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Taranikanti M, Mudunuru AK, Chunchu SR, Guntuka RK, Maddur S, Yerra AK, Taranikanti SS. Selection of Medical Teachers: An Initiative for Ensuring a Fair and Transparent Selection Process. Cureus 2024; 16:e52837. [PMID: 38406028 PMCID: PMC10884714 DOI: 10.7759/cureus.52837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The first step towards creating a sound educational environment and healthcare in a medical institute is employing medical teachers who maintain ethical behavior in their professional practice. A method where bias and subjectivity can be minimized is by making the recruitment process objective. MATERIAL AND METHODS The recruitment started as an offline process and was soon converted into an online form incorporating parameters for scoring. A total of 1,151 medical teachers had submitted their applications for posts in various departments, and 778 candidates were shortlisted and called for an interview. After the interview process, a unique symposium on the selection of medical teachers was organized. The feedback was incorporated into the online application that was released for the subsequent phases of recruitment. RESULTS The response rate of the study was 96.55%. Analysis of the feedback by the applicants showed that 47.59% of the applicants were of the opinion that the prevailing selection process in the country needs a change; 84.14% felt that the inclusion of objective criteria would make the selection process more transparent; and 91.03% were happy with the stratification of marks; 82.75% of the applicants and experts felt that knowledge of statistics for quality research and publications in indexed and institutional journals may be considered for the selection process; and 52.41% thought that all authors of an article should be given equal weightage. Adopting a fairly new concept of workplace-based assessment (WPBA) in India was acceptable to 83.45%. CONCLUSIONS Parameter-based, objective selection reduces bias, and merit alone is recognized.
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Affiliation(s)
- Madhuri Taranikanti
- Physiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND
| | - Aswin Kumar Mudunuru
- Physiology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Srinivasa Rao Chunchu
- Hematology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Rohith Kumar Guntuka
- Physiology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Srinivas Maddur
- Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Aruna Kumari Yerra
- Obstetrics and Gynaecology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, IND
| | - Sai Shriya Taranikanti
- Internal Medicine, Agartala Government Medical College and Govind Ballabh Pant Hospital, Agartala, IND
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Pelzang R. Why Bhutan needs a policy push on person-centred care. J Eval Clin Pract 2023. [PMID: 36871216 DOI: 10.1111/jep.13831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
Delivering quality healthcare services to people has become a core issue for the Bhutanese healthcare system. There are considerable challenges for healthcare policymakers to recognise and implement an appropriate healthcare model to enhance quality healthcare services in the Bhutanese healthcare system. Actions to improve quality healthcare services in Bhutan requires careful analysis of the healthcare model in the context of the Bhutanese socio-political and healthcare environment. This article provides a brief concept analysis of person-centred care in the context of the Bhutanese socio-political and healthcare environment and describes why it is important to integrate person-centred care into the healthcare system. The article argues that person-centred care is important and relevant to the Bhutanese healthcare system to achieve quality healthcare services and Gross National Happiness.
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Affiliation(s)
- Rinchen Pelzang
- Allity Princeton View Aged Care, Brighton East, Victoria, Australia
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Argyriadis A, Patelarou E, Paoullis P, Patelarou A, Dimitrakopoulos I, Zisi V, Northway R, Gourni M, Asimakopoulou E, Katsarou D, Argyriadi A. Self-Assessment of Health Professionals' Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care. Int J Environ Res Public Health 2022; 19:ijerph191811282. [PMID: 36141554 PMCID: PMC9517303 DOI: 10.3390/ijerph191811282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 05/06/2023]
Abstract
Current research often refers to cultural competence to improve health care delivery. In addition, it focuses on the cultural uniqueness of each health service user for optimal personalized care. This study aimed to collect self-assessment data from health professionals regarding their cultural competence and to identify their development needs. A mixed methods design was adopted using the Cultural Competence Self-assessment Checklist of the Central Vancouver Island Multicultural Society. This was translated into Greek, validated, and then shared with health professionals in Cyprus. Subsequently, a semi-structured interview guide was designed and utilized. This was structured in exactly the same question categories as the questionnaire. Data collection took place between October 2021 and May 2022, and convenience sampling was used to recruit 499 health scientists in Cyprus. The sample comprised doctors, nurses, psychologists, midwives, social workers, and physiotherapists. Subsequently, 62 interviews were conducted with participants from the same specialties. The results showed that (compared to other health professionals) nurses and psychologists are more sensitive to issues of cultural competence. It would appear that the more socially oriented sciences had better-prepared healthcare staff to manage diversity in context. However, there is a gap between knowledge and skills when comparing doctors to nurses; they seem to be more skilled and willing to intervene actively in cases of racist behavior or problem-solving. In conclusion, participants identified the importance of their cultural competence; they also realized the importance of optimal planning of personalized health care. There is a significant need for continuous and specialized cultural competence training for all health professions.
