Dissertations / Theses: 'Healthcare service'

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Pearce, Rebecca Elizabeth. "How can healthcare service engagement be supported for service users with complex healthcare needs?" Thesis, Lancaster University, 2015. http://eprints.lancs.ac.uk/79123/.

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By 2033 the number of elderly people in England and Wales is expected to exceed 16.4 million. The consequent increase in prevalence of chronic illness and demand on the health and social care services are major causes of concern for healthcare practitioners and policy-makers alike. In response, calls for greater service user autonomy, involvement, and self-care all indicate a shift away from existing paternalistic models of care to a model where service users knowledgably and competently manage their own healthcare and wellbeing. To equip healthcare professionals implement these fundamental changes, this thesis aims to capture, analyse, and articulate the process of healthcare service engagement. To investigate how healthcare services can be better designed to support healthcare engagement for service users with complex needs, this thesis conducts an empirical ethnographic study of a UK-based falls prevention service. Mixed methods were used to collect data from a wide range of sources, including twenty semi-structured interviews with healthcare professionals and service users, ninety-two surveys, referral forms, assessments, and healthcare promotional materials. The data were coded, conceptualised, and categorised to produce a grounded theory of healthcare service engagement represented in a specifically designed model. Key findings show that healthcare service engagement in the context of the chronically ill elderly needs to be understood as an interconnected, emergent, nonlinear, and situated process. It recommends that engagement should be supported in a more user-centric and personalised manner, assessing and responding to service users’ engagement needs as they emerge concurrently with the service’s pathway, integrating assessment practices within a wider healthcare context, and simplifying the existing multidisciplinary and multi-phase falls prevention pathway. Resulting from this thesis, healthcare professionals can more accurately, completely, and confidently reflect on the complex process of healthcare service engagement; better equipping the community for challenges it will face in the future.

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Hollis, Charles. "Service quality evaluation in internal healthcare service chains." Thesis, Queensland University of Technology, 2006. https://eprints.qut.edu.au/16267/1/Charles_Hollis_Thesis.pdf.

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Measurement of quality is an important area within the services sector. To date, most attempts at measurement have focussed on how external clients perceive the quality of services provided by organisations. Although recognising that relationships between providers within a service environment are important, little research has been conducted into the identification and measurement of internal service quality. This research focuses on the measurement of internal service quality dimensions in the complex service environment of an internal healthcare service chain. The concept of quality in healthcare continues to develop as various provider, patient and client, governmental, and insurance groups maintain an interest in how to 'improve' the quality of healthcare service management and delivery. This research is based in healthcare as a major area within the service sector. The service environment in a large hospital is complex, with multiple interactions occurring internally; health is a significant field of study from both technical and organisational perspectives providing specific prior research that may be used as a basis for, and extension into service quality; and the implications of not getting service delivery right in healthcare in terms of costs to patients, families, community, and the government are significant. There has been considerable debate into the nature, dimensionality, and measurement of service quality. The five dimensions of SERVQUAL (tangibles, assurance, reliability, responsiveness, and empathy) have become a standard for evaluations of service quality in external service encounters, although these have been challenged in the literature. As interest in internal service quality has grown, a number of researchers have suggested that external service quality dimensions apply to internal service quality value chains irrespective of industry. However, this transferability has not been proven empirically. This research examines the nature of service quality dimensions in an internal healthcare service network, how these dimensions differ from those used in external service quality evaluations, and how different groups within the internal service network evaluate service quality, using both qualitative and quantitative research. Two studies were undertaken. In the first of these, interviews with staff from four groups within an internal service chain were conducted. Using dimensions established through qualitative analysis of this data, Study Two then tested these dimensions through data collected in a survey of staff in a major hospital. This research confirms the hierarchical, multidirectional, and multidimensional nature of internal service quality. The direct transferability of external quality dimensions to internal service quality evaluations is only partially supported. Although dimension labels are similar to those used in external studies of service quality, the cross-dimensional nature of a number of these attributes and their interrelationships needs to be considered before adopting external dimensions to measure internal service quality. Unlike in previous studies, equity has also been identified as an important factor in internal service quality evaluations. Differences in service expectations between groups in the internal service chain, and differentiation of perceptions of dimensions used to evaluate others from those perceived used in evaluations by others were found. This has implications on formulation of future internal service quality instruments. For example, the expectations model of service quality is currently the dominant approach to conceptualising and developing service quality instruments. This study identifies a number of problems in developing instruments that consider differences in expectations between internal groups. Difficulty in evaluating the technical quality of services provided in internal service chains is also confirmed. The triadic nature of internal service quality evaluations in internal healthcare service chains and the problems associated with transferring the traditional dyadic measures of service quality are identified. The relationships amongst internal service workers and patients form these triads, with patient outcomes a significant factor in determining overall internal service quality, independent of technical quality. This thesis assists in supporting the development of measurement tools more suited to internal service chains, and will provide a stronger and clearer focus on overall determinants of internal service quality, with resultant managerial implications for managerial effectiveness.

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3

Hollis, Charles. "Service quality evaluation in internal healthcare service chains." Queensland University of Technology, 2006. http://eprints.qut.edu.au/16267/.

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Measurement of quality is an important area within the services sector. To date, most attempts at measurement have focussed on how external clients perceive the quality of services provided by organisations. Although recognising that relationships between providers within a service environment are important, little research has been conducted into the identification and measurement of internal service quality. This research focuses on the measurement of internal service quality dimensions in the complex service environment of an internal healthcare service chain. The concept of quality in healthcare continues to develop as various provider, patient and client, governmental, and insurance groups maintain an interest in how to 'improve' the quality of healthcare service management and delivery. This research is based in healthcare as a major area within the service sector. The service environment in a large hospital is complex, with multiple interactions occurring internally; health is a significant field of study from both technical and organisational perspectives providing specific prior research that may be used as a basis for, and extension into service quality; and the implications of not getting service delivery right in healthcare in terms of costs to patients, families, community, and the government are significant. There has been considerable debate into the nature, dimensionality, and measurement of service quality. The five dimensions of SERVQUAL (tangibles, assurance, reliability, responsiveness, and empathy) have become a standard for evaluations of service quality in external service encounters, although these have been challenged in the literature. As interest in internal service quality has grown, a number of researchers have suggested that external service quality dimensions apply to internal service quality value chains irrespective of industry. However, this transferability has not been proven empirically. This research examines the nature of service quality dimensions in an internal healthcare service network, how these dimensions differ from those used in external service quality evaluations, and how different groups within the internal service network evaluate service quality, using both qualitative and quantitative research. Two studies were undertaken. In the first of these, interviews with staff from four groups within an internal service chain were conducted. Using dimensions established through qualitative analysis of this data, Study Two then tested these dimensions through data collected in a survey of staff in a major hospital. This research confirms the hierarchical, multidirectional, and multidimensional nature of internal service quality. The direct transferability of external quality dimensions to internal service quality evaluations is only partially supported. Although dimension labels are similar to those used in external studies of service quality, the cross-dimensional nature of a number of these attributes and their interrelationships needs to be considered before adopting external dimensions to measure internal service quality. Unlike in previous studies, equity has also been identified as an important factor in internal service quality evaluations. Differences in service expectations between groups in the internal service chain, and differentiation of perceptions of dimensions used to evaluate others from those perceived used in evaluations by others were found. This has implications on formulation of future internal service quality instruments. For example, the expectations model of service quality is currently the dominant approach to conceptualising and developing service quality instruments. This study identifies a number of problems in developing instruments that consider differences in expectations between internal groups. Difficulty in evaluating the technical quality of services provided in internal service chains is also confirmed. The triadic nature of internal service quality evaluations in internal healthcare service chains and the problems associated with transferring the traditional dyadic measures of service quality are identified. The relationships amongst internal service workers and patients form these triads, with patient outcomes a significant factor in determining overall internal service quality, independent of technical quality. This thesis assists in supporting the development of measurement tools more suited to internal service chains, and will provide a stronger and clearer focus on overall determinants of internal service quality, with resultant managerial implications for managerial effectiveness.

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Robertson, Rachael. "Veterans’ Service Experiences in Healthcare: a Self-service Technology Orientation." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc500005/.

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This work focuses on how to improve medical services for veterans in a manner that will result in high levels of satisfaction and attainment of needed services. This research assess how veterans access healthcare and receive service. The problem to be addressed relates to reports by veteran healthcare organizations regarding the presence of gaps in coverage and customer service disparities in healthcare. Common concerns involve the gaps between veterans’ expectations for services and the provided services. This study created a survey instrument that contextualized components of established scales along with demographics and constructs specific to the current study. This study assessed the relationships among a variety of constructs and dimensions with healthcare expectations and service quality using a series of simple regressions. The results showed a statistically significant relationship between quality and the use or intention to use technology. The study supports the contention that respondents are willing to use self-service technologies. Technology that incorporates digital devices into healthcare services offers an opportunity to bridge service gaps and holds a promise for giving veterans faster access to service and care in a beneficial manner.

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Engström, Jon. "Patient involvement and service innovation in healthcare." Doctoral thesis, Linköpings universitet, Kvalitetsteknik, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-106661.

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This thesis adds to a stream of research suggesting that healthcare can be more patient centered and efficient by redefining the role of the patient from a passive receiver to a more active and collaborative participant. This may relate to healthcare provision (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) and innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Through research initiative containing four healthcare units and 68 patients, the present thesis combines healthcare research (e.g., Anderson and Funnell, 2005; Nelson et al., 2002) with service research (e.g., Grönroos, 2006; Vargo and Lusch, 2008, 2004) to explore three aspects of patient involvement and service innovation. Firstly, the concept of patient involvement itself is investigated through an extensive literature review of empirical research on patient involvement. A model describing the antecedents, forms and consequences of patient involvement is proposed. What value is, and how patients can co-create value is discussed from the perspectives of healthcare research and service management thought. Secondly, the thesis proposes a diary-based methodology for involving patients in service innovation. My colleagues and I developed the methodology in collaboration with the participating care providers and applied it in practice. We used the experiences we gained from the project and the contributions from the patients to examine the opportunities for user involvement in service innovation. The participants contributed with ideas and insights stemming from their experiences in their contact with healthcare and other resources. We suggest the following three ways of learning from the collected data: As ideas for improvements; through summary reports to illustrate other quantitative data; and as narratives to promote change. Thirdly, the thesis explores patients’ motivations to participate in service innovation, a hitherto unexplored field. Through an analysis of patients’ contributions and interviews with participants we found that there are a number of factors that motivate patients to participate and that participation is perceived as a social- and meaningladen event. Patients derive psychological well-being and support from participation, but disease was sometimes a barrier to participation. This thesis elaborates on how the most motivated users can be involved in service innovation, applying thinking from the lead-user methodology to a healthcare setting. Overall, the thesis explores patient involvement from new perspectives and, by doing so, adds to our collective efforts to improve healthcare.
Denna avhandling syftar till en mer patientcentrerad och effektiv sjukvård. Den bidrar till en strömning inom forskningen som menar att sjukvården kan förbättras genom en omdefiniering av patientrollen – från en roll som passiv mottagare till aktiv, samskapande aktör. Patienten kan ses som en resurs både i utförande av vården (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) och inom utveckling och innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Avhandlingen kombinerar sjukvårdsforskning (Anderson and Funnell, 2005; Nelson et al., 2002) med tjänsteforskning (Grönroos, 2006; Vargo and Lusch, 2008, 2004) i en forskningsansats som innefattar fyra vårdenheter och 68 patienter. Den utforskar tre aspekter av patientinvolvering och tjänsteinnovation. För det första undersöks konceptet patientinvolvering genom en omfattande litteraturöversikt av den empiriska forskningen på området. Översikten leder till en konceptuell modell för att beskriva patientinvolvering: vad dess förutsättningar är, vilka former av patientinvolvering som finns och vad patientinvolvering leder till. Avhandlingen diskuterar även begreppet värde och hur patienter kan samskapa värde, utifrån perspektiv inom vårdforskning och tjänsteforskning. För det andra föreslår avhandlingen en dagboksbaserad metod för att involvera patienter i tjänsteinnovation. Deltagande patienter skriver i denna metod ner sina ner sina idéer och upplevelser varje dag under två veckors tid. Mina kollegor och jag utvecklade metoden i samarbete med personal från de deltagande vårdenheterna och applicerade den på praktiken. Erfarenheterna från projektet och de deltagande patienternas bidrag användes för att utforska möjligheterna med patientinvolvering i utvecklingen av vården. Vi föreslår tre sätt att lära sig från det insamlade materialet: som direkta idéer till förbättringar; summerat till rapporter för att ge kvalitativ förståelse av andra kvantitativa mätningar; och enskilda patienters berättelser kan användas för att förmedla patientperspektivet i organisationen och mana till förändring. För det tredje undersöker avhandlingen patienters motivation att bidra till tjänsteinnovation, ett hittills outforskat område. Genom en analys av patienters bidrag och genom intervjuer med deltagare finner vi att patienter motiveras att delta av en rad olika anledningar, från ett behov av upprättelse till en glädje av att utföra aktiviteten. Deltagandet uppfattas som en social och meningsfull händelse. Patienter upplever psykiskt välbefinnande och stöd genom att delta, även om sjukdom kan vara ett hinder i deltagandet. Avhandlingen undersöker även hur de allra mest motiverade patienterna kan identifieras och inkluderas i tjänsteinnovation, detta inspirerat av lead user-metoden (von Hippel, 1986). Sammantaget utforskar avhandlingen patientinvolvering och tjänsteinnovation från nya perspektiv och bidrar därmed till våra gemensamma ansträngningar för att förbättra vården och patienters välbefinnande.

