Impact of an All-Female Surgical Team on Moroccan Patient Perspectives of Female Healthcare Providers

Abstract Introduction Increasing numbers of women in medicine could address Morocco’s 5.5-fold deficit in surgical providers. Cultural perceptions towards women limit female advancement in healthcare. This study evaluates the impact of an all-female surgical team on Moroccan attitudes. Objective This study aimed to evaluate how attitudes towards female healthcare professionals changed for Moroccan patients after exposure to a unique, all-female medical environment. Methods Cleft patients were surveyed after a surgery mission with all-female volunteers in Oujda, Morocco. Analysis included quantitative, qualitative, and mixed-methods approaches. Results Of 121 respondents (94%), 85% and 77% had prior exposure to a female nurse or doctor, respectively. 94% of respondents strongly agreed to receiving high-quality care. 75% developed increased confidence in female providers. 68% and 69% of respondents, regardless of gender (p = 0.950), felt that having a female nurse or doctor did not impact care. Female patients were more likely than male patients to strongly encourage female relatives to pursue medical careers (p = 0.027). Respondents without prior exposure to female nurses were more likely to: pursue medical careers (p = 0.034), believe female relatives could pursue medical careers (p = 0.006), and encourage them to do so (p = 0.011). Conclusions Increased visibility of women improved patient attitudes towards female providers, especially in patients without prior exposure. Initiatives that increase female representation in healthcare may have greater effects in cultures with more gender inequity.

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The Impact of Management on Hospital Performance

10.1101/2020.06.02.20119545 ◽

2020 ◽

Author(s):

Miqdad Asaria ◽

Benjamin Gershlick ◽

Alistair McGuire ◽

Andrew Street

Keyword(s):

Fixed Effects ◽

Management Practice ◽

Quality Care ◽

Healthcare Providers ◽

Hospital Performance ◽

Jel Classification ◽

Data Set ◽

Public Sector Hospital ◽

The Impact

AbstractBackgroundThere is a prevailing popular belief that expenditure on management by healthcare providers is wasteful, diverts resources from patient care, and distracts medical and nursing staff from getting on with their jobs. There is little existing evidence to support this narrative or counter-claims.MethodsWe explore the relationship between management and public sector hospital performance using a fixed effects empirical econometric specification on a panel data set consisting of 97 non-specialist acute National Health Service (NHS) hospitals in England for the financial years 2012/13 to 2018/19. Measures of managerial input and quality of management practice are constructed from NHS Electronic Staff Records and NHS Staff Survey data. Hospital accounts and Hospital Episode Statistics data are used to construct five measures of financial performance and of timely and high quality care.ResultsWe find some evidence that hospitals with more managers are more likely to achieve elective waiting targets and treat more patients. There is no evidence of an association between either the amount or quality of management input for the other measures of hospital performance.ConclusionThere is limited variation in managerial input across NHS hospitals suggesting managers may have limited discretion in performing their managerial functions, being tightly circumscribed by official guidance, targets, and other factors outside their control. Given these constraints, the lack of strong evidence of associations between managerial input and NHS hospital performance is unsurprising.JEL ClassificationM12, I11, L25, C33, J21

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Video Recording Patient Visits to Improve Patient Satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems Scores

Neurosurgery ◽

10.1093/neuros/nyz310_325 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Malika Bhargava ◽

Komal Naeem ◽

Randall W Porter

Keyword(s):

Patient Satisfaction ◽

Quality Care ◽

Video Recording ◽

Healthcare Providers ◽

Physician Satisfaction ◽

Video Recordings ◽

Hospital Consumer Assessment ◽

History Of ◽

Consumer Assessment ◽

The Impact

Abstract INTRODUCTION A history of good physician-patient communication is critical to improving patient satisfaction with their physicians. This study sought to evaluate the impact of video recording healthcare visits on patient satisfaction using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. METHODS HCAHPS surveys are administered by hospitals through Press Ganey. This institute's HCAHPS results were collected and analyzed from June 2016 through February 2019. The results of these surveys were divided into 2 physician groups: video recording users and non-users. The resulting percentile rankings of top-box answers (“always”) of HCAHPS measures were compared. RESULTS A total of 3516 HCAHPS surveys were completed between June 2016 and February 2019 at this institute. Of these, 1860 were completed by patients in the video recording users' group and 1656 were completed by patients in the non-users' group. Video recording users' HCAHPS scores were notably higher than non-users' scores. Most importantly, video recordings group patients vs non-users group patients who answered “always” (top-box score) for “Communication with the Doctor” and “Doctor Explained” had percentiles ranks of 91st vs 60th and 91st vs 57th, respectively. Perceived “Physician Skill” was the only category in which both groups scored high: 92nd percentile for video recordings users vs 93rd for non-users. In addition, 96% (137/142) of the video recordings patients watched their videos 1 to 5 times, and many reported that they chose to share their video with family or friends. CONCLUSION Physicians who provided patients with video recorded visits achieved higher HCAHPS physician satisfaction scores than those who did not. Practices that seek to improve their HCAHPS scores, especially considering incentivized payments of quality care, should consider offering video recordings for patients and their families to help improve real or perceived communication.

