Surviving Change: One District Health Board's Experience

1998 ◽  
Vol 11 (2) ◽  
pp. 33-38 ◽  
Author(s):  
J. Borody ◽  
K.J. Gieni
Keyword(s):  
Health Reform ◽  
Planning Process ◽  
Qualitative Evaluation ◽  
Communication Strategy ◽  
Health Board ◽  
Comprehensive Planning ◽  
District Health ◽  
Health Delivery ◽  
Quality Health ◽  
Quality Health Services

This qualitative evaluation examines critical steps the Moose Jaw-Thunder Creek District Health Board initiated to address health reform; in particular, the adoption of a governance philosophy, restructuring of services, development of a comprehensive planning process, and implementation of a communication strategy. The outcome has been a yearly health plan that maintains quality health services; provides opportunities for service growth, client-centred health delivery and increased accountability through defined outcomes; and ensures that the Board ends the year with a balanced budget.

Registered nurse prescribing: A descriptive survey of prescribing practices in a single district health board in Aotearoa New Zealand

2020 ◽  
Vol 36 (3) ◽  
pp. 61-72
Author(s):  
Melinda McGinty ◽  
◽  
Betty Poot ◽  
Jane Clarke ◽  
◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Registered Nurse ◽  
Health Conditions ◽  
Health Board ◽  
Prescribing Practices ◽  
District Health ◽  
Survey Tool ◽  
Aotearoa New Zealand ◽  
Descriptive Survey

The expansion of prescribing rights in Aotearoa New Zealand has enabled registered nurse prescribers (RN prescribers) working in primary care and specialty teams, to enhance nursing care, by prescribing medicines to their patient population. This widening of prescribing rights was to improve the population’s access to medicines and health care; however, little is known about the medications prescribed by RN prescribers. This paper reports on a descriptive survey of self-reported RN prescribers prescribing in a single district health board. The survey tool used was a Microsoft Excel spreadsheet to record nurse’s area of practice, patient demographic details, health conditions seen, and medicines prescribed and deprescribed. Simple data descriptions and tabulations were used to report the data. Eleven RN prescribers consented to take part in the survey and these nurses worked in speciality areas of cardiology, respiratory, diabetes, and primary care. Findings from the survey demonstrated that RN prescribers prescribe medicines within their area of practice and within the limits of the list of medicines for RN prescribers. Those working in primary care saw a wider range of health conditions and therefore prescribed a broader range of medications. This survey revealed that the list of medications available for RN prescribers needs to be updated regularly to align with the release of evidence-based medications on the New Zealand Pharmaceutical Schedule. It is also a useful record for both educational and clinical settings of the types of medications prescribed by RN prescribers.

scholarly journals Modeling the Costs of Hospital-Acquired Infections in New Zealand

2003 ◽  
Vol 24 (3) ◽  
pp. 214-223 ◽  
Author(s):  
Nicholas Graves ◽  
Tanya M. Nicholls ◽  
Arthur J. Morris
Keyword(s):  
New Zealand ◽  
Economic Cost ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Primary Data ◽  
Health Board ◽  
District Health ◽  
Hospital Acquired Infections ◽  
Input Variables ◽  
Hospital Acquired

AbstractObjective:To model the economic costs of hospital-acquired infections (HAIs) in New Zealand, by type of HAI.Design:Monte Carlo simulation model.Setting:Auckland District Health Board Hospitals (DHBH), the largest publicly funded hospital group in New Zealand supplying secondary and tertiary services. Costs are also estimated for predicted HAIs in admissions to all hospitals in New Zealand.Patients:All adults admitted to general medical and general surgical services.Method:Data on the number of cases of HAI were combined with data on the estimated prolongation of hospital stay due to HAI to produce an estimate of the number of bed days attributable to HAI. A cost per bed day value was applied to provide an estimate of the economic cost. Costs were estimated for predicted infections of the urinary tract, surgical wounds, the lower and upper respiratory tracts, the bloodstream, and other sites, and for cases of multiple sites of infection. Sensitivity analyses were undertaken for input variables.Results:The estimated costs of predicted HAIs in medical and surgical admissions to Auckland DHBH were $10.12 (US $4.56) million and $8.64 (US $3.90) million, respectively. They were $51.35 (US $23.16) million and $85.26 (US $38.47) million, respectively, for medical and surgical admissions to all hospitals in New Zealand.Conclusions:The method used produces results that are less precise than those of a specifically designed study using primary data collection, but has been applied at a lower cost. The estimated cost of HAIs is substantial, but only a proportion of infections can be avoided. Further work is required to identify the most cost-effective strategies for the prevention of HAI.