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Memon, Ally Raza. "Management in collaborative and integrated healthcare service systems : concept and practice." Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/21998.

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This study explores how managers are coping within a changing public healthcare service context and how the role of service managers and the nature of Management Development are being transformed. With the public healthcare sector in the UK facing complex challenges including financial constraint and increasing service demand, it is inevitable that collaborative partnership working and service integration are viewed as a means of addressing such challenges. Using the views and experiences of service managers from Scottish Community Health Care Partnership cases, the study highlights the experiences of managers in relation to partnership working and service integration and explores the potential implications of this for managerial learning, training and development. The research evidence establishes the importance of changing roles, responsibilities and relationships for managers in a changing healthcare service environment and takes on board a Service-Dominant approach and propositions from New Public Governance theory to explain these and to address attendant issues. Specifically, the challenges surrounding the learning, training and development of managers in an increasingly integrated services environment are explored and reconceptualised through a Services-as-Systems approach. The outcomes of this study allow for a better understanding of the changing nature of work that managers do and attempts to reframe Management Development in such a context for the future.

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Yip, Man Hang. "Healthcare product-service system characterisation : implications for design." Thesis, University of Cambridge, 2015. https://www.repository.cam.ac.uk/handle/1810/249205.

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The engineering design process transforms stakeholders’ needs and desires into design specifications. In this process, manufacturers make decisions that impact how much value can be generated from a new product/service. Clear design specification can enhance the value of a product/service. This research study focuses on the engineering design process for systems of products and services - product-service systems (PSSs). An unambiguous PSS classification could help manufacturers to produce clearer design specifications, however there is a lack of clear PSS classifications for engineering design. Existing classifications rely on an out-dated distinction between tangible objects as products, and everything else as a service, a division that inappropriately classifies digital products as services. To develop a coherent PSS classification, it is necessary to understand which characteristics of PSS can clarify its design specification. This research addresses this problem by determining the PSS characteristics that are useful for clarifying the design specification. The research aims to develop a PSS characterisation scheme and explore how the scheme influences design specifications. To achieve these aims, case study and action research methods are employed. This study has developed a PSS characterisation scheme that clarifies design specifications and a method to systematically apply this scheme, the PSS characterisation approach. This approach proves useful for practitioners to clarify design specifications, and has extended the application of the theory of technical systems to instruments supporting the engineering design process. The PSS characterisation scheme comprises four characteristics: customer perceived value level, ‘connectivity number’, type and degree of connectivity and configuration type. The scheme does not use the ‘tangibility’ distinction, but incorporates concepts of value creation and interdependencies within a PSS and between a PSS and its environment. This novel characterisation scheme contributes to the development of a PSS classification scheme for engineering design and also to the literature of PSS classifications.

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Young, Lisa. "iPawsome, LLC| A Healthcare Employee Well-Being Service." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10839189.

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Employee burnout has been a toxic concern in today’s American workforce. The prevalence of stress in the healthcare workplace is costing America billions of dollars and leading to medical errors, absenteeism, and turnover. Research indicates that human-animal bond provides physical, physiological, and psychological health benefits for professionals. This project will present the benefit of human-animal interactions (HAI) therapy in promoting the well-being in healthcare professionals. It will address services which will deliver to healthcare employees in the convenience of their workplace as well as educate the reader about the role animals play in humans’ lives. A combined minimal overhead cost and scientifically-proven health benefits of HAI, overall enhanced feelings of employee well-being and decreased animal abandonment are the strengths to this project. Finally, a discussion outlining the market, feasibility, legal and regulatory considerations and the proposal of financial analysis to deliver the project’s value with specific services from the human-animal interactions program.

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Shukla, Nagesh. "Unwarranted variations modelling and analysis of healthcare services based on heterogeneous service data." Thesis, University of Warwick, 2012. http://wrap.warwick.ac.uk/49485/.

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There is a growing demand worldwide to increase the quality and productivity of healthcare services thereby increasing the value of the healthcare services delivered. To deal with these demands, increasingly importance is being placed on analysing and reducing unwarranted variations in healthcare services to achieve significant savings in healthcare expenditure. Unwarranted variations are defined as the variations in the utilisation of healthcare services that cannot be explained by variation in patient illness or patient preferences. Current modelling and simulation approaches for healthcare service efficiency and effectiveness improvements in hospitals do not utilise multiple types of heterogeneous service data such as qualitative information about hospital services and quantitative data such as historic system data, electronic patient records (EPR), and real time tracking data for analysing unwarranted variations in hospital. Consequently, due to the presence of large amount of unwarranted variations in the service delivery systems, service improvement efforts are often inadequate or ineffective. Therefore, there is urgent need to: (i) accurately and efficiently model complex care delivery services provided in hospital; (ii) develop integrated simulation model to analyse unwarranted variations on a care pathway of a hospitals; and, (iii) develop analytical and simulation models to analyse unwarranted variations from a care pathway. Current process modelling methods to represent healthcare services rely on simplified flowchart of patient flow obtained based on on-site observations and clinician workshops. However, gathering and documenting qualitative data from workshops is challenging. Furthermore, resulting models are insufficient in modelling important service interactions and hence the resulting models are often inaccurate. Therefore, a detailed and accurate process modelling methodology is proposed together with a systematic knowledge acquisition approach based on staff interviews. Traditional simulation models utilised simplified flow diagrams as an input together with the historic system data for analysing unwarranted variations on a care pathway. The resulting simulation models are often incomplete leading to oversimplified outputs from the conducted simulations. Therefore, an integrated simulation modelling approach is presented together with the capability to systematically use heterogeneous data to analyse unwarranted variations on service delivery process of a hospital. Maintaining and using care services pathway within hospitals to provide complex care to patients have challenges related to unwarranted variations from a care pathway. These variations from care pathway predominantly occur due ineffective decision making processes, unclear process steps, their interactions, conflicting performance measures for speciality units, and availability of resources. These variations from care pathway are largely unnecessary and lead to longer waiting times, delays, and lower productivity of care pathways. Therefore, methodologies for analysing unwarranted variations from a care pathway such as: (i) system variations (decision makers (roles) and decision making process); (ii) patient variations (patient diversion from care pathway); are discussed in this thesis. A system variations modelling methodology to model system variations in radiology based on real time tracking data is proposed. The methodology employs generalised concepts from graph theory to identify and represent system variations. In particular, edge coloured directed multi-graphs (ECDMs) are used to model system variations which are reflected in paths adopted by staff, i.e., sequence of rooms/areas traversed while delivering services. A pathway variations analysis (PVA) methodology is proposed which simulates patient diversions from the care pathway by modelling hospital operational parameters, assessing the accuracy of clinical decisions, and performance measures of speciality units involved in care pathway to suggest set-based solutions for reducing variations from care pathway. PVA employs the detailed service model of care pathway together with the electronic patient records (EPRs) and historic data. The main steps of the methodology are: (i) generate sample of patients for analysis; (ii) simulate patient diversions from care pathway; and, (iii) simulation analysis to suggest set-based solutions. The aforementioned unwarranted variations analysis approaches have been applied to Magnetic Resonance (MR) scanning process of radiology and stroke care pathway of a large UK hospital as a case study. Proposed improvement options contributed to achieve the performance target of stroke services.

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KC, Binita. "ILLINOIS STATEWIDE HEALTHCARE AND EDUCATION MAPPING." OpenSIUC, 2010. https://opensiuc.lib.siu.edu/theses/256.

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Illinois statewide infrastructure mapping provides basis for economic development of the state. As a part of infrastructure mapping, this study is focused on mapping healthcare and education services for Illinois. Over 4337 k-12 schools and 1331 hospitals and long term cares were used in analyzing healthcare and education services. Education service was measured as ratio of population to teacher and healthcare service as the ratio of population to bed. Both of these services were mapped using three mapping techniques including Choropleth mapping, Thiessen polygon, and Kernel Density Estimation. The mapping was also conducted at three scales including county, census tract, and ZIP code area. The obtained maps were compared by visual interpretation and statistical correlation analysis. Moreover, spatial pattern analysis of maps was conducted using global and local Moran's I, high/low clustering, and hotspot analysis methods. In addition, multivariate mapping was carried out to demonstrate the spatial distributions of multiple variables and their relationships. The results showed that both Choropleth mapping and Thiessen polygon methods resulted in the service levels that were homogeneous throughout the polygons and abruptly changed at the boundaries hence which ignored the cross boundary flow of people for healthcare and education services. In addition they do not reflect the distance decay of services. Kernel Density mapping quantified the continuous and variable healthcare and educational services and has the potential to provide more accurate estimates of healthcare and educational services. Moreover, the county scale maps are more reliable than the census tract and ZIP code area maps. In addition, multivariate map obtained by legend design that combined the values of multiple variables well demonstrated the spatial distributions of healthcare and education services along with per capita income and relationships between them. Overall, Morgan, Wayne, Mason, and Ford counties had higher services for both education and healthcare whereas Champaign, Johnson, and Perry had lower service levels of healthcare and education. Generally, cities and the areas close to cities have better healthcare and educational service than other areas because of higher per capita income. In addition to numbers of hospitals and schools, the healthcare and education service levels were also affected by populations and per capita income. Additionally, other factors may also have influence on the service levels but were not taken into account in this study because of limited time and data.

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El, Enany Nellie. "Service user involvement in healthcare service development : knowledge, representativeness & the 'professional' user." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/14481/.

