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1
Tam, Yiu-man. "Clinical waste management and its future development in Hong Kong /." Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1745704X.
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MELO, ALEXANDRE CUNHA LOBO DE. "HOSPITAL MANAGEMENT: THE CASE OF PRIVATE HOSPITALS IN RIO DE JANEIRO." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2007. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=11057@1.
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Este trabalho tem por objetivo identificar quais são os
fatores críticos de
sucesso na gestão de um hospital e propor um modelo de
gestão baseado nas
melhores práticas de mercado. Partiu-se da proposição que
muitos destes fatores
estariam relacionados aos desafios enfrentados atualmente
pelos hospitais, às
estratégias adotadas, à forma de implementação dessas
estratégias e às tecnologias
de gestão empregadas. Assim sendo, foi feita uma revisão
da literatura sobre estes
temas e foram elaboradas perguntas de pesquisa sobre este
fundo teórico. Em
campo, foram pesquisados cinco hospitais particulares
situados na região
metropolitana do Rio de Janeiro. Todos eles têm as
cirurgias como uma de suas
principais atividades, a despeito de, também, realizarem
outros tipos de
atendimento. Assim, esses hospitais têm o médico como um
de seus principais
clientes na medida em que utilizam a estrutura hospitalar
para realizarem seus
procedimentos cirúrgicos. Os resultados revelam um mercado
hospitalar cheio de
espaços, com gestão predominantemente amadora e familiar e
com estratégias
informais. Na conclusão, é proposto um modelo de gestão
hospitalar que pode
ajudar os hospitais a se prepararem para a
profissionalização do mercado que está
por vir.This study`s objective is to identify the success critical factors in hospital management and to propose a management model based on the best practices in the market. It was presumed that many of these factors would be related to the challenges faced by the hospital in the market, to the strategies adopted, to the way these strategies are implemented and to the management technologies used. So, a literature review was made and the field questions were created focusing on these topics. In the field, five Rio de Janeiro metropolitan area private hospitals were studied. All of them have the surgeries as one of their main activities, despite of doing many other procedures. So, the doctors are one of their main clients, as far as they need the hospital structure to make their surgeries come to true. The results reveal a spacefull market, a lack of professional management as well as informal strategies. In the end, a hospital management model is proposed. This model may help the hospitals to make themselves ready to the market professionalization that must come soon.
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Clark, Andrea L. "Waste Management Minimization Strategies in Hospitals." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5064.
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During the delivery of healthcare services, hospital employees use enormous amounts of water, energy, and nonbiodegradable carcinogenic plastics. In the U.S., hospital staff generate an average of over 7,000 tons of waste per day at an average cost of $0.28 per pound for the disposal of regulated medical trash, which if efficiently managed or reduced, could result in substantial cost savings. Using the organizational learning and the transaction cost economics theories as the conceptual frameworks, the purpose of this qualitative case study was to explore strategies healthcare leaders used to minimize their waste management operational costs. Data were collected using semistructured interviews with 4 managers at a healthcare system in the Midwestern United States and reviewing financial documents as well as the participants' hospital website. Based on the thematic analysis, 4 primary themes emerged: (a) engaged leadership, (b) incorporate sustainability into the mission, vision, and values of the organization, (c) create an organizational culture of sustainability, and (d) innovation. Because society's health is largely dependent on the environment around them, these findings could assist hospital leaders in the implementation of cost-effective waste management strategies and contribute to positive social change.
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Li, Ling Xia. "Capacity resource management and performance in hospitals." Connect to resource, 1996. http://rave.ohiolink.edu/etdc/view.cgi?acc%5Fnum=osu1261407038.
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Knott, Jonathan Charles. "Management of mental health patients in the emergency department /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002656.
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Shaikh, Ahmed Al. "An assessment of operating performance in contract managed hospitals versus traditionally managed hospitals : a case study of Ministry of Health hospitals in Saudi Arabia." Thesis, Lancaster University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249804.
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Labuschagne, Gertruida. "An assessment of perceptions of lean opportunities in hospital management." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1012958.
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This is a quantitative study. The primary research objective is to investigate the importance of hospital management’s involvement when implementing lean elements in healthcare. In reality, incidents and quality problems are prime reasons why healthcare leaders are calling for redesign in healthcare delivery and systems. This paper presents a proposal for developing a lean culture in healthcare facilities equipped with managers who will be able to drive the implementation of lean elements from the top down, making use of multidisciplinary teams, including physicians, to deliver value-added services. This study ultimately endeavors to indicate the importance of management, multidisciplinary teams and physician involvement in implementing lean principles in healthcare successfully. “If we keep doing what we’re doing, we’re going to keep getting what we’re getting.” – Stephen Covey. The reasons why lean management is a particularly important strategy in healthcare currently, includes the following: •The need to reduce waste in healthcare cost; •The need to improve quality and on-time processes; •Fast-paced technological changes; •Ever-increasing patient expectations; and •The need to standardise processes and systems to get the high-quality results anticipated (Chalice, 2010).
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Choy, Man-shun, and 蔡敏順. "The importance of change management in hospital accreditation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46935356.
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Background: The Hong Kong Hospital Authority (HA) has adopted the Australian Council on Healthcare Standards (ACHS) scheme for their public hospital accreditation program. Continuous improvement is a vital aspect of the ACHS criteria and facilitates the movement from status quo to the desired state; therefore, change is necessary, and change management may be useful.
Objectives: To identify the current level of evidence regarding change management with respect to hospital accreditation and to identify the common change management tools that may be relevant to hospital accreditation.
Methods: The primary method was a search of MEDLINE and PubMed for articles published between January 2001 and April 2011. Grey literature was identified via a Google search. Unpublished data was retrieved from an on-going qualitative study of hospital accreditation in Hong Kong.
Results: No literature with the keywords “change management” and “hospital accreditation” were found in MEDLINE or PubMed. By adjusting these keywords to identify articles about change management in healthcare, 84 citations were identified, 18 of which were included for review. The majority of the literature described increased communication as a change management intervention. Change management framework and tools were also found in the grey literature review.
Results: No literature with the keywords “change management” and “hospital accreditation” were found in MEDLINE or PubMed. By adjusting these keywords to identify articles about change management in healthcare, 84 citations were identified, 18 of which were included for review. The majority of the literature described increased communication as a change management intervention. Change management framework and tools were also found in the grey literature review.published_or_final_version
Public Health
Master
Master of Public Health
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Saifi, Khader M. M. Al. "The impact of information technology on hospital management of Gulf Corporation Council public hospitals." Thesis, University of Hull, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272025.
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Information technology (m has become crucial to the functioning of modern hospitals. It includes a range of human elements, infornlation, equipment, knowledge and systems. It is important to hospitals, as these are complex environments including many systems with diversity of functions, sub-systems, and professionals. The adoption of technology can be explained by four general theories: economic, political, social and globalization theory. Based on these theories five sets of reasons can account for the adoption of IT in a hospital environnlent. They are, practical; to solve existing problems, economic/business; to achieve d profit or reduce costs or both, rational; to achieve efficienL1' and effectiveness, social; to respond to pressure from society for political reasons and to increase positive image, and supply driven forces by which IT producers seek to sell their products and services. However, no one theory or set of reasons can by itself explain the precise drive for use of IT because nluch depends on each hospital's needs and surrounding drcunlStances. The purposes of this research are to investigate the extent to which IT is being used in Gulf Corporation Council (GCC) public hospitals, why IT has been adopted, and the impact of IT on hospital managementThe methods used in conducting this research were based lllainly on three established methods for searching and collecting infomlation; a literature review, the surveyor questionnaire, intervie,,'s and case studies. Five case studies in Qatar, the United Arab Emirates (UAE) and Bahrain were undertaken to cover Gee hospitals and medical centres populations. Most health and medical services in Gee Countries are provided by public hospitals which account for approximately 64% of total hospital provision, employ most medical professionals, mainly expatriates, and contain most patient beds. In Gee hospitals, IT is still in the early stages of implementation. IT has been found to be adopted at a low level due to reasons such as lack of awareness, other priorities in health policy strategies, and the low level of funding allocated. IT can provide hospitals with many benefits, solve many problems and has many inlpacts on human and functional systems, internal power balances and on the social status of hospitals. The benefits are found to be mostly in the areas of processing work. Therefore, the areas which were given priority for IT implementation were medical records, finance, and personnel areas. No significant impacts v"ere found on hospital structure, chain of conlllland, span of control and nUlllber of employees, however, itwas found that IT increased management power, hospitals' social in1age and hospital political power, while there were disagreements about IT impacts on employees' social relations. The evaluation of IT impacts on Gee hospital management shows that the impacts were not at the same level of intensity or direction, for example, sonle impacts ,",'ere positive and some negative; some significant, moderate or nurunlal, some ambiguous or obvious, were some were slow and some fast. Some efforts at Gee States level were made to develop a model of adopting IT but no real results were detected. However, the future role of IT in Gee public hospitals will be increasing perhaps at a slower pace, but two strategic issues should be given proper consideration; first; the role of the education system, research centers, and industrictl foundation, and the second strategy concerns hospital systems and services structure. This later is related to increased privatization of medical services, economic pressure, and changes in governments' employment strategy. The importance of this thesis is to draw the attention of decisionmakers to the role of IT as an efficient managerial tool in some respects and to provide a foundation for future studies
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Gatang'i, Peter Gatheru. "Effective management of machinery in government-operated hospitals." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1237.
