Latin America. The latter were more advanced overall than those in Asia, but CEDs in both regions need to improve their level of development. Future research should focus on collecting more data from CEDs of developing countries, and expand the quantitative analysis that will be possible with a larger sample.

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Hidalgo, Stevan. "Healthcare expenditure vs healthcare outcomes a comparison of 25 world health organization member countries /." [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/SHidalgo2008.pdf.

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Muñoz, Jorge A. "What is the quality of care in a developing country? measuring physician practice and health outcomes /." Santa Monica, CA : RAND, 2002. http://books.google.com/books?id=7fDaAAAAMAAJ.

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Jallow, Carmen. "Assessment of changes in pharmaceutical performance among primary health care health facilities that received technical assistance in a rural district of the Eastern Cape, South Africa." University of Western Cape, 2019. http://hdl.handle.net/11394/7661.

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Master of Public Health - MPH
Twenty percent of the global population receiving antiretroviral therapy (ART) reside in South Africa (UNAIDS, 2017). Demand within the public health system, already constrained by human resource scarcities and budgetary and infrastructural challenges, is expected to increase given the estimate that only 56% of an estimated 7.1 million HIV positive people in South Africa are currently on ART (UNAIDS, 2017). Technical assistance (TA) interventions are deployed to support in-house government services to optimise services, however, rigorous studies to evaluate the impact of TA strategies are scarce.

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Ashaye, Olakunle Adebisi. "The effectiveness of the Camberwell Assessment of Need for the Elderly (CANE) as a needs assessment tool in the psychiatric day hospital care of older people." Thesis, University College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325591.

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Báez, Carmen Mercedes. "The Cuban Health Programme in Gauteng province: an analysis and assessment of the programme." Thesis, University of the Western Cape, 2004. http://hdl.handle.net/11394/254.

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Master of Public Health - MPH
Many parts of South Africa face a shortage of doctors within the public health system. While the PHC system is driven primarily by nursing staff, there is a need for doctors to provide certain services at primary and secondary levels. In 1996, as part of its efforts to address the shortage of doctors, the DoH began recruiting Cuban doctors to work in South Africa. This programme, now underway in eight of the nine provinces, falls under a government-to-government agreement aimed at strengthening the provision of health care in the areas of greatest need: townships and rural areas. The programme has demonstrated tangible success. However, it has also been criticised in some sections of the medical community and the media, where it has been portrayed in a controversial light. All this underlines the importance of an analysis of the programme, but to date, no such evaluation has been carried out.This research assesses the Cuban Health Programme in Gauteng province. On the basis of this thorough assessment, the government can take steps to improve the national programme, using Gauteng as a case study. This study was conducted in July 2004, employing qualitative methods to develop an in-depth understanding of recruitment and induction processes in Cuba and South Africa, the scope of practice of Cuban doctors, professional relationships, adaptation to the health system and broader society, and other factors. The researcher also conducted a review of official documents. Gauteng began with two Cuban doctors at the outset of the programme in 1996. The number peaked at 32, and has since dropped to 15. All of these doctors were interviewed in the course of the research, along with five managers and five peers. The study revealed that all the interviewees, except one manager, firmly believe that the programme has achieved its objectives, and should continue. Peers and managers commended the high quality, comprehensive and caring approach of the Cuban doctors, and say they are satisfying a real need. The Cuban doctors, however, believe that because they are providing mostly curative services, they are under-utilised. Flowing from the research are a series of recommendations. These include a proposal that the government recommit to the programme and ensure its continuity, and review the current role of the Cuban doctors, taking into consideration their willingness to provide training and expertise in preventive interventions.
South Africa

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Westman, Anders. "Musculoskeletal pain in primary health care : a biopsychosocial perspective for assessment and treatment." Doctoral thesis, Örebro : Örebro universitet, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-10084.

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Canning, Jennifer L. "Assessment of the skin condition of health care workers using digital image processing." Cincinnati, Ohio : University of Cincinnati, 2006. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1161025632.