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Policy makers have increasingly regarded user involvement as an important dimension of service development. Current government policy advocates the involvement of service users in healthcare service development across all levels of an organisation, ranging from the level of individual service user to the development and improvement of health services (DoH 1992, 1999, 2001a, 2001b, 2003a, 2003b, 2004, 2005a, 2007a, 2007b, 201Oa, 201Ob, 2011, 2012). This has manifested in the creation of a number of public and patient involvement initiatives including Patient Advocacy and Liaison Services (PALS), Locals Involvement Networks (LINks), Patients Forums and more recently Healthwatch Organisations. User movements and policy pressures have also led to the formation of user led groups pushing for changes in health and social care. However, these groups often operate on the margins, and as such, lack the legitimacy to work alongside professionals in service development and improvement. Despite involvement being driven by policy, research suggests that user involvement is often tokenistic, unrepresentative (Contandriopoulos et al. 2004; Harrison and Mort 1998; Rowe and Shepherd 2002) and subject to a selection of those users deemed to be a 'safe pair of hands' (Hogg 1999, p. 100). Furthermore, user involvement has been exacerbated by the 'tick' box culture in healthcare and the growing managerialisation of public services, creating a smokescreen to authentic user involvement. A recent study (Lakeman et al., 2007) suggests that a hierarchy of service users has emerged based on knowledge and authority in the service user community resembling stratification akin to the profession of psychiatry. This study is a platform for this research which aims to offer empirical analysis to illuminate the processes of stratification which give rise to this hierarchy of service users, which Lakeman et aI.'s work suggested existed, but which was not empirically supported. In doing so, discussions centre along three main themes; knowledge, representativeness and the 'professional' user. Policies on user involvement have led to health organisations developing strategies around involvement where users are involved at all levels of the organisation. As well as these, a plethora of grass roots groups have gained momentum over the past twenty to thirty years (Hogg 1999, p.127) and in recent times with the support of user involvement legislations have gained greater legitimacy amongst professionals. However, organisations are in constant flux and as they become more embedded in the system and established, user-led groups may become 'professional' working closely with 'sympathetic' professionals (Hogg 1999, p.127). By applying theories from the sociology of professions on expert knowledge and jurisdiction in the context of user involvement policy and practice, I describe the processes that lead to the stratification of users and ultimately to unrepresentative involvement. Using two comparative cases of user involvement, one a top down initiative in mental health service provision and the other a user led stroke group with a focus on stroke service development and improvement, I examine the processes of involvement that give rise to unrepresentative user involvement. In doing so I hope to contribute to theories on user involvement by illuminating the processes which lead to the stratification of users and unrepresentative user involvement. The thesis beings by exploring the historic context of public participation and user involvement, the involvement process and debates around representativeness. This framework informs an analysis of rationales for user involvement and the challenges of involving the 'right' user. Using 40 in-depth semi-structured interviews, observations and documentary analysis the study presents insights of various actors' perspectives of the involvement process, non-representative involvement and the professional user. The remainder of the thesis presents and compares the empirical results from the two cases in mental health and stroke. The study draws on theories from the sociology of professions to highlight the processes which lead to the stratification of service users including their professionalisation. Akin to professionals, users were found to delineate jurisdiction using their expert knowledge and education, gained through the involvement process but also by drawing on their social status and previous professional work. The theoretical and policy literatures coupled with the empirical findings present a number of tensions. Policy directives on user involvement are awash with ambiguities resulting in different ideas of how involvement activities should be played out in practice. This is aggravated by the increasingly target driven NHS culture, where professionals often choose the easier option and involve those users who are known to them and who are usually more articulate and able. This results in the repeated involvement of a certain 'type' of user and the marginalisation of other 'lay' users leading to a hierarchy of users where a cadre of professional users dominate the user community casting other 'lay' users as amateurs.

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Afrasiabi, Rad Amir. "Business process modeling in Web service-based healthcare systems." Thesis, University of Ottawa (Canada), 2009. http://hdl.handle.net/10393/28422.

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Web services composition is an emerging paradigm for enabling inter and intra organizational integration, and a landscape of languages and techniques for modeling business processes in web service based environments has emerged and is continuously being enriched. With the advent of modeling standards, different business sectors are investigating the options for modeling their workflows. In terms of business process modeling, healthcare is a rather complex sector of activity. Indeed, modeling healthcare processes presents special requirements dictated by the complicated and dynamic nature of these processes as well as by the specificity and diversity of the actors involved in these processes. Little effort has been dedicated to evaluating the capabilities and limitations of modeling languages based on healthcare requirements. This thesis presents a set of healthcare requirements and proposes an evaluation framework for process modeling languages based on these requirements. The suitability of three major process-based service composition languages, namely BPEL, BPMN and WS-CDL, is evaluated.

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Gombera, Peter Pachipano. "A risk management system for healthcare facilities service operators." Thesis, University of Derby, 2003. http://hdl.handle.net/10545/202349.

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Boström, Jonas. "Knowledge for Improving Healthcare Service Quality : Combining Three Perspectives." Licentiate thesis, Mittuniversitetet, Institutionen för kvalitets- och maskinteknik, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-40073.

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The Swedish public sector in general, and healthcare specifically, is struggling with large deficits: 19 of 21 regions have large negative results in 2019. The demands made by the citizens and their elected politicians that healthcare should offer effective, accessible, good and equal care are difficult to meet. However, when it comes to emergency care, Swedish healthcare scores high on international rankings. The difficulties and challenges today lie in ensuring good and equal care for the large groups of people with multiple illnesses, and patients who need long-term care from different healthcare providers. A complicated system has become even more complex. Organizational research has shown conflicts between different ways of working to improve and change the organization and the methods that support the daily work of providing healthcare services. Furthermore, quality research shows that there are knowledge gaps to be filled when it comes to understanding how complex problems should be handled and what kind of knowledge could contribute. This also applies to the tensions and conflicts that can arise when knowledge from patients, other professions and fields of knowledge must be integrated with the knowledge that the professions (physicians, nursing) possess. Several public organizations have in recent years also adopted methods, tools and approaches from the design field. Especially user involvement (human-centric), collaboration and visualization. Design research often highlights the methods which are favorable for handling complexity. The overall purpose of this thesis was therefore to gain a deeper understanding of how the quality development work in healthcare is expressed and how it is affected when different perspectives of knowledge are integrated - with a focus on improvement knowledge, professional knowledge and design thinking. Since the purpose of the licentiate thesis was to gain a deeper understanding of what happens when new knowledge to develop quality in healthcare emerges, the method is based on a qualitative approach. Three research questions were formulated and led to three studies. The first study, a literature review, showed that there is limited research in the area but that there are indications that user involvement in development work affects employees' attitudes and values. In study number two, a case study was set up using design methods and involving users. The results showed tensions between the improvement work and the daily clinical operations. This tension could primarily be attributed to the conflict between faster and slowerxviprocesses (doing and thinking), when moving between different practicing skills (design, improvement and professional). The last study aimed to understand more about the management's view of this, relatively new knowledge (design) in healthcare, in relation to the traditional way to work with improvement and change. The result stresses that there are potential conflicts between the different fields of knowledge. But the interviews were also interpreted as showing the synergy effects that can arise when different practitioners meet, and the results also show that different ways of thinking can challenge the traditional ways of handling improvement and change in the development of healthcare. The thesis result overall strengthens the research that shows that design can add another dimension to traditional improvement work in healthcare. However, there is also frustration about something which is perceived as more abstract and reflective and which can sometimes be slower than what the solutions-oriented professions, who work under great time pressure and with scarce resources, are used to. Furthermore, the thesis highlights the problem that also has been described in previous research and which signals the (in)ability to both share new knowledge and to absorb it.

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Khoo, Chow Huat Winston. "Internationalisation of private healthcare firms from Singapore." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/internationalisation-of-private-healthcare-firms-from-singapore(9ace1d62-009a-4a79-b23e-183d16984cd3).html.

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This research studies the phenomena of hospital groups expanding beyond their home country by setting up operations in less developed countries, and patients travelling out of their country for healthcare services, by looking at the internationalisation of private healthcare firms from Singapore. The research helps to address a gap in the literature as there is a lack of firm-level research on internationalisation of healthcare firms, and even more so for firms from Southeast Asia. For practitioners, the research offers a better understanding of the internationalisation strategies and choices adopted by healthcare firms, and more generally, service firms. With the region which Singapore is part of undergoing rapid integration, the study also offers useful insights on the impact of regional integration on internationalisation of healthcare firms. Using a multiple-case study of four private healthcare firms from Singapore, the research examines the where (market selection), how (entry modes) and when (timing) of their internationalisation, as well as their response to regional integration, in the context of existing literature on internationalisation of firms. The study shows that the internationalisation strategies of healthcare firms from Singapore, in relation to market selection, entry modes and timing of entry, were well-explained by existing theories on internationalisation of firms. Family ownership was identified as a reason for the deviation from theory for one of the cases. Specifically on the internationalisation of healthcare firms, the study shows that healthcare services in Singapore is undergoing commodification, with increasing use of and emphasis on 'marketing' to procure patients-customers; increasing emphasis on quality; and the creation of customers and consumers. This has made healthcare services increasingly 'exportable' in the sense that they can be 'sold' overseas away from the point of 'production', via representative offices, instead of having to rely on higher commitment non-export entry modes as indicated in the literature. Another deviation from literature was the case firms' stated preference to make market entry using management contract instead of joint venture. This can be attributed to their strategic need to internationalise quickly and the high cost of building new healthcare facilities. Using the findings from the analysis, the thesis proposed a characterization of the internationalisation strategies of a healthcare firm from Singapore, in terms of market selection, entry modes and timing of entry. A conceptual model on the internationalisation of healthcare firms was also developed, identifying the factors which may influence the internationalisation of healthcare firms. Besides, the study identified that the healthcare firms went through four phases of internationalisation process, namely, learning, opportunistic, de-internationalisation and maturisation, with each presenting some unique patterns of internationalisation by the firms. Further analysis showed that the four phases tied in well with the 'Link-Leverage-Learn' framework of Mathews (2006) for emerging/second wave multinational enterprises (MNEs), hence offering a new perspective for evaluating the internationalisation of such firms in future. On impact of regional integration, a possible 'ideal' model for a healthcare MNE in an economically integrated region was proposed. Applying the model, it is proposed that internationalisation by healthcare MNEs will increase as the region integrates, and there will be further consolidation within the industry. Healthcare MNEs from small countries like Singapore are likely to compete particularly strongly, as they are under even greater pressure to secure the foreign markets given the constraint of their small domestic population.

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BRANDTER, TOBIAS, and TORBJÖRN KÖLZOW. "The combination of Lean and Service Design - development of a communication tool for healthcare services." Thesis, KTH, Maskinkonstruktion (Inst.), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-192522.

