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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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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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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.
4
Piterman, Hannah, i 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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Sutton, Kathleen Rose Creagh, i 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.
6
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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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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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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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).
10
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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Fernandes, Adhemar Dizioli. "As transformações arquitetonicas e tecnico-construtivas do edificio publico de saude na cidade de São Paulo". [s.n.], 2003. http://repositorio.unicamp.br/jspui/handle/REPOSIP/257951.
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Orientador: Andre Munhoz de Argollo FerrãoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil
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Resumo: O hospital converteu-se em instituição social através dos séculos, transformouse em um edifício complexo, abrigando especialidades e equipamentos médicos múltiplos que refletiram na sua concepção e projeto. Neste trabalho descrevem-se as transformações arquitetônicas e construtivas do edifício público de saúde na cidade de São Paulo, principalmente, a partir da segunda metade do século XIX, com o desenvolvimento da cultura cafeeira, o advento da República e a estruturação do Serviço de Saúde Pública. Especificamente, identificam-se as intervenções físicofuncionais e técnico-construtivas ocorridas no período de 1998 a 2002, em uma série de hospitais públicos, construídos a partir de uma mesma tipologia, na Região Metropolitana da Grande São Paulo. Os resultados mostram que esses hospitais, concebidos em 1986, continuam atuais diante das alterações e reestruturações implementadas no seu espaço físico, visando abrigar novas unidades funcionais e equipamentos, possibilitando a execução de novos procedimentos médico-hospitalares
Abstract: Throughout the centuries the hospital has turned into a social institution, becoming a complex building, sheltering specialties and multiple medical equipment that is reflected in its conception and design. In this paper the architectural and constructive transformations of the public health building are described in the city of São Paulo, mainly, from the second half of the XIX century, with the development of the coffee culture, the coming of the Republic and the structuring of the Public Health Service. Specifically identified are the physical-functional and technical-constructive nterventions that happened from 1998 to 2002, in a series of public hospitals all built from the same typology in the Metropolitan Area of Great São Paulo. The results show that those hospital buildings, conceived in 1986, continue to be updated due to the alterations and restructuring implemented in the spitals, seeking to shelter new functional units and equipment, making possible the execution of new medical/hospital procedures
Mestrado
Edificações
Mestre em Engenharia Civil
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Greenwell, June. "NHS hospital restructuring". Thesis, University of Bristol, 2000. http://hdl.handle.net/1983/3018fcc4-1251-4a19-9c44-cac50388eb17.
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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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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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ShahabiKargar, Zahra. "Intelligent Scheduling for Hospital Operating Rooms". Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367615.
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Scheduling problems emerge almost everywhere in real world situations. Efficient scheduling of resources in dynamic complex real world environments continues to pose a significant research challenge. Every real world problem has its own idiosyn- crasies, and environments in the real world are often more complicated. In real world dynamic environments, inevitable and unpredictable real-time events often force a change in scheduled plans. Despite this, most current approaches have been focused on solving simplified scheduling models assuming that all problem characteristics are known in advance.
As the hospital’s largest revenue and cost centre, operating rooms are of pivotal importance to hospitals. Any improvement of surgery delivery systems is particularly important for hospitals. With healthcare starting to buckle under the pressures of growing demand and encumbered resources, improving operating room scheduling to deliver a significant improvement in utilisation of this overburdened resource is more important than ever. Motivated with this need, this dissertation describes our efforts to deliver significant improvements to operating room scheduling processes, particularly in Australian public hospitals.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Institute for Integrated and Intelligent Systems
Science, Environment, Engineering and Technology
Full Text
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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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Duwalage, Kalpani I. "Statistical modelling of public hospital emergency department presentations". Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/228610/1/Kalpani%20Ishara_Duwalage_Thesis.pdf.
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This thesis used statistical methods to investigate and more accurately forecast Australian emergency department presentations to four major public hospital EDs in South-East Queensland, Australia. The findings of this thesis assist Australian EDs in understanding trends in ED presentations, which can subsequently lead to reductions in presentations and improvement in the sustainability of the health system. This thesis further demonstrates the benefits of various statistical modelling methods over conventional methods in extracting more useful and accurate information from complex ED data.
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Naidu, Priyanka. "Surgical catastrophic health expenditure at New Somerset Hospital, a South African public sector hospital". Master's thesis, University of Cape Town, 2020. http://hdl.handle.net/11427/32510.
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Background: Catastrophic health expenditure (CHE) and impoverishing health expenditure (IHE) are significant barriers to surgical care. Worldwide, 3.7 billion people risk financial catastrophe if they require surgery, mostly affecting the poorest populations in LMICs. Surgical CHE and IHE are not described in the South African context. The objectives of this study were: 1) to determine the proportion of surgical participants at New Somerset Hospital (NSH) ), a second-level public sector South African hospital, who experienced CHE and IHE and 2) to determine the risk factors associated with out-of-pocket (OOP) payments. Methods: This study used a cross-sectional retrospective questionnaire administered to participants admitted to any department of surgery (obstetrics, gynaecology, general surgery, urology, otorhinolaryngology, or orthopaedics) for a surgical procedure at NSH. Direct healthcare expenditure for the surgical admission was defined to be catastrophic according to three definitions: 1) OOP payments 10% or more of annual household expenditure (HHE) (CHE10); 2) OOP payments 25% or more of annual HHE (CHE25); 3) OOP payments 40% or more of capacity to pay (CHE40). IHE was based on the national poverty lines and was defined according to new impoverishment or worsening impoverishment, as a result of OOP expenditure on the surgical admission. Multivariate regression analysis was used to assess the relationship between OOP payments and per capita HHE, age, type of procedure, department to which participant was admitted, distance from NSH, and length of stay. Results: Out of the 274 participants interviewed: 263 were included in the analysis (4% attrition rate). Two (0.8%), five (1.9%), and three (1.1%) participants experienced CHE according to the CHE40, CHE10, and CHE25 definitions, respectively. About 98.5% of participants spent less than 10% of their annual HHE, while 95.4% spent less than 10% of their annual non-food expenditure OOP. Median OOP expenditure was R100 (IQR R15 – R350). About 23% of the participants (n=62) were not charged for their surgical admission. Low per capita HHE (p=0.02), cancer (p=0.001), having a non-generous health insurance plan (p=0.002), and the hospital bill amount (p<0.001) correlated positively with OOP expenditure on healthcare. Linear regression revealed that there was no correlation between the proportion of OOP payments and LOS or distance. One in five patients (n=50, 19%) experienced new or worsening impoverishment and were pushed below the poverty line for receiving surgical care at a public hospital. Furthermore, 65 (25%) patients reported their household was unable to cope or household still recovering from the financial burden of the surgical admission. Discussion: Surgical CHE was not common among this study population, however IHE was substantial and the majority of participants incurred OOP for surgical care, with the main drivers of OOP costs being the hospital bill and transport. Financial catastrophe might have been low because: 1) most participants were protected by the uniform patient fee schedule and therefore did not incur a medical bill and 2) direct non-medical costs did not account for a significant proportion of OOP payments. Understanding the financial impacts of OOP health care expenditure is essential in the planning of the impending National Health Insurance in South Africa.