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Thesis (M.S.)--University of Cincinnati, 2006.
Title from electronic thesis title page (viewed Jan.25, 2007). Includes abstract. Keywords: Digital Imaging; Health Care Workers; Skin Condition; Erythema; Digital Image Analysis Includes bibliographical references.

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Saaristo, T. (Timo). "Assessment of risk and prevention of type 2 diabetes in primary health care." Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514297113.

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Abstract Type 2 diabetes is one of the fastest increasing lifestyle diseases globally. Its cure is not yet possible, but there is firm evidence from scientific studies that it can effectively be prevented by lifestyle changes. There is limited evidence-based information on the prevention of diabetes in practice. This dissertation offers new desirable information on the issue. The aim of this dissertation study was to describe the prevalence of risk factors for type 2 diabetes and hidden glucose disorders predicting the development of diabetes in the Finnish adult population, and to analyse whether the risk for developing diabetes could be reduced by simple lifestyle counselling. Furthermore, the ability of the Finnish Diabetes Risk Score (FINDRISC) to detect glucose disorders leading to diabetes and undiagnosed diabetes was analysed. In the dissertation data from large Finnish population surveys (the FINRISK 2002 glucose tolerance survey and the FIN-D2D 2004−2005 survey) were analysed. In addition, a prospective design and large-scale intervention were included. We found that obesity and glucose disorders are very common in the Finnish middle-aged population. Prevalence of obesity was 24% for men and 28% for women, that of abnormal glucose metabolism 42% for men and 33% for women, and that of undiagnosed diabetes 9% for men and 7% for men. One quarter of individuals aged 45−64 years were at high risk for diabetes. Lifestyle interventions were offered to more than 10,000 high-risk individuals, 3,379 men and 6,770 women. Of the men, 43% were also at high risk for cardiovascular morbidity and 42% at high risk for cardiovascular mortality estimated through the FRAMINGHAM and SCORE risk engines, respectively. The FINDRISC, originally developed for predicting the risk of development of type 2 diabetes, also predicted the prevalence of diabetes in the population. The effect of lifestyle interventions on weight and its association with glucose tolerance was evaluated in individuals at high risk for diabetes in a one-year follow-up. In total 17.5% of them lost ≥ 5% weight. Their relative risk for diabetes decreased 69% compared with the group that maintained their weight. This study shows that FINDRISC predicts prevalent type 2 diabetes. A significant proportion of middle-aged Finnish population has a glucose disorder including undiagnosed type 2 diabetes. Lifestyle interventions in primary health care may promote weight loss, which decreases the risk of diabetes
Tiivistelmä Diabetes on yksi nopeimmin lisääntyvistä elintapasairauksista maailmassa. Sitä ei vielä voida parantaa, mutta tieteellisissä tutkimuksissa on kiistattomasti osoitettu, että sitä voidaan tehokkaasti ehkäistä elintapamuutoksilla. Diabeteksen ehkäisystä käytännössä on hyvin niukasti tutkimustietoa. Tämä väitöskirja tuo kaivattua lisätietoa aiheesta. Väitöstutkimuksen päätavoitteena oli selvittää diabeteksen riskitekijöiden ja piilevien diabetesta ennakoivien sokerihäiriöiden yleisyyttä suomalaisessa aikuisväestössä. Tämän ohella tavoitteena oli selvittää voidaanko yksinkertaisella elintapaneuvonnalla vähentää sellaisten henkilöiden sairastumisvaaraa, joilla oli suuri riski sairastua diabetekseen. Lisäksi arvioitiin diabetesriskitestin kykyä tunnistaa ennakoivat sokerihäiriöt ja aiemmin tunnistamaton diabetes. Tutkimuksessa käytettiin laajoja suomalaisia väestötutkimusaineistoja: FINRISKI-2002 -tutkimusta, sen alaotosta ja D2D-väestötutkimusta 2004–2005. Mukana oli myös pitkittäisasetelma ja laajamittainen interventio. Tutkimuksen perusteella huomasimme, että lihavuus ja sokerihäiriöt ovat hyvin yleisiä keski-ikäisillä suomalaisilla. Merkittävästi lihavia (BMI ≥ 30 kg/m2) oli 24 % miehistä ja 28 % naisista ja poikkeava sokeriaineenvaihdunta oli 42 %:lla miehistä ja 33 %:lla naisista. Tunnistamaton diabetes oli 9 %:lla miehistä ja 7 %:lla naisista. Suuressa diabetekseen sairastumisvaarassa oli neljäsosa 45−64-vuotiaista. Interventioon otettiin yli 10 000 suuressa diabeteksen sairastumisriskissä olevaa henkilöä, 3 379 miestä ja 6 770 naista. Miehistä 43 % oli suuressa sairastumisvaarassa myös sydän- ja verisuonisairauteen ja 42 % suuressa kuolemanvaarassa Framingham- ja SCORE-riskilaskureilla arvioituna. Tyypin 2 diabeteksen sairastumisriskin arviointiin kehitetty Riskitesti ennusti hyvin myös diabeteksen esiintymistä väestössä. Elintapainterventioiden vaikutusta painoon ja sokeriaineenvaihduntaan analysoitiin vuoden seurannassa sellaisilla henkilöillä, joilla oli suuri diabetesriski. Paino laski 5 % tai enemmän 17,5 %:lla, jolloin sairastumisriski diabetekseen väheni 69 % verrattuna ryhmään, jonka paino ei muuttunut. Tutkimuksen perusteella lihavuus, sokerihäiriöt ja tunnistamaton diabetes ovat yleisiä keski-ikäisessä väestössä. Riskitesti on hyvä työkalu myös diabeteksen seulonnassa. Perusterveydenhuollossa tarjottavalla elintapaneuvonnalla voidaan saada aikaan laihtuminen, joka vähentää sairastumisvaaraa diabetekseen