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The methodology and the processes that are followed in the maintenance of government-operated district hospitals in the Eastern Cape Province of South Africa are outlined while the strategies that are employed to roll-out the maintenance plan have been investigated. The challenges in managing hospital maintenance are identified so that it can be improved and advice be given on the strategies currently being used. The objectives of the research were to determine the effectiveness of machinery maintenance in government-operated district hospitals. The study has been carried out by investigating 50 district hospitals within the Eastern Cape Province, with the aim of obtaining knowledge of practices in relation to the strategic plans and best practices in the maintenance industry. The following factors identified by the maintenance staff were found to be most important in maintenance management practices; realistic budgets, adherence to occupational health and safety regulations, engagement of qualified and skilled maintenance staff, good record management in relation to the equipment under maintenance, availability of tools and materials and keeping abreast with the latest technologies and trends of machinery advancement. The study also revealed that the majority of the hospitals use a combination of in-house and outsourced personnel during maintenance, the outsourced part being under contract from the National Department of Public Works Repair and Maintenance Plan (RAMP) projects. Service kits and recommended replacement parts for machinery are rarely stocked on the hospital premises while only minor spare parts that include replacement bulbs, electrical fittings, plumbing fittings and paint are readily available. In addition, the maintenance staff members have little or no input in maintenance budgeting, this aspect is controlled by hospital management. For maintenance to be effective, strategic planning that takes into account carefully thought-out maintenance management systems is the first step in the direction of setting out definite tangible objectives and goals. The real challenge lies in the implementation and sustainability of the maintenance management system and the monitoring thereof.
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Hoffman, Nyameka. "Promoting leadership effectiveness in the public hospitals: a case study at Uitenhage provincial hospital." Thesis, Nelson Mandela Metropolitan University, 2013.
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Effective leadership is essential for the achievement of any organisational success. The need for strong leadership and increased diversity is a prominent issue in today’s health service workforce. Effective leadership involves influencing others towards achieving the goals of the organisation. Leadership is the central ingredient necessary for progress as well as for the development and survival of organisations, especially in a changing environment such as is evident in South Africa. This study was undertaken to explore and describe the views of health professionals with respect to factors that promote or influence leadership effectiveness in public hospitals, with specific reference to Uitenhage Provincial Hospital. The research design of this study was a quantitative, explorative, descriptive survey. Interviews were conducted to explore and describe the views and perceptions of healthcare professionals (clinical and nonclinical), and the management of the Uitenhage Provincial Hospital, regarding leadership effectiveness in a public hospital. Firstly, a literature study was conducted on healthcare leadership generally and to identify various leadership approaches and factors that influence leadership effectiveness. More emphasis was put on the current and the most recent approaches to leadership. Secondly, an empirical study was conducted to gain the views and ideas of health professionals regarding leadership effectiveness in the institution. Lastly, the results of the empirical study were evaluated, conclusions were drawn and recommendations were made, based on the information obtained from both the literature study and the empirical study.
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Phasha, F. G. "Management of public hospitals in Waterberg District (Limpopo Province)." Thesis, University of Limpopo, 2015. http://hdl.handle.net/10386/1234.
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Thesis (MPH.) --University of Limpopo, 2015BACKGROUND: There were perceptions that doctors as Medical Superintendents were unable to provide proper financial management of hospitals, thus administrators were appointed to manage hospitals irrespective of qualifications. The aim of the study was to determine how public hospitals are managed in Waterberg district (Limpopo province). METHOD: A cross sectional survey was conducted among 27 hospital managers in the Department of Health Limpopo province, in Waterberg district hospitals. A self -administered questionnaire was used for data collection. Data were analyzed using SPSS version 22.0, where both descriptive and inferential analysis was conducted. RESULTS: Of the 27 managers, 59.3% were females 40.7% compared to males. 96.3% of managers reported that they did not correctly implement PMDS and polices on RWOP were not applied. There was no statistical difference in management styles, according to gender (p>.05) and managers had a fair working relationship among themselves. CONCLUSION: According to the study, there is a great need to train hospital managers in management skills and other related policies, and giving them support in terms of resources such as: staffing especially health professionals, financial and working resources.
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Seidner, Blake. "The Balance Between Financial and Quality Performance in For-Profit Hospitals versus Non-Profit Hospitals." Scholarship @ Claremont, 2018. http://scholarship.claremont.edu/cmc_theses/1950.
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Recent trends of financial distress for non-profit hospitals and the uptick in acquisition of these hospitals by for-profit entities indicate different focuses from the management of each type of hospital. Using data on hospital quality and basic financial measures, this study examines shift in the balance of financial and quality performance. The dataset focuses on private non-profit and for-profit hospitals with low bed counts, ranging from 50-200 total beds. Results indicate a positive relationship between for-profit status and basic financial performance measures, such as profitability, and a negative relationship with patient experience, cost reduction for the patient, and overall quality. This signals a tradeoff between financial performance and quality, especially measures relating to the customer. For-profit hospital management places more of an emphasis on the financial performance while non-profit hospital management demonstrates a balance between financial performance and high quality performance. Without being involved in hospital management decision-making, examining hospital outcomes is the best way to give insight into how hospital management is shifts performance priorities by different types of ownership.
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Spatzer, Susan M. "The new age workplace and effective management within vs. traditional management." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1993. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1993.Source: Masters Abstracts International, Volume: 45-06, page: 2888. Abstract precedes thesis title page as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 89-90).
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Adderley, A. E. "The management and implementation of energy-thrift in hospitals." Thesis, Cranfield University, 1989. http://dspace.lib.cranfield.ac.uk/handle/1826/10361.
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The 1984 Auditor Genera1's report on energy~thrift in the Health Service claimed that energy~thrift programmes in hospitals were not achieving their performance targets. In order to determine the reasons for this failure, twenty hospital energy~audits were analysed. It was discovered that the two principle factors impairing the performance werez- (a) The thermal conflict between thrift measures implemented on the same thermal system, and, (b) inefficient implementation strategies. In order to investigate the influences of thermal conflict and implementation strategy on the out~comes of energy~thrift programmes,four objectives were defined:~ (i) To develop a computer model which was capable of simultaneously thermally modelling the implementation of energy-thrift measures on several hospital sites. (ii) To use the model to predict the thermal and financial out~comes of various implementation strategies. (iii) To test the sensitivity of the outrcomes to changes of unit fuel prices and capital costs, and, (iv) to compare the predicted results with those actually obtained. Data from four hospital sites and ninety thrift measures were entered into the model for analysis. It was deduced that a law of diminishing returns existed between capital investment and annual savings and that thermal conflict was responsible for an average annual financial loss of 15.5%. The financial returns on the capital invested were considerably enhanced (in one case by 3ÖØ%) by spreading the financial resources over all four sites rather than by concentrating the same capital outlay on a single site. Furthermore it was discovered that there was a level of capital investment that yielded an optimal net present value over the selected project life. The programmes were more sensitive to reductions of unit fuel prices than increases of capital costs. Most of the thrift programmes remained viable (N.B. N.P.V. > Ø using the public sector discount rate _of 5% and a project life of 5 years) after the unit fuel prices had been reduced by 5Ø% of their 1985 levels. When the results of the implemented programmes were compared with the models' predictions, the accuracy of the estimated savings ranged from a 4.5% under-estimate t 2.5% over-estimate. The software was designed to find the best-fit Ventilation rate and`base temperature for each hospital site and for each thermal zone within the hospital. When the post-implementation assessments of overall air-change rate and site base temperature were compared with those predicted, the model detected changes closely matching the predictions. â The results indicated that the technique developed in this thesis has potential as a monitoring and targeting system as well as a thermal model for predicting the out- comes of energy-thrift programmes.
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Gomes, Regina Celia. "A visÃo de gestores e professores sobre as prÃticas de ensino e gestÃo no Hospital UniversitÃrio Walter CantÃdio da Universidade Federal do CearÃ." Universidade Federal do CearÃ, 2010. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=5386.
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nÃo hÃOs Hospitais de Ensino tÃm papel fundamental e estratÃgico para o Sistema Ãnico de SaÃde, para cumprirem sua missÃo na assistÃncia, ensino e pesquisa contribuindo para o desenvolvimento deste sistema, como referencia em alta complexidade e pÃlo formador de recursos humanos em saÃde, necessitam de alternativas que possibilitem o fortalecimento e sustentabilidade dessas unidades acadÃmicas. Este estudo traz como objetivo investigar a gestÃo e as prÃticas de ensino em saÃde na visÃo dos gestores e professores no Hospital UniversitÃrio Walter CantÃdio (HUWC) da Universidade Federal do Cearà (UFC). A metodologia utilizada no estudo apresenta caracterÃsticas de uma pesquisa com mÃtodos mÃltiplos. Foi aplicado um questionÃrio aos gestores e professores totalizando 57 pesquisados, sendo 40 gestores e 17 professores. O estudo identificou e analisou um conjunto de 36 determinantes com potencialidades para influenciar positivamente uma gestÃo sustentÃvel e boas prÃticas de ensino no HUWC. Os determinantes estÃo relacionados com os principais atores do processo que sÃo o MinistÃrio de EducaÃÃo, o HUWC, UFC, o Sistema Ãnico de SaÃde e o MinistÃrio da SaÃde e as prÃticas de ensino.Em 27 determinantes houve convergÃncia na visÃo dos gestores e professores, e 09 divergÃncias. Os maiores graus de convergÃncias foram a falta de concurso pÃblico para reposiÃÃo das aposentadorias e a consequente contrataÃÃo de serviÃos prestados, que traz como conseqÃÃncia grande repercussÃo financeira comprometendo a sustentabilidade da gestÃo. Outro percentual relevante de concordÃncia foi que, apesar da crise financeira em todas as dimensÃes, o ensino no HUWC ainda garante boa formaÃÃo de profissionais de saÃde. A defasagem da tabela do SUS, que contribui para a falta de sustentabilidade da gestÃo e reduÃÃo da qualidade do ensino tambÃm obteve alto percentual de concordÃncia dos professores e gestores respectivamente. Os resultados mostram 25% do total de divergÃncia, ficando os maiores percentuais com as questÃes relacionadas com a polÃtica de RH estabelecida pelo MEC que contempla recursos para treinamento e capacitaÃÃo. Para o grupo de professores e gestores a divergÃncia relacionada com o comprometimento dos servidores tÃcnico-administrativos com o HUWC tambÃm obteve alto percentual. Outra divergÃncia relevante entre professores e gestores foi que o HUWC contempla boas prÃticas de ensino de acordo com as diretrizes curriculares para os cursos de graduaÃÃo. Dentre outras conclusÃes, esta pesquisa revelou necessidade de um novo modelo de gestÃo, complementaÃÃo do quadro funcional, conhecimento de gestÃo e programas de capacitaÃÃo e formaÃÃo para gestores e professores, reconhecimento da importÃncia do HUWC pelo gestor local do SUS, acompanhamento permanente dos residentes pelos preceptores e fortalecimento de pesquisas clÃnicas sÃo encaminhamentos para soluÃÃo de alguns problemas relacionados com a gestÃo sustentÃvel e boas prÃticas de ensino.