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Leung, Chiu-fai Charles. "A study of the transformation of domestic services in the Hong Kong Hospital Authority". Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21037048.
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Farias, Diego Carlos. "Análise das práticas de gestão hospitalar: um estudo das interfaces (e lacunas) funcionais no Hospital Universitário Antonio Pedro da UFF". Niterói, 2017. https://app.uff.br/riuff/handle/1/4137.
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A complexidade da gestão hospitalar, em conjunto com um cenário de escasez de recursos financeiros, compromete as atividades desempenhadas em hospitais públicos universitários. O presente estudo tem o objetivo de analisar as práticas de gestão hospitalar no Hospital Universitário Antonio Pedro (HUAP), no sentido de identificar oportunidades de aprimoramento em seus processos administrativos, bem como os fatores críticos responsáveis, refletindo sobre a maneira como tais fatores estão inter-relacionados. Sob a perspectiva metodológica, o estudo apoia-se em uma vertente teórica, baseada na coleta de dados secundários através do levantamento bibliométrico do acervo técnico-científico referente à gestão hospitalar, relevantes para subsidiar a pesquisa empírica proposta para ser realizada junto a atores-chave do HUAP. Já em termos empíricos foram realizadas entrevistas semiestruturadas com as lideranças funcionais tanto administrativas, quanto de assistência. Os resultados obtidos evidenciam lacunas nas interfaces de trabalho, sobretudo na relação entre as equipes médica e a administrativa, o que impacta sobre o faturamento da organização. Além disso, observaram-se hiatos na definição de processos, o que compromete algumas atividades, tanto na esfera assistencial quanto administrativa, gerando conflitos entre profissionais e impactando no atendimento aos pacientes. Uma vez evidenciados os fatores críticos, elaborou-se um mapa conceitual, que apresenta o processo gerencial do HUAP como um sistema composto pelos referidos fatores, bem como a forma como estão conectados, facilitando a observação das relações de causalidade entre estes.
The complexity of hospital management, together with a scenario of scarcity of financial resources, compromises the activities performed in public university hospitals. This study aims to analyze the hospital management practices at the Hospital Universitário Antonio Pedro (HUAP), to identify opportunities for improvement in their administrative processes, as well as those responsible for critical factors, reflecting on how these factors are interrelated. Under the methodological perspective, the study relies on a theoretical, based on secondary data collection through the bibliometric survey of technical and scientific evidence related to hospital management, relevant to support the empirical proposed research to be conducted with key players of HUAP. In the empirical study were carried out semi-structured interviews with the managers of the institution. The results show flaws in the work interfaces, especially in the relationship between medical staff and administrative, which has a direct impact on revenues of the organization. In addition, there were shortcomings in the definition of processes, which undertakes some activities, both in care as administrative, generating differences between professionals and impacting on patient care. Once the critical factors were evidenced, a conceptual map was elaborated, presenting the HUAP management process as a system composed of these factors, as well as the way in which they are connected, facilitating the observation of the causal relationships between them.
21
Thomas, Patrick. "A stakeholder analysis of the UCT hospital". Master's thesis, University of Cape Town, 2003. http://hdl.handle.net/11427/9349.
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Includes bibliographical references.The UCT Hospital is a private, fully independent hospital within the buildings of the Groote Schuur Hospital. It has been operational for well over two years. Planning and development began a further four years before this. During the last two years the hospital has changed its name, shareholders and management structures. Since the start of the planning the various stakeholders will too have changed their respective structure and business foci. These changes have added to poor knowledge of all the stakeholders' aims and desires for the hospital. The aims and objectives of this study are to establish what the various stakeholders wish to gain from their relationship with the UCT Hospital. Furthermore, this study investigates the degree of public-private interaction with Groote Schuur Hospital and proposes various possibilities for their future existence and co-operation. A stakeholder analysis indicated that the primary stakeholders wish to expand and grow the hospital. Opponent stakeholders are not satisfied with the structure of and their relations with the UCT Hospital. Key problems in the relationship with Groote Schuur Hospital include tense relations, poor regulation of resource-sharing, and that the two hospitals are vying for comparable markets. These problems are inhibiting growth for both institutions. Communication, improved regulations and specialised market sectors are key needs to help resolve the problems between the two institutions. Various possibilities for future co-existence revolve around the degree of public- private interaction between the two institutions. The most viable option seems to be for the two hospitals to work closely together to form a public-private partnership, where the Groote Schuur Hospital Private Ward is outsourced to the UCT Hospital. This will involve UCT Hospital relinquishing some autonomy and freedom, but result in them having less competition and a greater market base. GSH will have to abandon their own private ward, but can increase risk-sharing, gain in efficiency and effectiveness in the private ward, and get involved in a co-management structure.
22
Fan, Gainson. "Association Between Hand Hygiene and Hospital Acquired Infections (HAI)| A Phenomenological Study at a Southeastern State Hospital". Thesis, Capella University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10680587.
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Greater awareness regarding healthcare-associated infections (HAIs) has drawn in a great deal of attention from the government at the local, state, and federal level as well as from the general public and medical insurance companies such as Medicaid and Medicare. This level of attention is the product of heightened interest in the quality of healthcare and the realization that most HAIs can be averted. Healthcare organizations and medical providers worldwide continue to observe exceptional developments in the comprehension of the physiology of uncommon or disease-causing agents and increased transmission of multidrug-resistant organisms in healthcare facilities both nationally and internationally. Such circumstances have prompted the re-examination of fundamental infection prevention processes in healthcare facilities. Evidence-based research has linked hand hygiene compliance to decreased nosocomial infections. With the World Health Organization (WHO) leadership and guidelines on hand hygiene in healthcare and patient safety initiatives, healthcare facilities must focus on compliance in hand hygiene practices. It is inexpensive, simple and it can save many lives.
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Oliveira, André Luis. "Management of public hospital clinic: organization lead for a good attendance". Universidade de Taubaté, 2004. http://www.bdtd.unitau.br/tedesimplificado/tde_busca/arquivo.php?codArquivo=58.