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Affiliation(s)
- Alexandros Argyriadis
- School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
- Correspondence: ; Tel.: +357-22394394
| | - Evridiki Patelarou
- School of Health Sciences, Hellenic Mediterranean University, 714 10 Iraklio, Greece
| | | | - Athina Patelarou
- School of Health Sciences, Hellenic Mediterranean University, 714 10 Iraklio, Greece
| | | | - Vasiliki Zisi
- Department of Physical Education and Sport Science, University of Thessaly, 382 21 Volos, Greece
| | - Ruth Northway
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK
| | - Maritsa Gourni
- School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
| | | | - Dimitra Katsarou
- Department of Pre-School Education and Educational Design, University of the Aegean, 811 00 Mitilini, Greece
| | - Agathi Argyriadi
- School of Education and Social Sciences, Frederick University, Limassol 3080, Cyprus
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Havlik JL, Mercurio MR, Hull SC. The Case for Ethical Efficiency: A System That Has Run Out of Time. Hastings Cent Rep 2022; 52:14-20. [PMID: 35476354 DOI: 10.1002/hast.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The American health care system increasingly conflates physician "productivity" with true clinical efficiency. In reality, inordinate time pressure on physicians compromises quality of care, decreases patient satisfaction, increases clinician burnout, and costs the health care system a great deal in the long term even if it is financially expedient in the short term. Inadequate time to deliver care thereby conflicts with the core principles of biomedical ethics, including autonomy, beneficence, nonmaleficence, and justice. We propose that the health care system adjust its focus to recognize the nonmonetary value of physician time while still realizing the need to deploy resources as effectively as possible, a concept we describe as "ethical efficiency."
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Alshyyab MA, Borkoles E, Albsoul RA, Kinnear FB, FitzGerald G. Safety culture in emergency medicine: An exploratory qualitative study. Int J Risk Saf Med 2022; 33:365-383. [PMID: 35213391 DOI: 10.3233/jrs-210031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Safety culture in Emergency Departments (EDs) requires special attention due to unique operational feature of the ED environment. Which may influence a culture of patients' safety in the ED. OBJECTIVE To identify the factors that influence patient safety culture in EDs. METHODS A qualitative study using semi-structured interviews with 12 ED staff was carried out in two Australian EDs. The data was thematically analysed to identify and describe the factors perceived by staff as influencing patient safety culture. RESULTS The findings revealed four super-ordinate themes and 19 categories. The themes were the following: (1) Environmental and Organisational; (2) Healthcare Professional (3) Managerial factors; and (4) Patients factors. CONCLUSIONS Safety culture in the ED is influenced by complex set of factors. The results of this study may help ED workers with improving patient safety culture and healthcare quality in the ED.
