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Choi, Ka-wing Janet. "Prioritization of planned maintenance works in public hospitals in Hong Kong." Click to view the E-thesis via HKU Scholars Hub, 2006. http://lookup.lib.hku.hk/lookup/bib/B37937637.
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Gong, Zhiping. "Developing casemix classification for acute hospital inpatients in Chengdu, China /." Access full text, 2004. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20050314.195349/index.html.
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Submitted to the School of Public Health, Faculty of Health Sciences. Thesis (Ph.D.) -- La Trobe University, 2004.Includes bibliographical references (leaves 320-329). Also available via the World Wide Web.
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Oliveira, Paula Maria de. "Hospital de São Sebastião (1889-1905): um lugar para a ciência e um lazareto contra as epidemias." reponame:Repositório Institucional da FIOCRUZ, 2005. https://www.arca.fiocruz.br/handle/icict/3988.
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Previous issue date: 2005Procura reconstituir a história do Hospital de São Sebastião, que foi fundado na cidade do Rio de Janeiro, em 1889, como um dos últimos atos do Imperador D. Pedro II. O objetivo central foi a análise da relação da criação e estruturação do Hospital de São Sebastião com o debate sobre a causalidade das doenças, em especial a febre amarela, e com o desenvolvimento da medicina pasteuriana. Desta forma reconstitui o processo de criação da instituição, suas características arquitetônicas, e seu papel no processo de estruturação dos aparelhos institucionais, no campo da saúde pública, especialmente no cenário das epidemias. Analisa a arquitetura da instituição, relacionando-a com os debates existentes na época sobre arquiteturas hospitalares e com as correntes médicas hegemônicas na época.
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Abdullah, Zainatul Shima. "Hospital information systems implementation framework: critical success factors for Malaysian public hospitals." Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/1441.
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The delivery of high quality health services is among the most important government policies in healthcare; it is demonstrated via the significant investment committed to expand the sector. In order to provide quality health services, Hospital Information Systems (HIS) development and adoption has to be initiated; though evidence has shown that implementing HIS is not easy. To ensure continuous successful implementation, the understanding and determination of HIS implementation factors has become a crucial consideration for health providers. This study, instigated to alleviate this problem, identified critical factors that influence HIS implementation and examined structured indicators to measure HIS implementation.Based on the critical success factors (CSFs) and DeLone and McLean’s Information Systems success model, the research study developed an implementation framework comprised of essential elements to guide HIS implementation. In the framework, the DeLone and McLean IS success measures were adapted and presented as a reflective second order factor to capture the multifaceted nature of success. A total of 500 questionnaires were distributed to six public hospitals in Malaysia and 213 were used for analysis. This reflects a high response rate of 42.6 percent. To evaluate the extent of success, the partial least squares (PLS) based structural equation modeling (SEM) approach was employed. The findings of the study revealed that the CSFs in Malaysia differ from studies in developed countries. Three out of seven success factors namely system selection, enterprise-wide communication and team composition proved to be significant. Key implementation factors such as top management support, business planning, project management and change management were found to be insignificant.The study is among the few that have tested empirically an implementation framework in the Malaysian settings; as such, it contributes significantly to theoretical, methodological and practical aspects of research. Theoretically, it established a new classification of CSFs that could influence HIS implementation. This new categorization is a significant effort to provide a practical list of CSFs that allows practitioners to focus on key areas during system implementation.Additionally, the study presents a new model that suggests links or correlations between the CSFs and how these factors should be implemented.With regard to research methodology, the study collected data from Malaysian public hospitals having a Total Hospital Information System (THIS) implementation; the type of data is rare considering the complex procedures involved. Also, the quantitative approach employed is suitable to attest the effectiveness of the implementation model. This study also utilized the SEM component-based or PLS analysis for assessing the implementation model. At present, it is still uncommon to find HIS implementation studies that utilize PLS analysis in Malaysia.In terms of a practical contribution, the study provides guidelines for managers in decision-making and planning future HIS implementation. The risks of failures for HIS implementation could be reduced as the study also proposed the approach on how the CSFs should be implemented. Most importantly, this study has established a model that could assists practitioners and researchers in understanding the implementation process of HIS, specifically for Malaysian public hospitals. Additionally, its contribution can be used in analogous domains such as information systems (IS), enterprise resource planning (ERP) and enterprise systems (ES).
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Allan, Cameron, and n/a. "Labour Utilisation in Queensland Hospitals." Griffith University. Griffith Business School, 1996. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20050906.171638.
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Within Australia and in Europe. there is evidence of growth in the incidence of non¬standard forms of employment such as part-time and casual work. Part of this growth can be attributed to changes in the structure of the economy and the increasing importance of service industries where non-standard forms of employment proliferate. There is also evidence, however, that employers at the firm level are progressively expanding their use of non-standard employment and reducing their reliance on full-time labour. One explanation for this organisational-level phenomena has been suggested by Atkinson (1987) in his account of the flexible firm. Atkinson claims that employers are increasingly attempting to divide the workforce into two major segments: a skilled, full-time core labour force and an unskilled, non-standard segment. This thesis examines Atkinsons flexible firm model through a study of labour-use practices of three acute hospitals in Queensland. A main finding of this thesis is the generalised and substantial growth of non-standard employment in all types of Queensland hospitals. The growth of non-standard hospital labour is not as, Atkinson would suggest, largely the result of demand-side strategies of employers but is also conditioned by supply-side factors. Gender, rather than skill, is found to be an important determinant of the proliferation of non-standard employment. Non-standard employment is not the major labour adjustment mechanism in all sectors of the hospital industry. Labour intensification is a critical and overlooked form of labour adjustment in the public sector. Overall, this thesis concludes that employers labour-use practices need to be conceptualised within the context of the opportunities and constraints imposed by the interaction of demand and supply-side factors.
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Toh, Carolyn Anne. "A new way of funding public hospitals /." Title page, and contents only, 1994. http://web4.library.adelaide.edu.au/theses/09EC/09ect645.pdf.
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Undrum, Michael, and Andreas Ebbesen. "Diffusion of Process Innovations in Public Hospitals." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for industriell økonomi og teknologiledelse, 2014. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-26165.
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Norwegian hospitals are challenged by demographic changes, an increasingly complex clinical picture and longer waiting lines. At the same time hospitals struggle with adopting process innovations aiming at improving efficiency and productivity at a satisfactory rate. This study is a specific contribution to an increased understanding of the diffusion of process innovations in public health care. The first question answered by this study is related to which specific determinants that affect the diffusion and adoption of process innovations in Norwegian, public hospitals. The second question considers how the efforts of process improvements observed in Norwegian hospitals relate to the innovation-decision model by E. Rogers (2003). To answer these questions a case study research was selected and 15 interviews with six unique case hospitals and three independent specialists were conducted. This provided the data needed to identify both the relevant determinants and new insight in the efforts for process improvement in Norwegian hospitals.This study has four main contributions to theory. First, the five most relevant determinants for the diffusion of process innovations were found to be reinforcement by management, meaning, professionalism, collective action, and experimentation. Second, the findings suggest that interconnectedness of determinants plays an important role for process innovations. Third, the identification of three phases in the process improvement in hospitals resulted in a proposed modification to the innovation-decision model. Fourth, the framework of determinants applied to the phases of process improvement yielded insight in the different determinants affecting each of the identified phases. Implications for managers are a need for increased understanding of how the local process is affected by various elements depending on the phase of a project and increased understanding of the importance of reinforcement by management in facilitating process innovation. Implications for policymakers are that the diffusion of process innovations involves high degrees of inspiration and adaptation, making it hard to facilitate the diffusion of a particular innovation and that the direct influence of policymakers seems to be low despite their given mandate to facilitate development.