Teaching hospitals have a key and strategic role for the National Health System to fulfill its mission of giving assistance, teaching and developing research to contribute to the development of the system. To serve as reference to the high complexity and the forming base for the human resources in health care it is necessary to find alternatives to fortify and sustain those academic units. The goal of this study is to investigate the management and teaching tools from the point of view of managers and professors in the Hospital UniversitÃrio Walter CantÃdio (HUWC) from the Universidade Federal do Cearà (UFC). The methodology used in this study presents characteristics of research with multiple methods. A questionnaire was sent to all the managers and professors (57 subjects responded). Out of those 57, 40 were managers and 17 professors. The study identified and analyzed a group of 36 determinants with potential to positively influence sustainable management and good teaching tools in the HUWC. The determinants are related to the main entities which are the Department of Education, HUWC, UFC, National Health System and Department of health and teaching tools. In 27 of the determinants there were convergences in the opinion of the mangers and professors, and 09 divergences. The biggest convergences were the lack of an entrance exam to replace people that got retired and as a consequence they ended up contracting services rendered and as a consequence the high costs compromise the sustainability of the management. Another relevant topic which was agreed upon is that, despite the financial crises in all dimensions, the teaching in HUWC is still able to form health professionals of good quality. The discrepancy in the chart of the National Health System which contributed to the lack of sustainability of the management and lowering the quality of teaching tools was also agreed upon by a high percentage of professors and managers. The results show 25% of divergences, most of them were related to the politics of Human Resources which are determined by the Ministry of Education. Most of these policies are related to the purpose of capacity building and training. For the group of professors and managers the divergence related to the commitment of the administrative workforce with the HUWC also obtained a high percentage. Other important divergence for professors and managers was that the HUWC contemplates good teaching practices according to curricular guidelines to graduate courses. The research showed the necessity of a new management model, complementing the workforce, the development of management and programs for capacity building and forming new managers and professor. The research also shows how important the HUWC is for its local management and the importance and necessity of monitoring the residents and fortifying clinical researches. These were some of the ways found to solve some of the problem related to a sustainable management and good teaching tools.
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Al-Amin, Mona. "Organizational Ecology and the Proliferation of Specialty Hospitals." Diss., Temple University Libraries, 2009. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/49933.
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Business AdministrationPh.D.
This dissertation examines the proliferation of specialty hospitals in the United States. Since the 1990s specialty hospitals increased in number and stirred much controversy, given that most are for-profit and physician-owned. They are examined here according to the Organizational Ecology Theory, a theoretical framework used in many industries to explain the founding of new organizational forms. Given that general hospitals have been the dominant organizational form in the hospital industry, the emergence of specialty hospitals is explained in this dissertation by applying organizational ecology theories: resource partitioning, density dependence and niche formation. Moreover, I examine the effect environmental and institutional variables have on the variations in specialty hospital proliferation between different states in the United States. The data used in this dissertation are mainly derived from the American Hospital Association Annual Database and the Area Resource File. The Negative Binomial Generalized Estimating Equations method is used to test the models in Stata 9. The findings from this dissertation provide support to both the density dependence, niche formation, and resource partitioning theories. The volume of surgical procedures seems to have a positive effect on the number of new specialty hospitals in a state. Specialty hospitals founding rates also seems to be positively related to the closure rate of general hospitals. Moreover, specialty hospitals founding rate was significantly affected by the intra-population density of specialty hospitals in the area they were founded. As for environmental and institutional factors, the presence of a Certificate of Need program negatively affects the founding rate of specialty hospitals in a state when specialty hospital density is not accounted for in the model. Economical variables, on the other hand, were significant in all the models. Specialty hospitals were positively related to state per capita income and negatively related to unemployment rate. One of the interesting findings of this study is that specialty hospitals founding rate is negatively related to physician expenditures. Thus, less income might be inducing physicians to open their hospitals to recoup financial losses. This dissertation is not just important due to its contribution to organizational ecology, it is also important because it explains to policy makers the reasons that lead to the proliferation of specialty hospitals and the future of these new entrants into the health care arena.
Temple University--Theses
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Spagnol, Carla Aparecida. "A trama de conflitos vivenciada pela equipe de enfermagem no contexto da instituição hospitalar : como explicitar seus nos?" [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312132.
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Orientador: Solange L'AbbateTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Nessa pesquisa, investiguei os conflitos vivenciados pela equipe de enfermagem do Hospital das Clínicas-UFMG, motivada pelo fato de o enfermeiro desempenhar atividade de gerência nos serviços de saúde e freqüentemente lidar com relações conflituosas. Os objetivos delineados foram: conhecer as diferentes percepções de conflito dos enfermeiros; identificar aqueles mais comuns e os principais fatores que geram esses conflitos; compreender como o enfermeiro lida com os conflitos no trabalho; levantar facilidades e dificuldades para lidar com os conflitos e propor aos enfermeiros a construção coletiva de um dispositivo socioanalítico, a ser utilizado como espaço de análise e reflexão da prática profissional, focalizando o objeto de estudo. Por se tratar de um fenômeno processual, optei pela abordagem qualitativa, desenvolvendo uma pesquisa-intervenção em duas fases. Na primeira, realizei uma pesquisa exploratória, com o objetivo de me aproximar dos sujeitos e do objeto de estudo, utilizando um questionário, que foi aplicado, em setembro de 2003, a cento e cinco enfermeiros (105), sendo que desses, trinta e sete (37), o devolveram. Na segunda, utilizei a perspectiva da socioanálise, para construir um dispositivo, visando a criação de um espaço que permitisse à pesquisadora e às pesquisadas realizarem, conjuntamente, análises e reflexões acerca da prática profissional, focalizando situações de conflito vivenciadas no trabalho. Foram realizados cinco encontros nos meses de setembro e outubro de 2005, com duração de duas horas cada, onde participaram seis enfermeiras que, no questionário, responderam afirmativamente quanto à sua continuidade no estudo. Nessa fase, as integrantes ao elaborarem a demanda de análise do grupo, expressaram vários motivos para participarem dessa investigação, dentre eles destaco suas implicações com a pesquisadora. Para as enfermeiras conflito é: diferença de pensamentos e de posições, coisa que incomoda e algo estressante. Apresentam uma visão bipolar desse fenômeno, pois, a princípio, são percebidos como negativos, mas dependendo do ângulo que se olha também o consideram como positivo, isso se forem discutidos com todos os envolvidos e conduzidos adequadamente. Identifiquei os seguintes tipos de conflitos: intrapessoal, interpessoal, intergrupal, de poder e de interesse. As principais causas que geram esses conflitos são: duplicidade de vínculo empregatício; deficiências na estrutura organizacional e no modelo de gerência implantado; escassez de recursos; centralização do trabalho; hierarquia; autoritarismo; imaturidade; escalas de serviço; falta de respeito e compromisso profissional, trazendo conseqüências para as relações interpessoais e para a assistência prestada. As enfermeiras lidam com situações de conflito, de forma racional, apresentando desejo de fuga, ao realizarem ações imediatistas, a fim de contornarem ou amenizarem a situação, assumindo que não são preparadas para conduzirem questões problemáticas ligadas ao comportamento e relacionamento interpessoal. Sendo assim, em determinadas situações, solicitam ajuda aos psicólogos da Diretoria de Recursos Humanos do hospital. O próprio dispostivo socioanalítico se constituiu em um analisador, permitindo explicitar instituídos e instituintes, implicações e transversalidades, presentes na organização hospital que é atravessada pelas 'instituições enfermagem e medicina¿. Diante das avaliações positivas relacionadas aos encontros grupais, sugiro desenvolvermos outros trabalhos tendo o dispositivo socioanalítico como um espaço coletivo de análise e reflexão das relações e práticas profissionais
Abstract: In this research, I investigated the conflicts experienced by a nursing team at the Federal University of Minas Gerais Hospital, motivated by the fact that nurses manage health care and frequently face conflict situations. The aims of this research were: to learn about nurses different perceptions regarding conflict; to identify the most common conflicts and the main factors that generate these conflicts; to understand how nurses manage conflicts at work; to find out motivations and difficulties to manage conflicts and propose to nurses a collective construction of a socio-analytical instrument to be used as a space for analysis and reflection of professional practice, focusing on the study object. As it is a process phenomenon, I used a qualitative approach, developing an intervention research in two phases. In the first phase, I developed an exploratory research with the purpose to get closer to the subjects and study object, using a questionnaire that was applied in September 2003 to 105 nurses. Among them, 37 responded and sent it back. In the second phase, I used the socio-analysis perspective to build an instrument, aiming at creating a space that would allow the researcher and research to be developed as well as analyses and reflections regarding professional practice, focusing on conflict situations experienced at work. Five meetings happened in September and October 2005, of two hours each, with the participation of six nurses that manifested in the questionnaire their intention to continue the study. In this phase, the members of the group expressed their motivations to participate in the study, emphasized its implications regarding the researcher. According to these nurses, conflict is a difference of thoughts and positions, something that may impair the relationship. They present a bipolar view of this phenomenon as at first they are perceived as negative, but depending on the way they are seen they can be considered positive, if they are discussed with all the persons involved and managed adequately. The following types of conflict were identified: intrapersonal, interpersonal, intergroup, of power and of interest. The main causes that generate these conflicts are: work in more than one place, problems regarding the organizational structure and management, lack of resources, work centralization, hierarchy, authoritarianism, immaturity, work shifts, lack of respect and professional commitment that influence interpersonal relations and the care provided. Nurses manage conflict situations in a rational way, presenting their desire to run away when they implement immediate actions, in order to minimize the situation, assuming that they are not prepared to conduct problems related to behaviors and interpersonal relationships. Therefore, in some situations they ask for help to psychologists from the Hospital Human Resources Division. The socio-analytical instrument was a means to analyze it, enabling them to expose the situations, implications and transversal intersections that are present at the hospital organization that is crossed by other institutions such as ¿nursing and medicine¿. Considering the positive evaluation of the group meetings, I suggest the development of other works based on socio-analytical instruments as a collective space for the analysis and reflection of relationships and professional practices
Doutorado
Saude Coletiva
Doutor em Saude Coletiva
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Barnawi, Abdullah. "Risk management of electronic health record system in hospitals." Thesis, De Montfort University, 2013. http://hdl.handle.net/2086/10411.