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Affiliation(s)
- Muhammad Ahmed Alshyyab
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Erika Borkoles
- School of Medicine, Gold Coast Campus, Griffith University, Southport, QLD, Australia
| | - Rania Ali Albsoul
- Department of Family and Community Medicine, School of Medicine, Jordan University, Aman, Jordan
| | - Frances B Kinnear
- Emergency Department, The Prince Charles Hospital, Brisbane, QLD, Australia.,University of Queensland, Brisbane, QLD, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
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Dartey AF, Dzansi G, Atachie C, Sunnu E, Nyande FK. The Experiences of Ghanaian Midwives on the Use of Nonadjustable Delivery Beds: A Qualitative Study. SAGE Open Nurs 2021; 7:23779608211038204. [PMID: 34869857 PMCID: PMC8642041 DOI: 10.1177/23779608211038204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 11/17/2022] Open
Abstract
Background Hospital beds are of great assistance to both clients and caregivers as they give lots of choices to the users. More often, clients have difficulty getting in and out of beds, but the adjustable features of the beds make it possible for them to be comfortable, regardless of their condition. This situation may not be the same if nonadjustable delivery beds (NADBs) are used in conducting deliveries at health care facilities. This study explored the experiences of midwives using NADBs in selected Christian Health Association of Ghana (CHAG) hospitals in the Volta Region of Ghana. Methods The study employed an exploratory qualitative research design with purposive sampling. Semistructured interview data were audio recorded. The inclusion criteria were professional midwives with at least 1 year of working skills and the midwives should have conducted deliveries using NADBs during their practice. Data were collected concurrently with data transcription and analyzed using content analysis. Saturation was reached after the 20th interview. Results Three themes emerged from the study: NADBs not comfortable to work with, assumption of awkward postures, and the nature of the delivery beds. Conclusion The findings of the study show that midwives experience several setbacks in the use of NADBs in conducting deliveries as they sacrifice their health for work.
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Affiliation(s)
- Anita F Dartey
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Gladys Dzansi
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon
| | - Constancia Atachie
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Evelyn Sunnu
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Felix K Nyande
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Abstract
BACKGROUND AND OBJECTIVE To develop a health care value framework for physical therapy primary health care organizations including a definition. METHOD A scoping review was performed. First, relevant studies were identified in 4 databases (n = 74). Independent reviewers selected eligible studies. Numerical and thematic analyses were performed to draft a preliminary framework including a definition. Next, the feasibility of the framework and definition was explored by physical therapy primary health care organization experts. RESULTS Numerical and thematic data on health care quality and context-specific performance resulted in a health care value framework for physical therapy primary health care organizations-including a definition of health care value, namely "to continuously attain physical therapy primary health care organization-centered outcomes in coherence with patient- and stakeholder-centered outcomes, leveraged by an organization's capacity for change." CONCLUSION Prior literature mainly discussed health care quality and context-specific performance for primary health care organizations separately. The current study met the need for a value-based framework, feasible for physical therapy primary health care organizations, which are for a large part micro or small. It also solves the omissions of incoherent literature and existing frameworks on continuous health care quality and context-specific performance. Future research is recommended on longitudinal exploration of the HV (health care value) framework.