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The effect of reconfiguration

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363507x212982 ◽

2007 ◽

Vol 89 (7) ◽

pp. 254-257 ◽

Cited By ~ 1

Author(s):

RP Sutcliffe ◽

PC Hale

Keyword(s):

Emergency Surgery ◽

Quality Care ◽

Clinical Judgement ◽

Technical Ability ◽

Medical Careers ◽

Surgical Trainees ◽

European Working ◽

Working Time Directive ◽

The Impact ◽

Effective Supervision

High-quality care of acute surgical patients depends on excellent clinical judgement, technical ability and experience. Clinical judgement and technical ability are developed throughout a surgeon's career by effective supervision combined with adequate operative exposure. A number of changes to working practice, such as the European Working Time Directive (EWTD) and to surgical training (eg Calman) have resulted in a significant reduction in emergency operative exposure for surgical trainees over the last ten years. The additional impact on operative exposure of recent changes in NHS structure and postgraduate training, such as the reconfiguration of emergency ser vices, independent treatment centres and Modernising Medical Careers, is unknown. The principal aims of this study were to report the volume of emergency surgery in a single centre and to evaluate the impact of reconfiguration on exposure of surgical trainees to emergency surgery.

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The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

Journal of Business and Economics ◽

10.15341/jbe(2155-7950)/12.10.2019/006 ◽

2019 ◽

Vol 10 (12) ◽

pp. 1183-1199

Author(s):

Mohammed Alrouili ◽

Keyword(s):

Work Environment ◽

General Hospital ◽

Professional Growth ◽

Healthcare Providers ◽

Entire Study ◽

Internal Work ◽

Research Findings ◽

Study Population ◽

The Right ◽

The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

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Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

Myanmar Health Sciences Research Journal ◽

10.34299/mhsrj.00936 ◽

2019 ◽

Vol 31 (2) ◽

pp. 131

Keyword(s):

Health Care ◽

General Hospital ◽

Health Care Providers ◽

Quality Care ◽

Healthcare Providers ◽

Medical Services ◽

Tertiary Level ◽

Care Providers ◽

Level Hospital ◽

Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

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Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽

10.1136/bmjopen-2020-041599 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041599 ◽

Cited By ~ 1

Author(s):

Mary McCauley ◽

Joanna Raven ◽

Nynke van den Broek

Keyword(s):

Low Income ◽

Online Survey ◽

Positive Impact ◽

Healthcare Providers ◽

International Medical ◽

Middle Income ◽

Use Of Resources ◽

The Uk ◽

Medical Volunteers ◽

The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

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The Impact of Longer Consultation Time: A Simulation-Based Approach

Applied Clinical Informatics ◽

10.1055/s-0040-1721320 ◽

2020 ◽

Vol 11 (05) ◽

pp. 857-864

Author(s):

Abdulrahman M. Jabour

Keyword(s):

Waiting Time ◽

Quality Care ◽

Working Hours ◽

Discrete Events ◽

Simulation Based ◽

Patient Waiting Time ◽

Free Environment ◽

The Impact ◽

Consultation Time ◽

Patient Waiting

Abstract Background Maintaining a sufficient consultation length in primary health care (PHC) is a fundamental part of providing quality care that results in patient safety and satisfaction. Many facilities have limited capacity and increasing consultation time could result in a longer waiting time for patients and longer working hours for physicians. The use of simulation can be practical for quantifying the impact of workflow scenarios and guide the decision-making. Objective To examine the impact of increasing consultation time on patient waiting time and physician working hours. Methods Using discrete events simulation, we modeled the existing workflow and tested five different scenarios with a longer consultation time. In each scenario, we examined the impact of consultation time on patient waiting time, physician hours, and rate of staff utilization. Results At baseline scenarios (5-minute consultation time), the average waiting time was 9.87 minutes and gradually increased to 89.93 minutes in scenario five (10 minutes consultation time). However, the impact of increasing consultation time on patients waiting time did not impact all patients evenly where patients who arrive later tend to wait longer. Scenarios with a longer consultation time were more sensitive to the patients' order of arrival than those with a shorter consultation time. Conclusion By using simulation, we assessed the impact of increasing the consultation time in a risk-free environment. The increase in patients waiting time was somewhat gradual, and patients who arrive later in the day are more likely to wait longer than those who arrive earlier in the day. Increasing consultation time was more sensitive to the patients' order of arrival than those with a shorter consultation time.