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This thesis investigates the use of electronic medical record (EMR) systems and risk management in hospitals. It provides a critical analysis of recognized EMR systems and potential failures and discusses six traditional risk management techniques including brain storming, cause, effect analysis, failure mode effective analysis (FMEA), fault tree analysis (FTA), and Binary Decision Diagram (BDD) in addition, to one of the most recent systematic risk management techniques, Systems Theoretic Accident Model Process (STAMP). The traditional techniques are not as well suited to managing risks and preventing failures in modern information systems with complex software that involves human and machine interaction. The thesis introduces the implementation of common traditional risk management technique such as BDD and FTA which is mostly used in nuclear plants, transportation and medical devices backed by a hypothetical example to help and explain the process of the FTA usage. Most traditional techniques rely on a direct cause-and-effect chain and have no clear formal guidance. The systematic technique introduced and used in this study, is known as Systems Theoretic Accident Model Process (STAMP). It is one of the recent systematic techniques developed and used in many sectors including aerospace. This study applied the STAMP technique to the EMR system failure at King Khalid General Hospital (KKGH) in Riyadh. One of the reasons for selecting the STAMP technique is that it is based on system theory and established the risk factors that lead to system failure. It also provides guidance for managing and controlling risk factors. This thesis discusses the implementation of STAMP, supported by examples, to explain how the technique conducted. System failures occur unexpectedly and have the potential to affect health services; they can compromise patient health and sometimes lead to death. The aims of this study are to explore The Kingdom of Saudi Arabia healthcare usage of EMRs and risk factors that leads to system failure and demonstrate the benefit of STAMP for RM in EMR system, define gaps and provide suggestion based on international best practice The study was conducted in three phases. The first phase explored EMR system usage and failures. The second phase implemented the STAMP risk management technique at one hospital of our 8 surveyed hospitals, the King Khalid General Hospital’s (KKGH), to identify and manage risks. In the third phase, the study modified the STAMP technique and reapplied it. The modified technique STAMP Checklist (STAMPC) was compared with the original STAMP technique. We found that STAMPC is much more usable and subjectively beneficial for the hospital that uses a hybrid system. Data extracted using the modified technique provided more useful information to improve EMR system safety, and prevent potential failures. This study addresses the challenges of how effectively RM techniques used to reduce the potential risk of EMR system failures in hospitals. It improves the efficiency of the STAMP risk management technique by proposing a new (STAMPC) technique. There are 3 important implications for both RM and EMRs practice: first, the study suggests that RM and EMRs are integral parts of the management decision-making process; second, they are necessary to improve human health and safety; and, third, RM may minimise the possibility of system failure.
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Al-Amri, Haiyaf Salih. "Human resource management practices & performance indicators in hospitals." Thesis, University of Birmingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251835.
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Kwok, Ching John, and 郭靖. "A systematic review of the impact of service line management on quality and efficiency." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48423671.
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BACKGROUND: The healthcare landscape is changing at a pace that traditional management structures are ill equipped to handle. In response to demands for accountability and greater value, service line management (SLM), a popularized concept in the 1980s, has recently gained renewed attention as an organizational tool for improving hospital-physician relationships, coordinating care, and aligning organizational goals, resources, and strategies.
OBJECTIVES: The aim is to systematically review the literature on SLM to evaluate its effects on quality and efficiency in healthcare organizations and to identify factors that may affect success. After evaluating its impact and the potential factors affecting success, this paper will explore SLM’s generalizability and applicability in Hong Kong’s public healthcare system.
METHODS: Using key words, a systematic search of EBSCO, Medline (OvidSP), ProQuest, and PubMed databases was conducted. The reference lists of the literature were further examined to find more articles. The extracted data was evaluated for strengths, weaknesses, opportunities, and threats (SWOT analysis). This analysis was used to identify and explain the organizational and environmental factors influencing SLM.
RESULTS: The initial search yielded 1049 citations. After applying exclusion criteria and reviewing reference lists, 17 articles were identified. The review found that a variety of management structures could be use to achieve organizational objectives. Since each healthcare organization is unique, the structure must be tailored to its internal and external context. Success depends on multiple factors. The internal positive factors or strengths of SLM include enhanced care coordination, communication among staff, multidisciplinary collaboration, leadership, cost finding and planning, integration of information, and greater resource allocation to SLs. The internal negative factors or weaknesses include resistance to organizational change, lack of buy-in among key constituents, lack of internal readiness, inappropriate organizational structures, inadequate leadership skills, difficulties in identifying priority SL, disruptions due to the implementation process, and decreases in funding for non-prioritized areas. Positive external factors or opportunities include the potential for developing a market advantage, identifying improvement areas, enhancing patient safety, and improved public perception. Negative external factors or threats include funding cuts, alterations in reimbursement schemes, advancements in technology, and changes in market forces.
CONCLUSION: Despite the hopeful results and discussions presented in the reviewed articles, there is a lack of strong evidence to support implementation and to identify factors affecting success. This is largely due to the variety of ways in which SLM have been implemented and tailored to the diverse organizational and environmental factors. Despite difficulties in comparing various SLs, hospitals and health systems that fully embrace service line management are finding success. Using the service line approach may create opportunities and confer benefits, but it may also disrupt the provision of care. Thus, physicians and managers must consider the positive and negative impacts and implications of SLM before moving forward.published_or_final_version
Public Health
Master
Master of Public Health
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Fransson, Sellgren Stina. "Nursing management at a Swedish University hospital : leadership and staff turnover /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-330-6/.
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Roberts, Angela K. "Factors involved in management decision-making : a study of Indiana hospital public relations directors' perceptions." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/941717.
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This study of Indiana hospital public relations professionals investigated factors predicting a person's participation in management decision-making. A telephone survey was conducted of professionals directing public relations activities in Indiana hospitals, yielding 55 usable responses.Each respondent was asked the likelihood he or she would be called on by top hospital management to help solve hospital problems, and the likelihood that his or her advice would be seriously considered when making major decisions about programs or policies. Each of the seven questions was answered using a Likert-type scale, with values assigned from 1.0 (highly unlikely) to 5.0 (highly likely). Values were averaged for a total "influence" score.A stepwise multiple regression measured the relationship between influence scores and eight variables: age, gender, salary, department size, education, manager score, technician score, and use of research and evaluation. Only the manager score, research score, and department size were found to be related to influence.Department of Journalism
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Sofohlo, Patrick Mbeko. "Critical assessment of the management practices of Dr. Yusuf Dadoo Hospital." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4222.
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Thesis (MPA (Public Management and Planning))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: The objective of the study was to critically assess the management practices of Dr Yusuf Dadoo Public Hospital in terms of the five public management functions, namely: policy-making, planning, organising, leading and controlling. From the study it is evident that managers of the public hospitals work in a complex and dynamic environment. This is as a result of the pressure felt due to expectations of the public on the quality of service rendered in the hospitals. The primary function of public managers is to ensure that efficient and effective services are rendered to the public. Therefore, all public managers are subject to compliance to the unique guidelines of the relevant legislative framework. In the study, the five public management functions were explained in terms of the broad theoretical framework on management practices on the part of the public sector. The research approach was qualitative and the diagnostic evaluation design was used. The target population for the study included all 48 managers of Dr Yusuf Dadoo Public Hospital who occupy supervisory and higher positions. From the results in the analysis of the questionnaire it is evident that the five public management functions, namely, policy-making, planning, organising, leading and controlling were satisfactory - except the leadership function that needed attention. Public managers of hospitals are an important link between the legislature and the community who are the recipients of policy and are involved at the ground level in the execution of policy. These managers are at an advantage to identify the shortcomings in the existing policy and bring them to the attention of policy-makers. Policies and procedures at Dr Yusuf Dadoo Public Hospital were developed, interpreted and implemented. When discipline on employees was taken, relevant policies as stipulated in the Labour Relations Act, no 66 of 1995, were followed. Policies that support personal development through training and development were not implemented satisfactorily. The existing updated policy manuals were not adequately available to all the employees of Dr Yusuf Dadoo Public Hospital. The function of planning at the hospital referred to the planning processes and mechanisms that were designed to facilitate the planning work. The purpose of planning as a management function was to give guidelines to the managers of Dr Yusuf Dadoo Public Hospital on what they would do in the future. Management of Dr Yusuf Dadoo Public Hospital ensured that employees understood the vision and mission of the hospital. These employees were involved in developing the operational plan of the hospital. Management of Dr Yusuf Dadoo Public Hospital also ensured that operational plans of the employees supported the overall goals of the hospital. Recruitments, selections and appointments were done by human resource department, as was the orientation of new employees to the job. The organisational structure gave employees a clear idea of their responsibilities, the authority they had, and the person to whom they had to report. The functional structure of Dr Yusuf Dadoo Public Hospital grouped together similar or related occupational classes. Expectations were clearly explained by supervisors to subordinates when assigning tasks. Activities and functions were organised and managers allocated responsibility commensurate to authority when delegating tasks to subordinates. Personnel expenditure at Dr Yusuf Dadoo Public Hospital did not impede service delivery. The hospital needed strong leadership to survive and overcome challenges that managers faced. The leadership function at Dr Yusuf Dadoo Public Hospital related to the way management defined what the future of the hospital would look like, to align people with the vision and inspire them to make things happen. Not enough was done by the management of the hospital in this area. The management of Dr Yusuf Dadoo Public Hospital should do everything it could to train and develop managers and those employees who show potential in this area. The five public management functions, namely, policy-making, planning, organising, leading and controlling are executed in a complex and dynamic environment. It is necessary to assess, regularly, the management practices of public hospitals, focusing on the five public management functions. It is also necessary for public managers of Dr Yusuf Dadoo Public Hospital to ensure that the public management functions are carried out, to realise the set goals of the hospital.