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Piterman, Hannah, and Hannah Piterman@med monash edu au. "Tensions around introducing co-ordinated care a case study of co-ordinated care trial." Swinburne University of Technology, 2000. http://adt.lib.swin.edu.au./public/adt-VSWT20050418.092951.
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The aim of the research was to analyse the organisational dynamics surrounding a health care reform implementation process associated with the introduction of coordinated care, which is an Australian Government initiative to introduce structural changes to the funding and delivery of health-care in response to rising health care costs. A longitudinal case study of an implementation team was studied. This included the perceptions and experiences of individuals and institutions within hospitals, the general practice community and Divisions of General Practice. Furthermore, the case study explored organisational structures, decision-making processes and management systems of the Project and included an examination of the difficulties and conflicts that ensued. The broader context of health care reform was also considered.
The study found that an effective change management strategy requires clarity around the definition of primary task in health care delivery, particularly when the task is complex and the environment uncertain. This requires a management and support structure able to accommodate the tensions that exists between providing care and managing cost, in a changing and complex system. The case study indicated that where tensions were not managed the functions of providing care and managing costs became disconnected, undermining the integrity of the task and impacting on the effective facilitation of the change process and hence, the capacity of stakeholders to embrace the model of co-ordinated care. Moreover, the micro dynamics of the project team seemed to parallel the macro dynamics of the broader system where economic and health care provision imperatives clash. Through its close analysis of change dynamics, the study provides suggestions for the improved engagement of stakeholders in health care change.
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Trachuk, Antonina. "Newspaper framing of a hospital the impact of hospital public relations /." online access from Digital Dissertation Consortium, 2006. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?1443582.
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Sutton, Kathleen Rose Creagh, and res cand@acu edu au. "A Study of the Mater Children’s Hospital Tile Project." Australian Catholic University. School of Arts and Sciences, 2005. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp105.11092006.
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This thesis examined the relationship between children’s visual art and hospital contexts. It specifically focused on children’s art in the Tile Project within the Mater Children’s Hospital, Brisbane, Queensland, Australia. This ethnographic study consisted of interviews with the creators of the Tile Project as well as interviews and a survey with parents, staff, and children within the Mater Children’s Hospital. The interviews were informed by a review of literature in the areas of art in health settings. The study made observations of the community interacting with the tiles and collected images of the tiles used in the hospital and employed the framework of Bourdieu’s (1993) fields of cultural production and Abbs’s (1987) aesthetic field and dimensions, as well as the aesthetic dimensions of Beardsley (1982), Eisner (1985), and Csikszentmihalyi (1990). The study investigated the aesthetic characteristics of the tiles and their health outcomes in relation to the hospital community. This study is significant because the Mater Children’s Hospital Tile Project was a project that reflected art in healthcare settings involving Community Arts, art in design, and art in public buildings. The research identified the unique nature of the Tile Project which saw the hospital as a children’s space with artworks for children by children. The study reflected on the value of the tiles in having a healing and distracting quality for parents and children alike and that engagement with the tiles through touch, imagination, and playful games improved the atmosphere of the hospital.
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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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BLOMQVIST, ISABELLE, and MALIN MATTSSON. "Facilitating Dissemination of Innovations in Public University Hospitals." Thesis, KTH, Industriell Management, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-191285.
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The health sector is today facing many challenges, requiring a need for capabilities in managing innovations. At Karolinska University Hospital in Sweden, the management of some of the innovations has been centralized to the Innovation Center. The Innovation Center can be involved in all phases of an innovation process, but have identified difficulties to deal with innovations that have already been successfully implemented. Further implementation of these innovations to other hospital units, creates benefits for more patients and care givers, and is therefore of high importance. Therefore, managing innovations also includes making sure that successfully implemented innovations are spread to other clinics in the hospital, a phenomenon hereby called dissemination of innovations. Studies show that many innovations, even though they are successfully implemented at one location, disseminate slowly, or not at all. In fact, two out of three implementation efforts in the health care sector fail due to various barriers. The purpose of this master thesis is therefore to explore how dissemination of innovations can be facilitated at university hospitals in public health care systems. By dissemination we refer to the intentional spreading of innovations to other hospital units, or repeated implementations following the initial implementation target. Therefore, dissemination is targeted by studying the dynamics of implementation processes through the following research question: How do organizational factors affect the implementation of innovations at public university hospitals? By organizational factors we mean general areas that can be influenced by central management functions, such as: funding, leadership and culture. The research question has been studied qualitatively through a literature study, a contextual study and three case studies. The cases consist of three innovation projects managed by the Innovation Center that have undergone some sort of dissemination. The empirical data has been collected through semi-structured interviews with both administrative and clinical staff. The data has been structured and analyzed using a theoretical framework developed from findings in previous research. In accordance to previous research, our results indicate that various organizational factors affect the dissemination of innovations. For instance, the complex and unstandardized way of getting funding to dissemination projects are impeding the process. Also, it needs to be clearly established who is to assume responsibility of an innovation, both during its initial implementation process as well as its dissemination. Resistance from clinicians may also function as a barrier and is caused by, for instance, a lack of information about the innovation or bad experiences from earlier failed projects. Additionally, if innovations do not meet identified and prioritized needs at the clinic, or if it is not properly adapted to local conditions and requirements, this may also impede the implementation. To properly involve clinicians is therefore of high significance in order to enable a successful implementation. Finally, rigid structures affect implementation negatively. These are built up by, for instance: extensive use of, and sometimes contradicting, policies and regulations; high administrative requirements as well as an organizational structure that separates medical disciplines. This inertia, together with sparse time allocated for innovation activities among the clinics, leads to difficulties when implementing and disseminating innovations in the hospital.
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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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Hongoro, Charles. "Costs and quality of services in public hospitals in Zimbabwe : implications for hospital reform." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://researchonline.lshtm.ac.uk/1649006/.