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Cameron, Kirsteen Sarah. "Needs-led assessment in health and social care : a community-based comparative study." Thesis, University of Glasgow, 2006. http://theses.gla.ac.uk/2984/.

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The assessment of need underpins the delivery of community-based care. Following the NHS and Community Care Act (1990), the principle of needs-led assessment was reinforced as it applied to the assessment and care management process. Translation of needs-led assessment into practice in Scotland has been further influenced by policy-based organisational change including the introduction of Single Shared Assessment and Community Health Partnerships. This study seeks to describe the political and practice landscape within which needs-led assessment exists, identify and explore factors which influence needs-led assessment, and consider the practice implications of the policy driver for community-based practitioners across the main disciplines of health and social care. Following a short pilot, the main study was undertaken using sequences vignettes within a semi-structured interview involving 105 social workers, health and housing staff. Key findings indicated a cloak of consensus around definitions of need and assessment with perceptions based upon a medical or social model of care or a professionally or personality-driven assessment of need. A preoccupation with the outcome of assessments caused many respondents to describe needs with reference to the interventions or resources required to address them. The practice of needs-led assessment, according to study results, was hampered by an awareness of resource availability, concerns over client compliance and risk and, an underlying alignment to the values and principles upheld by the employing discipline.

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Pavlou, Pavlos Georgiou. "The application of quality award driven assessment models in the health care sector." Thesis, University of Salford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247487.

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Bentley, Lucy May. "What do parents report of the Education, Health and Care needs assessment process?" Thesis, University of East London, 2017. http://roar.uel.ac.uk/6407/.

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The relatively recent Special Educational Needs and Disability (SEND 2014) legislation called for a ‘stronger voice’ for parents in educational planning for their children and higher aspirations for children and young people. This study was designed to investigate what parents report of the Education, Health and Care (EHC) needs assessment process (also ‘statutory assessment’) since the inception of the SEND (2014) reforms, particularly if the aims of the reforms have been met from parents’ perspectives. The research is exploratory as there is currently little known about parents’ experiences of statutory assessment since the SEND (2014) reforms and it is also emancipatory, where parents of children and young people with special educational needs and disability represent a traditionally marginalised group. The study further aims to improve practice for Educational Psychologists (EPs) who have a central role in statutory assessment, as well other professionals who may also be involved. Semi-structured interviews were used to collect data from parents whose children were undergoing statutory assessment. Data was collected from each parent at three points in the process and data was analysed using a thematic analysis described by Braun and Clarke (2013). The findings indicate that in order for the aims of the (2014) reforms to met, this can only be realised in the social spaces created by parents and professionals working together. In order for professionals working within statutory assessment procedures to deliver the aims of the SEND (2014) reforms there needs to be a greater focus on ensuring co-construction and meaningful participation for parents in practice. It was found that this was particularly important when working with parents who have less means of creating their own conditions of empowerment.