AFRIKAANSE OPSOMMING: Die doel van die studie was om die bestuurspraktyke van Dr. Yusuf Dadoo Openbare Hospitaal krities te assesseer in terme van die vyf openbare bestuursfunksies, naamlik beleidmaking, beplanning, organisering, leiding en beheer. Uit die studie is dit duidelik dat bestuurders van openbare hospitale in ’n komplekse en dinamiese omgewing werk. Dit is die gevolg van die druk wat ervaar word vanweë verwagtinge van die publiek ten opsigte van die gehalte van dienslewering in die hospitale. Die primêre funksie van openbare bestuurders is om te verseker dat doeltreffende en effektiewe dienste aan die publiek gelewer word. Derhalwe is alle openbare bestuurders onderworpe aan voldoening aan die unieke riglyne van die betrokke wetgewende raamwerk. In die studie is die vyf openbare bestuursfunksies verduidelik in terme van die breë teoretiese raamwerk vir bestuurspraktyke aan die kant van die openbare sektor. Die navorsingsbenadering was kwalitatief en die diagnostiese evalueringsontwerp is gebruik. Die teikenpopulasie vir die studie het al 48 bestuurders van Dr. Yusuf Dadoo Openbare Hospitaal wat toesighoudende en hoër posisies beklee, ingesluit. Uit die resultate van die ontleding van die vraelys het dit geblyk dat die vyf openbare bestuursfunksies, naamlik beleidmaking, beplanning, organisering, leiding en beheer, bevredigend is – behalwe die leierskapsfunksie wat aandag moet geniet. Openbare bestuurders van hospitale is ’n belangrike skakel tussen die wetgewer en die gemeenskap wat die ontvangers van beleid is en op grondvlak betrokke is by die uitvoering van beleid. Hierdie bestuurders het die voordeel dat hulle die tekortkominge in die bestaande beleid kan identifiseer en onder die aandag van beleidmakers kan bring. Beleide en prosedures by Dr. Yusuf Dadoo Openbare Hospitaal is ontwikkel, vertolk en geïmplementeer. Wanneer dissiplinêre stappe teen werknemers gedoen is, is toepaslike beleide gevolg soos voorgeskryf in die Wet op Arbeidsverhoudinge, no. 66 van 1995. Beleide wat persoonlike ontwikkeling deur opleiding en ontwikkeling ondersteun, is nie bevredigend geïmplementeer nie. Die bestaande bygewerkte beleidshandleidings is nie toereikend vir al die werknemers van Dr. Yusuf Dadoo Openbare Hospitaal beskikbaar nie. Die funksie van beplanning by die hospitaal verwys na die beplanningsprosesse en meganismes wat ontwerp is om die beplanningswerk te vergemaklik. Die doel van beplanning as bestuursfunksie is om riglyne aan die bestuurders van Dr. Yusuf Dadoo Openbare Hospitaal te verskaf oor wat hulle in die toekoms sal doen. Die bestuur van Dr. Yusuf Dadoo Openbare Hospitaal het seker gemaak dat werknemers die visie en missie van die hospitaal verstaan. Hierdie werknemers was betrokke by die ontwikkeling van die bedryfsplan van die hospitaal. Die bestuur van Dr. Yusuf Dadoo Openbare Hospitaal het ook seker gemaak dat bedryfsplanne van die werknemers die oorkoepelende doelwitte van die hospitaal ondersteun. Werwing, keuring en aanstelling word deur die menslikehulpbron-departement gedoen, asook die oriëntering van nuwe werknemers. Die organisasiestruktuur gee aan werknemers ’n duidelike idee van hul verantwoordelikhede, hul gesag en die persoon aan wie hulle moet rapporteer. Die funksionele struktuur van Dr. Yusuf Dadoo Openbare Hospitaal groepeer soortgelyke of verwante beroepsklasse saam. Verwagtinge word duidelik deur toesighouers aan ondergeskiktes verduidelik wanneer take toegewys word. Aktiwiteite en funksies is georganiseerd en bestuurders wys verantwoordelikheid in ooreenstemming met gesag toe wanneer take aan ondergeskiktes gedelegeer word. Personeeluitgawes by Dr. Yusuf Dadoo Openbare Hospitaal belemmer nie dienslewering nie. Die hospitaal het sterk leierskap nodig om uitdagings waarmee bestuurders te doen het, te oorleef en te oorkom. Die leierskapsfunksie by Dr. Yusuf Dadoo Openbare Hospitaal hou verband met die manier waarop die bestuur die toekoms van die hospitaal gedefinieer het, die belyning van mense met die visie en die inspirasie van mense om dinge te laat gebeur. Nie genoeg is deur die bestuur van die hospitaal op hierdie gebied gedoen nie. Die bestuur van Dr. Yusuf Dadoo Openbare Hospitaal moet alles moontlik doen om bestuurders en daardie werknemers wat potensiaal op hierdie gebied toon, op te lei en te ontwikkel. Die vyf openbare bestuursfunksies, naamlik beleidmaking, beplanning, organisering, leiding en beheer, word uitgevoer in ’n komplekse en dinamiese omgewing. Dit is noodsaaklik om die bestuurspraktyke van openbare hospitale gereeld te assesseer deur op die vyf openbare bestuursfunksies te fokus. Dit is ook noodsaaklik dat openbare bestuurders van Dr. Yusuf Dadoo Openbare Hospitaal verseker dat die openbare bestuursfunksies uitgevoer word om die gestelde doelwitte van die hospitaal te verwesenlik.
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Moran, Monica. "The impact of a home based education and self management programme for patients with chronic back pain after completion of a multidisciplinary pain management programme /." St. Lucia, Qld, 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16743.pdf.
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Azevedo, Jane Mary Rosa. "A contratualização no âmbito da gestão do Hospital das Clínicas da Universidade Federal de Goiás: análise do período de 2001 a 2013." Universidade Federal de Goiás, 2017. http://repositorio.bc.ufg.br/tede/handle/tede/7363.
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This thesis reports a descriptive exploratory case study with qualitative and quantitative approach carried out at the Hospital das Clínicas of the Federal University of Goiás. Its objective is to analyze the possible impacts resulting from the contractualisation process implemented in 2004 with the Municipal Secretary of Health of Goiânia. It analyzed the period from 2001 to 2013, focusing on the production of health care, indicators of hospital performance, financial aspects and investments. A document analysis was made available by the institution and a semi-structured interview with seventeen managers who worked in the management before and after the contracting process of the institution, the Municipal Health Department of Goiânia and the Ministries of Education and Health. The quantitative data and the content analysis for the qualitative ones, using WebQDA software. The results showed that there was a financial impact with contracting, with a reduction in hospital care production, unmet physical goals, low institutional performance with reduction of occupancy rates, idleness, turnover, and reduction in the number of beds. In the manager’s perception, contracting is a definitive policy for hospitals that attend the Brazilian Unified Health System and its effectiveness has brought several benefits, although there are still aspects to be reviewed, such as quantity and quality of human, financial and other resources. It is concluded that this process contributes to decisions and executions actions related to this management model, committed to the quality of health services provided to the population. Negotiations and more feasible pacts are suggested, with compliance with the Ordinance and constant participation of federal, municipal and institutional managers, favoring both hospital performance and improved quality.
Esta tese relata um estudo de caso descritivo exploratório com abordagem qualitativa e quantitativa realizado no Hospital das Clínicas da Universidade Federal de Goiás, tem como objetivo analisar os possíveis impactos decorrentes do processo de contratualização implantada em 2004 com a Secretaria Municipal de Saúde de Goiânia. Analisou o período de 2001 a 2013, com foco quanto à produção da assistência à saúde, dos indicadores de desempenho hospitalar, dos aspectos financeiros e dos investimentos. Realizada uma análise documental disponibilizadas pela instituição e por uma entrevista semiestruturada com dezessete gestores que atuaram na gestão antes e após o processo de contratualização da instituição, da Secretaria Municipal de Saúde de Goiânia e dos Ministérios da Educação e da Saúde. Conduzido uma análise horizontal para os dados quantitativos e a análise de contéudo para os qualitativos, utilizando o software WebQDA. Os resultados mostraram que houve impacto financeiro com a contratualização, com redução na produção da assistência hospitalar, metas físicas não cumpridas, apresentou baixo desempenho institucional com redução das taxas de ocupação, ociosidade, rotatividade, e redução no número de leitos. Na percepção dos gestores a contratualização é uma política definitiva para os hospitais que atendem o Sistema Único de Saúde e sua efetivação trouxe diversos benefícios, apesar de existirem ainda aspectos a serem revistos, tais como quantidade e qualidade de recursos humanos, financeiros e outros. Conclui-se que esse processo contribui para tomadas de decisões e execuções ações relacionadas a esse modelo de gestão, comprometida com a qualidade dos serviços de saúde prestados a população. Sugere-se negociações e pactuações mais exequíveis, com cumprimento da Portaria e participação constante dos gestores federais, municipais e da própria instituição, favorecendo tanto no desempenho hospitalar quanto a melhoria da qualidade desenvolvida.
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Santana, Douglas Nascimento. "Hospitais públicos de ensino de São Paulo: evolução do desempenho sob diferentes estruturas gerenciais." Escola de Administração da Universidade Federal da Bahia, 2014. http://repositorio.ufba.br/ri/handle/ri/17598.