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Hospitals come under the focus of health planners and policy makers because they invariably consume large and increasing amounts of health care resources and performance is commonly believed to fall short of that possible. The common response by governments to this situation has been to implement hospital reforms. However, emerging evidence from impact evaluations of such reforms shows little clear evidence of performance enhancement. It is argued in this study that hospital reforms in most countries are implemented without enough understanding of current performance, or knowledge of hospital behaviour. Such information is necessary for effective design, implementation and evaluation of reforms. The aim of the study was to measure hospital performance and contribute to the understanding of its determinants. The role of internal organisation and management to hospital performance has been underplayed in most studies such that the workings of the hospital remain a "black box". The study sought to demonstrate that understanding hospital performance entails understanding not only the technical relationships of dimensions of hospital performance but also the institutional context, and behaviour of individuals or groups within it who ultimately shape hospital behaviour. A multiple case study approach was used to study six tertiary hospitals in Zimbabwe. Hospital performance was first assessed through analysis of utilisation statistics. This was followed by an assessment of two dimensions of hospital performance: costs and quality of inpatient services. Costs were measured using standard cost accounting methods at hospital, ward and patient level. At patient level, a combination of. prospective micro-costing and top-down costing methods was applied to cohorts of patients suffering from selected tracer diseases: 207 malaria and 158 pulmonary tuberculosis cases. The quality of hospital inpatient services was also measured at hospital and patient level using structural and process approaches. The relationship between cost and quality of services was then explored at patient level using tracer conditions. A triangulation of methods was then used to explore internal organisation and management: staff interviews, observations, attendance at hospital meetings and review of administrative records. Analysis of activity statistics showed that the six hospitals had different levels of activity although they had similar roles in the referral hierarchy. Distinctive unit cost patterns were observed across the hospitals. Unit cost variation across hospitals was generally similar at hospital, ward and patient level. The results from the analysis of activity statistics were predictive of hospital cost classifications. The quality of hospital services varied across hospitals from both structural and process perspectives. There was little convergence in results from hospital level structural quality assessment, and process quality assessment. Cost-quality relationships in inpatient care showed a distinct pattern across tracer diseases, which permitted classification of the six hospitals into three performance categories. These classifications were used to relate quantitative and qualitative results of the study. The institutional contexts within which public hospitals in Zimbabwe operate is explored and described. There are fundamental policy design weaknesses related to the way hospitals are financed, governed and managed, which affect hospital performance. Hospital staff appears apathetic about hospital performance because of lack of appropriate incentives. Several hospital internal factors were reported as impinging on hospital performance. These factors can broadly be summarised as lack of management capacity and skills, inappropriate internal organisational and management structures, and staff reward systems. The current incentive structure at individual and institution level does not engender performance improvement. Relative hospital performance did not vary systematically with different institutional characteristics. For instance, compliance or non-compliance with mandated organisation and management structures did not account for performance differences whilst weak associations were found between relative performance, and differences in management capacity and skills. The absence of direct relationships between institutional characteristics and relative performance was not unexpected given the exploratory nature of the study and the possible multiple interrelationships between these factors Nonetheless, the study systematically describes and exposes current weaknesses in the internal structure of public hospitals in Zimbabwe, and identifies those internal organisational and management features considered important to performance. The study concludes that there is considerable scope for improving hospital efficiency and quality of services (with available resources) by changing internal organisation and management of hospitals. Of particular importance is the need to change and align incentives (monetary and nonmonetary) at both individual and institution level in ways that promote performance improvement.
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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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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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Sibert, Ronald I. "Privatization and corporate governance mining synergy from conflict across sectors, a case study /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 1.02 Mb., 264 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3200537.
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Fortuna, André Pacheco. "The optimum size of the portuguese public hospital." Master's thesis, NSBE - UNL, 2009. http://hdl.handle.net/10362/9451.
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and EconomicsIn a context of intensive structural reform, this paper estimates optimum bed-sizes for the Portuguese public hospitals. Considering costs and production data for the period 2003-2006, we estimate a production-theoretic quadratic cost-function, adjusted to better describe the underlying technology. Room for short-run scale-economies exploitation is found, but long-run scale-diseconomies are unambiguous. In light of these predictions and of an optimum around 233 fully-occupied beds, there is mixed evidence of potential gains from two hospital mergers and from one of the forthcoming constructions of public hospitals. The results are expected to contribute to shape the hospital network in a cost-efficient manner.
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Al, Salem Gheed F. "An assessment of safety climate in Kuwaiti public hospitals." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/30685/.
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Background: Patient safety in healthcare organisations received global attention following the Institute of Medicine’s release of its hallmark report “To Err Is Human: Building a Safer Health System”, where it was estimated that 44,000–98,000 patients die annually in US hospitals as a result of errors in care. Similar rates of error and avoidable harm have been reported in different research studies in many modern health systems across the world. “Safety Culture” has been identified as a key element of healthcare organisations’ ability to learn from errors and reduce preventable harm to patients resulting from health care. The perceived importance of safety culture in improving patient safety and its impact on patient outcomes has led to a growing interest in the assessment of safety culture in healthcare organisations. The use of safety climate questionnaires is one of the most popular methods for assessing safety culture. These questionnaires are thought to help in measuring healthcare workers' perceptions of the prevailing safety culture or “safety climate” in their organisations. Since no surveys of safety climate have been conducted at public hospitals in the state of Kuwait, nor are valid or reliable survey instruments available, this thesis aimed to investigate patient safety climate in public hospitals in Kuwait. The main objectives of the study were: 1. To identify an existing safety climate tools to be employed in my PhD thesis. 2. To test the psychometric properties of the identified tool in a sample of Kuwaiti public hospitals. 3. To provide a measure of the prevailing safety climate in Kuwaiti public hospitals. 4. To explore with key stakeholders the main findings of the safety climate survey and identify the potential barriers and facilitators to safety improvement initiatives in Kuwaiti public hospitals. Based on the overall findings, a series of recommendations are made for clinical leaders, policy makers and others to consider and a conceptual model informing a systems’ based approach to safety culture theory and practice is proposed for future research. Methods: A multi-method, triangulated approach including both quantitative and qualitative methods was adopted for the study. There were four phases of the research: A systematic review of published literature on safety climate tools used in acute hospital settings was carried out using seven electronic databases, with manual searches of bibliographies of included papers and key journals. A suitable tool was identified. A cross-sectional survey of 1,511 healthcare staff in three public hospitals was conducted for two purposes: Firstly, to assess the psychometric properties of the identified tool and develop an optimum model for assessing safety climate in Kuwaiti hospitals. Secondly, to provide an assessment of the current state of safety climate in Kuwaiti hospitals. Finally, interviews with key personnel were conducted to extend the examination of the survey findings and provide a rounded picture of the current state of safety climate in Kuwaiti public hospitals. Results: The search strategy identified 3,576 potential papers. Of these, eighty-eight papers were reviewed, with five studies meeting the inclusion criteria. Three out of five studies, covering three tools, were rated as ‘good’ quality papers and reported more robust psychometric properties. The Hospital Survey on Patient Safety Culture (HSOPSC) was selected as the most appropriate for my PhD thesis (in terms of usability, applicability and psychometric properties), and was pilot tested with minor modifications. A modified version of the HSOPSC was used to conduct the survey using a sample of healthcare staff with an 87% (n=1,310) response rate. Results of psychometric evaluation, including exploratory factor analysis, confirmatory factor analysis, reliability and correlation analysis, showed an optimal model of eight factors and 22 safety climate items. General evaluation of the prevailing safety climate amongst the workforce in acute hospital settings was conducted. The dimensions “Teamwork within units” (84%), “organisational learning-continuous improvement” (82%), “supervisor/manager expectations and actions promoting safety” (77%) and “management support for patient safety” (74%) were identified as strongly positive areas for the three hospitals. The dimensions “Non-punitive response to error” (34%), “communication openness” (47%) and “frequency of event reporting” (50%) were identified as areas in need of improvement. Building on the survey findings, interviews with key stakeholders added rich insight into hospital employees' perceptions on safety and allowed exploration of emerging issues in more detail. The research findings of my PhD thesis, and of the literature informed the design of a preliminary framework that aims to extend the examination of the construct of safety climate beyond the domains and items that typically inform safety climate theory to include system wide factors which potentially influence the prevailing safety culture/climate. Conclusions: This is the first validation study of a Standardised safety climate measure in a Kuwaiti healthcare setting. The study assessed the psychometric properties of the HSOPSC questionnaire and constructed an optimal model for assessing patient safety climate in Kuwaiti hospitals. It highlighted important patient safety and staff wellbeing concerns to inform organisational and national learning, and provided a baseline for measuring patient safety climate in Kuwaiti hospitals. As such, my PhD thesis raises and emphasizes the critical importance of appropriate validation of safety climate questionnaires before extending their usage in different countries or healthcare contexts. It provided new knowledge about areas of strength and weakness in safety climate with the potential to drive local improvements in Kuwaiti public hospitals. It is recommended that future investigations of patient safety culture and climate combine both quantitative and qualitative approaches and adopt a system wide approach to inform safety climate theory and questionnaire development, leading to stronger frameworks guiding safety culture research and practice.
