Using tablets in medical consultations: Single loop and double loop learning processes

Tablet in the Consultation Room and Physician Satisfaction

The purpose of the study is to investigate patient-physician interactions during a clinical encounter to ascertain the impact of tablet computing on physician satisfaction during a clinical encounter. This study was conducted at a primary care clinic, and the physicians who participated could use a tablet during their clinical encounters. The authors compared satisfaction between physicians who used the tablet during a clinical encounter and those who did not using data from 122 clinical encounters involving 82 patients. The results indicate that physicians who used the tablet during clinical encounters are more satisfied than those who did not. Additionally, there was a meaning difference in satisfaction between physicians who used the tablet to educate patients and share information than those who did not. HITs have potential benefits, but they also come with risks. To effectively manage the risks and benefits of HITs, healthcare providers should be deliberate and strategic in the implementation of HITs.

Exploration on the gap of single- and double-loop learning of balanced scorecard and organizational performance in a health organization

This paper addresses and interprets learning styles, namely, single- and double-loop learning, of BSC implementation in the background of healthcare organizaiton/industry, through which barriers and facilitators are inducted for the BSC for the healthcare industry. Samples of this study are from a community hospital with 290 beds was probed with samples of 34 BSC members interviewed. Based on the qualitative research's grounded theory, the transcript data of this study were analyzed using open, axial, and selective coding through NVIVO 10.0. By using single- and double-loop learning, this study distinguishes between adding and changing a health organization's specific capabilities, routines or abilities. Findings of this study indicated that BSC learning is more likely to improve the efficiency of the strategic management and strengthen the company's existing capabilities and routines; but it is not possible for single-loop learning to develop new capabilities. This study contributes to indicate that single-loop learning can be useful facilitators for organizational learning via affecting the positive performance of the organization, because employees are in favor of following existing routines and rules and allowing the employees to see the meaning of this balanced scorecard. However, employees still do not have the power to make changes they expect, because they do not have the power and right to change. The purpose of this research is to evaluate organizational learning performance via the implementation of the balanced scorecard in order to understand the mechanism's impact on organizational development. In short, this paper contributes practically to depict the process of executing BSC in learning organization in detail, and theoretically to understand the mechanism in optimizing organizational learning effect via BSC implementation through discussion of (1) downward penetration of single-loop learning from organization vision and goals, and upward following and promotion of double-loop learning of sub-units in the form of routines, norms, action plans and others; (2) ways of eliminating the gap by linking organizational member's values with the organization's vision in the form of giving individuals opportunities to make their own interpretation of learning results in the workplace.

Internet access, usage and trust among medical professionals in China: A web-based survey

OBJECTIVES

Social media has changed methods of communication in the medical profession. As part of a "doctor as communicator" strategy, Chinese medical professionals are actively embracing social media, which may have an impact on tense physician-patient relationships in China. This paper aims to examine a pattern of Internet access, Internet usage, and trust among Chinese medical professionals and further explores the reasons for these relationships on an individual level.

DESIGNS

A web-based questionnaire was designed, based on a media literacy model, and was divided into 3 dimensions: public information, general medical information, and specialty information. After a two-round pilot study, 1001 physicians were included. Additionally, 4 interviewees were chosen to participate in in-depth interviews and content analysis was performed. Data were analyzed using SPSS 25.0.

RESULTS

Findings showed that new media has become a major approach for medical professionals in China to retrieve and get access to various information. However, they still trust traditional media (n = 1001, P < 0.01) and professional journals more (n = 1001, P < 0.01). Internet access, usage, and trust were positively correlated (r = 0.185-0.344, P < 0.01). Regarding usage habits, 47.66% of the participating physicians would practice science popularization through their new media accounts and 71.23% would forward approved health information within their professional realm. A validated instrument can be provided for further related studies.

CONCLUSIONS

Science popularization is a specific usage of new media among Chinese medical professionals, through which they have achieved new authority and empowered communication because of self-media. To some extent, physician-patient relationships in China can be improved because this online interaction is conducive to building harmonious and lasting offline physician-patient relationships.

Reducing medication errors using lean six sigma methodology in a Thai hospital: an action research study

Purpose

The purpose of this paper is to illustrate the use of Lean Six Sigma (LSS) and its associated tools to reduce dispensing errors in an inpatient pharmacy of a teaching hospital in Thailand.

Design/methodology/approach

The action research methodology was used to illustrate the implementation of Lean Six Sigma through the collaboration between the researcher and participants. The project team followed the Lean Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC) methodology and applied its tools in various phases of the methodology.

Findings

The number of dispensing errors decreased from 6 to 2 incidents per 20,000 inpatient days per month between April 2018 and August 2019 representing a 66.66% reduction. The project has improved the dispensing process performance resulting in dispensing error reduction and improved patient safety. The communication channels between the hospital pharmacy and the pharmacy technicians have also been improved.