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Affiliation(s)
- Rutger Friso IJntema
- Research Group Financial-Economic Innovation, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands (Messrs. IJntema and Duits); Department of Rehabilitation, Physical Therapy Science and Sports, Brain, Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, Utrecht, the Netherlands (Mss. Barten and Veenhof); and Department of Management and Organization Studies, VU University Amsterdam, Amsterdam, the Netherlands (Mr. Tjemkes)
| | - Di-Janne Barten
- Research Group Financial-Economic Innovation, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands (Messrs. IJntema and Duits); Department of Rehabilitation, Physical Therapy Science and Sports, Brain, Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, Utrecht, the Netherlands (Mss. Barten and Veenhof); and Department of Management and Organization Studies, VU University Amsterdam, Amsterdam, the Netherlands (Mr. Tjemkes)
| | - Hans B. Duits
- Research Group Financial-Economic Innovation, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands (Messrs. IJntema and Duits); Department of Rehabilitation, Physical Therapy Science and Sports, Brain, Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, Utrecht, the Netherlands (Mss. Barten and Veenhof); and Department of Management and Organization Studies, VU University Amsterdam, Amsterdam, the Netherlands (Mr. Tjemkes)
| | - Brian V. Tjemkes
- Research Group Financial-Economic Innovation, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands (Messrs. IJntema and Duits); Department of Rehabilitation, Physical Therapy Science and Sports, Brain, Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, Utrecht, the Netherlands (Mss. Barten and Veenhof); and Department of Management and Organization Studies, VU University Amsterdam, Amsterdam, the Netherlands (Mr. Tjemkes)
| | - Cindy Veenhof
- Research Group Financial-Economic Innovation, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands (Messrs. IJntema and Duits); Department of Rehabilitation, Physical Therapy Science and Sports, Brain, Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, Utrecht, the Netherlands (Mss. Barten and Veenhof); and Department of Management and Organization Studies, VU University Amsterdam, Amsterdam, the Netherlands (Mr. Tjemkes)
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Lopez-Picazo JJ, Vidal-Abarca I, Beteta D, López-Ibáñez M, García-Vázquez E. Impact of the COVID-19 Pandemic on the Hospital: Inpatient's Perceived Quality in Spain. J Patient Exp 2021; 8:2374373521998625. [PMID: 34179398 PMCID: PMC8205378 DOI: 10.1177/2374373521998625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Although the Coronavirus disease 2019 (COVID-19) pandemic has generated a large amount of studies, the patient-perceived quality of care (PQ) in this context is still not well known, so more studies intending to focus on this issue are strongly needed. This study assesses changes on PQ in patients hospitalized in Spain during the first month of the COVID-19 pandemic and investigates differences between those admitted for this cause and the rest a descriptive study using the “Net Promoters Score” and the hospital regular monitoring plan. Due to this point of view, ethical approval is not applicable. Four PQ dimensions (nurse, physician, and nurse assistant actions [NA], and discharge information [DI]) were measured in all COVID patients (57) and in a sample of non-COVID patients (60) discharged at home during the first month of the pandemic, and also compared with another sample (384) from an immediately previous period. The COVID patients scored worse (8.2) than non-COVID ones (9.0; P < .0001), especially in NA and DI, and were more likely to be detractors (odds ratio [OR]: 3.05, P < .0001) and less to be promoters (OR: 0.64, P < .05). Global and DI net promoters score values before the pandemic were higher than afterward. In conclusion, the COVID-19 pandemic negatively and significantly influenced the health care quality as perceived by inpatients, both in COVID and in non-COVID ones, but more intensely in the former. As a health care organization, this knowledge meant an opportunity from improvement and to be better qualified to face the pandemic.
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Affiliation(s)
- Julio J Lopez-Picazo
- Healthcare Quality Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia (España), Spain
| | - Inmaculada Vidal-Abarca
- Healthcare Quality Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia (España), Spain
| | - Dolores Beteta
- Nursing Teaching, Quality and Research Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia (España), Spain
| | - Mercedes López-Ibáñez
- Nursing Teaching, Quality and Research Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia (España), Spain
| | - Elisa García-Vázquez
- Department of Infectious Diseases, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia (España), Spain
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Alarifi M, Patrick T, Jabour A, Wu M, Luo J. Full Radiology Report through Patient Web Portal: A Literature Review. Int J Environ Res Public Health 2020; 17:ijerph17103673. [PMID: 32456099 PMCID: PMC7277373 DOI: 10.3390/ijerph17103673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study discusses the gap between the patient web portal and providing a full radiology report. A literature review was conducted to examine radiologists, physicians, and patients’ opinions and preferences of providing patients with online access radiology reports. The databases searched were Pubmed and Google Scholar and the initial search included 927 studies. After review, 47 studies were included in the study. We identified several themes, including patients’ understanding of radiology reports and radiological images, as well as the need for decreasing the turnaround time for reports availability. The existing radiology reports written for physicians are not suited for patients. Further studies are needed to guide and inform the design of patient friendly radiology reports. One of the ways that can be used to fill the gap between patients and radiology reports is using social media sites.