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Banks, Janet. "Carrying the load : nursing care experiences in a public hospital system /." Digital version accessible at:, 2000. http://wwwlib.umi.com/cr/utexas/main.
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Mangano, Maria. "Frontier methods for comparing public hospital efficiency." Thesis, Curtin University, 2004. http://hdl.handle.net/20.500.11937/2109.
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This research examines the impact, if any, of the introduction of casemix funding on public hospitals in Victoria. The results reported here show that in Victoria, during the period under observation, rural hospitals showed a significantly greater preponderance, relative to metropolitan hospitals, to either amalgamate or close down. Since 1 July 1993 public hospitals in Victoria have been compared for efficiency in the delivery of their services. The casemix funding arrangements were installed, among other reasons, to improve efficiency in the delivery of hospital services. Duckett, 1999, p 107 states that under casemix funding 'The hospital therefore becomes more clearly accountable for variation in the efficiency of the services it provides'. Also, 'Generally, case-mix funding is seen as being able to yield efficiency improvements more rapidly than negotiated funding'. Hospital comparisons provide State bodies with information on how to allocate funding between hospitals by means of annual capped budgets. Budgets are capped because funding is restricted to a given number of patients that can be treated in any given year. Thus, casemix funding relies heavily on cost comparisons between hospitals, and the way that hospital output is measured relies on the use of diagnosis related groups (DRGs).
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Lockhart, Judith. "Women, health and hospitals in Birmingham : the Birmingham and Midland Hospital for Women, 1871-1948." Thesis, University of Warwick, 2008. http://wrap.warwick.ac.uk/3647/.
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This study considers the social history of the Birmingham and Midland Hospitals for Women Incorporated between 1871 and 1948. The hospitals were an integral part of the voluntary hospital system in Birmingham, where two general infirmaries and a range of smaller specialist institutions had been set up to deal with the health care needs of a growing population during the period of industrialization. Two underlying historiographical themes are discussed throughout the thesis; the motivation of those that founded and supported such institutions and the feminist critique of the developments in the practice of gynaecology. Much of the current literature on women's health in this period concentrates on the underlying ideology rather than health care. Here the emphasis is reversed; it is to the medical care and treatment of diseases associated with women's sexual and reproductive organs that this thesis is directed. I have adopted a broadly chronological approach, with Chapters 1 to 4 exploring the founding of the hospital in 1871 and the important early years during which it became established. Chapters 5 to 7 consider developments during the Edwardian period and the inter-war years. In the organization of the individual chapters I have adopted a thematic approach considering the association that different group of people had with the hospital; the governors, medical staff and patients, both within the context of their health care and the lives and circumstances of working-class women in the wider sense. To provide an analytical framework for this study, the dominant historiographical paradigms in the field of women's health are discussed in the introduction to this thesis.
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Kimsey, Linda Gail. "HOW EFFICIENT ARE MILITARY HOSPITALS? A COMPARISON OF TECHNICAL EFFICIENCY USING STOCHASTIC FRONTIER ANALYSIS." Lexington, Ky. : [University of Kentucky Libraries], 2009. http://hdl.handle.net/10225/1093.
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Thesis (Ph. D.)--University of Kentucky, 2009.Title from document title page (viewed on October 29, 2009). Document formatted into pages; contains: ix, 153 p. : ill. (some col.). Includes abstract and vita. Includes bibliographical references (p. 143-152).
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Amadi-Nwada, Obumneke. "Association Between Physician Characteristics and Surgical Errors in U.S. Hospitals." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10254898.
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The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients’ safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians’ home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians’ field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.
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Shika, Matsepane Rebecca. "Radiation safety standards at public hospitals in Limpopo Province, South Africa." Thesis, University of Limpopo (Turfloop Campus), 2012. http://hdl.handle.net/10386/859.
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Lertiendumrong, Jongkol. "Efficiency of hospitals in the context of change : a case study of general public hospitals in Thailand." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408670.
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Guzman, Castillo M. "Modelling patient length of stay in public hospitals in Mexico." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/345554/.
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This thesis is concerned with the modelling of patient length of stay in public hospitals in Mexico. Patient length of stay is the most commonly worldwide employed outcome measure for hospital resource consumption and performance monitoring. Most of the hospitals around the world use average length of stay as starting point for resource planning. However average estimates frequently gives non-accurate results due to the high variability of the length of stay data. The reason for such high variability may be attributable to the diversity in the patient population and the environment where the patient is treated. Through a systematic review of the literature on methods and models in the field of calculating and predicting patient length of stay, this research highlights the areas of opportunity and research gap from previous studies and practices, and proposes the use of finite mixture models to approximate the distribution of length of stay. Also, these models are proposed as the foundation of more sophisticated models designed to include the internal and external factors associated with LoS. In this context, the thesis proposes three different approaches to explore such factors: individual-based approach, group-based approach and multilevel group-based approach. These interrelated approaches allow a better understanding of the diversity in the patient population and enable length of stay predictions for individual patients, and for cohorts of patients within and between hospitals. In addition, this research is built and evaluated using data from all types of patients treated at two public hospitals operating in Mexico. It is the consideration of the full case-mix of these healthcare facilities that gives this research its unique nature.
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Timothy, Badgery-Parker. "Measuring low-value care in New South Wales public hospitals." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/20145.
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My aim in this thesis is to develop and apply measures of low-value care (where expected benefits do not outweigh the potential harm) based on hospital administrative data in New South Wales (NSW), Australia. Measurement is a prerequisite for understanding the drivers of and exploring remedies for low-value care. I developed low-value care measures for 27 procedures. In 2016-17, between 4487 and 8986 hospital episodes involved low-value care, accounting for 10% to 20% of all episodes involving these 27 procedures. However, my results almost certainly underestimate low-value care for these procedures. The proportion of low-value care varied considerably between hospitals. Multilevel modelling analysis confirmed that most variation is between hospitals; Local Health District and residential area have little association with low-value care. None of the (limited) hospital variables available were associated with low-value care. Further exploration of inter-hospital variation will require more detailed hospital data, including attitudes of individual clinicians within hospitals. Low-value care is also a patient safety issue. I used 16 hospital-acquired complications (HACs) to examine some immediate adverse consequences of low-value care. Across seven procedures where recommended care would not normally involve hospital admission, HAC rates ranged from 0.1% to 15.0% of the low-value episodes. To the best of my knowledge, these patients only entered hospital for the low-value procedure; therefore, the HACs can be attributed to the low-value care. This project occurred in partnership with the NSW Ministry of Health. Two other states commissioned analyses using their own data, and a peak private health insurance industry body commissioned an analysis using private health fund data. State health departments are using these methods to provide feedback to clinicians and hospital managers and may in future incorporate the indicators into funding and performance agreements.
