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Salehi R, Masoudi-Asl I, Gorji HA, Gharaee H. Gap analysis of strategies for promoting interprofessional teams in healthcare units. J Health Organ Manag 2024; 38:857-887. [PMID: 39198959 DOI: 10.1108/jhom-02-2024-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2024]
Abstract
PURPOSE A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap. DESIGN/METHODOLOGY/APPROACH This study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population. FINDINGS Based on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas. PRACTICAL IMPLICATIONS This research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units. ORIGINALITY/VALUE Improving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.
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Affiliation(s)
- Reza Salehi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Iravan Masoudi-Asl
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Abolghasem Gorji
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hojatolah Gharaee
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Rezaei S, Ghiasvand H, Brown H. Time series analysis of COVID-19's impact on physician and dentist visits in Iran. Sci Rep 2024; 14:16453. [PMID: 39013932 PMCID: PMC11252254 DOI: 10.1038/s41598-024-67238-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 07/09/2024] [Indexed: 07/18/2024] Open
Abstract
This study aimed to assess the impact of the COVID-19 pandemic on general practitioner (GP), specialist, and dentist visits among 40 million Iranians covered by the Social Security Organization (SSO). A monthly interrupted time series analysis was conducted over a period of 72 months, including-47 months before the pandemic and 25 months after its onset. The outcomes variables were monthly number of GP, specialist, and dentist visits per 1000 SSO-insured individuals. The analysis was performed by total visits, visits to the SSO direct sector, and visits to the indirect sectors. The study found that in the first month of the pandemic, the number of visits per 1000 insured individuals significantly decreased for visits to GPs (by 51.12, 95% CI -64.42 to -37.88), visits to specialists (by 39.11, 95% CI -51.61 to -26.62), and visits to dentists (by 6.67, 95% CI -8.55 to -4.78). However, during the subsequent months of the pandemic, there was a significant increase in the number of monthly visits for all three categories, with GPs experiencing the highest increase (1.78 visits per 1000 insured), followed by specialists (1.32 visits per 1000 insured), and dentists (0.05 visits per 1000 insured). Furthermore, prior to the pandemic, the number of monthly GP visits per 1000 insured individuals was statistically significantly lower in the indirect sector compared to the direct sector (45.79, 95% CI -52.69 to -38.89). Conversely, the direct sector exhibited lower rates of specialist visits (25.84 visits per 1000 insured individuals, 95% CI 22.87 to 28.82) and dentist visits (0.75 visits per 1000 insured individuals, 95% CI 0.12 to 1.36) compared to the indirect sector. Additionally, the study found that in the first month of the pandemic, the monthly number of GP visits in the indirect sector significantly increased by 34.44 times (95% CI 24.81 to 44.08) compared to the direct sector. For specialist visits and dentist visits, the increase was 3.41 (95% CI -5.87 to 12.69) and 5.01 (95% CI 3.48 to 6.53) per 1000 insured individuals, respectively. Overall, the findings of this study demonstrate statistically significant disruptions in GP, specialist, and dentist visits during the COVID-19 pandemic, although some recovery was observed. Both the direct and indirect sectors experienced decreased visits.