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The administration of the public service of health, historically organized for the state, passes for transformations that search the improvement of the service offered to its public, the using citizen. The state of São Paulo implemented from 1998 a management system that uses recognized entities socially (SOH - Social Organization of Health) to execute the planned and controlled actions of health for the government. In agreement to this trend of opening and development of the public politics, the federal government search to improve the quality of relationship in its sectors of attendance. The presented research evaluated questions organizations of a clinic of specialties of the city of São Paulo that functions operated for a SOH. Using the perspective of the user, it searched to verify with are the administrative questions that are perceived and valued for the citizen. The results had evidenced low the capacity of perception and evaluation of the users of the clinic. The analysis perceived in the data of the research with superficial characteristics and without criteria technician, can be related with the low educational level of the layers poor of main the Brazilian population that are user public system of health. (National system of health). The research proved the development of the public management in the health area, as well as the viability of application of research correlated to the applied model.A administração do serviço público de saúde, historicamente organizada pelo Estado, passa por transformações que buscam a melhoria do serviço oferecido ao seu público alvo, o cidadão usuário. O estado de São Paulo implementou a partir de 1998 um sistema de gestão que utiliza entidades reconhecidas socialmente (OSS Organização Social de Saúde) para executar as ações de saúde planejadas e controladas pelo governo. Em concordância à essa tendência de abertura e remodelamento das políticas públicas, o Governo Federal busca melhorar a qualidade de relacionamento em seus setores de atendimento. A pesquisa avaliou questões organizacionais de um ambulatório de especialidades da cidade de São Paulo que funciona operacionalizado por uma OSS. Usando a perspectiva do usuário, buscou verificar quais são os quesitos administrativos que são percebidos e valorizados pelo cidadão. Os resultados evidenciaram a baixa capacidade de percepção e avaliação dos usuários do ambulatório. A análise percebida nos dados da pesquisa, com características superficiais, emotivas e sem critérios técnicos, pode estar relacionada com o baixo nível educacional das camadas mais pobres da população brasileira que são os principais usuários do sistema público de saúde (SUS Sistema Único de Saúde). A pesquisa provou o desenvolvimento do gerenciamento público na área de saúde, assim como a viabilidade de aplicação de pesquisas correlacionadas ao modelo aplicado.
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Salge, Torsten Oliver. "Essays on innovation : the case of public hospital services". Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611708.
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Cairns, John Douglas. "Some characteristics influencing utilisation of public hospital outpatients services". Thesis, Queensland University of Technology, 1990. https://eprints.qut.edu.au/36386/1/36386_Cairns_1990.pdf.
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The demand for health care in Australia has been influenced by the numerous changes in financing arrangements at Federal Government, State Government and
institutional levels during the last two decades. The task of performing empirical studies of health care demand has been made difficult by the frequent changes that have occurred with health insurance arrangements in particular. This research project commences at a macro level and traces the development of health insurance in Australia with particular emphasis on the issues that have
influenced demand for primary health care. The debate on the appropriateness of
voluntary and compulsory health insurance systems is discussed in the context of the theoretical issues that influence health care demand. An historical overview of the development of the Queensland's health care system
is presented with the emphasis being on the provision of primary health care. Aspects of the provision of primary medical care through hospital outpatient services and community health centres are compared and contrasted. The paucity of information on outpatient activity is discussed and suggestions provided from the literature are offered to overcome this problem. The need for more adequate measures of activity is discussed in terms of this being a prerequisite for effective planning, evaluation and policy development. The theoretical aspects of utilisation are discussed with reference to empirical studies of demand and utilisation of primary health care services. As well, the influence of health insurance and provider behaviour on demand for health care are discussed. This leads into the development of the hypothesis to be tested, that outpatient utilisation of Queensland public hospitals has decreased since the
introduction of Medicare in 1984. Statewide aggregate data of hospital outpatient activity were analysed concurrently with data obtained from surveys of patients attending outpatient clinics at two nearby Brisbane hospitals. The data from theses sources support the hypothesis proposed. The analysis of the data provides sufficient evidence on the attributes of the patients attending outpatient services to question the appropriateness of continuing to provide outpatient services as effective alternative forms of care.
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Barbosa, Rafael Ribeiro. "Primary public health care and socioeconomic asymmetries in Portugal". Master's thesis, NSBE - UNL, 2012. http://hdl.handle.net/10362/9566.
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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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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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Tordoff, June Margaret, i n/a. "Evaluating the impact of a national hospital pharmaceutical strategy in New Zealand". University of Otago. School of Pharmacy, 2007. http://adt.otago.ac.nz./public/adt-NZDU20070712.151527.
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Background: In September 2001, in addition to their existing management of primary care pharmaceutical expenditure, PHARMAC, the New Zealand government�s Pharmaceutical Management Agency, was authorized to manage pharmaceutical expenditure in public hospitals.[1] In February 2002 PHARMAC launched a three-part Strategy, the National Hospital Pharmaceutical Strategy (NHPS), for this purpose.[2] The Strategy focused on Price Management (PM), the Assessment of New Medicines (ANM), and promoting Quality in the Use of Medicines (QUM). Major initiatives planned were: for PM, to negotiate new, national (as opposed to current, local) contracts for frequently used pharmaceuticals; for ANM, to provide economic assessments of new hospital medicines; and for QUM, to coordinate activities in hospitals.
Aims: To assess the impact of each of the three parts of the National Hospital Pharmaceutical Strategy, and assess any impact of the Strategy�s new contracts on the availability of those medicines.
Methods: Price Management was assessed in 2003, 2004 and 2005 using data from eleven selected hospitals to estimate savings for all 29 major hospitals, and by tracking hospital pharmaceutical expenditure from 2000 to 2006. For other aspects, cross-sectional surveys were administered to chief pharmacists at all hospitals employing a pharmacist; 30 hospitals in 2002, 29 in 2004. Surveys were undertaken in 2002 and 2004 to examine ANM and QUM activity in hospitals before and after the Strategy. Surveys were undertaken in 2004 and 2005 to examine any changes in the availability of medicines on new contracts, in hospitals. In 2005 a survey was undertaken of opinions on PHARMAC�s specially-developed pharmacoeconomic (PE) assessments.
Results: PM results indicated that, by 2006, savings of $7.84-13.45m per annum (6-8%) had been made on hospital pharmaceutical expenditure, and growth in inpatient pharmaceutical expenditure appeared to slow for all types of hospitals in 2003/4. ANM surveys indicated that, by 2004, hospital new medicine assessment processes, predominantly formal, became more complex, more focused on cost-effectiveness, and the use of pharmacoeconomic information increased. The PE survey indicated that PHARMAC�s economic assessments of new medicines were mainly viewed favourably but were not sufficiently timely to be widely used in hospital formulary decisions. Availability surveys indicated that new contracts occasionally caused availability problems e.g. products that were "out of stock", or products considered inferior by respondents. Problems were usually resolved within weeks, but some took over a year. QUM activities showed little change between surveys, but during the period an independent organisation was formed by the District Health Boards of New Zealand, with representation from PHARMAC, to coordinate the Safe and Quality Use of Medicines in New Zealand.