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No Brasil, no período pós-edemocratização, o aumento das exigências quanto à prestação de serviços públicos pela população, bem como os custos crescentes de produção decorrentes das incorporações tecnológicas desafiaram o modelo burocrático de administração pública nacional. A partir de meados da década de 1990, a Segunda Reforma Administrativa do Estado foi iniciada, sob a égide do Novo Gerencialismo e com foco na máxima eficiência na prestação de serviços públicos. Onipresentes na estrutura do Estado, essas mudanças ocorreram no setor saúde com a adoção de Políticas Públicas que aproximaram os serviços públicos de saúde dos entes privados mediante a criação de estruturas gerenciais mistas, como Organizações Sociais e Parcerias Público-Privadas e pela adoção de programas de incentivo ao desempenho. Este trabalho tem por objetivo avaliar em que medida o desempenho dos diferentes hospitais públicos de ensino, organizações estruturantes da rede de saúde pública, respondem, ao longo do tempo, aos estímulos trazidos pelos programas focados no aumento da eficiência. Para tanto, foram realizadas revisão bibliográfica e um estudo empírico, quantitativo, retrospectivo, de 2008 a 2012, no grupo de 44 hospitais credenciados ao Sistema de Avaliação dos Hospitais de Ensino do Estado de São Paulo. Os resultados demonstram que, quando categorizados quanto às estruturas gerenciais, os hospitais da Administração Direta, Autarquias e Organizações Sociais, os três grupos da amostra, apresentaram diferenças no padrão de evolução do desempenho assistencial ao longo dos cinco anos do estudo. Os hospitais da Administração Direta apresentaram padrão de evolução do desempenho predominante estacionário e não responsivo aos estímulos, as Organizações Sociais apresentaram padrão predominante crescente, enquanto as Autarquias apresentaram padrão estacionário em alguns indicadores e crescente em outros. A produtividade das Organizações Sociais foi significativamente maior que a dos demais grupos para todos os indicadores selecionados. O grupo de hospitais da Administração Direta apresentou taxa de infecção hospitalar significativamente menor que a os demais grupos. Entre os hospitais públicos estudados e ao longo do período selecionado, as Autarquias foram os grandes repositórios de alunos e de produção de conhecimento científico do estado de São Paulo. Uma possível explicação para as diferenças no padrão de evolução do desempenho assistencial pode estar na estrutura gerencial dos hospitais públicos, quando categorizados por autonomia administrativa e financeira, regime de vinculação de pessoal e modalidade de contratações. Hospitais sem autonomia administrativa e financeira, com trabalhadores estatutários e obrigados legalmente a contratar por licitações, como os da Administração Direta, ocuparam o polo estacionário do desempenho, enquanto hospitais com autonomia total, trabalhadores celetistas e com diferentes possibilidades para contratações, como as Organizações Sociais, ocuparam o polo crescente do desempenho. In Brazil, in the post-democratization period, increased demands for public services for the population and rising costs of production, resulting from technological developments, challenged the bureaucratic model of national administration. From the mid-1990s, the Second State Administrative Reform was started under the aegis of the New Public Management and focusing on maximum efficiency in delivering public services. Ubiquitous in the State structure, these changes occurred in the health sector by the adoption of Public Policies that brought together the public health services and private entities through the creation of joint management structures, such as Social Organizations and Public-Private Partnerships, and also by the adoption of performance incentive based programs. This paper aims to assess to what extent the performance of different public teaching hospitals, structuring organizations of public health network, respond, over time, to stimuli brought by programs focused on increasing efficiency. For this purpose, literature review and an empirical study, quantitative, retrospective, 2008-2012, in the group of 44 hospitals accredited to the System for the Evaluation of Teaching Hospitals of the state of São Paulo were held. The results show that, when categorized by its managerial structures, Direct Administration hospitals, Autarchy and Social Organizations, the three groups found at the sample, showed differences in the pattern of evolution of healthcare performance over the five years of the study. Direct Administration hospitals showed a predominant steady pattern of performance evaluation and unresponsive to stimuli, Social Organizations showed increasing predominant pattern, while the Autarchy showed a steady pattern in some indicators and growing in others. Productivity of Social Organizations was significantly higher than that of other groups for all selected indicators. The group of Direct Administration hospitals showed markedly lower nosocomial infection index, when compared to other two groups. Among the public hospitals and throughout the selected period, the Autarchy were main repositories of students and production of scientific knowledge of the state of São Paulo. One possible explanation for the differences in the evolution of the performance patterns of healthcare may be management structure of the public hospitals, when categorized by administrative and financial autonomy, workers hiring regime and modality of aquisition of insumes and services. Hospitals without total administrative and financial autonomy, with statutory workers and legally obligated to hire by bids, such as the Direct Administration hospitals, occupied the pole of steady performance, while hospitals with complete autonomy, non statutory workers and market-free possibilities to buy insumes and services, such as Social Organizations hospitals, occupied the increasing performance polo.
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Kabeya, Schola Mutumene. "Strategies to Implement Innovations in Hospitals." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5884.
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The Patient Protection and Affordable Care Act, which promoted quality of care, started the transformation of healthcare systems in the United States. The purpose of this qualitative multiple case study was to explore clinical practice innovation strategies used by hospital middle managers to improve quality of care and profitability. Pettigrew's theory was the conceptual framework for this study. Participants were 8 middle managers from 2 high-performing hospitals in the southwestern region of the United States. Data were collected from semistructured interviews, personal notes, and review of the hospital's publicly reported documents and literature. Member checking and methodological triangulation increased the credibility, validity, reliability, and trustworthiness of the study findings. Content and thematic data analysis provided the basis for coding the findings. Data analysis resulted in the emergence of 4 themes: organizational culture, leadership, systematic approach to management by objectives, and staff engagement. The findings showed the interactions among internal context, content, and process constructs of Pettigrew's theory as relevant to clinical practice innovation strategies for improving the quality of care and organizational profitability. The implications for positive social change include the potential for hospital middle managers to implement innovative strategies to improve patients' quality of care and save lives and the overall health and wellness of individuals in the communities they serve.
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Strassburger, Nândri Cândida. "Hotelaria hospitalar : um estudo sobre a gestão da qualidade dos serviços." reponame:Repositório Institucional da UCS, 2009. https://repositorio.ucs.br/handle/11338/552.
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Atualmente, percebe-se que algumas unidades hospitalares, preocupadas com as constantes mudanças no mundo globalizado, onde a demanda está em constante evolução, aplicam em suas organizações os procedimentos da organização hoteleira, com o objetivo de atender o paciente com maior qualidade. Este estudo teve por objetivo avaliar o modelo de gestão da hospitalidade hospitalar implantado em um Hospital localizado em uma cidade da Serra Gaúcha, e descrever o nível de satisfação dos pacientes em relação aos serviços prestados nessa organização. O método de pesquisa aplicado, face ao problema e aos objetivos, foi de caráter descritivo, de corte qualitativo. No estudo, empregou-se a pesquisa bibliográfica, entrevista estruturada com os coordenadores e gestores de áreas, entrevistas semiestruturadas com os pacientes internados atendidos através de convênios e particulares, e observação direta realizada no Hospital. Os aspectos levantados evidenciaram que os pacientes entrevistados possuíam um conhecimento limitado sobre o conceito de qualidade de serviços. O resultado também sugere que os gestores reavaliem o conceito e as estratégias praticadas para prestar um serviço com qualidade, levando-se em conta a importância da hospitalidade no ambiente hospitalar.Submitted by Marcelo Teixeira (mvteixeira@ucs.br) on 2014-06-03T17:06:37Z No. of bitstreams: 1 Dissertacao Nandri Candida Strassburger.pdf: 1271472 bytes, checksum: 42a24415bf2124fdee90e6cfceabdc13 (MD5)
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Yiu, Yee-ming. "Design and build as an alternative method of procuring major publicly funded hospital projects in Hong Kong : a case study /." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25948751.
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Syoufi, Maria. "An Exploratory Assessment of IT Management Issues in Ontario Hospitals." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37943.
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Background and context: Given the constant evolving developments in information technology (IT) in healthcare in Canada and Ontario, and the relatively nonexistent body of literature on IT management issues from the perspectives of top IT managers (i.e. Chief Information Officers, IT directors, IT top managers) in hospitals, a follow up study of IT management issues to the study done by Jaana et al. is conducted.
Purpose: To develop an authoritative list of IT management issues in Ontario hospitals and compare the results to the earlier study and the literature.
Methods: Using the Ranking Type Delphi technique, the responses from IT top managers in three main panels of Ontario hospitals were solicited through a controlled iterative feedback process. The hospitals were divided into the academic panel (n = 6), community panel (n = 12), and the rural panel (n = 8) for a total of 26 out of 33 participants who completed the study.
Results: 26 issues were raised and a total of 24 issues were ranked in the study. Among the 14 common issues between the three panels, the top five issues were limited funding, keeping infrastructure current, external security threats, increasing cost, and managing demands for IT projects. Comparing with the study by Jaana et al. (2011), a total of 7 new issues emerged which are concerned with technology, regulatory challenges, and human issues. A total of 10 issues were dropped from the earlier study spanning areas of strategic, technological, organizational, and human issues. The participants in the study did not significantly differ individually based on their background characteristics, where the only significant difference observed between the hospital panels was due to hospital characteristics. During the brainstorming phase a total of 195 issues were provided which were consolidated by two researchers to form a list of 26 IT management issues, with an inter coder reliability of 88%. The issues with a 4.5 out of 7 rating and higher on a Likert scale were retained to narrow down the list. This resulted in 19 issues for the rural and community panels, and 21 issues for the academic panel, with 14 of the 26 issues being common to all three panels. The ranking phase was conducted with two rounds of ranking due to the low consensus levels during the first round. The consensus level after two rounds was; W academic = 0.235, W community = 0.254, and W rural = 0.381.