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Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Hesam Ghiasvand
- Research Centre for Healthcare & Communities, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
| | - Heather Brown
- Division of Health Research, Lancaster University, Lancaster, UK
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Wang YY, Zhang WW, Lu ZX, Sun JL, Jing MX. Optimal resource allocation model for COVID-19: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:200. [PMID: 38355468 PMCID: PMC10865525 DOI: 10.1186/s12879-024-09007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND A lack of health resources is a common problem after the outbreak of infectious diseases, and resource optimization is an important means to solve the lack of prevention and control capacity caused by resource constraints. This study systematically evaluated the similarities and differences in the application of coronavirus disease (COVID-19) resource allocation models and analyzed the effects of different optimal resource allocations on epidemic control. METHODS A systematic literature search was conducted of CNKI, WanFang, VIP, CBD, PubMed, Web of Science, Scopus and Embase for articles published from January 1, 2019, through November 23, 2023. Two reviewers independently evaluated the quality of the included studies, extracted and cross-checked the data. Moreover, publication bias and sensitivity analysis were evaluated. RESULTS A total of 22 articles were included for systematic review; in the application of optimal allocation models, 59.09% of the studies used propagation dynamics models to simulate the allocation of various resources, and some scholars also used mathematical optimization functions (36.36%) and machine learning algorithms (31.82%) to solve the problem of resource allocation; the results of the systematic review show that differential equation modeling was more considered when testing resources optimization, the optimization function or machine learning algorithm were mostly used to optimize the bed resources; the meta-analysis results showed that the epidemic trend was obviously effectively controlled through the optimal allocation of resources, and the average control efficiency was 0.38(95%CI 0.25-0.51); Subgroup analysis revealed that the average control efficiency from high to low was health specialists 0.48(95%CI 0.37-0.59), vaccines 0.47(95%CI 0.11-0.82), testing 0.38(95%CI 0.19-0.57), personal protective equipment (PPE) 0.38(95%CI 0.06-0.70), beds 0.34(95%CI 0.14-0.53), medicines and equipment for treatment 0.32(95%CI 0.12-0.51); Funnel plots and Egger's test showed no publication bias, and sensitivity analysis suggested robust results. CONCLUSION When the data are insufficient and the simulation time is short, the researchers mostly use the constructor for research; When the data are relatively sufficient and the simulation time is long, researchers choose differential equations or machine learning algorithms for research. In addition, our study showed that control efficiency is an important indicator to evaluate the effectiveness of epidemic prevention and control. Through the optimization of medical staff and vaccine allocation, greater prevention and control effects can be achieved.
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Affiliation(s)
- Yu-Yuan Wang
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, Urumqi, China
| | - Wei-Wen Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, Urumqi, China
| | - Ze-Xi Lu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, Urumqi, China
| | - Jia-Lin Sun
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, 832003, PR China.
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, Urumqi, China.
- Department of Nutrition and Food Hygiene School of Public Health Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ming-Xia Jing
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, 832003, PR China.
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, Urumqi, China.
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Amsah N, Md Isa Z, Ahmad N, Abdul Manaf MR. Impact of COVID-19 Pandemic on Healthcare Utilization among Patients with Type 2 Diabetes Mellitus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4577. [PMID: 36901588 PMCID: PMC10002238 DOI: 10.3390/ijerph20054577] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
As the COVID-19 pandemic continues, healthcare services have been grossly overwhelmed by the pandemic. Due to this circumstance, routine care for individuals with type 2 diabetes mellitus (T2DM) has been temporarily disrupted. The purpose of this systematic review was to summarize the evidence regarding the impact of the COVID-19 pandemic on healthcare utilization among patients with T2DM. A systematic search was conducted in the Web of Science, Scopus, and PubMed databases. The process of identifying the final articles followed the PRISMA guidelines. The inclusion criteria were articles published between 2020 and 2022, written in English, and studies focusing on the research question. Any proceedings and books were excluded. A total of fourteen articles relevant to the research question were extracted. Following that, the included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT) and the Joanna Briggs Institute Critical Appraisal Tool to assess the quality of the studies. The findings were further classified into three themes: reduced healthcare utilization among T2DM patients in routine healthcare services, a surge of telemedicine usage, and delay in the delivery of healthcare services. The key messages include demands for monitoring the long-term effects of the missed care and that better preparedness is crucial for any pandemic in the future. A tight diagnostic workup at the community level and regular follow-ups are crucial in managing the impact of the pandemic among T2DM patients. Telemedicine should be on the agenda of the health system to maintain and complement healthcare services. Future research is warranted to determine effective strategies to deal with the impact of the pandemic on healthcare utilization and delivery among T2DM patients. A clear policy is essential and should be established.