Conclusion: The National Hospital Pharmaceutical Strategy has been moderately successful in New Zealand. Savings of NZ$7.84-13.45m per annum were made, and growth in inpatient pharmaceutical expenditure appeared to slow in the year following the Strategy�s launch. The study has indicated some important short-term effects from the Strategy, but further research is needed to ensure that favourable effects are sustained and unfavourable effects kept to a minimum. Similar, centralized, multifaceted, approaches to managing pharmaceutical expenditure may be worth considering in other countries.
1. New Zealand Parliament. New Zealand Public Health and Disability Act. In: The Statutes of New Zealand 2000. No 91.Wellington: New Zealand Parliament; 2000
2. Pharmaceutical Management Agency. National Hospital Pharmaceutical Strategy Final Version. Wellington: PHARMAC; 2002
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Silva, Nilce Mara da. "Aspectos facilitadores e dificultadores do trabalho do enfermeiro em cargos gerenciais em hospital". Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-07032016-210705/.
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A nova configuração do papel dos hospitais, na perspectiva da construção de redes de atenção à saúde, tem implicações para o trabalho do enfermeiro com cargo gerencial no tocante às suas ações/decisões administrativas, assistenciais e de ensino. Nesse sentido, este estudo teve o objetivo de identificar os aspectos facilitadores e dificultadores do trabalho do enfermeiro em cargos gerenciais, em um hospital público, de urgência, do interior paulista. Para tanto, foi realizado um estudo descritivo de abordagem quantitativa de dados qualitativos, utilizando a Técnica do Incidente Crítico, para o levantamento das percepções e atitudes em relação ao objeto de investigação. O estudo foi desenvolvido em uma instituição hospitalar de ensino, pública, de nível terciário, situada no nordeste do Estado de São Paulo, Brasil. Participaram 15 enfermeiros em cargos gerenciais que atuavam no referido cargo há pelo menos um ano, sendo excluídos aqueles que se encontravam ausentes do local de trabalho à época da coleta dos dados, em decorrência de afastamentos legais ou por não ter sido possível realizar a entrevista após cinco agendamentos cancelados. A coleta dos dados ocorreu por meio de entrevista semiestruturada individual. Foram relatados incidentes críticos, que se constituíram em 42 situações, das quais 33,3% foram positivas e 66,7% negativas; repercutindo em 57 comportamentos, sendo 84,2% positivos e 15,8% negativos e 74 consequências, sendo 41,9% positivas e 58,1% negativas. Os dados da análise de conteúdo foram agrupados por similaridade de conteúdo. Consideram-se aspectos facilitadores situação/comportamento/consequência com referências predominantemente positivas, as categorias, a saber: interação: equipe, paciente, família; gerenciar a unidade de trabalho; questionar a implantação do Grupo Gestor e comunicar-se. Em contrapartida, foram considerados aspectos dificultadores situação/comportamento/consequência com referências predominantemente negativas, as categorias: estrutura organizacional; gestão de infraestrutura e gestão de pessoas. Cabe destacar que esses resultados podem subsidiar o trabalho do enfermeiro em cargo gerencial e, também, dos próprios gestores do hospital, uma vez que os aspectos dificultadores do trabalho do enfermeiro em cargo gerencial dizem respeito, em sua maioria, a questões de pouca governabilidade para esse profissional. Assim, evidencia-se a necessidade de maior aproximação dos gestores e enfermeiros com cargo gerencial, a fim de, juntos, solucionarem questões que favoreçam o processo de cuidar e de coordenar o trabalho. É inegável a clareza que os participantes trouxeram sobre sua responsabilidade profissional, visto que, embora os incidentes tenham tido referências predominantemente negativas, os comportamentos apresentados tiveram referências predominantemente positivas, evidenciando os esforços que esses profissionais despendem para superar as dificuldades vivenciadas e a importância considerada em poder compartilhar decisões e ações a serem realizadasThe new configuration of the role of hospitals, with a view to building health care networks, has implications for the work of nurses in management positions in relation to their administrative, helth care and teaching actions/decisions. This study aimed to identify the facilitating and hindering aspects of the work of nurses in management positions in a public emergency hospital in the interior of the state of São Paulo. A descriptive study with quantitative approach of the qualitative data was performed, using the Critical Incident Technique, to survey the perceptions and attitudes in relation to the researched object. The study was developed in a public tertiary-level teaching hospital, located in the northeast region of São Paulo state, Brazil. In total, 15 nurses in management positions, who worked in the function for at least one year, participated, excluding those who were absent from the workplace at the time of data collection as a result of legal absences or because it was not possible to conduct the interview after five appointments canceled. Data collection was performed through individual semi-structured interview. Critical incidents consisting of 42 cases were reported, of which 33.3% were positive and 66.7% negative, culminating in 57 behaviors, of which 84.2% positive and 15.8% negative, and 74 consequences, 41.9% positive and 58.1% negative. Content analysis data were grouped by similarity of content. Situation, behavior and consequence with predominantly positive references were considered as facilitating aspects, with the following categories: interaction- team, patient, family; to manage the work unit; to question the implementation of the Management Group and to communicate. On the other hand, situation, behavior and consequence with predominantly negative references were considered hindering aspects, with the following categories: organizational structure; infrastructure management and personnel management. It is highligted that these results may support the work of nurses in management positions as well as hospital managers, once the hindering aspects of the work of nurses in management positions are related mostly to issues of poor governance to this professional. Thus, the study evidences the need for closer alignment of managers and nurses with management position, in order to commonly solve issues that favor the care process and work coordination. It is undeniable the clarity that participants have about their professional liability, since although the incidents have had predominantly negative references, behaviors presented had mainly positive references, showing the efforts that these professionals expend to overcome the difficulties experienced and the importance considered in sharing decisions and actions to be taken
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Salameh, Joseph. "Le statut des médecins libéraux dans les hôpitaux publics". Thesis, Aix-Marseille, 2013. http://www.theses.fr/2013AIXM1045/document.