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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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Ashton, Kathleen L. "A survey of the status of marketing and public relations in the Indiana hospital industry." Virtual Press, 1994. http://liblink.bsu.edu/uhtbin/catkey/935923.
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The fields of public relations and marketing are experiencing interdisciplinary assimilation, especially in the health care industry and specifically in hospitals. With the recognition of this basic trend many questions have been raised by public relations practitioners, marketers, and health care administrators dealing with present and anticipated functions of these public relations/marketing departments.To survey the status of public relations and marketing in Indiana hospitals the study's research question became: What is the status of the functions of public relations and marketing in Indiana hospitals?A questionnaire was the basic research tool in this study of the status of hospital marketing and public relations. The questionnaire included three sections: 1) hospital demographics; 2) identification of public relations and marketing functions performed; and 3) professional staff demographics. This study's universe was defined as healthcare marketing/public relations professionals in the State of Indiana and therefore drew its sample from the Indiana Society for Healthcare Public Relations and Marketing membership list, 1993.The researcher's survey findings led her to the conclusion that because marketing is such a new and powerful force in Indiana's hospital industry, it is swiftly integrating its functions into traditional hospital public relations programs and even rising to a position of primacy over traditional public relations programs.Department of Journalism
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Mangano, Maria. "Frontier methods for comparing public hospital efficiency." Curtin University of Technology, School of Economics and Finance, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=17497.
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This research examines the impact, if any, of the introduction of casemix funding on public hospitals in Victoria. The results reported here show that in Victoria, during the period under observation, rural hospitals showed a significantly greater preponderance, relative to metropolitan hospitals, to either amalgamate or close down. Since 1 July 1993 public hospitals in Victoria have been compared for efficiency in the delivery of their services. The casemix funding arrangements were installed, among other reasons, to improve efficiency in the delivery of hospital services. Duckett, 1999, p 107 states that under casemix funding 'The hospital therefore becomes more clearly accountable for variation in the efficiency of the services it provides'. Also, 'Generally, case-mix funding is seen as being able to yield efficiency improvements more rapidly than negotiated funding'. Hospital comparisons provide State bodies with information on how to allocate funding between hospitals by means of annual capped budgets. Budgets are capped because funding is restricted to a given number of patients that can be treated in any given year. Thus, casemix funding relies heavily on cost comparisons between hospitals, and the way that hospital output is measured relies on the use of diagnosis related groups (DRGs).
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Sukkar, Malak, and sukkarm@stvmph org au. "Executives' Decision Making in Australian Private Hospitals: Margin or Mission?" RMIT University. Graduate School of Business, 2008. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20081031.162754.
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This thesis examines decision making at executive level in Australian private hospitals as a social phenomenon, since individuals draw meaning from their own biographical and social environmental experiences. The researcher interpreted the constructed realities of the factors influencing executives' decisions within the context of private hospitals - a field that is rarely examined through the lens of social research. Using an Interpretivist research paradigm, the researcher conducted semi- structured and in-depth interviews with sixteen executive members who are experts in their field and represent both sectors of the private hospital industry: private for-profit and private not-for-profit. The data generated was transformed into technical accounts using an abductive research strategy and adopting Schütz's notion of first-order and second-order constructs. Using Giddens' Structuration Theory, that stressed the fundamental role of the human agent, the structure and their mutual dependence, the researcher moved beyond the interpretation of individuals' meanings, to incorporate the structure as an entity that can be formed and reformed. The researcher interpreted social actors' constructed meanings of these social phenomena in their work environment to form the elements of a two-dimensional decision making model at organisational level, incorporating the present with the future and the internal with the external factors. On an individual level, three different approaches to decision making were identified, based on whether executives perceived the decision making phenomenon as intuition, as a reasoned process or as an expected outcome. While being from a limited research sample, the findings of this study suggest that the paradox of mission / economic decisions restrained executives in the not-for-profit sector from strengthening their hospitals' financial performance, putting at risk, therefore, their ability to achieve social dividends as a way to proclaim their mission. On the other hand, in the for-profit sector, shareholders' dividends appeared to be a strong catalyst for attaining profit maximisation when making decisions. In both settings, the findings suggest that the role of stakeholder theory is questionable, particularly when executives remained hesitant to involve medical specialists, whom they considered to be major stakeholders and profit generators for private hospitals. This attitude appeared to be constant, despite the changes identified in executives' individual approaches to decision making. However, early signs of shifts towards adopting more commercially and socially accountable decisions were apparent in not-for-p rofit and for-profit sectors respectively. The thesis sets out recommendations to assist executives in managing the different factors that interplay to form executives' decisions. The importance of having a mission in business longevity and the integration, as opposed to alignment, of strategic goals with business operations when making executive decisions in private hospitals was highlighted. The implications for both sectors are described and recommendations for further research are suggested.
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Braun, Lesley Anne, and lgbraun@bigpond net au. "Complementary Medicines in Hospitals - a Focus on Surgical Patients and Safety." RMIT University. Health Sciences, 2007. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080414.115624.
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This study aimed to determine how CMs used by surgical patients are managed in the hospital system by doctors and pharmacists and what patient and practitioner influences affect this management. Research design and method Five systematic reviews were conducted to investigate the peer-reviewed literature for information about Australians use of CM; overseas and Australian doctors and CM; surgical patients use of CM and safety information about CMs in surgery as a basis to design and conduct three surveys. Surveys of hospital doctors, pharmacists and surgical patients were used to obtain measurement of people's attitudes, perceptions, behaviours and usage of CMs. For healthcare practitioners, knowledge of complementary medicines (CMs), past training, current practice and interest in future practice of complementary therapies (CTs) and education was also investigated. Approximately 50% of surgical patients reported taking CMs in the 2 weeks prior to surgery and approximately 50% of these patients intended to continue use in hospital. The most commonly used CMs were: fish oil supplements, multivitamins, vitamin C and glucosamine supplements as well as some CMs considered to potentially increase bleeding risk or induce drug interactions. It was not uncommon for CMs to be used at the same time as prescription medicines. Most surgical patients in general self-prescribe their CMs or have them recommended by family and friends whereas medical practitioners were the main prescribers to cardiac surgery patients. Nearly 60% of patients using CMs in the 2 weeks prior to admission did not tell hospital staff about use. The main reason for non-disclosure was not being asked about use whereas fear of a negative response was rarely a concern. The most common sources of information surgery patients refer to were GPs, pharmacists and health food stores. Hospital doctors and pharmacists did not routinely refer to information sources about CMs safety. The majority of doctors and pharmacists did not routinely ask patients about CMs, or record usage information. They had little training and knowledge of the evidence of commonly used CMs and lacked confidence in dealing with CMs-related issues. Their attitude to CMs is moderately negative and many are wary of safety, efficacy and cost-effectiveness issues. The majority of practitioners considered some CTs as potentially useful, particularly acupuncture, massage and meditation whereas the medicinal CTs and chiropractic were considered potentially harmful. Most practitioners were interested in future education about CMs and CTs and some would consider practising CTs. Personal usage of CTs was low although there was substantial interest in receiving future treatment. Despite many strategically orientated initiatives developed in Australia to promote evidence based medicine (EBM) and quality use of medicines (QUM), it appears that CMs have been largely ignored and overlooked in the practice of Medicine and Pharmacy within the hospital system. Furthermore, it appears that in regards to CMs a 'don't ask, don't tell, don't know' culture exists within hospitals and that evidence based patient-centred care and concordance is not being achieved and potentially patient safety and wellbeing is being compromised.