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Affiliation(s)
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
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Semenova Y, Trenina V, Pivina L, Glushkova N, Zhunussov Y, Ospanov E, Bjørklund G. The lessons of COVID-19, SARS, and MERS: Implications for preventive strategies. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2051126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yuliya Semenova
- Department of Neurology, Ophthalmology and Otolaryngology, Semey Medical University, Semey, Kazakhstan
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Varvara Trenina
- Department of Neurology, Ophthalmology and Otolaryngology, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
- Department of Emergency Medicine, Semey Medical University, Semey, Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics & Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | | | - Erlan Ospanov
- Department of Neurology, Ophthalmology and Otolaryngology, Semey Medical University, Semey, Kazakhstan
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
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Population Access to Hospital Emergency Departments: The Spatial Analysis in Public Health Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031437. [PMID: 35162454 PMCID: PMC8835408 DOI: 10.3390/ijerph19031437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
The emergency medical services support the primary health care system. Hospital emergency departments (HEDs), which provide medical assistance to all patients in a state of emergency are of considerable importance to the system. When studying access to HEDs, attention should be focused on spatial relations resulting from the location of HEDs and the places of residence of the potential patients. The aim of the paper is to explain the level of spatial accessibility of HEDs and its changes as a result of organizational and spatial transformations of HEDs' networks in Poland. The research was conducted within two time series, comparing the changes in the distribution of HEDs in 2011 and 2021. GIS techniques were used to measure the distances between emergency departments and places of residence. It was observed that the transformation of the spatial organization of the hospital emergency department network in 2011-2021 resulted in the overall improvement of the spatial accessibility of these facilities, reducing the distance between them and places of residence.
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Ortíz-Barrios MA, Coba-Blanco DM, Alfaro-Saíz JJ, Stand-González D. Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8814. [PMID: 34444561 PMCID: PMC8392152 DOI: 10.3390/ijerph18168814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has strongly affected the dynamics of Emergency Departments (EDs) worldwide and has accentuated the need for tackling different operational inefficiencies that decrease the quality of care provided to infected patients. The EDs continue to struggle against this outbreak by implementing strategies maximizing their performance within an uncertain healthcare environment. The efforts, however, have remained insufficient in view of the growing number of admissions and increased severity of the coronavirus disease. Therefore, the primary aim of this paper is to review the literature on process improvement interventions focused on increasing the ED response to the current COVID-19 outbreak to delineate future research lines based on the gaps detected in the practical scenario. Therefore, we applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform a review containing the research papers published between December 2019 and April 2021 using ISI Web of Science, Scopus, PubMed, IEEE, Google Scholar, and Science Direct databases. The articles were further classified taking into account the research domain, primary aim, journal, and publication year. A total of 65 papers disseminated in 51 journals were concluded to satisfy the inclusion criteria. Our review found that most applications have been directed towards predicting the health outcomes in COVID-19 patients through machine learning and data analytics techniques. In the overarching pandemic, healthcare decision makers are strongly recommended to integrate artificial intelligence techniques with approaches from the operations research (OR) and quality management domains to upgrade the ED performance under social-economic restrictions.
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Affiliation(s)
- Miguel Angel Ortíz-Barrios
- Department of Productivity and Innovation, Universidad de la Costa CUC, Barranquilla 081001, Colombia; (D.M.C.-B.); (D.S.-G.)
| | - Dayana Milena Coba-Blanco
- Department of Productivity and Innovation, Universidad de la Costa CUC, Barranquilla 081001, Colombia; (D.M.C.-B.); (D.S.-G.)
| | - Juan-José Alfaro-Saíz
- Research Centre on Production Management and Engineering, Universitat Politècnica de València, 46022 Valencia, Spain;
| | - Daniela Stand-González
- Department of Productivity and Innovation, Universidad de la Costa CUC, Barranquilla 081001, Colombia; (D.M.C.-B.); (D.S.-G.)
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