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De longue date, l’hôpital public a voulu faire fonctionner un service public autonome avec ses propres moyens et ses personnels.Cependant, il s’est trouvé dans l’obligation d’ouvrir ses portes à des opérateurs privés (l’intervention des médecins libéraux l’illustre) pour répondre à ses besoins de fonctionnement et d’organisation, dont les voies ont été ouvertes par la dernière loi hospitalière. Ainsi, la loi HPST a créé des dispositifs contractuels via notamment le « contrat d’exercice libéral » et le contrat de « clinicien hospitalier » pour que l’hôpital public propose des conditions statutaires plus attractives à l’attention de ces nouveaux opérateurs.Ce besoin nouveau qui s’impose, sans être véritablement souhaité, entraîne le recours à des solutions juridiques trop diversifiées.De ce fait, une cohabitation et un foisonnement de statuts s’est créé au sein de l’hôpital public. Cette situation apporte une vraie contradiction de règles statutaires, un véritable fatras qui met à mal sa cohérence.Un rapprochement des statuts des praticiens hospitaliers et des praticiens libéraux paraît inévitable pour clarifier et donner une lisibilité à l’hôpital public avec le souci unique d’apporter des soins de qualité aux usagers du service publicThe public hospital has long been willing to operate an independent public service with its own means and own staff.However, it was forced to open its doors to some private operators (the intervention of private doctors illustrates it) to satisfy its needs for operating and organization, the path of which has been opened by the last Hopsital Act. Thus, the HPST Law has created some contractual arrangements mainly with the “private practice contract”and the contract of “hospital clinical practitioner” in order that the public hospital offers more attractive statutory conditions to these new operators.This new major need, not being really desired, requires legal solutions which are too diverse.Consecuently, a coexistence and a lot of statuses have emerged within the public hospital. This situation causes a real contradiction of the statutory rules, a real hackneyed nonsense which undermines its consistency.An harmonization of the hospital and private practitioners statuses seems to be inevitable in order to clarify and make the public hospital more transparent with the sole concern to improve the quality of the health care provided to the public service users
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Kalibatas, Vytenis. "Evaluating Hospital Costs in Kaunas Medical University Hospital". Thesis, Nordic School of Public Health NHV, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3289.
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The purpose of the study is to evaluate hospital costs in Kaunas Medical University Hospital (KMUH). KMUH is the largest hospital in Lithuania, having 1995 in-patient beds, 26 specialised in-patient departments, 5130 employees, and providing wide range of in-patient services. Methods. Methods, used in the study include assessment of inputs and outputs, evaluation of average cost per case, estimation of cost structure, estimation of case-mix dimensions in in-patient departments and clinical categories and assessment of impact of case-mix dimensions to cost per case, using multiple regressionanalysis. Cross-sectional study designwas used in the study, evaluating mainly cases and expenses of all 26 specialised in-patient departments of KMUH per year 2002. Five cost groups have been used and defined inmonetary terms in each in-patient department: labour costs; medication costs; laboratory, radiology and anaesthesiology costs; running costs of medical equipment supply andother costs (including in-patients’ mealcosts, transportation, laundry, communication, etc. costs). Case was defined as one treatment episode in particular in-patient department. Cases were analysed using following case-mix dimensions: sex, age, absenceor presence of surgical operation, patient separation status and in-patientservice group. Results. Average costs per case vary widely among in-patient departments, ranging from 126.01 Litas (36.52 Euro) to 3451.68 Litas (999.73 Euro) per case.During the study average cost per case were also estimated in clinical profiles – surgery – 1161.0 Litas (336.24 Euro), therapy – 1312.15 Litas (380.02 Euro),obstetrics and gynaecology –685.82 Litas (198.62 Euro), newborn and child care – 893.54 Litas (258.78 Euro) and intensive care – 1292.92 Litas (374.45 Euro). Using multiple regression analysis method, costper case ineach in-patient department and clinical category according case-mix dimensions were predicted. In all in-patient departments predicted values of average costs per case according case-mix dimensions, comparing with actual values, did not differ so much. Positive contributions to predictedvalue of cost per case, shows only one variable – IA in-patient service group. In any predicted case contributions of independent variables have notbeen observedas significant (p>0.05). Conclusions. Inputs (measured in the number of beds) and outputs (measured in the number of in-patientcases and the number of bed-days) are different across in-patient departments, as well as outputs (measured inthe number of treatment episodes according to case-mix dimensions). The average costs per case vary widely across in-patient departments and clinical categories. The analysis of the structure of average costs per case demonstrated striking differences in in-patient departments. In all in-patient departments the predicted values of the average costs per case according to case-mix dimensions, do not differ so much comparing with theactual observed costs per case. Positive contributions to the predicted value of the cost per case, shows only onevariable – IA in-patient service group. The results of the study have proved the evidence that clinical casestreated within the same in-patient department of the hospital are not similar. The results of studyhave showedthe failure of use of “in-patient service groups” as proxy of International Disease Classification due to numberof reasonsISBN 91-7997-101-6
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Pécoul, Annabelle. "Le service public hospitalier". Thesis, Paris Est, 2016. http://www.theses.fr/2016PESC0109.
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Le service public hospitalier a été institué par la loi du 31 décembre 1970 qui en donne une définition fonctionnelle. Bien que le législateur promeuve un modèle hospitalo-centré, il n’exclut pas les établissements privés associés au service public hospitalier par le biais de modalités de participation qui les défavorisent. Affaibli par les réformes hospitalières successives, le service public hospitalier va s’atrophier jusqu’à la réforme du 21 juillet 2009 qui supprime la notion pour lui substituer celle de missions de service public. Cette conception fonctionnelle est conforme à la théorie du service public et compatible avec la définition du service d’intérêt général défendue par le droit de l’Union européenne, mais elle est en décalage avec les faits. À la définition fonctionnelle théorique défendue par le législateur depuis 1970, se substitue, en pratique, une conception organique résultant de modalités de mise en œuvre du service public hospitalier nettement favorables au secteur public. En effet, les établissements publics de santé bénéficient d’un statut singulier caractérisant leur prépondérance. La loi du 26 janvier 2016 confirme la prégnance de la conception organique en réhabilitant la notion de service public hospitalier, et en maintenant les établissements du secteur public dans leur rôle d’acteurs naturels de ce service public. Des interrogations demeurent, toutefois, concernant la pérennité du système de santé. Celui-ci doit céder la place à un service public de santé, intégrant le service public hospitalier, susceptible de chapeauter l’action de l’ensemble des protagonistes de la santé et de garantir le déroulement d’un parcours de santé accessible, égalitaire et qualitatifThe public hospital utility has been established by the law of December, 31st, 1970, which gives a functional definition. Although the legislator promotes a hospital-centered model, it doesn’t exclude the private establishments associated to the public hospital utility by means of methods of participation which penalize it. Weakened by successive hospital reforms, the public hospital utility will atrophy until the reform of July, 21st, 2009 which deletes the notion and substitutes it by the concept of public service missions. This functional conception is in accordance with the service public theory and compatible with the definition of general interest service defended by the European Union law, but isn’t in keeping with facts. The theoretical functional definition supported by the lawmaker is replaced, in practice, by an organic conception resulting from details of implementation of public hospital utility decidedly favorable to sector public. Indeed, public health establishments benefit from a singular status characterizing its predominance. The law of January, 26, 2016 confirms the resonance of the organic conception by rehabilitating the notion of public hospital utility, and by maintaining public sector institutions in its role of natural actors of this public utility. Questions remain, nonetheless, concerning the durability of the health system. It must step back for a public health service, integrating the public hospital utility, able to head the action of all health protagonists and to guarantee the progress of an accessible, egalitarian and qualitative fitness trail
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Street, Andrew. "Issues in evaluating the efficiency of the public hospital sector". Thesis, University of York, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273908.