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407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

International Psychogeriatrics ◽

10.1017/s1041610220002604 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 123-123

Author(s):

Ken Schwartz ◽

Robert Madan ◽

Anna Berall ◽

Marsha Natadira ◽

Anna Santiago

Keyword(s):

Family Caregivers ◽

Health Care Providers ◽

Healthcare Providers ◽

Well Being ◽

Moderate Degree ◽

Quick Response ◽

Care Providers ◽

High Level ◽

Person With Dementia ◽

The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

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An evaluation of the implementation of quality improvement (QI) in primary care dentistry: a multi-method approach

BMJ Open Quality ◽

10.1136/bmjoq-2019-000839 ◽

2021 ◽

Vol 10 (2) ◽

pp. e000839

Author(s):

Heather Cassie ◽

Vinay Mistry ◽

Laura Beaton ◽

Irene Black ◽

Janet E Clarkson ◽

...

Keyword(s):

Primary Care ◽

Quality Improvement ◽

Case Studies ◽

Quality Care ◽

Theoretical Domains Framework ◽

Team Members ◽

Knowledge And Skills ◽

Scottish Government ◽

The Impact

ObjectivesEnsuring that healthcare is patient-centred, safe and harm free is the cornerstone of the NHS. The Scottish Patient Safety Programme (SPSP) is a national initiative to support the provision of safe, high-quality care. SPSP promotes a coordinated approach to quality improvement (QI) in primary care by providing evidence-based methods, such as the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology. These methods are relatively untested within dentistry. The aim of this study was to evaluate the impact to inform the development and implementation of improvement collaboratives as a means for QI in primary care dentistry.DesignA multimethod study underpinned by the Theoretical Domains Framework and the Kirkpatrick model. Quantitative data were collected using baseline and follow-up questionnaires, designed to explore beliefs and behaviours towards improving quality in practice. Qualitative data were gathered using interviews with dental team members and practice-based case studies.ResultsOne hundred and eleven dental team members completed the baseline questionnaire. Follow-up questionnaires were returned by 79 team members. Twelve practices, including two case studies, participated in evaluation interviews. Findings identified positive beliefs and increased knowledge and skills towards QI, as well as increased confidence about using QI methodologies in practice. Barriers included time, poor patient and team engagement, communication and leadership. Facilitators included team working, clear roles, strong leadership, training, peer support and visible benefits. Participants’ knowledge and skills were identified as an area for improvement.ConclusionsFindings demonstrate increased knowledge, skills and confidence in relation to QI methodology and highlight areas for improvement. This is an example of partnership working between the Scottish Government and NHSScotland towards a shared ambition to provide safe care to every patient. More work is required to evaluate the sustainability and transferability of improvement collaboratives as a means for QI in dentistry and wider primary care.

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Does a comprehensive service user-led education programme effect more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress in medical students? A comparative cohort study

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867420987886 ◽

2021 ◽

pp. 000486742098788

Author(s):

Giles Newton-Howes ◽

Jessica Senior ◽

Ben Beaglehole ◽

Gordon L Purdie ◽

Sarah E Gordon

Keyword(s):

Cohort Study ◽

Medical Students ◽

Lived Experience ◽

Service User ◽

Mental Distress ◽

Healthcare Providers ◽

Education Programme ◽

Positive Attitudes ◽

Comprehensive Service ◽

The Impact

Objective: This study sought to investigate the impact of a service user-led anti-stigma and discrimination education programme, encompassing numerous interventions focused on facilitating multiple forms of social contact, the promotion of recovery, and respect for human rights, on medical student attitudes. Method: A comparison cohort study was used to compare the attitudes of two cohorts of medical students who received this programme as part of their fifth (the fifth-year cohort) or sixth (the sixth-year cohort) year psychological medical education attachment (programme cohorts) with two cohorts of equivalent students who received a standard psychological medical attachment (control cohorts). Attitudes to recovery (using the Recovery Attitudes Questionnaire) and stigma (using the Opening Minds Scale for Healthcare Providers) were measured at the beginning and end of the attachments for each year and compared both within and between the cohorts using Wilcoxon signed-rank or Wilcoxon rank-sum tests. Results: With sample sizes ranging from 46 to 70 across all cohorts, after their psychological medicine attachment both the programme and control cohorts showed more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress. Significant differences between the programme cohorts and the control cohorts were found for recovery attitudes (median difference of 2, p < 0.05 in both fifth and sixth year), with particularly large differences being found for the ‘recovery is possible and needs faith’ subdomain of the Recovery Attitudes Questionnaire. There were no significant between cohort differences in terms of stigmatising attitudes as measured by the Opening Minds Scale for Healthcare Providers. Conclusion: The introduction of a comprehensive service user-led anti-stigma and education programme resulted in significant improvements in recovery attitudes compared to a control cohort. However, it was not found to be similarly superior in facilitating less stigmatising attitudes. Various possible reasons for this are discussed.

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