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Olafsson, Gunnar Alexander. "Merging Hospitals : Motives, methods and outcomes." Thesis, Nordic School of Public Health NHV, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3180.
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This thesis reviewed recent hospital mergers in Gothenburg, Sweden, and Reykjavik, Iceland, and describes, analyzes, compares, and assesses those mergers. The study focused on the underlying reasons for the mergers, examining both the methods used in the merging process and the merger outcomes. Background information includes organizational theory regarding mergers, hospitals as professional bureaucracies, organizational change and communication, and quality and efficiency in organizations. The study is based on secondary data derived mainly from official documents, evaluations, and research reports. While the study determined similar reasons—mainly economic—underpinning both mergers, the processes differed. The Swedish merger was much better prepared, more radical, and invested more time and money in its process compared to the Icelandic merger, which was less radical and characterized by decisions from the top. Interestingly, the Icelandic merger, which sought to curtail the growth of expenditures but did not demand savings, achieved outcomes that reflected its main goals. Conversely, the Swedish merger sought unrealistic savings in its goals and the savings demands made it impossible for the management team to gain other objectives of the merger, like better service, quality and more competent institution.ISBN 978-91-85721-56-6
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Carter, Nakia, and Rick Wallace. "Collaborating with Public Libraries, Public Health Departments, and Rural Hospitals to Provide Consumer Health Information Services." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/8682.
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East Tennessee State University Quillen College of Medicine Library (ETSUQCOML) developed a training program to enable public libraries, public health workers, and rural hospital staff to be consumer health information providers. Four NN/LM-developed classes were taught to public libraries. Regional public library directors were invaluable in obtaining the concurrence of their boards for release time for class attendance. Classes were also developed for the public health workforce and rural hospital staff. Five-hundred thirty-three students attended the classes. Fifty-two public library workers will receive the MLA's Consumer Health Information Specialist certification. Thirty-one public libraries have joined NN/LM. All ordered MedlinePlus marketing materials for their libraries from InformationRx.org.
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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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Hernandez, Beverly J. D. "The relationship between leadership styles and performance success in hospitals." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/789.
Full textAbstract:
Upheavals in the health care landscape threaten the sustainability of contemporary hospital organizations. Yet there is limited research regarding the characteristics of leaders within successful hospitals. The problem is the leadership styles needed to effectively run hospital organizations have not been identified and/or established. The purpose of this study was to develop a model of congruent leadership styles linked to the success of hospitals in one metropolitan city. The research questions sought to uncover (a) consistent leadership styles within successful hospitals, and (b) what, if any, relationship exists between leadership styles and measures of success. Examination of the literature uncovered the value of leadership to organizations through theoretical frameworks of organizational development, organizational culture, leadership, and change strategies that supported the need for hospital organizations to foster leadership practices associated with successful outcomes. Correlational analyses were used to examine the relationship between leadership styles and successful hospital outcomes. Primary data for this research were collected from 109 hospital leaders via the Multifactor Leadership Questionnaire (MLQ) Form 5X. Results from this study indicated an increased likelihood of performance success with the application of transformational characteristics. These findings support positive social change as results may serve as a model for leadership practices within 21st century hospitals. Results should further heighten social consciousness to spawn the development of related college curricula, scholarship programs, and leadership alliances that weave transformational characteristics into the leadership fabric of contemporary hospital organizations.
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Pham, Mai. "Performance of Australian public and private hospitals." Phd thesis, 2008. http://hdl.handle.net/1885/110263.
Full textAbstract:
Given the importance of the Australian hospital industry, understanding the
performance of public and private hospitals is essential for interested groups including
patients, hospital staff, insurance companies and governments. Jn Australia, little
information is available on hospitals' relative performance. Hence, studies
investigating the issue are needed. This thesis addresses a part of this gap, in the
context of hospital performance, investigating how public and private hospitals in
Western Australia perform differently in terms of quality of care, and how Australian
public hospitals in different peer groups perform differently in terms of cost technical
efficiency.
The thesis consists of two main parts and the data for each part were obtained from
different sources. Data on hospital quality of care analysis are obtained from the
Department of Health, Western Australia. Hospital morbidity and mortality data in
Western Australia in the period 1995-2004 are provided by the Data Linkage Unit.
Data on hospital cost technical efficiency analysis are obtained from the Australian
Institute of Health and Welfare and information on hospital cost5 in Victoria, New
South Wales, Queensland, South Australia, Tasmania, and Northern Territory in the
period 2002-2005 is provided.
The study is structured as follows. The first chapter states the motivations and the
questions this study attempts to address. The second chapter summarizes the state of
the Australian hospital industry in the past two decades with respect to the relative
importance of public and private hospitals. Chapter three presents the literature review
including brief outlines of theoretical and empirical work concerning the performance
of public and private firms, and a critical summary of studies involving the hospital
quality of care measurement, hospital cost function and technical efficiency measures.
Chapters four and five outline the descriptive statistics, the models used for analyzing
the quality of care of public and private hospitals in Western Australia, the econometric
results obtained, and the discussion. Similarly, chapters six and seven include the
descriptive statistics, the methods of efficiency analysis for Australian public hospitals,
the regression results and the discussion. While concluding the whole study, chapter
eight also points out the study's limitations and suggestions for further research. The study uses appropriate methods to derive important results. For hospital quality of
care, this study applies multi-level random intercept logistic models. Since the data
include information on patient and hospital characteristics, multi-level models appear to
be the most suitable approach for analyzing the data. Among six quality of care
indicators, only one gives the results that public hospital perform worse than their
private counterparts. On two indicators, public hospitals' performance is superior and
on the other three, no difference in the performance of the two sectors can be found.
For hospital technical cost efficiency, the stochastic frontier approach (SFA) is applied.
Among the two main approaches of technical efficiency investigation, namely Data
Envelopment Analysis (DEA) and SFA, the later has advantages on its relaxation of
statistical noise non-existence. The results show that major and large public hospitals
are more cost efficient than small ones, and there is no evidence of a trade-off between
hospital cost technical efficiency and quality of care.
The study provides important policy implications. The results of hospital quality of
care analysis suggest policies to reduce the gap in operation between public and private
hospitals. They include private hospitals taking a larger share of more severely-sick
patients and more complicated cases, and public hospitals being provided with more
funding as part of solution for medical staff and bed availability shortage. The results
of hospital cost efficiency analysis suggest policies to reduce the heavy workload for
major public hospitals. Improving hospital quality of care policies would not damage
technical cost efficiency since no evidence of a trade-off between the two can be found.