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Inom vården kämpar man idag med ineffektiva arbetsprocesser och strama monetära tillgångar för att möta utmaningar som kommer med en allt äldre befolkning och de krav som detta ställer på vårdapparaten. Som ett svar dessa problem har detta examensarbetet fokuserat på att förbättra arbetsprocesser på ett akutsjukhus i Stockholmsregionen och göra dessa tids- och kostnadseffektiva samtidigt som man vill bibehålla en hög patientsäkerheten. Genom att kombinera Lean och tjänstedesignmetoder identifierades, efter observationer och intervjuer, icke-värdeskapande aktiviteter under ett operationsförfarande på centraloperationsavdelningen. Utifrån dessa togs lösningar fram för att förbättra de största problemområdena. Under tre arbetsiterationer analyserades och förbättrades konceptet. Det slutliga konceptet var en lösning för att förbättra kommunikationen mellan anestesiavdelningen och uppvakningsavdelningen. Genom att delautomatisera kommunikationen med hjälp av IT- systemet för operationsplanering kan UVA-koordinatorn göra en preliminär platstilldelning proaktivt och på så sätt undvika onödig telefonkommunikation i patientkristiska lägen. Denna visas sedan för anestesiavdelningen i operationsplaneringsprogrammet Orbit samt på en slavskärm vid ingången till uppvakningsavdelningen. Studien visade på positiva praktiska resultat för kombinationen av Lean och tjänstedesign. Den användarcentrerade utvecklingsmodellen skapade en stark förankring hos personalen av förändringsarbetet med Leanprocesser. Vidare sågs styrkor med tjänstedesign i att identifiera och tydliggöra kundvärde. En potentiell svårighet som diskuteras är huruvida det användarcentrerade arbetssättet passar för andra implementationsnivåer. Studien erbjuder inte en färdig verktygslåda för kombinationen av Lean och tjänstedesign men väl praktiska exempel som kan vara en grund för vidare studier.
In healthcare today there is a constant struggle with inefficient work processes and tight monetary assets to meet the challenges that come with an aging population and the demands it puts on the health care system. In response to these problems, this thesis focused on improving working processes at a large hospital, in Stockholm Sweden, and solving the problems to achieve a higher time and cost efficiency while maintaining a high level of patient safety. Non-value adding activities during a surgical procedure at the central surgical department were identified after observation and interviews by combining Lean and service design methodology. Design solutions based on these activities were developed to improve the most problematic areas. During three work iterations the concepts was analyzed and improved. The final concept was a solution to improve communication between the department of anesthesia and recovery section. By implementing semi-automated communication in the IT system for operation planning the recovery room coordinator can do a preliminary bed allocation proactively, thus avoiding unnecessary telephone communication in care intensive situations. The bed allocation information is then displayed for the anesthesia department in the operation planning program Orbit and on a screen at the entrance to the recovery section. The study indicated positive results of the combination of Lean and service design. The usercentered development method created a strong support for the change towards Lean processes amongst the employees. The service design methodology proved useful in identifying and clarifying customer value. A potential weakness in adapting the user-centered method to other levels of Lean implementation was discussed in the study. The study does not provide a plug and play toolkit for the combination of Lean and service design. It rather provides a practical example for future studies on the subject.

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Casteberg, Anna, and Emelie Hägglund. "Lean : En komparativ studie mellan Lean Service och Lean Healthcare." Thesis, Södertörns högskola, Institutionen för ekonomi och företagande, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-9402.

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Kervall, Fredrik. "Standards and Business Aspects of Service Oriented Architectures in Healthcare." Thesis, Blekinge Tekniska Högskola, Avdelningen för programvarusystem, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-4801.

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Extensive efforts are being conducted in the area of integrating and merging together applications and systems in public administration, including healthcare. One approach against integrating applications is to introduce a Service Oriented Architecture (SOA). This could be conducted by modifying the previously stand-alone systems and make them act as services or components, communicating through some sort of common services or directly interoperate. This thesis describes several standards and best practices addressing integration currently present in healthcare. Additionally, a number of business key aspects connected to Service Oriented Architectures are described and also how customers and contractors could benefit from these. By conducting an industrial case study of an integration project, standards and business aspects could be applied and used to analyze the project. Both software engineering issues and business aspects are identified, important to the study.

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Gimenes, Douglas Almeida. "Lean Sigma Applications to Service Departments in the Healthcare Industry." OpenSIUC, 2011. https://opensiuc.lib.siu.edu/theses/591.

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The Health Care System has struggled with many problems such as medical errors, poorly designed processes, waste, and customer dissatisfaction. The Lean Six Sigma methodology has been shown to be efficient in solving problems in the manufacturing industry and in services, as well. In this study, a framework for applying Lean Six Sigma to the health care industry is presented. The framework depicts a systematic methodology to solve problems typically found in this industry. A case study is also presented on how to apply this framework. The DMAIC Model has been conducted in an Imaging Department to identify the root causes of problems and to define a future state of the process

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Jia, Hao. "A web application for Medasolution Healthcare Company customer service system." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2612.

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Medasolution is a virtual company designed by the author to handle Medicare insurance business. The web application (which uses ASP.net and SQL Server 2000) facilitates communication between Medasolution and all its clients: members, employers, brokers, and medicare providers through separate web pages based on their category levels. The program incorporates security so that it follows government privacy rules regarding client information.

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Engström, Jon. "Co-creation in Healthcare Service Development : A Diary-based approach." Licentiate thesis, Linköpings universitet, Kvalitetsteknik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-78717.

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The patient is the only person who experiences the complete course of a healthcare problem, from first symptom to any contacts with the healthcare system to examination, treatment, follow-up activities and rehabilitation. The aim of this thesis is to explore how caregivers, together with patients, can draw on the knowledge patients acquire from their experiences in healthcare service development. This represents a break with the traditional role of the patient, which has been one of a passive receiver of care, following a supplier-centered view on value creation, which has increasingly been challenged both in the healthcare management discourse and in service research. Instead it is argued that value can only be co-created with customers, or patients in the case of healthcare. This means that the patients’ value-creating processes and contexts need to be emphasized and that patients are seen as a possible resource in their own care but also in the development of services and products. Despite this change in discourse, practical methods and empirical studies concerning patient involvement are scarce. This thesis adds to the field through an empirical exploration of co-creation in the development of healthcare. Through an action research approach, researchers and healthcare personnel have collaborated to develop a model for involving patients in service development, by inviting patients to share ideas and experiences through diaries. A workable, three-phase (preparation, execution and learning) model for patient involvement through diaries has been developed, and applied in three clinics (orthopedic, rehabilitation, gastro). A total of 53 patients from the different care processes have contributed ideas and experiences using paper and pen diaries or blogs, or by calling an answering machine. By doing so for a period of 14 days, the patients have submitted a total of 360 ideas. Three ways are proposed for utilizing the rich data submitted by the patients in service development. First, ideas from diaries can be used as input for service development. Second, a larger sample of diaries can be used to create a report of patient experiences, in which problem areas in the care process can be identified, and combined with other statistics. Third, individual patients’ stories can be highlighted and serve as a basis for discussion in the organization to shift the focus to the patient’s experience, serving as a motivator for change within the caregiving organization. The study shows that patients can share ideas and experiences regarding a range of topics, including clinical, organizational, social, informational, and practical issues and attitudes among healthcare staff. The contexts to which these ideas and experiences applied were caregiver, home, extended caregiver, and work, and often concerned topics and aspects of the patient’s care process that are invisible to the caregiver. Although healthcare organizations should be aware of the limitations to participation an illness may imply among some patients, patient co-creation in service development provides several important benefits. Acquiring knowledge regarding the parts of the patient’s care process that are invisible to the caregiver is key to improving care and supporting patients’ work of healing and managing life. Patients’ insights and creativity are an untapped resource for development of many aspects of the healthcare process.

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Sugarman, Philip A. "A model of integrated healthcare governance." Thesis, University of Northampton, 2009. http://nectar.northampton.ac.uk/2716/.

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The history of psychiatry is littered with serious failures of governance, to the detriment of mentally disordered people, especially those resident in psychiatric hospitals. Current mental health providers, increasingly focussed on community care, have also struggled to develop effective internal governance systems. Nine peer-reviewed research papers, published by the author (mostly with others) and the wider literature, reveal deficits in mental health governance at a jurisdictional, professional, and corporate level. In this thesis new governance solutions are developed against this background, built on contemporary principles in mental health and healthcare management. A new model of mental health governance is presented, based on the key demands of the strategic and regulatory environment, articulated as rights, risks and recovery. This integrated healthcare governance approach, covering provider policy, staff training and service audit, can monitor and ensure the protection of patients’ rights, as well as those of others; it also promotes the management of clinical risks, and of patients’ recovery outcomes. Rights-based risk-reduction training is the core interventional element of the model, whilst the monitoring element can be formalised as part of a Balanced Scorecard reporting system. This thesis makes a contribution to research methodology, theory and practice in mental health, human rights, healthcare management and governance. The model generates specific propositions for testing in mental health governance, with the potential for application in wider settings of service provision.

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Allen, Susan. "Creating an integrated nursing team within primary healthcare : an action enquiry approach." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/27841.

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This thesis is based on a journey towards developing team working within a primary healthcare setting which enabled the NHS agenda for primary care service delivery to keep pace with the government modernisation agenda. (Department of Health, 1997). Initially the focus was on the development of an integrated nursing team which enabled all disciplines of nurses to work towards a patient focussed healthcare service, but it soon became evident that all staff involved in delivering the primary healthcare service were essential to the process and developments of the enquiry if the objective was to be achieved. An action enquiry approach based on collaborative and participative action research (Carr and Kemmis, 1986; Lincoln and Guba, 1989; Cayer, 1997) was discussed and was the prime method of enabling changes to occur in the healthcare practice. This is represented by the interrelated four main cycles of enquiry that have emerged from the data, and discussed in this thesis. Key to the success of the developments was an understanding of team working and leadership as it applied within a healthcare setting and also the underlying dynamics, which are evident when different professional groups from different traditions and knowledge base work together. (Schon, 1983) This was explored within the context of a systems approach to organisational development and through reflective dialogue along the principles advocated for creating a learning organisation. (Senge, 1990) This thesis will demonstrate how confidence developed in myself and the practitioners, especially those from marginalised groups, and how the wider healthcare system made an impact on the developments within the practice. The area of leadership will be discussed from multiple perspectives and recognition that as a concept all stakeholders had a poor understanding of leadership. The key finding from this study identifies the need for a holistic approach to manage and sustain change, and indeed everyday productive working relationships. This especially identifies the importance of giving attention to the preparation of future healthcare workers, the appropriateness of organisational structures in which services are delivered and support structures available to those in team leadership positions.

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Johnson, Geoffrey Stuart. "Managed empowerment in the modernised National Health Service." Thesis, University of Sussex, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341531.

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Hadziabdic, Emina. "The use of interpreter in healthcare : Perspectives of individuals, healthcare staff and families." Doctoral thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-14418.

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This thesis focuses on the use of interpreters in Swedish healthcare. The overall aim was to explore how individuals, healthcare professionals and family members experience and perceive the use of interpreters in healthcare. The study design was explorative and descriptive. The thesis included Serbo-Croatian(Bosnian/Croatian/Serbian)speaking individuals(n=17), healthcare professionals(n=24), official documents(n=60)and family members(n=10)of individuals using interpreters in healthcare. Individual interviews, written descriptions, review of official documents in the form of incident reports from a single case study and focus group interviews were used to collect data. Data were analyzed using phenomenography, qualitative content analysis and qualitative data analysis of focus group interviews. The overall finding from all perspectives was the wish to have a qualified interpreter whose role was as a communication aid but also as a practical and informative guide in healthcare. The perception of a qualified interpreter was someone highly skilled in medical terminology, Swedish and individuals’ native language with ability to adapt to different dialects, wearing non-provocative and neutral clothes, of the same gender, with a professional attitude and preferably in personal contact through face-to-face interaction. Besides being a communication aid, the interpreter was perceived as having an important role in helping individuals to find the right way to and within the healthcare system because foreign-born individuals were unable to understand information in healthcare. Another aspect was to have a well-developed organization with good cooperation between the parties involved in the interpretation situation, such as patients, interpreter, interpreter agency, family members and healthcare professionals to offer a good interpretation situation. In conclusion, the use of an interpreter was determined by individual and healthcare situational factors. Individualized holistic healthcare can be achieved by offering and using high-quality interpreters and cooperation within a well-developed interpreter organization. Keywords: communication, healthcare service, patient-safe quality care, qualitative data collection, qualitative data analysis, users’ perceptions/experiences, utilization of interpreters.

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Lee, Seung Yup. "Proactive Coordination in Healthcare Service Systems through Near Real-Time Analytics." Thesis, Wayne State University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10839804.