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Affiliation(s)
- Mohammad Alarifi
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
- College of Medical Applied Sciences, King Saud University, Riyadh, SA 11451, USA
| | - Timothy Patrick
- College of Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Abdulrahman Jabour
- Health Informatics Department, Faculty of Public Health and Tropical Medicine at Jazan University, Jazan, SA 45142, USA;
| | - Min Wu
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
| | - Jake Luo
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
- Correspondence:
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Shirzadi SM, Sheibani-Tehrani D, Shirzadi NS, Yaghoubi M. Identifying factors affecting hoteling quality in Iranian public hospitals using DEMATEL approach. J Educ Health Promot 2020; 9:103. [PMID: 32509911 PMCID: PMC7271927 DOI: 10.4103/jehp.jehp_316_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 11/14/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The most important goal of a proper health-care system is to provide good health. Today, patients do not consider hospitals as simply a place of rehabilitation; rather, they compare the hospital with a hotel in terms of environment, facilities, services, and quality of accommodation. This study aims to use DEMATEL approach to extract factors affecting the hoteling quality. METHODS This was a descriptive, cross-sectional study conducted in 2018. The study was carried out in two steps. In the first step, the factors affecting the hoteling quality were extracted, and in the second step, the DEMATEL technique was used to analyze and rank the cause and effect. The study population consists of all experts in the fields of medicine and health care (hospital managers, deputies, and faculty members familiar with accreditation and hoteling), among which twenty experts were selected using purposeful sampling and a questionnaire designed by the researcher consisting of 11 dimensions was distributed among them. The reliability of the questionnaire was calculated using Cronbach's alpha coefficient which was equal to 0.85 while its validity was confirmed using Delphi technique. DEMATEL approach was used for data analysis. RESULTS The results show that among factors, human factors and economical-financial factors and, among subfactors, maintaining human dignity and quick action in providing emergency services are among the most important factors affecting the hoteling quality. Maintaining human dignity and speed of action in providing emergency services to patients was identified as the most important factor in improving hoteling quality. CONCLUSION The results of this study can be used to evaluate the quality of accommodations and health facilities, medical equipment, and building quality of hospitals, which can lead to effective actions and improvement of patient satisfaction and the eventual success of health transformation plan.
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Affiliation(s)
- Seyyed Majid Shirzadi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Nafiseh Sadat Shirzadi
- School of Medicine, Islamic Azad University, Najafabad, Isfahan, Iran
- Clinical Research Development Centre, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Maryam Yaghoubi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Albsoul R, FitzGerald G, Finucane J, Borkoles E. Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study. Int J Health Plann Manage 2019; 34:e1820-e1832. [PMID: 31448478 DOI: 10.1002/hpm.2898] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/14/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Missed nursing care (MNC) is a significant health care issue that impacts on the quality of health care and patient safety. It refers to delayed or omitted aspects of nursing care (totally or partially). MNC is an under-researched area in the Australian health care context. OBJECTIVE This research sought to further explore the MNC phenomenon in the context of an acute care hospital and to identify its common elements and the factors influencing its occurrence. DESIGN A convergent parallel mixed methods design was employed involving secondary analysis of routinely collected hospital data and a survey of 44 nursing staff using the MISSCARE survey instrument. The two sources of data were converged to address the objective. FINDINGS The study found that the most common elements of missed nursing care include failure of patient ambulation, emotional support for patients and/or family, and the provision of full documentation. These elements are consistent with previous international studies conducted in acute care hospital settings. This study identified that local context impacting on MNC was also important and included interruptions to workflow, "perceived" lack of management support, poor handover, and communication breakdown between the nursing team and medical staff. CONCLUSION Consideration of the local health care context is foundational in understanding the MNC phenomenon. The findings of this research may help nursing managers mitigate the possible effects of MNC and therefore improve patient safety in their acute care environment. Additional multisite studies are required to further explore factors associated with MNC in both general and local contexts.