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Cooper, Dhanmathie. "Supply chain management in a public hospital in Gauteng." Thesis, 2016. http://hdl.handle.net/10539/21767.
Full textAbstract:
A Thesis submitted to the faculty of Commerce, Law and Management,
University of Witwatersrand, School of Governance in 50% fulfilment for the
Master of Management in the field of Monitoring and Evaluation
9 May 2016The purpose of the study was to analyse the Supply Chain Management (SCM) approaches used in the Public Hospital Outpatients Pharmacy and compare the findings with successful supply chain practices from other industry sectors. The study of academic literature locates the unavailability of drugs in the public hospital pharmacies to the domino effect of the lack of governance and accountability in the public hospital. The data for the study was gathered from public and private hospitals in Gauteng, and large FMCG manufacturers and retailers. The study finds that the public sector adoption of SCM in the absence of a coherent technology and human resource support environment results in a lack of accountability and coherence across systems. The research study corroborated the view of academics and the interviewees that the unavailability of drugs in the public hospital is a multidimensional problem that has its roots in the lack of governance throughout the drug supply chain. It is a complex manifestation of policy, processes, practices, structure, people, communication and donor funding that contribute to the problem. Resolving the drug availability issues will require the ‘whole supply chain re-engineering’ with the added focus on developing the operational capability and capacity of the actors within the supply chain continuum.
MT2017
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Eckermann, Simon. "Hospital performance including quality : creating economic incentives consistent with evidence-based medicine /." 2004. http://www.library.unsw.edu.au/~thesis/adt-NUN/public/adt-NUN20051018.135506/index.html.
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Williams, Robert Melvin. "The costs of emergency department services dissertation submitted in partial fulfillment ... for the degree of Doctor of Public Health (Health Policy) ... /." 1994. http://books.google.com/books?id=JsdBAAAAMAAJ.
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Butler, Patricia A. "Medicaid HMO enrollees in the emergency room use of non-emergency care : a dissertation submitted in partial fulfillment ... for the degree of Doctor of Public Health (Health Policy) ... /." 1996. http://books.google.com/books?id=PysoAAAAMAAJ.
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Van, der Heever Hendry. "Financial management of public hospitals." Thesis, 2009. http://hdl.handle.net/10500/3218.
Full textAbstract:
Interactive version of the thesis is filed with the printed copy in the UNISA archivesThe study investigated and described public hospitals in terms of management processes with reference to financial planning, organizing, leading and control in order to identify deficiencies in the financial management of public hospitals. The aim was to identify gaps in the management of financial processes and to provide guidelines and strategies to improve these. The purpose of the research was addressed within a quantitative approach applying exploratory and descriptive designs. A self-administered questionnaire was used to collect the data that fit the objectives of the research. The study population compassed all 27 public hospitals as study units in a specific geographic area, namely Mpumalanga Province with the following inclusion criteria: active patient capacity of 100 beds and more, which employ personnel such as (1) medical, (2) paramedical and (3) administrative and a working application of the BAS as financial accounting system since its interception in the year 2000. Nine public hospitals were randomly selected as the sample hospitals. Within the nine hospitals, four groups of staff were selected by means of stratified random sampling, namely management, health professionals, and financial and administrative staff. The number of staff selected within each hospital differed, from 15 to 50, amounting to a sample size of three hundred (n=300). A response rate of 66.66% v (n=182) was achieved. The sample consisted of 4 (2.27%) chief executive officers, 3 (1.70%) financial managers, 84 (47.72%) unit managers and 91 (50.00%) subordinates. The response rate of 66.66% in this study was an indication of the unavailability of the health care professionals (which include management, health professionals and financial and administrative staff) within the nine public hospitals. The major inferences drawn from this study are that the different health care professions have a poor perception of the scope of financial management in terms of financial needs, utilization of resources, the scope and function of leading and delegation, and applying appropriate financial control methods.
Health Studies
D. Litt. et Phil. (Health Services Management)
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HSU, YEA-JEN, and 徐雅真. "Hospital Choice of the Disadvantaged and Medical Role of Public Hospitals." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/02098531778848286738.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
91
Philosophy of free economy and reevaluation of government’s role gradually encourage privatization trend of public services. Although the National Health Insurance program, implemented in 1995, satisfies a certainly level of medical needs, approximately 4% of the residents in Taiwan are still not enrolled, and the vulnerable sub-populations may still face the uncertainty of medical accessibility. Private hospitals seems to deliver care more efficiently than public hospitals, however, whether private hospitals could fully replace its public counterparts or to allow non-for profit organizations to take over public hospital managements remain under considerable policy debates. In order to investigate whether public hospitals play a different role from private hospitals, this study used the National Health Insurance Research Database to observe the trends of patient’s hospital choice behavior in Taiwan, and to analyze how hospital choices vary by provider levels, geographic areas, and vulnerable sub-populations between 1996 and 2000. The main results are summarized below： 1. When patients chose higher levels of hospitals, greater proportion of patients went to public hospitals. For ambulatory care visits, 34.4%, 30.8%, and 16% of visits occurred in medical centers, regional hospitals, and district hospitals, respectively. For inpatient admissions, the proportions were 34.7%, 31.5%, and 19.5%. 2. The likelihood of choosing public hospitals varied substantially between counties. The off-shore island residents were most likely to choose public hospitals, the Changhua county residents were least likely to go to public hospitals for care. 3. The socio-economically disadvantaged like the indigent and the unemployed were more likely to choose public hospitals than others. The higher the insurable amount, the higher probability of choosing public hospitals. However, aborigines were less likely to choose public providers than non-aborigines. 4. The health disadvantaged sub-populations such as patients with a major illness preferred to choose public hospitals, in contrast to those without. 5. The medical resources disadvantaged sub-populations like residents in remote areas or areas without sufficient medical resources had no significantly different preference for public hospitals from residents in other areas.
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Chuang, Yu-hui, and 莊裕會. "Sensitivity Analysis of Public Hospitals’ Efficiency." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/36987250112071129761.
Full textAbstract:
碩士國立高雄大學
高階經營管理碩士在職專班(EMBA)
103
With the launch of the national health insurance (NHI) in 1995, the growth rate of health care expenses has been exceeding which of the economy. Taiwanese medical institutions can be partition into hospital or clinic. The number of clinic constantly increase during 2008-2013 representing the unattractive of its business environment, thus the performances of medical institutions become an important issue. This research aims to investigate the impact of different medical departments and the applications of hospital beds on the public hospital operational efficiency. Moreover, we consider the structural difference of public hospitals between regions, ownerships, and metropolis. The results show that the dentists, the special beds and others beds contribute significantly different to the various ownership public hospitals. The research also indicates west medicine doctor differently influences public hospitals in various regions, especially south area. Finally, the medical departments and the applications of hospital beds denote no structural difference of efficiency discussing metropolis. According to our empirical results, we conclude there is a need to consider the medical departments and the applications of hospital beds while discussing the performance of public hospitals to avoid bias evaluation and wrong managerial suggestion.
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Beech, Bettina M. "Patient satisfaction and nursing staff work satisfaction in an urban public teaching hospital /." 1995. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:9610025.
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Hsu, Hui-Shu, and 許惠淑. "A Comparison of Contracted and Public Management Performance of Public Hospitals – Case Study of Kaohsiung Municipal Hospitals." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/60870400238280287915.