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Owen, Karen, i n/a. "Managing interorganisational relationships an in-depth study in a hospital context". Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20061206.115448.
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Can interorganisational relationships be managed for effective functioning? This is
the problem investigated in this research. Organisations world-wide are adopting
co-operative relationships with other organisations. These interorganisational
relationships are viewed as a way to enhance their own business performance
(Williamson 1985, 1991; Dyer 1997; Gulati 1998; Barringer & Harrison 2000; Das
& Teng 2000; Quinn 2000; Stuart 2000; Johnson, Korsgaard & Sapienza 2002).
Despite this, the success rate for interorganisational relationships is not high (Hutt,
Stafford, Walker & Reingen 2000; Quinn 2000; Hitt, Ireland & Vaidyanath 2002)
with many of them failing to achieve their objectives. Understanding how to
manage these boundary-spanning arrangements is important to realising the
objectives of the business strategy.
The research setting is a large private hospital in Australia. It works with a
network of external service organisations that provide the Hospital with a range of
clinical and non-clinical support services including: Diagnostic Imaging, Pathology
Pharmacy, Food Services, Environmental Services, and Human Resources support.
This research explores how these different relationships were managed in their
operating period: 1998 to 2002. It reveals the dynamic and often ad hoc way, in
which managers made sense of the collaborative service context, and how
managers influenced the process of interorganisational relationship formation.
Extant research about interorganisational relationships comes from a variety of
fields. For this research it is most relevant to draw from the research fields of
organisational theory, organisation behaviour, sociology, psychology and
management. These fields contribute findings that provide useful knowledge upon
which to build further understanding about how managers contribute to construct
interorganisational relationships functioning (Ring & Van de Ven 1992, 1994;
Walsh 1995; Chikudate 1999a, 1999b; Boddy, Macbeth & Wagner 2000; Hutt,
Stafford, Walker & Reingen 2000; Lasker, Weiss & Miller 2001).
This research uses an interpretivist methodology that enables the researcher to
explore the dynamic nature of the Manager's sense-making in the construction of
six interorganisational relationships. For the purposes of this research,
interorganisational relationships are defined as new structures that emerge through
the social interaction of actors involved in shared service delivery. The
collaborative context of interorganisational relationships stimulates managers'
sense-making by challenging institutionalised ways of behaving. This sensemaking
process builds new knowledge stores and contributes to emerging, new
management routines. The process is transformative and enables the emergence of
interorganisational relationships.
It emerges from this research that managers take cues from their context. These
cues are used to interpret and make assessments that enable decisions about those
actions that they take to construct the interorganisational relationships. A
manager's processing of contextual cues, through interpretive frames and
dispositional sense-making filters, is an inter-subjective, socially constructive
process. The 'self' is a dimensional influence in the managers' sense-making and
management behaviours and is implicated through the notion of contextual
interpretive frames and dispositional sense-making filters. A model of
interorganisational relationship management as a transformational process is
developed. The association between contextual influences and managers'
behaviours will raise awareness for professional practitioners of the challenges
involved in managing across organisational boundaries and in turn, may contribute
to more successful implementation of interorganisational business relationships.
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Owen, Karen. "Managing interorganisational relationships an in-depth study in a hospital context /". Australasian Digital Thesis Program, 2005. http://adt.lib.swin.edu.au/public/adt-VSWT20061206.115448.
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Thesis (DBA) - Swinburne University of Technology, Australian Graduate School of Entrepreneurship, 2005.Dissertation submitted to [the] Australian Graduate School of Entrepreneurship, Swinburne University of Technology in partial fulfilment of the requirements for the Doctor of Business Administration, 2005. Typescript. Includes bibliographical references (p. 268-300).
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Polanecká, Šárka. "Public Relations a komunikace ve zdravotnictví". Master's thesis, Vysoká škola ekonomická v Praze, 2009. http://www.nusl.cz/ntk/nusl-18298.
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The goal of theses is to introduce the theoretical knowledge in the field of Public Relations and subsequently on the basis of marketing research to map the situation of public relations management between hospitals in the Czech Republic.
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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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Allan, Cameron, i 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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Gong, Zhiping, i gongzhiping@gmail com. "Developing Casemix classification for acute hospital inpatients in Chengdu, China". La Trobe University. School of Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050314.195349.
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Hospital information systems in China are improving and a casemix system for describing inpatient care is looking more feasible than previously. Implementing a casemix classification system for acute inpatient care in China could help to improve regional planning and hospital quality and efficiency. The purpose of this study was to evaluate the Australian DRG system as the basis for developing an acute inpatient casemix system appropriate for China. The applicability of the Australian AR-DRG system has been evaluated (in terms of homogeneity achieved and comparability of rank order) using inpatient data from Chengdu in Sichuan.
Homogeneity achieved was good. The R2 value (the coefficient of multiple determination) was 0.12 for LOS and 0.17 for cost using untrimmed data and using (L3H3) trimmed data, R2 was 0.45 for LOS and 0.59 for cost. This explanatory power is comparable to other DRG classification systems although there are a few MDCs in which AR-DRGs exhibit poorer explanatory power.
Rank order of groups was generally comparable. The AR-DRG system incorporates hierarchies of DRGs within groups of adjacent DRGs, within medical and surgical partitions and across all DRGs within each MDC. I have compared the ranking of DRGs based on average cost with the ranking assumed by the AR-DRG system, at the adjacent group level, within partitions and at the level of the MDC. I used the Spearman Rank Correlation coefficient to compare DRG order across partitions and whole MDCs. In general the cost relativities of the Chinese inpatient episodes grouped by the AR-DRG system correspond to the logical hierarchies assumed by the system. On this basis Chinese and Australian episodes of care within most of the MDCs appear to reflect the same broad pattern of resource consumption.