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The United States (U.S.) healthcare system is the most expensive in the world. To improve the quality and safety of care, health information technology (HIT) is broadly adopted in hospitals. While EHR systems form a critical data backbone for the facility, we need improved 'work-flow' coordination tools and platforms that can enhance real-time situational awareness and facilitate effective management of resources for enhanced and efficient care. Especially, these IT systems are mostly applied for reactive management of care services and are lacking when they come to improving the real-time "operational intelligence" of service networks that promote efficiency and quality of operations in a proactive manner. In particular, we leverage operations research and predictive analytics techniques to develop proactive coordination mechanisms and decision methods to improve the operational efficiency of bed management service in the network spanning the emergency department (ED) to inpatient units (IUs) in a hospital, a key component of healthcare in most hospitals. The purpose of this study is to deepen our knowledge on proactive coordination empowered by predictive analytics in dynamic healthcare environments populated by clinically heterogeneous patients with individual information changing throughout ED caregiving processes. To enable proactive coordination for improved resource allocation and patient flow in the ED-IU network, we address two components of modeling/analysis tasks, i.e., the design of coordination mechanisms and the generation of future state information for ED patients.

First, we explore the benefits of early task initiation for the service network spanning the emergency department (ED) and inpatient units (IUs) within a hospital. In particular, we investigate the value of proactive inpatient bed request signals from the ED to reduce ED patient boarding. Using data from a major healthcare system, we show that the EDs suffer from severe crowding and boarding not necessarily due to high IU bed occupancy but due to poor coordination of IU bed management activity. The proposed proactive IU bed allocation scheme addresses this coordination requirement without requiring additional staff resources. While the modeling framework is designed based on the inclusion of two analytical requirements, i.e., ED disposition decision prediction and remaining ED length of stay (LoS) estimation, the framework also accounts for imperfect patient disposition predictions and multiple patient sources (besides ED) to IUs. The ED-IU network setting is modeled as a fork-join queueing system. Unlike typical fork-join queue structures that respond identically to a transition, the proposed system exhibits state-dependent transition behaviors as a function of the types of entities being processed in servers. We characterize the state sets and sequences to facilitate analytical tractability. The proposed proactive bed allocation strategy can lead to significant reductions in bed allocation delay for ED patients (up to ~50%), while not increasing delays for other IU admission sources. We also demonstrate that benefits of proactive coordination can be attained even in the absence of highly accurate models for predicting ED patient dispositions. The insights from our models should give confidence to hospital managers in embracing proactive coordination and adaptive work flow technologies enabled by modern health IT systems.

Second, we investigate the quantitative modeling that analyzes the patterns of decreasing uncertainty in ED patient disposition decision making throughout the course of ED caregiving processes. The classification task of ED disposition decision prediction can be evaluated as a hierarchical classification problem, while dealing with temporal evolution and buildup of clinical information throughout the ED caregiving processes. Four different time stages within the ED course (registration, triage, first lab/imaging orders, and first lab/imaging results) are identified as the main milestone care stages. The study took place at an academic urban level 1 trauma center with an annual census of 100,000. Data for the modeling was extracted from all ED visits between May 2014 and April 2016. Both a hierarchical disposition class structure and a progressive prediction modeling approach are introduced and combined to fully facilitate the operationalization of prediction results. Multinomial logistic regression models are built for carrying out the predictions under three different classification group structures: (1) discharge vs. admission, (2) discharge vs. observation unit vs. inpatient unit, and (3) discharge vs. observation unit vs. general practice unit vs. telemetry unit vs. intensive care unit. We characterize how the accumulation of clinical information for ED patients throughout the ED caregiving processes can help improve prediction results for the three-different class groups. Each class group can enable and contribute to unique proactive coordination strategies according to the obtained future state information and prediction quality, to enhance the quality of care and operational efficiency around the ED. We also reveal that for different disposition classes, the prediction quality evolution behaves in its own unique way according to the gain of relevant information. (Abstract shortened by ProQuest.)

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Altintakan, Umit Lutfu. "Design And Implementation Of Semantically Enriched Web Services In The Healthcare Domain." Master's thesis, METU, 2004. http://etd.lib.metu.edu.tr/upload/12605696/index.pdf.

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Healthcare Informatics suffers from the lack of information exchange among domain partners. Allowing cooperation among distributed and heterogeneous applications is a major need of current healthcare information systems. Beyond the communication and integration problems, medical information itself is by nature complex, combined with data and knowledge. The increasing number of standards and representation of the same data in different structures using these standards constitute another problem in the domain. Platform and implementation independency makes Web service technology the natural way to solve the interoperability problems in the healthcare domain. Standardizing the access to data through WSDL and SOAP rather than standardizing the electronic health record will help to overcome the integration problems among different standards in medical information systems. However, introducing Web services to the healthcare systems will not suffice to solve the problems in the domain unless the semantics of the services are exploited. This thesis aims to show that by generating web services and classifying these services through their functionalities, it is possible to achieve the interoperability among healthcare institutes, such as hospitals. The designed system is based on Artemis P2P Framework, and the annotation of the system is realized in the same framework.

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Gallagher, Martha S. "The Impact of an International Healthcare Mission on Participating Healthcare Professional Students." University of Toledo / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1083527751.

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Vassen, Ansuya. "Determining and improving the level of service quality at International Healthcare Distributors." Thesis, Port Elizabeth Technikon, 2002. http://hdl.handle.net/10948/82.

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The levels of service quality at International Healthcare Distributors (IHD) have been determined. Service quality in organisations require a strong emphasis on customer service and service delivery processes. The main area of this study focuses on the need for appropriate levels and criteria of service quality that will satisfy customers of pharmaceutical distributors. Various determinants affecting service quality levels have been discussed. The nature of service quality has been outlined and customer expectation standards have been determined. Customer satisfaction versus service quality has been discussed and the consumers’ perceptions towards service quality have been identified. Obstacles to attaining service quality have been described and potential causes of service quality shortfalls have been defined. Various surveys were studied to determine the implementation of service quality dimensions in a variety of disciplines. A sample was taken from the IHD customer base and a questionnaire was designed and distributed to the customers. The questionnaire examined five dimensions, tangibility, reliability, responsiveness, assurance and empathy. There was a hundred percent response rate. The results indicated that the tangibility dimension was highest in terms of customer agreement and reliability the lowest. The results of the questionnaire have proven that two of the hypotheses are negative and one positive. Concluding remarks and recommendations were highlighted and it is evident that IHD needs to improve its level of service quality in order to meet their customer requirements.

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Namana, Subhadra, and Sanar Al-Dori. "Healthcare Management : Measuring patient satisfaction of service quality in Swedish dental clinics." Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-37082.

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ABSTRACT:Healthcare management is a field that is related to management, leadership, and service of anorganization. Due to high competition and change in the environment of healthcare organizations,managers need to embrace the innovation to respond to those changes and make the organizationsuccessful by improving the process, structure, and culture of the organization as well as to provideefficient and effective care that will lead to achieve patient satisfaction. Service quality is one ofthe key factor among the service innovations that contribute to business development and leadingposition in the business world with high competition. Patient satisfaction is important for anyhealthcare organization. Patient satisfaction improves hospital/clinic image, which changes into anincrease in the use of services provided by the healthcare systems and increases market share.Patient satisfaction is dependent on the service quality which is the main factor in healthcareinnovations.Purpose: The purpose of this study is to understand experience levels of the patient satisfaction ofservice quality in Swedish dental clinics, based on the factors affecting dental service quality.Data Sources: Interviews with staff from six clinics in Sweden, 240 patient surveys from twopublic and two private Swedish dental clinic, group interviews with three Swedish dental clinics,Science-Direct, Research Gate, ABI Inform, Google Scholar, Academia.edu.Method: This study is based on the quantitative and qualitative analysis (i.e., mixed methodapproach) and abductive approaches to measure patient satisfaction in Swedish dental clinicsthrough service quality. The problem is analyzed through interviews with the staff in private andpublic dental clinics. The factors affecting the dental service quality are analyzed throughtheoretical and empirical analysis. The patient’s satisfaction was measured by SERVQUAL toolthrough using patients’ survey that consists of 12 questions based on the four factors (tangibility,empathy, responsiveness, and Assurance). Patient survey is conducted in four dental clinics. SPSSwas used to calculate mean and standard deviation for the survey’s result. After analyzing the result,group interviews with clinic 1, clinic 3 and clinic 5 was conducted to understand different valuesin the tool i.e., the value created, value destroyed, and value missed based on the customerperception to analyze the service quality of the dental clinics.Findings: The result from the surveys showed that the factor empathy has highest positive affectand responsiveness has the lowest effect in four dental clinics. The lowest effect in the factorresponsiveness is based on the waiting time to meet a dentist. The group interviews gave us thedifferent values which are based on the idea of the value mapping tool in customer perspective.The value that the clinics gained trust from their patients. The value missed\destroyed is the waitingtime to meet a dentist. The new opportunities are to improve the services by installing newtechnology products and changing the appearance of the clinic.

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Rust, Tom. "Dynamic Analysis of Healthcare Service Delivery: Application of Lean and Agile Concepts." Digital WPI, 2013. https://digitalcommons.wpi.edu/etd-dissertations/456.

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Hospitals are looking to industry for proven tools to manage increasingly complex operations and reduce costs simultaneously with improving quality of care. Currently, €˜lean€™ is the preferred system redesign paradigm, which focuses on removing process waste and variation. However, the high level of complexity and uncertainty inherent to healthcare make it incredibly challenging to remove variability and achieve the stable process rates necessary for lean redesign efforts to be effective. This research explores the use of an alternative redesign paradigm €“ €˜agile€™ €“ which was developed in manufacturing to optimize product delivery in volatile demand environments with highly variable customer requirements. €˜Agile€™ redesign focuses on increasing system responsiveness to customers through improved resource coordination and flexibility. System dynamics simulation and empirical case study are used to explore the impact of following an agile redesign approach in healthcare on service access, care quality, and cost; determine the comparative effectiveness of individual agile redesign strategies; and identify opportunities where lean methods can contribute to the creation of responsive, agile enterprises by analyzing hybrid lean-agile approaches. This dissertation contributes to the emerging literature on applying supply chain management concepts in healthcare, and opens a new path for designing healthcare systems that provide the right care, at the right time, to the right patient, at the lowest price.

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Andrews, Kathy M. "Best practices to establish successful mobile health service in a healthcare setting." Thesis, Pepperdine University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10251009.

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Alternative healthcare programs have been steadily flooding the health care market, with the most notable being mobile health. Mobile health, more popularly known as mHealth, is expected to generate upward of $59 billion dollars. This is astonishing, considering the mHealth market is still in its infancy as an alternative healthcare model. Still, there are over 100,000 mHealth smartphone applications and platforms on the market. The concept of offering affordable medical services that are accessible to anyone, at any time and in any place appeals to the mission and purpose of healthcare organizations. However, a large number of the studies and publications on mHealth are associated with the technologies behind mHealth and provide very little information on the practices and challenges associated with implementing mHealth, especially within a medical facility. For this reason, it was important to learn from executive health IT professionals who have successfully implemented mHealth services within the US healthcare system. Accordingly, the purpose of this study was to identify the practices used and challenges faced by CIOs in implementing mHealth technologies. The study also obtained recommendations CIOs believe are associated with successful mHealth services.

This was a qualitative study that used a phenomenology lens focused on the viewpoint of CIOs and the growing phenomenon of mHealth as a part of the U.S. healthcare system. This approach allowed the research to obtain data on the lived experiences of seven CIOs through semi-structured interviews who were identified as top experts by Becker Hospital Review publications. The analysis of their experiences revealed 13 best practices for mobile health implementation. The findings in this study aimed to identify how mHealth services could expand access to medical services by outlining key considerations and resources required for successful implementation.

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Heller, Rebecca Lily. "No missed opportunity : expanding sexual healthcare provision beyond current service delivery models." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/28997.