Research limitations/implications

This study was conducted in an inpatient pharmacy of a teaching hospital in Thailand. Therefore, the findings from this study cannot be generalized beyond the specific setting. However, the findings are applicable in the case of similar contexts and/or situations.

Originality/value

This is the first study that employs a continuous improvement methodology for the purpose of improving the dispensing process and the quality of care in a hospital. This study contributes to an understanding of how the application of action research can save patients' lives, improve patient safety and increase work satisfaction in the pharmacy service.

The impact of media type on shared decision processes in third-age populations

PURPOSE

To examine the relationship between the media, through which medical information was made available (e.g. digital versus printed), and the patients' desire to play an active part in a medical decision in an SDM or an ISDM-based process. The goal of this research was to expand knowledge concerning social and personal factors that affect and explain patients' willingness to participate in the process.

METHODS

A questionnaire was distributed in this empirical study of 103 third-age participants. A theoretical model formed the basis for the study and utilized a variety of factors from technology acceptance, as well as personal and environmental influences to investigate the likelihood of subjects preferring a certain decision-making approach. The research population included men and women aged 65 or older who resided in five assisted living facilities in Israel. The sample was split randomly into 2 groups. One group used digital information and the other print. A path analysis was conducted, using Structural Equation Modelling (SEM) in AMOS SPSS, to determine the influence of the information mode of presentation on the patient's choice of the SDM or ISDM model.

RESULTS

When digital media was accessible, the information's perceived usefulness (PU) led participants to choose an ISDM-based process; this was not true with printed information. When information was available online, higher self-efficacy (SE) led participants to prefer an SDM-based process. When the information was available in print, a direct positive influence was found on the participant's choice of SDM, while a direct negative influence was found on their choice of an ISDM-based process. PU was found to be affected by external peer influences, particularly when resources were made available in print. This meant that digital resources tended to be accepted at face value more readily. Cognitive absorption had a positive effect on the research variables only when the information was available digitally. The findings suggest the use of digital information may be related to cognitive functions of older adults, since the use of digital technology and information requires more cognitive effort.

CONCLUSIONS

The study illustrates factors that make patients choose SDM or ISDM-based processes in third-age populations. In general, the results suggest that, even though a physician may attempt to place the patient in the center of the decision process, printed information does not empower the patient in the same way that digital resources do. This may have wider ramifications if the patient does not buy into the treatment plan is and becomes less motivated to be compliant with the treatment. Another key contribution of this research is to identify processes that reflect information assessment and adoptions, and the behaviors related to medical decision making, both as a model and as a process. This study suggests what health care professionals should expect to see as the transition to more digital information sources becomes the norm among the elderly population. Future research is needed to examine this model under different conditions, and to check for other variables and mechanisms perceived as mediators in the choice of SDM or ISDM processes.

Smoking cessation: Exploration of perceived technology-related information value

This study describes a unique approach to information transfer affecting the perceived value of this information and related impact on smoker behavior. Data were collected via survey, sampling approximately 120 participants. An online survey tool was used for the survey creation, data collection and monitoring. Another online tool was used by participants to create short animation videos as a means of increasing their engagement with information in an experiential fashion. Study findings included that the process experienced by the test group was influential and facilitated participants' change of mind regarding enrollment in a smoking cessation workshop. This was partly attributable to the IKEA effect. The study provides evidence that a change in habits crucial to improve health and enhance positive lifestyle choices can be stimulated through active engagement with artifact creation in a technology-mediated environment.

The ability of older adults to use customized online medical databases to improve their health-related knowledge

INTRODUCTION

Patient compliance with medical advice and recommended treatment depends on perception of health condition, medical knowledge, attitude, and self-efficacy. This study investigated how use of customized online medical databases, intended to improve knowledge in a variety of relevant medical topics, influenced senior adults' perceptions.

METHOD

Seventy-nine older adults in residence homes completed a computerized, tablet-based questionnaire, with medical scenarios and related questions. Following an intervention, control group participants answered questions without online help while an experimental group received internet links that directed them to customized, online medical databases.

RESULTS

Medical knowledge and test scores among the experimental group significantly improved from pre- to post-intervention (p<0.0001) and was higher in comparison with the control group (p<0.0001). No significant change occurred in the control group.

CONCLUSION

Older adults improved their knowledge in desired medical topic areas using customized online medical databases. The study demonstrated how such databases help solve health-related questions among older adult population members, and that older patients appear willing to consider technology usage in information acquisition.

The use of mobile technology in waiting rooms to leverage women's empowerment: A conceptual context

This article focuses on a conceptual framework that can be applied to the use of mobile technology in the waiting room with the goal of empowering women recently diagnosed with abnormal Pap test results. It further describes trends which indicate a need for improved and timely information dissemination. Genecology practice outpatients report a predominant feeling of worry on receipt of abnormal medical test results, along with a clearly expressed wish for additional information. This research suggests that there is room for improvement in existing processes through use of mobile technology with carefully vetted materials which indicate a doctor is interested in the patient's well-being.