Further research will be needed to determine where and how the grouping rules used in the AR-DRG system might need to be changed to more accurately reflect Chinese circumstances. For example the cost structures of Chinese health services are different from those in Australia. The Australian Refined DRGs (AR-DRGs) would provide a sound basis from which to develop a Chinese version of DRGs.
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Polimeni, Anne-Maree, i Anne-Maree Polimeni@dhs vic gov au. "Narrative of women's hospital experiences the impact of powerlessness on personal identity". Swinburne University of Technology, 2004. http://adt.lib.swin.edu.au./public/adt-VSWT20050309.143640.
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Since women dominate the health care system as consumers, it is important to understand how women want to be treated by medical staff, and the factors that contribute to satisfactory hospital experiences. The present research comprised two separate but integrated studies exploring these issues. The first study adopted an
atheoretical approach. Qualitative and quantitative methods were used to examine the
importance of hospital experiences in the lives of women, and the role of power within those experiences. Closed answer items about hospital experiences were completed by 124 women who had had a hospital stay of at least one night. In addition, ten of the women provided open-ended oral and written comments about their hospital
experiences, which were used as the basis of the qualitative data. The majority of the women were satisfied with their hospital stay, but a small group recalled experiences of powerlessness associated with the non-medical aspects of their treatment, such as behaviours on the part of health professionals that influenced participants� sense of control as hospital inpatients. The qualitative data reflected similar issues to the quantitative data and provided �process� information by demonstrating how health professionals� behaviour could contribute to patients� feelings of powerlessness. The results suggested that hospital experiences were a salient part of these women�s lives. The richness of the qualitative data suggested that qualitative methodology would be a productive way to further study this area.
The second study was an extension of the first via in-depth interviews with 19 women who perceived their hospital experiences as life-altering. The interview content and the analysis were based on a narrative approach that used the theoretical framework of McAdams� (1993) Life Story Model of Identity. Using McAdams� methodology enabled the researcher to evaluate how women constructed meaning from their hospital
experiences, and the main issues they faced. The life story interview also proved a useful way to explore issues of loss and self-growth in the face of traumatic hospital experiences. Transcripts of descriptions of positive and negative experiences were analysed according to McAdams� themes of agency (sense of power and control) and communion (relationships with others), and sequences of redemption and
contamination. Redemption sequences involve the storyline moving from a bad, affectively negative life scene, to a good, affectively positive life scene. In a contamination sequence, the narrator describes a change from a good, affectively
positive life scene, to a subsequently bad, affectively negative life scene (McAdams & Bowman, 2001). Participants also rated their experiences according to Hermans� (Hermans & Oles, 1999) list of affects. There was strong agreement between McAdams� coding of agency and
communion and Hermans� agentic and communal indices: the women�s hospital stories strongly emphasised the negative or opposite of McAdams� agentic theme �Self Mastery through Control�, which indicated powerlessness, and Hermans� affects, which involved low self-enhancement. It may be useful for future studies to conceptualise
McAdams� themes as bipolar by incorporating currently coded themes and their reverse; in particular, by expanding ideas of agency to incorporate powerlessness, as this theme was pervasive in women�s hospital experiences. The rating of affects added to the findings as this showed a latent dimension of communion manifested as isolation. The common agency and communion themes were apparent in the two distinct but related aspects of hospitalisation that affect patients� sense of control: the medical condition and the manner in which patients are treated by medical staff. The findings of the main study built on the pilot study by showing how ideas of control and powerlessness can inform better practice. For example, respectful, dignified and fair treatment by health professionals played a part in determining redemption sequences; women also indicated this was how they wanted to be treated. Due to the vulnerability of the �sick role�, disrespectful or offhand treatment by health professionals had particularly distressing effects evident in contamination sequences, such as negative changes to sense of self and attitudes toward the health care system. In some cases, such treatment led to participants� avoiding subsequent interactions with doctors and to sustained feelings of helplessness. The present thesis demonstrates that doctors, nurses
and other health professionals need to allow time to attend to the affective as well as the medical aspects of the encounter. Health professionals need a good bedside manner, compassion, and communication skills, as these characteristics play a part in maintaining female patients� sense of self and their faith in and satisfaction with the health care system.
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Wendall, Pamela S. "Clients' spiritual perspective of care". Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1191724.
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Spiritual dimensions are an important focus for nursing care and nurses can be catalysts for spiritual care. The purpose of this descriptive comparative analysis is to examine the spiritual care needs as perceived by terminally ill clients, non-terminally ill clients, and well adults. The theoretical framework for this study is Leininger's "Cultural Care Theory" that supports the notion that spiritual care needs to be culturally congruent.Participants were obtained from a 225-bed hospital, hospice, home care, and a wellness program in a midwestern city. Permission was obtained from the hospital President, Vice President of Nursing, the directors of Hospice and Home Care, and the community's Wellness Program. The number of participants was 76. The process for the protection of human rights was followed.Findings were that terminally ill, non-terminally ill, and well-adults all agree that receiving spiritual care that is congruent with beliefs is important. The terminally ill clients rated spiritual needs higher than both non-terminally ill and well-adults. All groups rated the same in the persons from whom it was wished to receive spiritual care. Common themes of spiritual care desired from these persons for the terminally ill group was: pray for/with me and talk to me. For the non-terminally ill group it was: give me information, The understanding, and provide emotional and spiritual support. Finally, for the well-adults it was: listen to me, talk to me, be confident, and support me.No statistical difference between groups (.940) on the SPS. On the SPC, the terminally ill group was more satisfied (5.20) with spiritual support they were receiving than the non-terminally ill group or well-adults.It was concluded that regardless of the stage of illness, the same spiritual needs are prominent, all individuals have spiritual needs, and several types of interventions are preferred. It has been demonstrated in this study that prayer is the most sought after component of spiritual care among all three groups. Second to that would be someone to talk to and someone to listen to them.Implications call for nurses to facilitate spiritual care from family, friends, minister or priest, and hospital chaplain. This could be written into the plan of care by having the client describe the type of spiritual care they want to receive. Nursing Administration needs to work with nursing staff to define spirituality and religion and what they mean to the nurse.School of Nursing
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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
44
Voake, Cheryl. "Modelling trauma hip fracture hospital activities". Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/42402/.