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Affiliation(s)
- Rania Albsoul
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Finucane
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Erika Borkoles
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
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Abstract
Massive open online courses (MOOCs) are increasingly available in the area of health and medicine. These MOOCs are offered through various commercial and noncommercial online platforms. When offered through reputable institutions, they can provide valuable access to reliable information without the constraints of time, geographical location, or level of education. Most current courses appear introductory in nature. In its drive for quality health care, the National Academy of Medicine has prioritized a focus on known chronic care conditions. Many of these conditions are shared internationally. Among its initiatives, the academy encourages consumer and professional groups, patients, clinicians, health care organizations, and universities to work together to identify evidence-based care processes consistent with best practices, organize major prevention programs to target key associated health risk behaviors, and develop systems to measure and evaluate improvements in the provision of patient- and family-centered health care. Carefully designed and collaboratively developed MOOCs would appear a valuable resource to contribute to these initiatives. Such MOOCs can, 1) increase the health literacy of the public with regard to the prevention and treatment of known chronic care conditions, 2) provide ready access to continuing professional, and interprofessional, education, and 3) explore innovative teaching models for student learning focused on patient- and family-centered care. MOOCs would also appear helpful to facilitate effective communication among international communities of patients and clinicians, including student clinicians, with shared interests. Further, the accumulation of MOOC data through large-scale measurement and analysis, obtained nationally and internationally, has the potential to assist in greater understanding of the risk for diseases and their prevention, with this translating into medical education, and authentic, patient- and family-centered methods for student learning. This paper explores these issues.
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Affiliation(s)
| | - Leonard A Crocombe
- Centre for Rural Health, Faculty of Health Sciences, University of Tasmania, Hobart, TAS, Australia
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Gartlehner G, Matyas N. How contextual issues can distort shared decision making. Z Evid Fortbild Qual Gesundhwes 2016; 118-119:17-23. [PMID: 27987564 DOI: 10.1016/j.zefq.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/10/2016] [Accepted: 10/11/2016] [Indexed: 11/17/2022]
Abstract
Shared decision making in medicine has become a widely promoted approach. The goal is for patients and physicians to reach a mutual, informed decision by taking into consideration scientific evidence, clinical experience, and the patient's personal values or preferences. Shared decision making, however, is not a straightforward process. In practice, it might fall short of what it promises and might even be misused to whitewash monetary motives. In this article, which summarizes a presentation given at the 17th Annual Conference of the German Network Evidence-based Medicine on March 4th, 2016 in Cologne, Germany, we discuss three contextual factors that in our opinion can have a tremendous impact on any informed decision making: 1) opinions and convictions of physicians or other clinicians; 2) uncertainty of the evidence regarding benefits and harms; 3) uncertainty of patients about their own values and preferences. But despite barriers and shortcomings, modern medicine currently does not have an alternative to shared decision making. Shared decision making has become a central theme in good quality health care because it has a strong ethical component. Advocates of shared decision making, however, must realize that not all patients prefer to participate in decision making. For those who do, however, we must ensure that shared decisions can be made in a neutral environment as free of biases and conflicts of interest as possible.
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Affiliation(s)
- Gerald Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Austria; RTI International, NC, USA.
| | - Nina Matyas
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Austria
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Vaijeyanthi V, Vishnuprasad K, Kumar CS, Ramachandran KI, Gopinath R, Kumar AA, Yadav PK. Towards enhancing the performance of multi-parameter patient monitors. Healthc Technol Lett 2014; 1:19-20. [PMID: 26609370 DOI: 10.1049/htl.2013.0041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/12/2014] [Accepted: 02/18/2014] [Indexed: 11/19/2022] Open
Abstract
Multi-parameter patient monitors (MPMs) have become increasingly important in providing quality healthcare to patients. It is well known in the medical community that there exists an intrinsic relationship between different vital parameters in a healthy person, these include heart rate, blood pressure, respiration rate and oxygen saturation. For example, an increase in blood pressure would lead to a decrease in the heart rate, and vice versa. Although it is likely to improve the performance of MPM systems, this fact is not explored in engineering research. In this work, experiments show that deriving additional features to capture the intrinsic relationship between the vital parameters, the alarm accuracy (sensitivity), no-alarm accuracy (specificity) and the overall performance of MPMs can be improved. The geometric mean of the product of all the vital parameters taken in pairs of two was used to capture the intrinsic relationship between the different parameters. An improvement of 10.55% for sensitivity, 0.32% for specificity and an overall performance improvement of 1.03% was obtained, compared to the baseline system using classification and regression tree with the four vital parameters.