Contributions: This study presents a significant contribution to the management of medical informatics field by providing an approach to categorize IT management issues to observe trends overtime as well as present the application of a seminal framework to explain the changes in these issues as organizations change and grow overtime. At the management and practical levels, the list of prioritized issues provides an evidence base for top IT managers to make IT related decisions at the organizational level. The list also acts as a second benchmarking tool to evaluate hospital performance overtime with the various issues. At the policy development level, provincial governments can use the list to devise comprehensive IT management strategies to address the various regulatory issues reported. Future research can focus on exploring the resonating behind the rankings provided and replicating this study over time and across various geographies so that a large survey can be developed to follow the evolutions of IT management issues in healthcare over time.
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Zigan, Krystin. "An Exploration of the Management of Intangible Resources in Hospitals." Thesis, University of Surrey, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486069.
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The aim of the research was to explore the meaning of intangible resources in different European hospitals. Specific objectives were the identification of key intangible resources and the exploration of their management and utilisation. In this context, a further objective was to analyse the impact of various contextual factors, such as public sector regulations, on the management of intangible resources. The three objectives provided the structure for a theoretical model, which formed the framework of the research. It is based on a strategic perspective on intangible resources. Thus, despite the great variety of intangible resources in hospitals, the model limits its focus to certain intangible resources that have been identified as important in the literature and preliminary study. Since the literature revealed that the management of intangible resources is strongly related to operational management tools such as human resource management and knowledge management, the model comprises related activities. The validity of the theoretical model was tested through primary research, which was undertaken in two stages. The preliminary study was exploratory and aimed to investigate the extent to which important intangible resources are considered in the performance measurement systems of hospitals. This was realised through qualitative semi-structured interviews with senior and middle managers at various European hospitals. The second part of the research focused on the identification of specific intangible resources that were important for achieving high performance services. It investigated how the management of intangible resources was carried out and what kind of contextual factors were influential. For this, the theoretical model was tested by applying a single embedded case study approach. The case study was carried out in a German university hospital. Qualitative semi-structured interViews with top and middle managers and the employees of a single department provided insight into the awareness and utilisation of intangible resources. The findings of the research confirmed the importance of specific intangible resources for hospitals, such as knowledge, the attitude towards the organisation and the creation of partnerships with external service providers. In addition, intangible resources such as internal social relationships were identified as highly important. The research refers to them as social capital. Analysis ofthe efforts regarding the management of social capital, however, revealed that there was not enough awareness of its significance. It seemed that the lack of attention regarding the meaning of social capital hampered the utilisation of other intangible resources. In this context, the importance of communication and identification with the organisation was highlighted. Although the literature has not explicitly considered the impact of contextual factors on the management of intangible resources, the research found that public sector regulations, the profile of staff, and the style of leadership in particular influence the management and utilisation of intangible resources. The research enhances knowledge of the awareness and management of intangible resources in hospitals. It contributes to the related literature in that the importance of specific intangible resources was revealed or confirmed. Further, the research significantly extended knowledge of various factors that influence the management of intangible resources.
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Barkenbush, Mark Joseph 1962. "A database system for managing the clinical activity of the faculty and residents of the Department of Anesthesiology at University Medical Center." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276636.
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A computerized data base system for managing clinical activity of faculty and residents has been developed and tested in The Department of Anesthesiology, University Medical Center, Tucson, AZ. Using d-Base III+ and an IBM PC AT the system provides the department residents with tabulated data on a monthly and year-to-date basis, which can be easily transposed onto annual clinical activity reports required by The American Board of Anesthesiology. The system maintains a clinical activity history for the faculty, which allows for equitable work scheduling. The system also tabulates anesthesia equipment usage and problems. The system has been in operation since October, 1987 with residents and faculty receiving clinical activity reports on a monthly basis. System operation requires 10 to 12 hours of secretarial time weekly.
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Abor, Patience Aseweh. "Healthcare governance, ownership structure and performance of hospitals in Ghana." Thesis, University of Southampton, 2014. https://eprints.soton.ac.uk/367746/.
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It is argued that healthcare governance should play an important role in the overall functioning and effective performance of hospitals. However, the literature is devoid of how healthcare governance influences the performance of hospitals in Africa and other developing countries. This study examines the effects of hospital boards and ownership structure on the performance of hospitals in Ghana. The study specifically examines the characteristics of hospital boards, ascertains whether the presence of a hospital board and ownership structure affect hospital performance, evaluates the effects of hospital board characteristics and ownership structure on hospital performance, and also investigates the interaction effects of hospital board characteristics and ownership on performance. Based on a sample of 132 hospitals, the study produces a number of results. First, the study indicates that 69% of the hospitals have a board in place. The results also show that all the mission hospitals have a board in place. Half of the public hospitals and 80% of the private hospitals also have a board. The hospitals with a board exhibit varying board characteristics. Using regression models, the results show that hospitals with a board demonstrate lower occupancy, higher discharge and deliver better quality healthcare. In terms of the effect of board characteristics on performance, smaller boards are associated with better health service quality and lower occupancy. Hospitals with greater proportion of outside board members assist management to be cost efficient and improve on their operations leading to higher discharge. The results also show that hospitals with greater representation of medical staff on the board perform better in terms of occupancy but are less cost efficient. Hospitals with CEO duality perform better in terms of efficiency. However, hospitals with separate positions for the CEO and chair perform better in terms of discharge and service quality. Additionally, the evidence suggests that boards with higher female representation deliver better quality of healthcare, resulting in higher discharge rate. Also, frequency of board meetings is associated with lower occupancy, higher discharge and improved health service quality. The results also show that mission-based and private hospitals perform better than public hospitals. Further, the results of the interaction effects suggest that mission-based and private hospitals with effective board governance exhibit better performance than public hospitals. This study makes a number of new and meaningful contributions to the extant literature and the findings support managerialism, stakeholder and resource dependency theories. The findings also have important implications for effective and efficient governance and management of hospitals.
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DeMartini, Mikaela. "Exploring Self Care Programs in Hospitals." Thesis, Mills College, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13426861.
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Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.
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Chong, Yukyeong. "Evaluation of TQM performance and organizational management effectiveness for foodservice and clinical nutrition service management in hospital settings /." free to MU campus, to others for purchase, 1998. http://wwwlib.umi.com/cr/mo/fullcit?p9904838.
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Stringer, Lisa, Kate E. Beatty, K. Wilson, and A. Ciecor. "From the Hospitals’ Perspective: Collaboration among Non-Profit Hospitals and Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6851.
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Beatty, Kate, Kirstin Wilson, Amanda Ciecior, and Lisa Stringer. "From the Hospitals’ Perspective: Collaboration among Non-Profit Hospitals and Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6856.
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Tam, Yiu-man, and 譚耀敏. "Clinical waste management and its future development in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31253544.
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Fuck, Marcos Fabio. "Metodologia de implementação de um laboratório de calibração de equipamentos médico-hospitalares." Universidade Tecnológica Federal do Paraná, 2006. http://repositorio.utfpr.edu.br/jspui/handle/1/1332.
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O controle metrológico de equipamentos utilizados nos ambientes de saúde é essencial para a garantia dos resultados relatados. No Brasil, há a ausência de laboratórios de calibração habilitados a realizar o controle metrológico desses equipamentos. Deste modo, neste trabalho propõe-se uma metrologia de implementação de um laboratório de calibração de equipamentos médico-hospitalares. Para concretização da proposta, fundamentou-se nos requisitos da norma da ABNT NBR/IEC 17025, oficialmente adotada pelo INMETRO, em outras publicações específicas voltadas à calibração de equipamentos médico-hospitalares, e nos critérios de habilitação de laboratórios estabelecidos pela ANVISA. Como resultados da pesquisa, encontram-se: um roteiro base para implementação de laboratórios de calibração de equipamentos médico-hospitalares, como expressão da metodologia desenvolvida; uma sistematização para o cálculo de incerteza da medição; um modelo de procedimento de calibração voltado à calibração de esfigmomanômetros; e indicadores de desempenho para o laboratório. O resultado da implementação da metodologia apresentada permite ao laboratório postulante garantir sua acreditação junto ao INMETRO e à ANVISA, por meio de uma abordagem que envolve a definição da área de atuação do laboratório, de suas políticas e seus responsáveis, documentação necessária e encaminhamento do pedido de solicitação de acreditação. Desta maneira, o processo rumo à qualificação de laboratórios de calibração de equipamentos médico-hospitalares será atingido, contribuindo para o preenchimento da lacuna da qualidade voltada aos ambientes de saúde.Metrological control of health-care environmental equipment is essential for the assurance of their results. In Brazil, there is a lack of specific laboratories able to perform metrological control of such equipment. The purpose of this research is to introduce a methodology to establish the infrastructure and laboratory calibration modus operandi for medical equipment. The developed proposal is based on the requirements of ABNT NBR ISO/IEC 17025 standard, officially adopted by INMETRO, besides other specific publications about medical equipment management, and laboratories certification criteria established by ANVISA. The achieved results are: a guideline for the establishment of a medical equipment uncertainly measurement; a calibration procedure for sphygmomanometers; and performance indicators for the laboratory. The resultant methodology allows the laboratory candidate to reach its accreditation goal up to INMETRO and ANVISA, with an approach which covers the definition of the laboratory area, its politics and responsibilities, documentation and accreditation requirements. Then, the process to obtain the qualification of a calibration laboratory will be reached, fulfilling the existing gap in the quality system of health-care environment.
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Camacho, Reinaldo Rodrigues. "Custeio alvo em serviços hospitalares: um estudo sob o enfoque da gestão estratégica de custos." Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/12/12136/tde-16042009-112113/.