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Hip fracture is the most common reason for an elderly person to be admitted to an acute orthopaedic ward. The main aim of this research is to provide a statistical evaluation of a hip fracture database, and then to use Operational Research (OR) techniques, using the statistical output, to model activities associated with the care of hip fracture patients. OR techniques employed in this thesis include simulation and queuing theory. This research focuses on hip fracture admissions to the University Hospital of Wales in Cardiff, with a primary aim of ascertaining whether the time between admission and surgical intervention has any impact upon patient outcome. Outcome is considered in terms of mortality, hospital length of stay and discharge destination. Statistical analyses are performed, via regression and CART analysis, to investigate length of stay and mortality variables. The results from these statistical tests are compiled, compared and investigated in more depth. Additionally, a principal component analysis is performed to investigate whether it would be feasible to reduce the dimensionality of the dataset, and subsequently principal component regression methodology is used to complement the output. Simulation is used to model activities in both the hip fracture ward and the trauma theatre. These models incorporate output from the statistical analysis and encompass complexities within the patient group and theatre process. The models are then used to test a number of ‘what-if’ type scenarios, including the future anticipated increase in demand. Finally, results from queuing theory are applied to the trauma theatre in order to determine a desired daily theatre allocation for these patients. Specifically, the M | G | 1 queuing system and results from queues with vacations are utilised. The thesis concludes with some discussion of how this research could be further expanded. In particular, two areas are considered; risk scoring systems and the Fenton-Wilkinson approximation.
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Lourens, Guinevere Margaretha Attilla Couldridge. "Implementation framework of the hospital revitalisation programme in a regional secondary level public hospital in Paarl, South Africa". Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/1690.
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Thesis submitted in fulfillment of the requirements for the degree Doctor of Technology: Public Management in the Faculty of Business at the Cape Peninsula University of TechnologyThe National Department of Health of South Africa implemented a Hospital Revitalisation Grant to modernize and transform the infrastructure and health technology of hospitals and improve the quality of care and access to health care. Paarl Hospital, a secondary level semi-rural public regional hospital, was entered as a project into the Hospital Revitalisation Programme (HRP) in January 2006 and reached practical completion on 23 March 2012. This study critically evaluated the HRP implementation at Paarl Hospital and developed a framework for implementation which addresses the needs of the clients and staff, and assures technical quality of care. Building healthcare facilities is complex and the incorrect planning and implementation thereof can give rise to expensive mistakes. Research on quality of care in health fulfils a social and practical mandate to create information for use by public managers to improve services or by decision makers to inform policy. A descriptive case study design, with qualitative research methodology was utilized for this study. The case study involved an intensive exploration of the circumstances, dynamics and complexities of this public hospital project. A multi-method approach to data collection was taken which included focus group discussions; individual and pair interviews; as well as photographic and document review. Action research methodology, which is concerned with collaborative knowledge enquiry and sharing, was applied by means of an intervention. The findings which arose during the study were simultaneously used and actions were taken to improve HRP implementation in the Psychiatry planning and decanting stage. The study’s findings indicate that hospital revitalisation holds huge benefits for the community the relevant hospital serves, but that client, staff and technical quality are at risk during implementation. The proposed implementation framework serves to inform of the risk management strategies that can be taken for the infrastructure, health technology, organisational development and quality assurance deliverables of the HRP. Future hospital revitalisation projects stand to benefit from the framework to enhance quality of care during implementation, in the interest of economically effective and efficient allocation of public resources and quality health for all.
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Banedj-Schafii, Mandana. "System transferability of public hospital facility management between Germany and Iran". Karlsruhe KIT Scientific Publ, 2009. http://d-nb.info/100219606X/04.
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Kamau, George Michungu. "Factors affecting supply chain integration in public hospital pharmacies in Kenya". Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/7915.
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The purpose of this study was to develop and empirically test the Supply Chain Integration Framework (SCI framework) in order to develop a framework to address the inefficiencies experienced in the public hospital pharmacies’ Supply Chain (SC) in Kenya. Supply Chain Management (SCM) can be regarded as a vibrant business entity that is changing and evolving continually because of constant changes in technology, competition and customer demands. The study investigated and analysed how the independent variables, namely SCI initiatives, performance improvement drivers, organisation environmental forces, workforce and management support, financial factors, flow and integration, regulatory framework and information sharing and technology influenced the SCI. The SCI was categorised into three components namely: customer order fulfilment, supplier collaboration and dedicated SC as the dependent variable. The literature reviewed established that globalisation and intensive worldwide competition, alongside technological developments, creates a completely new operating environment for organisations. The researcher reviewed various models and theories related to SCI which include systems theory, value chain models and value ecology models among others. An SCI framework was then developed to capture the interacting variables within the SCI network that could be adopted for the public hospital pharmacies in Kenya. The study was conducted using a survey questionnaire (Annexure B) that comprised both open and closed ended questions that were distributed to managers in public hospitals and pharmacies in Kenya. The population for the survey was 154 public hospital pharmacies in Kenya, with the final sample comprised of 280 respondents. The study was conducted using a survey questionnaire (Annexure B) that comprised both open and closed ended questions that were distributed to 325 respondents in 154 public hospitals and pharmacies in Kenya. The population for the survey was 154 public hospital pharmacies in Kenya, with the final sample comprised of 280 respondents. Exploratory factor analysis was used to ascertain the validity of the measuring instrument and the Cronbach alpha coefficients were used to measure the reliability of the measuring instruments. Key preliminary tests performed were the Kaiser-Meyer-Olkin test (KMO test) of sample adequacy, the Bartlett’s test of sphericity and the Kolmogorov-Smirnov test (Z-Statistic test) for normality and multi-collinearity diagnostic. Analysis of Variance (ANOVA) and multiple linear regressions were the main statistical procedures used to test the regression model fit and the significance of the relationships hypothesised among various variables in the study. Statistical softwares, namely Statistica 10 (2010) and Statistical Package for Social Sciences (SPSS) Version 18, were used to analyse quantitative data. The study identified five statistically significant relationships between customer order fulfilment and workforce and management support, financial factors, flow and integration, information sharing and technology, supplier collaborations and dedicated SCI. In addition, a total of six statistically significant relationships exist between the supplier collaborations and SCI initiatives i.e. performance improvement drivers, workforce and management support, financial factors, flow and integration, information sharing and technology adoption as well as dedicated SCI. Furthermore, four statistically significant relationships were found between dedicated SCI and SCI initiatives, workforce and management support, financial factors, flow and integration, information sharing and technology adoption.
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Chang, Chun Pin, i 張鈞萍. "Public Hospital Privatization". Thesis, 2000. http://ndltd.ncl.edu.tw/handle/50240511520599218664.
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Cooper, Dhanmathie. "Supply chain management in a public hospital in Gauteng". Thesis, 2016. http://hdl.handle.net/10539/21767.
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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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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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