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Betley, Lucy-May. "What do parents report of the Education, Health and Care needs assessment process?" Thesis, University of East London, 2017. http://roar.uel.ac.uk/6408/.

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The relatively recent Special Educational Needs and Disability (SEND 2014) legislation called for a ‘stronger voice’ for parents in educational planning for their children and higher aspirations for children and young people. This study was designed to investigate what parents report of the Education, Health and Care (EHC) needs assessment process (also ‘statutory assessment’) since the inception of the SEND (2014) reforms, particularly if the aims of the reforms have been met from parents’ perspectives. The research is exploratory as there is currently little known about parents’ experiences of statutory assessment since the SEND (2014) reforms and it is also emancipatory, where parents of children and young people with special educational needs and disability represent a traditionally marginalised group. The study further aims to improve practice for Educational Psychologists (EPs) who have a central role in statutory assessment, as well other professionals who may also be involved. Semi-structured interviews were used to collect data from parents whose children were undergoing statutory assessment. Data was collected from each parent at three points in the process and data was analysed using a thematic analysis described by Braun and Clarke (2013). The findings indicate that in order for the aims of the (2014) reforms to met, this can only be realised in the social spaces created by parents and professionals working together. In order for professionals working within statutory assessment procedures to deliver the aims of the SEND (2014) reforms there needs to be a greater focus on ensuring co-construction and meaningful participation for parents in practice. It was found that this was particularly important when working with parents who have less means of creating their own conditions of empowerment.

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Rutten, Martine. "The economic impact of health care provision : a CGE assessment for the UK." Thesis, University of Nottingham, 2004. http://eprints.nottingham.ac.uk/10318/.

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This thesis seeks to determine the macro-economic impacts of changes in health care provision, whilst recognising the simultaneous effects of consequent changes in health on effective labour supplies and the resource claims made by the health care sector. The resource allocation issues have been explored in theory, by developing an extension of the standard Rybczynski theorem from a low-dimension Heckscher-Ohlin framework, and empirically, by developing a Computable General Equilibrium model, calibrated to a purpose-built dataset for the UK. The theory predicts that, if the government is solely concerned with improving per capita income, a morally questionable policy of targeting health care provision towards skilled workers performs best. Furthermore, the impact of an expanding health sector on the outputs of non-health sectors is shown to depend on the sign and magnitude of a scale effect of increased effective labour supplies and a factor-bias effect of changes in the ratio of skilled to unskilled labour, although the latter effect dominates if effective labour supplies are relatively inelastic with respect to health care provision. The theoretical predictions are not generally validated by the applied model due to added real-life complexities. The main findings are that a rise in NHS expenditures, the employment of foreign health care-specific skilled workers, and costless factor-neutral and skill-biased technical change in the UK health sector have a positive impact upon overall welfare via direct improvements in population well-being and indirect benefits from increased worker incomes. The study indicates that if an expansion of the health sector is financed from a reduction in state benefits, the non-working households and pensioners may require some compensation since they rely relatively heavily on these as a source of income. The presence of health care-specific factors and rising pharmaceutical prices impact negatively upon the health sector and overall welfare, suggesting the importance of tackling rising input costs and structural rigidities. This may be achieved by the immigration policy, although since effects on domestic workers if their wages are not sustained, and on countries of origin faced by a 'brain-drain', are negative, in the long-term increasing the number of medical school places may be more desirable. Another suitable policy response is to purchase a more effective pharmaceutical product. Fairly small productivity gains in health care were shown to generate overall welfare gains. Finally, factor-neutral and skill-biased technical improvements yield significant welfare gains and cost-savings in the health sector. Such technical improvements may come in the form of improved medical procedures, which have been developed abroad yet are freely available or have been funded by charitable institutions, but also may reflect domestic policy which aims at reducing administrative overheads so that more resources can be devoted to front-line staff. The sensitivity of the results to the elasticity of the waiting lists with respect to health care indicates the importance of ensuring that additional resources are effectively employed, attainable by the technical and administrative improvements in health care.