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Background: Despite a wide range of contraceptive options available in the United Kingdom, the unplanned pregnancy rate remains high. Contraceptive services are currently delivered by general practitioners, sexual health clinics and pharmacies, but there may be scope to expand the places that these are offered, and increase the options available within each service. Doing so could increase the uptake of contraceptive methods, particularly the most effective methods, and therefore reduce the unplanned pregnancy rate. Aim and objectives: Research in this thesis aimed to investigate novel delivery models of contraception. The research had two main areas of focus. Firstly the capacity of the pharmacy to deliver regular contraception was examined, in the context of existing literature, and then through a pilot study. After that the expansion of contraception care to maternity services was investigated, first in the literature and then using an observational study. Methods: In undertaking this thesis I used a variety of methods. Two patient surveys were employed to investigate patients’ perspectives on proposed novel methods of contraceptive delivery. A pilot study investigated the feasibility and acceptability of delivery of the contraceptive injection at the pharmacy. Quantitative results about the numbers of injections given were collected, as were patient questionnaires. Qualitative one-to-one interviews were conducted with participating pharmacists, these were recorded, transcribed and analysed. An observational study was also undertaken to assess routine delivery of insertion of intra-uterine contraception at the time of caesarean section. Patients were seen at six weeks following insertion, and contacted by telephone at three, six and 12 months about satisfaction and continuation of the method. Results: 220 women completed a questionnaire about attending the community pharmacy to receive a contraception injection. 33% of current non-users indicated that they would consider using this method if it was available at the pharmacy. 50 established users of the contraceptive injection participated in a pilot project receiving up to three injections from the community pharmacy. Only 48 injections of a possible 150 were delivered at the community pharmacy. Only 7 participants received all three injections at the pharmacy, and participants reported mixed experiences accessing the pharmacy. The practical obstacles around pharmacy engagement and the challenges of retaining participants were significant, and more research is necessary before proceeding with a randomised controlled trial. 250 women on a postnatal ward completed questionnaires about their pregnancy intentions. 96.7% were not planning a baby in the next year, but only 23.6% were planning on using the most effective methods of contraception. One in three respondents described themselves as likely to use either an implant or intra-uterine contraception if it could be inserted before they left the hospital. In an observational study, 120/877 women opted to have intra-uterine contraception inserted at the time of caesarean section. Continuation rates at 12 months were 84.8% of those contacted, and 92.6% were either ‘very’ or ‘fairly’ happy with their contraception. Conclusion: Although patients are receptive to contraception being delivered using novel service models, alternatives to current practice need careful investigation. Contraceptive injections at the community pharmacy are not necessarily more convenient for patients, and therefore may not increase uptake of this method. However, offering intrauterine contraception to patients at the time of caesarean section is highly acceptable to patients, and results in a substantial majority continuing this highly effective method. Robust and careful research using a range of methods can help to identify which innovative approaches to contraceptive delivery offer the most promise.

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Kwon, Junhyuk. "The Effect of Value Co-creation and Service Quality on Customer Satisfaction and Commitment in Healthcare Management." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804961/.

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Despite much interest in service quality and various other service quality measures, scholars appear to have overlooked the overall concept of quality. More specifically, previous research has yet to integrate the effect of the customer network and customer knowledge into the measurement of quality. In this work, it is posited that the evaluation of quality is based on both the delivered value from the provider as well as the value developed from the relationships among customers and between customers and providers. This research examines quality as a broad and complex issue, and uses the “Big Quality” concept within the context of routine healthcare service. The last few decades have witnessed interest and activities surrounding the subject of quality and value co-creation. These are core features of Service-Dominant (S-D) logic theory. In this theory, the customer is a collaborative partner who co-creates value with the firm. Customers create value through the strength of their relations and network, and they take a central role in value actualization as value co-creator. I propose to examine the relationship between quality and the constructs of value co-creation. As well, due to the pivotal role of the decision-making process in customer satisfaction, I will also operationalize the value co-creation construct. Building upon the “Big Quality” concept, this study suggests a new approach by extending the quality concept to include the value-creation concept in Service Dominant Logic. This study identifies the associated constructs and determinants of Big Quality in routine healthcare management service, and examines the relationship among the associated quality constructs, customer satisfaction, and customer commitment. This study employed an online survey methodology to collect data. In data analysis, I used the variance-based structural equation modeling (PLS-SEM) approach to confirm the factor structure, proposed model, and test the research hypotheses. The results show that the customer’s participation in in-role and extra-role behaviors are positively associated with their perceived quality, satisfaction, and commitment level. The major contribution of this study to decision sciences and the service quality literature is the development of a comprehensive framework explaining the importance of value co-creation within the context of healthcare quality. Finally, this work examines perceived service quality as a key factor of customer satisfaction and the relationship of Big Quality with commitment level in healthcare service management.

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Willems, Sharon A. "Employee satisfaction and its affects (sic) on customer service in a healthcare facility." Menomonie, WI : University of Wisconsin--Stout, 2005. http://www.uwstout.edu/lib/thesis/2005/2005willemss.pdf.

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Houser, Kurt J. "Personnel planning in the Medical Service Corps : a training guide for healthcare executives /." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1996. http://handle.dtic.mil/100.2/ADA324958.

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Thesis (M.S. in Manpower, Personnel and Training Analysis) Naval Postgraduate School, December 1996.
Thesis advisor(s): James A. Scaramozzino, Steven R. Lamar. "December 1996." Includes bibliographical references (p. 81-83). Also available online.

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Marufu, Masiya Passmore Alex. "ICT-based innovation using service dominant logic in healthcare : a design thinking perspective." Thesis, University of Pretoria, 2017. http://hdl.handle.net/2263/64294.

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Health professionals in the developing world face the twin challenge of growing populations requiring services and dwindling resources in the face of reduced funding. Developments in information and communication technologies (ICT) present an opportunity to streamline service offering in a way that maximises the available meagre resources. Such innovations require the input and support of the public that these institutions serve. Design thinking has over the last 20 years developed into a “design paradigm” that can assist service providers to craft solutions to problems that take into account the views of the stakeholders involved. This work explored how information technology can be used to improve service delivery. Adopting a pragmatic philosophical paradigm and a design science research approach, the researcher used concepts underlying the theory of service dominant logic, coupled with technology capability concepts, to develop a conceptual framework for use in design thinking projects. The development of the Technovation Framework continued over three design cycles, in which a number of design teams focused their efforts on how ICT could be used to improve post-natal care services. The empathy input for these workshops was derived from an eight-week-long in-depth study into the lives of new mothers, using journals and interviews. Interviews with midwives and doctors provided a healthcare perspective of the provision of post-natal care. The first design workshop was made up of four teams, each consisting of two midwives, two mobile developers and two mothers in a design thinking workshop. The workshop resulted in the development of four prototypes of mobile applications aimed at assisting midwives in educating mothers as well as providing off-site monitoring. Two further workshops were conducted, providing two more iterations of the design process and resulting in further prototypes of potential solutions for use in healthcare. A final evaluation workshop was conducted to validate the fully developed Technovation Process. This study contributes to knowledge in a number of ways. The first is a deep understanding of the lives of new mothers and challenges they face in a low-resource environment as they struggle with raising their babies in the first eight weeks after giving birth. The second contribution is a framework and an enhanced design thinking process that streamlines the process of consolidating empathy output while providing a mechanism to apply technology capabilities to proposed solutions. A third contribution is the set of lessons that arise from observing design teams at work. The final contribution is in the form of a number of prototypes that could be developed into solutions for use in a developing environment healthcare setting. Keywords: ICT in healthcare, e-Health, innovation, co-creation, design thinking, developing country, post-natal care, design science research, Technovation, technology capabilities
Thesis (PhD) - University of Pretoria, 2017.
Informatics
PhD
Unrestricted

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YE, LIANG-HONG, and 葉亮宏. "Mobile Indoor Healthcare Service System." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/nzg678.

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碩士
崑山科技大學
電腦與通訊研究所
104
Along with the development of mobile communication and smart handheld devices, wearable devices are honored as the important technology for next generation. The emergence of the concept of M-Health has changed people’s idea towards healthy life; to enable people to quickly know their health condition and avoid accidental injuries caused by bad physical condition, this study bases on indoor positioning combining with wearable devices to develop a mobile health promotion system; this study develops an integrated health promotion system which enables users to obtain real-time health information; when emergent accidents occur, this system enable users to know their current location and provide location-based services such as indoor positioning and route guidance; in addition, this system enables surrounding service user’s to monitor the user’s health condition and exercise habit, providing health inquiry service. Meanwhile, it enables users to wear in everyday living and measure all physiological parameters, assisting users to know their personal physical condition and promoting physical health.

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Chen, Shiuh-Bin, and 陳旭彬. "The Study of Business Model for ICT-assisted Healthcare Service Companies : Remote ICT-assisted Healthcare Service." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/54gh42.

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碩士
國立交通大學
管理學院高階主管管理碩士學程
101
It is evitable that Taiwan is soon approaching an ageing society, with a projected ageing population (65 years or older) accounting for 13.67% of the total population by 2017. Coming with this trend is the market demand for products and services to meet the needs of these relatively wealthy retirees, hence creating a unique niche and business opportunity that must not be overlooked. To properly address the health and ageing issues, the Government of Taiwan has announced corresponding policies and programs. The industrial, governmental and academic sectors have also been aggressively planning and developing a friendly and effective service platform to enable a sound business environment with high functionality. ICT-assisted remote healthcare services undoubtedly meet this need, therefore sparking a worldwide effort on research and development of innovative products and suitable business models. This paper is to study the business model of ICT-assisted health care service companies – targeting at ICT-assisted remote healthcare services. Major subjects under the study are:  Review of international policies and plans on healthcare of ageing society  Integration of ICT technology and healthcare service industry  Investigation of business model for remote ICT-assisted healthcare services In this study, it is found that, despite of the governmental effort in promoting remote healthcare services, the program has not been widely practiced yet. Experts have attributed the reasons as follows:  Inadequate national system (abuse of labor medical care system, uneven retirement annuity, restrictions of medical regulations)  Concept of remote healthcare not being widely accepted  Less-than-easy operability of technology-based service products  Unsure profit model resulting from problems of fee collection and pricing As a result, many companies opted to discontinue their effort in business development and services, after failing to secure a profit model and suffering from a long-term loss. Nevertheless, few companies are still active in this emerging business and there is a sign of business growth at this moment, hence warranting a further study and assessment of a feasible business strategy. An in-depth research reveals that, ICT-assisted remote healthcare represents an innovative technology-based service, which requires a horizontal split of work and vertical integration among different industries. In addition to the development and commercialization of performance-oriented ICT technologies, there is a need to incorporate other considerations, so as to ensure a complete product framework and a successful business model. In other words, a full integration of technology and service will necessitate the reflection and planning of an innovative business model which takes into account of both entrepreneurial and social values. Such a model should include the following aspects:  Humane services – a care-oriented business model with continual innovation strategy  Entrepreneurial value-chain initiative – value sharing with society and action plans  Measures to match the governmental policy on health promoting for ageing population That is to say, within the overall guideline of ensuring a short and long-term profitability, an enterprise needs to take an integrated approach towards establishing a key resource and flow system for value-added product services. During this study, an innovative business model for remote healthcare has been developed, based on Clayton M. Christensen’s “Reinventing Your Business Model” and Michael E, Porter’s “Creating Shared Value”, and verified against the case of a successful remote healthcare company. Company visit and expert interviews have been conducted. The results have confirmed our proposed business model for ensuring a successful remote healthcare operation. It also indicates that remote healthcare business is promising, but a comprehensive thinking and approach is a must for this industry. Continual product and service innovation to meet the dynamic needs of the clients has to go hand in hand with the corporate strategy of coping with the change of the social environment, to ensure the corporation’s economic profitability. This study suggests that, the remote healthcare industry has proven to be successful in advanced countries and the aged population enjoys a technology-enhanced healthcare service. However, the same has not been observed in Taiwan. It is our belief that, the lack of a comprehensive and integrated thinking as well plan on the side of both the industry and government is perhaps the stumbling block to its further growth. While aware of the potential business opportunity, there has no real effort in offering a value-added remote healthcare product and service. The community in general is insensitive to the benefits that technology-based healthcare products bring, particularly with respect preventive medical care. Rather, the ageing population still chooses to visit the clinics and hospitals when in illness. The remote healthcare for the ageing population triggers an interaction and value-sharing among the individual (aged people), family and community; government’s medical care resources, health and welfare policy; humane consideration and experience of technology-enhanced products; business model of cooperative industries and service platform. This indeed reflects a complex eco-system and business model. It is for this very reason that the government as well as the industry need to recognize the complexity of the involved issues, and work together to find a solution to resolve the hidden policy and resources problems. On the matter of policy, the government is recommended to make timely adjustments to the health promotion measures, set up necessary software and hardware systems to suitably care and relive the aged people, and revamp the relevant acts and regulations to facilitate the operation and growth of the healthcare industry for the aged population. Examples include: promotion and implementation of long-term care insurance, reasonable adjustment of remote medical care acts and regulations. As for the healthcare industry, it is highly suggested that a full spectrum of aspects must be considered and integrated, to consolidate the resources of different industries and service sectors. This full service and value sharing industry must weigh in the following business elements at the same level, including: technologies and services; individual as well as family and community; business profit and social benefits. This study concludes that, with the appropriate governmental support and regulatory adjustments, a suitable strategy for ICT-assisted remote healthcare needs to be built upon a core corporate value chain tied to social benefits, so as to plan a value-sharing business model, and design a short and long-term revenue-profit model considering the factors of individuals as well as the society

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HSIU-LI, CHEN, and 陳秀麗. "The Impact of Different Healthcare Provision on the Prison' Healthcare service." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/78905329623343163937.