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Esta pesquisa teve como objetivo verificar a viabilidade e identificar as peculiaridades da aplicação do Custeio Alvo em serviços hospitalares. Como produto teste da pesquisa, elegeu-se a cesariana realizada em pacientes via planos de saúde com internação em apartamentos Standard. Visando alcançar os objetivos da pesquisa, utilizou-se diversas fontes de dados e informações, tais como: levantamento bibliográfico, questionário, entrevistas, observação direta dos processos e atividades, e levantamento de dados nos relatórios contábeis, financeiros e administrativos da entidade objeto deste estudo de caso. A literatura pesquisada forneceu subsídios para entender e explicar o processo de aplicação do Custeio Alvo em serviços hospitalares. Paralelamente à pesquisa bibliográfica, elaborou-se um questionário que foi aplicado em um grupo de 50 (cinqüenta) mulheres com o objetivo de verificar a percepção delas em relação ao grau de importância de cada atributo do produto teste. Além disso, foram realizadas entrevistas com os gestores da entidade com o objetivo de verificar como são estabelecidos os preços e margens da cesariana realizada em pacientes via planos de saúde. A análise documental realizada em planilhas de custos, balancetes, e demais relatórios contábeis, financeiros e administrativos contribuiu para conhecer os procedimentos adotados pela instituição para mensurar e controlar seus custos e receitas. Antes de testar a aplicabilidade do Custeio Alvo a produtos e serviços hospitalares através de um caso prático, verificou-se, primeiramente, sua possível aplicação em termos teóricos, ou seja, verificando se os princípios e requisitos do Custeio Alvo, tal como foram expostos nos tópicos 2.5 e 2.6 são aplicáveis a este segmento. Na seqüência, foi possível demonstrar passo a passo, o processo de aplicação do Custeio Alvo em serviços hospitalares, além de se constatar alguns aspectos específicos da aplicação do Custeio Alvo em serviços hospitalares não encontrados na literatura consultada.This research aimed at verifying the practicability of the Target Costing application to hospital services, as well as identifying its peculiarities. The caesarian operation was selected as the research test product, when carried out in patients hospitalized in standard room, using health plan. Based on such purposes, several data and information sources were used such as: bibliographic survey, questionnaire, interviews, direct observation of the processes and activities, and data survey in accounting, financial and administrative reports from the entity chosen for this case study. The literature provided subsidies to understand and explain the Target Costing application process in hospital services. A questionnaire was also performed and applied to a group of 50 (fifty) women in order to verify their perception of the importance degree of each test product characteristic. Besides, some interviews with the entity directors were accomplished to verify how the caesarian prices and margins are established for patients with health plan. The documental analysis carried out in cost spreadsheets, balance sheets and other accounting, financial and administrative reports contributed to know the procedure adopted by the entity to measure and control its costs and revenues. Before testing the Target Costing applicability to hospital products and services using a practical case, at first, the possibility of the application was analized in theoretical terms, that is, it was verified if the Target Costing principles and requisites are applicable to this segment, as they were exposed in 2.5 and 2.6 topics. After that, it was possible to demonstrate the Target Costing application process in hospital services, step by step, and to find out some specific aspects of the Target Costing application in hospital services not found in the literature verified.
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Wood, Victorine Alexandra. "A critical appraisal of post-acute stroke management in NHS hospitals." Thesis, University of Bristol, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299734.
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Willis, James Russell. "The adoption of management and service innovations by rural Ohio hospitals /." The Ohio State University, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487849696965916.
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Ikediashi, Dubem Isaac. "A framework for outsourcing facilities management services in Nigeria's public hospitals." Thesis, Heriot-Watt University, 2014. http://hdl.handle.net/10399/2815.
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Literature has established FM as a global business model that continues to explore how organisation can grow faster through expansion into new markets, find new ways of fostering innovation through collaborative outsourcing that will achieve right balance between the decision to outsource, risks and legal requirements embedded in the service level agreement (SLA) between client organisations and their FM outsourcing vendors. The study aims to develop and test a framework for outsourcing facilities management services using data from Nigeria’s public hospitals. The specific objectives are among others; to determine a set of key factors that influence the decision to outsource facilities management services in public hospitals; to conduct an empirical survey of facilities management services outsourced in public hospitals; to access the satisfaction of users of outsourced FM services and model the satisfaction of users on quality of outsourced facilities management services using SEM; and assess the probability and severity of risks associated with outsourcing of facilities management services in public hospitals. Data for this study were collected using a cross sectional 2-strand questionnaire survey and case study. During the first strand of questionnaire survey, a total of 85 responses were received from the six states comprising the study area while 11 of them were discarded due to missing data resulting in 74 usable responses. This gave an overall response rate of 45.4%. A total of 246 survey responses were received during the second strand of questionnaire survey. Of these, 38 were not fully completed and therefore discarded leaving 208 as usable responses. This resulted in an overall response rate of 25.1%. The case study component involved semi-structured interview section with 4 participants representing 4 cases (3 hospitals and 1 FM organisation). Findings revealed that 25 of the 31 factors were significant in explaining the decision to outsource FM service in Nigeria’s public hospitals; while 15 of them grouped into 5 broad categories were recommended for framework construction based on their factor loadings during analysis. Also, 6 facilities management services including plant management and repairs; general cleaning services; waste disposal and environmental management; landscape maintenance; security; and catering/restroom management are completely outsourced in all the 74 hospitals. Findings additionally revealed that service quality in relation to catering, plant maintenance, waste management, security, landscape maintenance, and cleaning services received very high satisfaction ratings from respondents. Findings also established 24 out of the 35 risk factors as critical, 4 factors as somehow critical, and 5 factors as not critical. Besides, 9 risk factors were selected based on their factor loadings from PCA to develop the outsourcing framework. Drawing on theoretical analysis and input from the questionnaire survey and case study, an outsourcing framework comprising 4 components was developed to assist public hospitals administrators achieve sustainable best practice resource management. It is recommended among others that further research be conducted to develop standardised criteria for vendor selection processes.
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Lee, Ha-yun, and 李夏茵. "A SWOT analysis of the hospital performance management system in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206979.
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The existing financing model is not going to be sustainable for the ageing demographic in the future Hong Kong. In regards, Government suggested a voluntary and government-regulated health insurance scheme to provide more choices with better protection for those who are able and willing to pay for private healthcare services. However, performance of the Hong Kong health system is rarely discussed despite vast health expenditure has been spent. The objective of this project is to identify the strength, weakness, opportunities and threats of the hospital performance management system in Hong Kong.
The project involves a literature search for key success factors for performance management systems in healthcare. The SWOT analysis of the hospital performance management systems in Hong Kong are then analyzed with reference to the findings. Findings: Six success factors could be identified: position in the policy process and defined objectives, process of development, indicator validity, reliability, responsiveness and feedbacks. The public hospital system has partially incorporated these factors in its system but a structured performance monitoring and management system is lacking for the private sector.
The current Hong Kong hospital performance systems are not able to provide adequate information for the payers to make the appropriate choice. There is an urging needs to develop a robust and transparent performance management system in Hong Kong in order to support healthcare reform.published_or_final_version
Public Health
Master
Master of Public Health
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Sumner, Jennifer L. "Healthcare communication networks the dissemination of employee information for hospital security /." Orlando, Fla. : University of Central Florida, 2007. http://purl.fcla.edu/fcla/etd/CFE0002010.
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Zargarian, Herand Ron. "CEO Compensation and Performance in Publicly-Traded Hospitals| 2011-2016." Thesis, Northcentral University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10840268.
Full textAbstract:
Average compensation of a CEO of publicly-traded hospitals was about $4 million a year for the period 2011 to 2016. Their compensation is growing while people have a hard time to pay the medical bills. The passage of the Affordable Care Act of 2010 has a significant effect on the healthcare system specifically on hospital operations. Hospitals account for 32% of the total healthcare costs. Through the passage of the ACA, lawmakers intended to reduce costs and increase the quality of care. Publicly-traded entities because of the separation of the management (agent) and ownership (principal) have conflicts of interest that lead to agency problems and costs such as the cost of monitoring and low return to shareholders. The publicly-traded hospitals are no exception. Hospitals provide incentives to the CEOs to reduce these costs and align their and shareholders? objectives. The purpose of the quantitative study was to examine the following question. What correlation, if any, existed between CEO compensation and financial performance of the U.S. hospitals post the ACA Act of 2010 for 2011-2016? The following metrics, operating margin, return on assets, return on equity, occupancy rate, length of stay, and profit per discharge, were used to perform multiple regression analysis. Initially, seven hospitals were selected, but one hospital was excluded because of missing data. Spearman?s rho correlation was used because data violated some of the parametric assumptions. The Operating margin, occupancy rate, and profit per discharge variables were statistically significant in explaining the CEO compensation. Other variables affected the CEO compensation but were not statistically significant. Finally, including all six variables explained less than 30% of CEO compensation, which would indicate agency problems exist in the hospitals. Future studies should identify what other variables explain the change in CEO compensations
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Nimnuan, Chaichana. "Epidemiological study of functional somatic syndromes in general hospitals." Thesis, King's College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314008.
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Yao, Wei-yen Rosa. "An evaluation of the reform and quality of pharmacy service in Hospital Authority : a case study at Princess Margaret Hospital /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14035534.
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Waun, Cynthia J. "Identified strengths of successful Chief Executive Officers leading psychiatric hospitals| A multiple case study." Thesis, Capella University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3734733.
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This multiple case study research examines the personal strengths of Chief Executive Officers (CEOs) and how these strengths contribute to their success as they lead their personnel and manage psychiatric hospitals in their charge. The study provides an understanding of the role of personal strengths in the successful CEO and discusses each CEO’s utilization and development of those strengths. The Clifton StrengthsFinder 2.0 as found in StrengthsFinder 2.0 (Rath, 2007) instrument was employed in the study to provide a common language that facilitated the researcher’s conversation with the participants. Used as a heuristic device, the results of the strengths identifier tool were not applied in any comparative analytical format but rather provided a common frame of reference for both the researcher and the participant. The experience of responding to the strengths identifier tool provided a starting point for an interview that allowed the participants to talk about their strengths, their development, and the contribution of their strengths to their success. The theme of self-awareness emerged as an important component of their success, common to all of the participants in the study. Secondary themes of courage and humility, connected to self-awareness, contributed to understanding how the participants utilized their signature strengths to engage in a successful career leading psychiatric hospitals. The participants were able to describe their capacities, strengths, and how they used their abilities in unique ways while leading their hospitals.