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Mangwanya, Maonei Gladys. "An assessment of the budgeting system in the Eastern Cape Department of Health to ensure effective and efficient health care service delivery." Thesis, University of Fort Hare, 2016. http://hdl.handle.net/10353/2061.

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The National Department of Health is the executive department of the South African government which is assigned to the national health issues of the country. This research was however aimed specifically on the budgeting process within the Eastern Cape Provincial Department of Health. This was provisioned by assessing the significance of the budgeting system and its correlation to efficient and effective healthcare service delivery. The aim of the research was to highlight on how policies have an effect on the budgeting system at the provincial level, considering the provincial health department is responsible for the provision of publicly funded health services. This research assessed the budgeting system in the Eastern Cape Department of Health in an attempt to propagate effective and efficient health service delivery for the general citizenry. This was a qualitative study design which harnessed the merits of secondary data as the main code of the research design which enabled the comprehension of the budgeting system in the Eastern Cape Department of Health. Data was analysed using thematic analysis to examine the distinctive themes and sub-themes identified from within the reviewed literature. The Eastern Cape Province is succumbing to insufficient funding at provincial level and this has a clear-cut reflection on the administration of services within respective departments, particularly the Health Department. This is despite the fact that the Public Finance Management Act, 1999 promotes the objectives of good financial management aimed at maximizing service delivery through the effective use of the limited resources. Resultantly it was fundamental to comprehend on the issues underpinning the scope of budget reporting as well as budget accountability and the effect it has on service delivery in the Eastern Cape Department of Health. Recommendations were thus given based on the discussed and derived themes to ensure that there is an appropriate budgeting system to ensure efficient and effective provision of health care services in the Eastern Cape Department of Health.

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46

Motsohi, Tsepo. "Management of hypertension in mental health patients in a primary care setting : an assessment of quality of care." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/12136.

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Includes summary.
Includes bibliographical references (leaves 44-48).
In his experience working in the Metro District Health Services Clinics of the Department of Western Cape, the researcher has encountered numerous cases of sub-standard quality of medical care for mental health patients. These encounters, as well as a need to audit the general quality of care of patients with chronic diseases of lifestyle, have been the motivation behind the creation of this research project.The study is a retrospective cohort study using patient folders as a source of data. It compares the standards, processes and outcomes of the management of hypertension in two populations at Crossroads Community Health Clinic in Cape Town. The first cohort consists of hypertensive patients with psychiatric illnesses, and the second are hypertensive patients without psychiatric illnesses. The study attempts to examine the quality of care of established hypertension in patients with psychiatric illnesses.

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47

Beard, Sandra Lynn. "A health technology assessment of Lovaas Autism Treatment : the role of evidence in legal, health policy and health care contexts." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/30716.

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In 1998 parents of autistic children launched a Charter of Rights and Freedoms challenge against the Province of BC for failing to fund Lovaas Autism Treatment (LAT) (Auton et al.). Although initially successful, in 2004 the Supreme Court of Canada overturned the lower courts' decisions and rejected the parents' claims for public funding. In addition to the Charter issue, these legal proceedings also highlighted the discourse over judicial policy making and the Courts' interpretation of medical evidence - specifically, the effectiveness of LAT. The use of medical evidence in law had been identified as an issue by both the American Institute of Medicine (IOM) and the Agency for Healthcare Research and Quality (AHRQ). This thesis was designed to expand on the lOM/AHRQ's previous work by investigating the conceptualizations and processes used by law, health policy and health care within the context of the Auton legal proceedings in order to gain an understanding of how each domain seeks, understands and applies evidence. This was accomplished in two parts. First, the legal dimension of a comprehensive health technology assessment (HTA) framework utilized a qualitative grounded theory methodology to examine participant interviews a n d legal documents. This analysis resulted in a conceptual framework of scientific evidence pathways that further defined, contextualized and dimensionalized the phenomena of seeking, understanding, and applying evidence within the three sectors. Grounded theory proved to be an effective approach for exploring the legal context and serves to broaden the scope of evidence HTA researchers can offer. Second, the effectiveness dimension of the HTA framework employed the methods of systematic review and critical appraisal to investigate the current state of knowledge on the effectiveness of LAT. This analysis concluded that there remains a paucity of rigorously designed studies due to ongoing methodological limitations. Overall, the strength of the body of evidence on LAT was poor and did little to advance its effectiveness claims. Together, these two analyses provided an update on the effectiveness of Lovaas Autism Treatment; insight into how the evidence of LAT was handled in the Auton case; and a depiction of how the sectors of law, health policy and health care conceptualize the evidentiary process in general.
Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate