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碩士
臺中健康暨管理學院
健康管理研究所
93
Abstract The purpose of this study was to investigate (1) prisoners’ satisfaction of health care quality provided by different correctional institutes and (2) the influenced factors associated with their satisfaction. Importance-Performance Analysis (IPA) was employed to investigate the health care services which needed to be improved urgently by correctional institutes. The study populations were the prisoners in nationwide correctional institutions in Taiwan. Correctional institutions were separated into five levels according to the types of health care services, scopes and regional distributions. Nine correctional institutions were selected using stratified random sampling method. A total of 1893 prisoners were included as the studied samples in this study. Among the six characteristics of health care services, “accessibility,” “comprehensiveness,” “appropriateness,” and “continuity” serviced were treated as the dimensions to evaluate health care quality. The descriptive statistics showed the prisoners’ characteristics; bivariate analysis explored the differences between prisoners’ satisfaction of different health care services and the percepts of their importance; linear multiple regression analysis was used to investigate the factors associated with the prisoners’ satisfaction of different types of health care services; finally, IPA was employed to find out the health care services which needed to be improved urgently. The results showed that the prisoners from different scopes of correctional institutions were significantly different in terms of the health care satisfaction and the percepts of their importance. Regression analysis indicated that the following factors had great impacts on prisoners’ satisfaction, such as (1) prisoners’ personal characteristics (age and education level), (2) health status (major/injured illness and chronics disease), (3) experiences of health care services (monthly expenditures of medication and monthly out-of-pocket fees for health care services), and (4) different health care services. In the light of difference types of health care services, the affiliation of hospitals had the greatest impact and followed by the percentage of out-of-pocket fees for health care services. In addition, the results of IPA analysis indicated that the top three health care services that the prisoners most satisfied with were “environmental hygiene,” “attitude/courtesy of hospital staffs,” and “attitude of physician’ consolations.” With respect to the percept of the importance of health care services, “the effect of medication,” “disease explanation,” and “the continuous trace of health care services provided by the correctional institutions” were prisoners’ primary concerns. Subjects also reported that the health care services which needed to be improved urgently were “the subsequent consultation provided by the correctional institutions after hospitalization” and “continuity.” Based on the result, this study provided the followings suggestions to the administration and fieldwork practice. The suggestions were (1) to establish the specific health care policy and responsibility for the provision of comprehensive health care service network, (2) to integrate health care resources for supporting the health care services between society and correctional institutions, and (3) to promote of the health care services model of Taichung prison Pei-te hospital. For the fieldwork application, the suggestions were (1) to build up prisoners’ medical history referred to the disease categories of Bureau of National Health Insurance (BNHI) dataset, (2) to establish the standard of medical expenditures specifically for out-of-pocket fees for medical services and medication, and (3) to reinforce of the continuity of prisoners’ health care services and to reach the goal of patient-focused health care services. Keyword : Correctional institution, Prisoner, Types of health care services, Quality of health care services, Satisfaction of health care, Importance - Performance Analysis

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Tsai, Jum-wei, and 蔡君瑋. "Consumer’s Preference in Mobile Healthcare Service." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/20733381649543354954.

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碩士
義守大學
企業管理學系碩士班
97
The importance of health management issues is increasing to the general public while the appearing status of aging population, increasing chronic disease, health knowledge and action to improve the development of communication technologies. Hospital in home and abroad, the preservation of the industry, telecommunication, mobile phones and related systems, such as equipment manufacturers have to invest in the industry, and actively develop actions related to mobile health management services, hope to have mobile management services to the health of the business opportunities that arise. Next to the skin through the action of people provided a mobile health management services to the public can easily grasp and manage their own health. Analysis and summary of this study was provided by domestic and foreign business operation and mobile health management services, the use of network analysis to explore the Taiwan region in patient with chronic disease patients with mobile health management services for the operation of the preferred, and consumers to further explore the service delivery model for the view and price. The results of this study pointed out that both the chronically ill or non-action preferences in patients with chronic disease and mobile health management services and service models are consistent. Services preferred action cases were mobile health management, mobile health education and counseling and mobile pharmaceutical operation security. Preferred mode of service interaction patterns were, storage and upload, storage. Consumer Mobile Health management services to the preference between the price of 101-500 million, preference to pay a one-month pay cycle Research data point out that though the Taiwan operations of local public mobile health management for the knowledge not yet universal, but the demand has already existed.

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Huang, Shih-Pei, and 黃世貝. "Business Models of Innovative Healthcare Service." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/13754362025493753938.

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碩士
國立臺灣大學
高階公共管理組
97
An aging population accompanied by the global trend of declining birth rates result in many industries facing a structural change. Its impacts on the expansion of need of medical and health services are facing shortage of supply-side pressures. Therefore, it subsequently squeezed out the demand for innovation in healthcare services and industry. Innovation of healthcare is by the way of re-examining the public health needs, identifying unmet health needs of valuable lives, especially in the existing medical institutions incapable of care to demand, followed by integration of health care, information and communication technology, long-distance healthcare call service, physiological measurement devices, user interface, and customer service processes such as cross-cutting health professional''s innovative business model, and then to provide cost and market price expected to serve different market segments and strata of customers. Innovative healthcare care industry has been the life cycle of many "innovators" to enter the "early adopters", but has not yet entered the "early majority" stage. At the current stage, many entrepreneurs try to operate a direct "B2C" model, but generally encountered difficulties in rapidly achieving market share, of which the phenomenon that the people have not been able to accept the price more than that people questioned the value of health services is the major factor. Therefore, in the real entry into the "early majority" stage, "B2B2C" model into the proper market segmentation is the key to success. Analyzing the market segments, the strategy of from medical institutions, business community, community, home, and then to action groups, is currently the reasonable market development strategy. Innovative healthcare service operators are required to integrate cross-cutting health care professional and processes, the establishment of different market segments with a flexible operation of the core competencies, including integration of the medical profession, the information and communication technologies, long-distance voice services, medical equipment, and customer service professionals, being the key of core competencies. The development strategy of innovation in healthcare services is how to develop brand and original service management, and to establish strategic partnerships, including medical, industrial, academic, and insurance institutions. Taiwan''s medical quality, operational efficiency and service exquisite degree of advanced countries such as the United States, Europe, and Japan, is the leading position in the Chinese living region, and therefore most have the opportunity to create health services brand. On the other hand, original service management is the model to enter the mainland or other countries, but the search for suitable strategic channel partners will be the key. Competitive advantage lies in how the layout of market positioning, and the implementation of the five executive factors, including integration of force (streaming systems, devices, interfaces, and services), research and development force (service management, hardware and software specifications, value-added services, innovation mode) , the bargaining power (cost control, economies of scale), original service management force (strategic partners, strategic channels) and brand strength (indicator of operating performance, corporate image marketing, corporate social responsibility). Proper positioning of market segments, well-planned recruitment and layout of capital and resources, and the implementation of executive factors are the key to success of innovative healthcare services.

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Colon, Jorge. "Service pricing for the healthcare professional." 2021. http://hdl.handle.net/10757/657213.

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Festival de Innovación Educativa de la UPC. Ponente: Dr. Jorge Colon
El primer FIE de la UPC es un espacio de docentes para docentes, en donde se compartirán las estrategias innovadoras de aprendizaje que se han venido aplicando en los últimos meses de educación online. Es una oportunidad para intercambiar conocimiento, seguir aprendiendo y atrevernos a innovar como parte del proceso de enseñanza y aprendizaje.

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Lochab, Rahul. "Service Innovation Framework In Complex Healthcare System." Thesis, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-44589.

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In the last two decades, Innovation in healthcare has brought about a significant transition from the conventional methods relating to activities within the healthcare system such as medical record journaling and patient diagnosis and additionally to the way clinical care is delivered to the patients. Service innovation as opposed to product innovation is the integration or positive increment of new or existing services cumprocesses in the system through the introduction of new methods, techniques, or abstract services. Healthcare industry is primarily a service driven sector. As compared to other industries it is unique given its setting. It is emotionally vulnerable, highly sophisticated and encounters life-death situations on a daily. Service innovation holds the key for large private multi-speciality to move forward.As of now, numerous challenges plague the healthcare sector such as increased healthcare costs, reduced monetary and ethical quality of clinical value care. Service innovation holds the key especially for large private multi-speciality to move forward towards. Inclusion of ancillary services such as rehabilitation,testing, nursing, emotional care coupled with digital service innovation (Telemedcine, Electronic health records, billing systems) overcome challenges of efficient billing, remote diagnosis, emotional burnout, and high medical expenditure for patients.The purpose of this thesis to underline the need for service-based innovation and its framework in correlation to a complex healthcare system. Case of an upcoming super-speciality Venkateshwara hospital located in New Delhi, India is analysed to answer the research question and understand theoretically the conflicting nature of barriers of different stakeholders involved in the process. Currently, most literature is centred around the importance of product innovation, with lacking focus on concept of service science. The study fills the gap by providing an exhaustive approach of defining service-based innovation within healthcare setting and addressing difference between product drive logic and service dominant logic. Additionally, a new service model is implemented utilizing NK Kauffman model and Greenhalgh’s (2008)eight pillar model.Since the Hospital is a private entity, paradox specific to healthcare that is “ethical vs economical” conundrum is assessed through primary empirics. Complexity of a tertiary healthcare organization is addressed in relation to the level of interrelatedness between services innovation. Venkateshwara as a multispeciality service system ranks into a highly complex organisation with high interrelatedness between varying components. Study is qualitative with explorative nature. Primary data is collected via semi-structured interviews and physical observation of the organization, while secondary data is collected via official website and brochures. Triangulation method serves the purpose of data analysis and rigour. Data Analysis section uses thematic coding to generate themes and complexity of Venkateshwara Hospital is mapped through component and interrelatedness graph.The discussion section puts forth detailed overview of over-arching and sub-themes coupled with collected data(Primary and secondary) to highlight the significance in need for service innovation. Results formally answer the research question. New services such as value-based care and telemedicine are discussed. Challenges specific to Venkateshwara hospital are put forth and categorized by needs of different stakeholders when implementing the service innovation framework. Concluding remarks include future need of service innovation. Lastly, theoretical, and practical implications of the study are provided.