Full textAbstract:
碩士高雄醫學大學
醫務管理學研究所碩士在職專班
100
Research purposes This study compares the performance of eight Kaohsiung municipal hospitals in the period 2008-2010. The indicators are identified to study the difference in performance and current operation status between contracted and public management of public hospitals. The effectiveness of management and the sustainability of operation are also discussed. Research Methods The study conducted a retrospective analysis of secondary data from eight Kaohsiung municipal hospitals, excluding the one established in 2010. The data included organizational scale, management type (contracted or public), personnel structure and performance indicators, such as service volume, finance (revenue, expenditure, surplus/deficit), and major equipment investment. All statistical tests were conducted using SPSS version 19.0 software, JMP 9.0, descriptive statistics, independent samples t-test, Chi-square test, and Mann-Whitney U test. Conclusions and recommendations The study included eight Kaohsiung municipal hospitals. The results showed the service volume (329,754±163,905 vs. 140,999±61,693) and fiscal surplus (-114,601,501.10 TWD±90,986,949 vs. 26,415.67 TWD± 36,819.29) of regional hospitals are statistically significantly higher than local hospitals. Among regional hospitals, the performance of private management is better than those of public management. The service volume (406,618±101,742 vs. 130,540±55,918) and major equipment investment (19,656 TWD±17,037.90 vs. 2,173.80 TWD±3,690.20) of general hospitals are statistically significantly higher than none-general hospitals. Among general hospitals, the performance of private management is better than those of public management. The personnel costs of public hospitals under private management are lower than those of public management. The study found that to hire on more nurse increases 875.75 visits and 346.05 TWD in revenue; to hire one more administration staff will increase 1552.37 visits and 585.38 TWD in revenue. These results are statistically significant. Although current public and private healthcare organizations in Taiwan are for non-profit, the operation sustainability is critical. Certain percentage of hospitals encounters operational difficulties, especially for public hospitals. To truly reveal the performance, the municipal hospitals should exclude government grant while evaluating financial indicators. The future goal is to continually establish database of municipal hospitals for further comparison in performance with private hospitals in Kaohsiung city.
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Kuo, Ting-Yu, and 郭亭玉. "A Research of Hospital Marketing Public Relations - in Local Hospitals of Taipei." Thesis, 2000. http://ndltd.ncl.edu.tw/handle/41208647038235308617.
Full textAbstract:
碩士銘傳大學
管理科學研究所
88
Abstract Following the footstep of America, Taiwan implemented its own NHI system in 1995. Since its implementation, the heath care market in Taiwan has changed dramatically. For many years, hospitals have viewed patients paternalistically and failed to address many customers'' needs and wants. Many hospitals ignored patients needs or choices were not given to the patients in regarding to different kinds of service. But now, because of the NHI system, patients were free to choose and hospitals began to realize the importance of Hospital Marketing and Hospital Marketing Public Relations (HMPR). For hospitals today, they can no longer ignored patients needs. Many hospitals set up MPR department to promote their image and relationship between hospital and patient. In addition, hospitals'' MPR departments try to use different promotion to increase their business. This study is aimed to show how hospitals'' MPR department can do in promoting their image and promoting the hospital-patient relationship. Two questionnaires will be passed out and result will be analyzed by SAS. The results could be a reference for HMPR managers of hospitals to make a strategic decision.
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Mafora, Puni Peter. "Leadership at public hospitals: a case study of the Matlala District Hospital." Diss., 2020. http://hdl.handle.net/10500/27209.
Full textAbstract:
The purpose of the study was to explore and describe leadership at Matlala District
Hospital in Limpopo, a province of South Africa. The study was critical for a better
understanding of leadership styles adopted in different situations (hospital, district or
province) at Matlala District Hospital in the Sekhukhune district.
The main objectives of the study were described in chapter 1 on leadership styles
(transformational and transactional), to determine how best to investigate leadership
styles at Matlala District Hospital, to determine what the current leadership style at
Matlala District Hospital is and to propose the most appropriate leadership style for
Matlala District Hospital.
A mixed-methods approach was used with an exploratory and descriptive design. In
terms of the qualitative methodology, purposive sampling was used as the managers
were selected on their knowledge of the issues under investigation. Firstly, an
interview schedule was developed and used to collect data at Matlala District Hospital.
The sample size was 82. Interviews were conducted with 12 members of the executive
committee who were regarded as senior managers of the hospital. Secondly, the
researcher distributed the questionnaires to participants of the hospital that met the
inclusion criteria. Seventy participants completed questionnaires, which were
collected upon completion. A 100% response rate was reached.
Thematic analysis was used to assess the qualitative data. With regard to quantitative
data analysis, descriptive, frequency tables and charts and inferential statistics were
used. According to the results, those managers who felt that resources had be
provided felt strongly that leadership at the hospital should be improved. Accordingly,
guidelines for improving leadership at Matlala District Hospital have to be developed
to ensure that mitigating factors are in place for the improvement of the situation at
the hospital.Public Administration and Management
M. P. A. (Public Administration)
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Nxumalo, Goodhope Singabakho. "Public relations practices within selected public hospitals in KwaZulu-Natal." Thesis, 2015. http://hdl.handle.net/10321/1427.
Full textAbstract:
Submitted in fulfillment of the requirement for the Masters Degree of Technology (Public Relations Management), Department of Public Relations Management, Durban University of Technology, Durban, South Africa, 2015.In South Africa, the media coverage and the general perceptions of the public about public hospitals have been pervasively negative and this has resulted in the overshadowing of the good work being done in hospitals. In an effort to overcome these negative perceptions, the Kwazulu-Natal Department of Health has introduced the practice of public relations in public hospitals since 2001. This effort is in line with the National Health Act 2004 (Act No 61 of 2003). The act is described by the Health Systems Trust to rest heavily on the Constitution which, amongst other things, requires the State to take reasonable legislative and other measures to progressively achieve the right of access to health care services, and reproductive health care, within its available resources. The rationale behind the introduction of public relations was that, by managing and influencing the public’s perceptions, public relations professionals in public hospitals would initiate a sequence of behaviours that would contribute towards the achievement of the hospitals’ objectives. However, are relevant stakeholders aware of the presence, the role and the functions of public relations in public hospitals? Based on the above, this study seeks to evaluate public relations practices within selected public hospitals in Kwazulu-Natal, South Africa. The study is qualitative, cross-sectional and descriptive in nature. Data will be collected through observation, questionnaires and interviews. The findings revealed that a lot more needs to be done by both the Department of Health in KwaZulu-Natal and hospital CEOs in order to benefit greatly from the practice of public relations in public hospitals as public relations practitioners are under-utilized. Issues of budget constraints, lack of public relations understanding by hospital CEOs are some of the factors impacting negatively the function of public relations in hospitals. It is more of a technical role that public relations practitioners play in public hospitals. This study came to the realisation that not enough attention is given to the practice of public relations in public hospitals. One of the major recommendations is that public relations practitioners should participate in the strategic management processes and be part of the planning process and they should use public relations strategies to build harmony between the hospital and all its external and internal publics. For public hospitals to realise the need and value from the function of public relations, they have to appreciate that the practice of public relations has grown over the years and they have to employ effective public relations practitioners in order to accomplish their goals.