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Affiliation(s)
- V Vaijeyanthi
- Department of Electronics and Communication Engineering , Machine Intelligence Research Laboratory , Amrita Vishwa Vidyapeetham , Amritanagar , Coimbatore , India
| | - K Vishnuprasad
- Department of Electronics and Communication Engineering , Machine Intelligence Research Laboratory , Amrita Vishwa Vidyapeetham , Amritanagar , Coimbatore , India
| | - C Santhosh Kumar
- Department of Electronics and Communication Engineering , Machine Intelligence Research Laboratory , Amrita Vishwa Vidyapeetham , Amritanagar , Coimbatore , India
| | - K I Ramachandran
- Department of Electronics and Communication Engineering , Machine Intelligence Research Laboratory , Amrita Vishwa Vidyapeetham , Amritanagar , Coimbatore , India
| | - R Gopinath
- Department of Electronics and Communication Engineering , Machine Intelligence Research Laboratory , Amrita Vishwa Vidyapeetham , Amritanagar , Coimbatore , India
| | - A Anand Kumar
- Department of Neurology , Amrita Institute of Medical Sciences , Cochin , India
| | - Praveen Kumar Yadav
- Department of Neurology , Amrita Institute of Medical Sciences , Cochin , India
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Abstract
A crucial element in the delivery of high-quality health care is patient safety. The rate of adverse events among hospital patients is an indication of patient safety. A systematic review of in-hospital adverse events revealed the median incidence of adverse events as 9.2%; 7.4% were lethal and 43.5% preventable. All the studies in the systemic review were from developed countries, as research is lacking from developing countries. In 2012, data from 10 developing countries reported adverse events ranging from 2.5 to 18.4% per country; 30% were lethal and 83% preventable. This study places patient safety as one of the major concerns of the health policy agenda in developing countries. Human resources for health deficits in developing countries constitute a major structural constraint for ensuring patient safety. The key to reducing adverse events in health care is system-based interventions rather than clinical interventions or technologies. Patient safety skills training, effective communication, and good team work are essential in improving patient safety in developing countries. Research on patient safety is needed to address the knowledge gap in developing countries.
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Affiliation(s)
- Hadiza Shehu Galadanci
- Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, No. 1, Zaria Road, PMB 3254, Kano, Nigeria.
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Ogbuanu C, Goodman DA, Kahn K, Long C, Noggle B, Bagchi S, Barradas D, Castrucci B. Timely access to quality health care among Georgia children ages 4 to 17 years. Matern Child Health J 2012; 16 Suppl 2:307-19. [PMID: 23054451 PMCID: PMC4538931 DOI: 10.1007/s10995-012-1146-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically underserved area variable, and restricted to Georgia children ages 4-17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). Andersen's behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8 % reported access to higher quality care, 24.8 % reported access to moderate quality care, 22.8 % reported access to lower quality care, and 19.6 % reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15-9.26), and special health care needs (AOR:2.68; 95 % CI 1.42-5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18-0.53) and Hispanic (AOR:0.20; 95 % CI 0.08-0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia.
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Affiliation(s)
- Chinelo Ogbuanu
- Maternal and Child Health Epidemiology Section, Maternal and Child Health Program, Division of Public Health, Georgia Department of Community Health, 2 Peachtree Street NW, Atlanta, GA 30303, USA.
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