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Lin, Chi-Chang, and 林繼昌. "Create Value of Orthopedic Healthcare: Business Model of Integrated Orthopedic Specialist Healthcare Service." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/95635359529680531501.

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碩士
國立臺灣大學
高階公共管理組
96
In the past decades, as the explosion of medical knowledge and progress of biotechnology science, the well-trained medical specialists are widely welcome and popularized, but the segmentation and discontinuity of specialist healthcare also demonstrate their weakness in treating the patient as a whole person rather than a specific organ system. Nowadays for the shortage of payoff system, many new or advanced healthcare items innovated especially by most medical specialists are denied by the insurance payer that patients should pay by themselves if they stick on the treatment. This promotes the development of specialist practice in public for maintenance of their economic level. With the balance of benefit of the general and specialist practice, integrated specialists service targeting the value of the patients might become a future mode of healthcare for their adequate population and excellent quality. This will be started with the integrated orthopaedic specialist practice. Before the implementation of integrated specialist practice, some concepts of healthcare service should be updated. The traditional medical mission for healthcare personels may be shift to value-added healthcare service industry. The idea of consumption health service has to be built up in addition to prerequisite medical service. The mystery of medical treatment should be released in a transparent, systemic format for health personels to follow. In order to achieve economic volume, the manpower type of market is to be replaced by the capital market through standard procedure in diagnosis and treatment with the aid of advanced modern informative technology. In addition to the core business of healthcare service for the patients who come to seek help from orthopedist specialists, there are many concerns before and after the management in the orthopedic healthcare value chain system. The business model of integrated orthopedic specialist practice service is to link all the possible niche market to create the value of the patients based on their points of view. In order for the avoidance of further bone trauma or disease, one should promote his status of health through delivery of medical knowledge, diet and healthfood prescription and participating in physical exercise and sport activity. In the post-orthopedic management healthcare, physical and occupational therapy is the golden link in this value chain to restore the functional loss. There are a lot of paramedical industry in supplying the materials, instruments and facilities in the orthopaedic service value chain. For the compensation of inadequate pay from the insurance, it is an opportunity to build up a new integrated healthcare system aiming for creation of patient value. By way of vertical integration of the healthcare value chain including sports, diet and health food for the health status and physical therapy after management, it will make a lock-in effect for the customers and the entry barrier for the competitors. The implementation of this integrated healthcare model comes from a setup of an agency service for the customers with orthopedic complaints and problems and an internet healthcare information system with web 2.0 format in data acquisition and a medical problem consulting service station in real world. The practice will start with one single disease or function disorder such as osteoporosis or inadequate height for the public. Its key success factor lies on the complete and consequent serial evaluation of patient’s body and function by way of intimate IT and software system. The fulfillment of integrated practice idea of medical specialists is not a step but a long way to go with interdisciplinary connection and cooperation. The ideal clinical practice network is achieved by re-integration of each integrated subunits of specialists practice in each special field. Its success will depend on the interconnectivity of the patient information and medical technical knowledge in the net for the prospect of value driven healthcare.

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Chen, Eric, and 陳達元. "The study growth strategy for healthcare service business:the case study of Excelsior Healthcare Group." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/33278962610731533585.

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碩士
國立政治大學
國際經營管理碩士班(IMBA)
97
ABSTRACT Taiwan government in March of 2009 announced that six emerging industries have been specially selected for intensive development. They were biotechnology, medical care, green energy, quality agriculture, cultural creative and tourism. ”Biotechnology Takeoff Package” was firstly launched on March 26. This package is expected to bring Taiwan’s biotechnology and medical service environment to international standards, and rapidly making it “trillion dollar industry.” However, resource is limited. Compared to other technology advanced countries such as America and Japan, Taiwan owns less population, smaller size economy and rather limited nature resources. How should Taiwan develop its specially selected industries? What would be the best strategy for Companies interested in entering these selected industries? The aim of this study is to explore the growth strategy of medical services related companies and to conclude with some useful suggestions for Companies interested in entering biotechnology and medical service industry. This paper uses a case to observe the growth path of medical service industry. The author collected the data relating to the case company from its annual reports and various periodicals, and then applied theories of growth aiming to conclude the successful strategies made by the company. The current study chooses the largest dialysis treatment services company in Taiwan, the Excelsior Health Care Group, as the case study subject. During its twenty-one-year development history, the Group has been growing through vertical and horizontal integration and entering joint ventures with diversified businesses, such as cosmetics medicine, long-term health care, pharmaceutical logistics services and various clinical services such as dental and eye clinical services. The growth strategy of the group can be decrypted in the models of “Resource Based View”, “Core Competence Theory” and “The Boston Matrix.” This research concludes that the company has made several successful strategies including (1) using financial leverage to gain sufficient funding to sustain its investment in new businesses, (2) basing its original core competence and development related to other core competencies, (3) extensively entering into joint ventures with partners when exploring new business.

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Wu, Wen Chin, and 吳文智. "Design of Drug Safety Service for Personal Healthcare." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/14494190225453680458.

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碩士
長庚大學
資訊管理學系
99
In the last hundred years the medical technology has advanced rapidly and the medical environment has improved a great deal, and the death rate consequently plummeted. As people live longer, the aging society began to experience increased medical expenses which, in turn, has become the primary burden to advanced nations around the world. The biggest component in the medical expenses today is associated with the treatment and care of patients with chronic illnesses. The treatment of chronic patients is mostly through applying drugs, and the interaction among drugs as well as the physiological characteristics of patients may cause undesirable side effects. Patients also may have misconceptions in drug applications. They purchased over-the-counter drugs or they go to a number of doctors for treatment simultaneously, causing the fragmentation of their medical information, which increases the risk of undesired drug interactions, not even mentioning the waste of resources on unused or wrongly used medicines. This research attempts to increase the drug safety through designing a patient-centered drug information system. Using existing standards to integrate the drug-usage information between different hospitals. We also provide personal drug records through cloud service to let user confirm the information easily, so that we can compare the information we saved with the medication safety system instantly. To identify the exclusive medicine and finally return it through a general user interface to medical institute which is need of complete drug usage information. Forming a overall drug safty condition for the patients. This study implements SOA (Service-Oriented Architecture) and develops modular service component for quick response to system changes.

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Ogunduyile, O. Oluwagbenga. "Integrating wireless body area networks with web services for ubiquitous healthcare service provisioning." 2013. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1001110.

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M. Tech. Information Networks
This dissertation reports on a prototype implementation of an architecture that seamlessly integrates Wireless Body Area Networks with Web services for ubiquitous healthcare service provisioning. The prototype ubiquitous monitoring system proactively collects body physiological signals of remote patients to recommend diagnostic services. The technologies that are based upon Wireless Body Area Networks and Web services can provide ubiquitous accessibility to variety of services by allowing distributed healthcare resources to be massively reused. This contributes to improving quality of healthcare services and shields individuals from physically moving to locations where healthcare services are provided, except in a critical situation. In addition, the technology can reduce costs of healthcare services by allowing individuals to remotely access services to support their healthcare. Especially our system is designed for ubiquitous monitoring of elderly and patients in recovery (or rehabilitation). The Wireless Body Area Networks - Web services architecture is at crossroad of embedded engineering of hardware, software and networking protocols. Testing of the prototype was carried out on enthusiastic volunteers and it has shown to be an efficient, reliable and support state-of-art service provisioning of ubiquitous healthcare monitoring in health sector.

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Tung, Yu-Wei, and 童羽薇. "An Investigation on How to Apply Design Thinking to Innovative Healthcare Service —A Case of Healthcare Service Innovation in Tele-Health." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/9x437p.

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碩士
國立臺灣大學
商學研究所
104
As technology improves, most industries transit gradually and customers’ needs also change constantly with the improvement of technology. To catch up on the speed of changing needs, modern corporations keep pursuing innovation and believe in the word of ‘ innovate or perish‘. Design Thinking is arising from this generation background. Using the core value of ‘human center’ to discover insight and reach the goals of innovation or improvement by systematically innovative methods and steps. Recently, technology of tele-healthcare has been gradually developed in Taiwan. Although we have the forth-generation tele-healthcare service, which can provide synchronous data analyzing function and high level of integration of patients’ care structure, tele-healthcare in Taiwan still need to be fine-tuned. Therefore, in this study, we will begin from ‘patient’s center’ and investigate the insight of service experiences of early users. At the meantime, we will conclude the constraints as well as possibilities of applying Design Thinking to innovative healthcare service. First, we synthesize the information of Design Thinking and Service Design methodically in order to get familiar with the methods and tools used in Design Thinking. Then we choose a hospital as our research target and finish one round of diverge and converge stage. Following the result of converging, we propose four recommendations to different parts, which are promotion, medical profession, tele-healthcare device, and case manager. In the end, we find that Design Thinking can exactly help us connect with interviewees and make them share their view or experience spontaneously, and develop insight as well. Meanwhile, there are some constraints such as differences between nature of medical service and general service. Besides, the law and regulations also become difficulties when we want to use Design Thinking methods to discover users’ insight.

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TSAI, SHU-YI, and 蔡淑宜. "Exploring the Perception of Healthcare Service Quality on the Technician for Caring Service." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/9cu99y.

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碩士
嘉南藥理大學
醫務管理系
105
In order to cope with the urgency of aging in Taiwan, the demand for technician for caring service is also increasing rapidly. However, the relevant research on nursing staff at home and abroad is obviously inadequate. As a professional and long-term care work has certain degree of specificity and complexity in the provision of health services to meet the needs of service users in the process, service users in the service quality satisfaction is the most concerned about the relationship with the technician for caring service, that is, to take care of service and service The relationship between the quality of the service will affect the quality of the service, so from the service users’ point of view to understand the feelings of receiving care services. And whether the institutional units have the ability to improve service quality and the use of service providers to establish a good interactive relationship between the various units to enhance the competitiveness of one of the important factors. Based on the service quality model, this study aims to explore the current situation of the quality of care services and how to improve the quality and cognitive quality of service providers and how to improve and improve the quality of care services.In this study, the service quality model of P.Z.B. was used as the theoretical framework, and the method of SERVQUAL scale and the degree of attention and performance analysis (IPA) was used as the tool to measure service quality in this study, and the service users were informed about the service and the status quo. This study discusses the current situation of service users' service quality and performance, and obtains the conclusion after the questionnaire survey by the organizations, nursing home and community. The results of this study show that the level of service quality of service users perceived the reliability, reactivity, assurance, empathy, tangibility and reliability are the most influential elements of overall service quality. The average of which is between 4.34-4.62, with the highest level of awareness that "I am comfortable with the caregiver of the caregiver and which ensures the safety of the case", "I have a sense of awareness of the caregiver's ability to assist in case activities and sports" lowest. Service users perceive the quality of service satisfaction in terms of reliability, assurance, reactivity, empathy, tangibility, "reliability" is the overall service quality of the most influential facets, the quality of service The average is between 4.07-4.26, with the highest level of awareness that "I am comfortable with the caregiver of the caregiver and which ensures the safety of the case", "I have the lowest level of perception that the caregiver can assist in case activities and sports." Perceived service quality will be significantly different due to the personal attributes of service users and caregivers; service quality is a key facilitator of job satisfaction, with a number of organizational attributes affecting both. P.Z.B. The quality of service quality, such as "tangibility", "reliability", "reactivity", "guarantee" and "empathy", affect the quality of customer perceived service. There is a positive and significant impact on the importance and satisfaction of customers in expecting and perceiving service quality. Among them, the reliability, assurance and reactivity of a significant level. Attention and satisfaction of the complex regression model also has statistical significance, service quality represents a professional. Each unit can measure the quality of the service in order to achieve overall satisfaction.

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Dissertations / Theses on the topic 'Healthcare service'

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