scholarly journals EVALUATION OF MONITORING HYPERTENSION CASE BASED ON NINE SURVEILLANCE ATTRIBUTES IN JOMBANG DISTRICT HEALTH OFFICE IN 2018

2021 ◽  
Vol 16 (1) ◽  
pp. 89
Author(s):  
Dewi Lestari
Keyword(s):  
Evaluation Method ◽  
Qualitative Evaluation ◽  
Noncommunicable Diseases ◽  
Research Subject ◽  
District Health Office ◽  
District Health ◽  
Data Collection Technique ◽  
Reported Data ◽  
Primary Healthcare Centers

Hypertension is still a global problem, therefore, even affecting the citizens of Indonesia. Among 10 most common diseases in Jombang regency, hypertension was ranked second in 2017. One of the efforts in overcoming hypertension was by monitoring hypertension cases through Noncommunicable Diseases (NCD) surveillance system strengthening. However, the completeness of the MSS hypertension reports in Jombang region was low.The purpose of this study was to evaluate the monitoring of hypertension cases based on surveillance attributes in the Jombang District Health Office throughout 2018. This study was conducted using the qualitative evaluation method. The research subject was NCD surveillance, specifically in monitoring hypertension cases in the Jombang District Health Office. The determination of the informants used purposive sampling. The research informants consist of NCD officers in Jombang District Health Office, and NCD officers in 2 selected primary healthcare centers. The data collection technique used interview guidelines and document observation where data analysis was performed descriptively. The results show in the assessment of surveillance attributes of simplicity, acceptability, positive predictive value, data quality, and stability the results were low. While, flexibility, sensitivity, representativeness, and timeliness cannot be assessed. The conclusion was that the assessment of the surveillance attributes was quite good, but there are still obstacles in its implementation, namely incomplete reports, no attendance records, and so on. This study suggests to implement attendance records in each unit allowing the reported data to be used for planning in preventing hypertension.Keywords: evaluation, hypertention, surveillance attribute.

scholarly journals Community Governance and Civil Society: An Examination of the Purpose, Intent and Structure of Residents' Groups in New Zealand

2021 ◽  
Author(s):  
◽  
Jarrod Coburn
Keyword(s):  
New Zealand ◽  
News Media ◽  
Local Community ◽  
Political Activity ◽  
Health Board ◽  
District Health ◽  
Community Governance ◽  
Set Up ◽  
Civil Defence ◽  
Charitable Activities

<p>Residents’ groups have been in existence in New Zealand for almost 150 years yet very little is known about them. The collection of residents’, ratepayers’ and progressive associations, community councils, neighbourhood committees and the like make up a part of the community governance sector that numbers over a thousand-strong. These groups are featured prominently in our news media, are active in local government affairs and expend many thousands of volunteer hours every year in their work in communities… but what exactly is that work? From the literature we see these groups can be a source of local community knowledge (Kass et al., 2009), a platform for political activity (Deegan, 2002), critical of government (Fullerton, 2005) or help maintain government transparency and accountability (Mcclymont and O'Hare, 2008). They are sometimes part of the establishment too (Wai, 2008) and are often heard promoting the interests of local people (Slater, 2004). Residents’ groups can be set up to represent the interests of a specific demographic group (Seng, 2007) or focus on protecting or promoting a sense of place (Kushner and Siegel, 2003) or physical environment (Savova, 2009). Some groups undertake charitable activities (Turkstra, 2008) or even act in a negative manner that can impact on the community (Horton, 1996). This research examines 582 New Zealand organisations to derive a set of purposes that residents’ groups perform and ascertains how their purposes differ between geo-social and political locality and over three distinct eras of community development. The thesis also examines the relationship between residents’ groups and councillors, council officers, district health board members and civil defence and seeks to uncover if the level of engagement (if any) has an affect on their overall raison d’etre. The research concludes with a typology of New Zealand residents’ groups along with the key purposes of each type.</p>