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48

Hernandez, Rodolfo. "Broadening the valuation space in health technology assessment : the case of monitoring individuals with ocular hypertension." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=230150.

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The economic evaluation (EE) component of health technology assessments (HTA) often defines value in terms of health related quality of life, with many HTA agencies requiring the use of EQ-5D based Quality Adjusted Life Years (QALYs). These approaches do not capture value derived from patient experience factors and the process of care. This thesis widens the valuation space beyond this limited perspective, taking account of such factors, using monetary values generated from a discrete choice experiment (DCE), incorporating these into a discrete event simulation (DES) and conducting a cost-benefit analysis (CBA). The case study is monitoring individuals with ocular hypertension. Five strategies were compared using a DES: 'Treat All' at ocular hypertension diagnosis with minimal followup; Biennial monitoring (either in primary or secondary care) with treatment according to predicted glaucoma risk; and monitoring and treatment according to the UK National glaucoma guidance (either conservative or intensive). DCE based Willingness to pay (WTP) estimates for relevant health outcomes (e.g. risk of developing or progressing glaucoma and treatment side effects), patient experience factors (e.g. communication and understanding with the health care professional) and process of care (e.g. monitoring setting) were obtained. Conditional logit, mixed logit preference space and mixed logit WTP-space (rarely used within health economics) econometric specifications were used. These WTP valuations were aggregated in the DES, as fixed mean values or allowing variation between simulated individuals. While the standard cost-utility analysis (CUA) using EQ-5D implied 'Treat All' was most likely cost-effective, CBA with broadened valuation space identified, consistently across different econometric specifications, 'Biennial hospital' as the best choice. This thesis proposes an approach to broaden the valuation space that can be promptly used for EE-HTA. Researchers should be attentive of the valuation space considered in their EE and choose wisely the EE approach to be used (e.g. CUA and/or CBA).

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49

Tsetswa, Mncedisi Patrick. "Assessment of the quality of primary health care services rendered at Moses Mabida Clinic." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/880.

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Health is a basic human right enshrined in the South African Constitution. It is the responsibility of government to ensure that the nation is healthy because good health is a prerequisite for social and economic development as well as an outcome of that process. Special attention on the healthcare needs of rural communities should be given because these communities were the worst affected by the legacy of the apartheid regime. Moses Mabida community is no exception. Since the advent of democracy, work has been done to ensure that adequate primary health care services are delivered to previously disadvantaged communities such as Moses Mabida. To monitor progress on health care service delivery, evaluation of these services is needed. The evaluation of these services will help identify the strengths and weaknesses so as to come up with quality improvement strategies, hence this study. This study takes form of an assessment survey involving a literature review and a survey of members of the Moses Mabida community who depend on the clinic for their health care needs. The literature identified best practice models of primary health care and these were used as an analytic tool to determine to what extent the primary health care services at Moses Mabida comply with national and international standards. It has been shown that the primary health care services at Moses Mabida Clinic largely comply with national and international standards although several recommendations have been presented for consideration.

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50

Brennan, Caitlin W. "Patient Acuity: Concept Clarification and Psychometric Assessment." Case Western Reserve University School of Graduate Studies / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1277406093.

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