scholarly journals Promoting positive interactions between midwives and obstetricians at the primary/secondary interface

2021 ◽  
Vol 57 ◽  
pp. 41-48
Author(s):  
Rachel Cassie ◽  
Christine Griffiths ◽  
George Parker
Keyword(s):  
New Zealand ◽  
Thematic Analysis ◽  
Maternity Care ◽  
Interprofessional Collaboration ◽  
Theoretical Perspective ◽  
Positive Interactions ◽  
Health Board ◽  
District Health ◽  
Interprofessional Communication ◽  
Aotearoa New Zealand

Background: Interprofessional communication is a critical component of safe maternity care. The literature reports circumstances in Aotearoa New Zealand and overseas when interprofessional collaboration works well between midwives and obstetricians, as well as descriptions of unsatisfactory communication between the two professions. Aim: To explore and define effective collaboration between midwives and obstetricians at the primary/secondary interface in maternity care, in order to generate suggestions to foster positive collaboration. Method: Eight primary care midwives, three obstetricians and two obstetric registrars from a single District Health Board in Aotearoa New Zealand were interviewed about their interactions at the primary/secondary interface and their understanding, and use, of the Referral Guidelines. The theoretical perspective was Appreciative Inquiry. Data were analysed using thematic analysis. Findings: Results indicate usually positive interprofessional interactions. Dominant emergent themes are the need to negotiate differing philosophies, to clarify blurred boundaries that sometimes lead to lack of clear lines of responsibility, and the importance of three-way conversations. Of the three themes, this article focuses on three-way communication between midwife, obstetrician/registrar and woman. Participants reported that, when effective three-way communication between woman, midwife and obstetrician occurred, philosophical difference could be negotiated, blurred boundaries clarified and understanding of the respective roles of the LMC midwife and the obstetric team promoted. Participants value the Referral Guidelines but report some limitations to their applicability. Conclusion: Effective three-way communication promotes good maternity care. This study has identified ways to support optimal communication.

scholarly journals Healthcare Quality Management System in Pakistan

2019 ◽  
Vol 3 (2) ◽  
pp. 74-77
Author(s):  
Wajahat Hussain
Keyword(s):  
Quality Management ◽  
Health Services ◽  
Healthcare System ◽  
Planning Process ◽  
Quality Management System ◽  
International Health ◽  
Quality Of Healthcare ◽  
Poor Quality ◽  
Operational Planning ◽  
Quality Health

The competitive healthcare system and healthcare environment, modern hospitals with substantial investment, healthcare reforms, availability of specialized persons in hospital management, health services management, the success of quality management programs in developed nations and high interest of international health organizations like WHO has led the developing countries like Pakistan to pay due attention to quality in national healthcare system.  Since the time of independence healthcare system in Pakistan is striving for improvements. Despite of the physical infrastructure and availability of qualified workforce for service delivery there are gaps in strategic and operational planning which resulted in poor quality health services. The leaders in healthcare has little awareness that the quality management is an organized specialty to improve the quality of healthcare. It is need of the hour that healthcare leaders in Pakistan must integrate quality improvement activities in strategic and operational planning process of healthcare system. This the only way to maximize the benefits of healthcare system and restore the rapidly deteriorating public trust.

scholarly journals NABH ACCREDITATION STANDARDS IN PERCEPTIVE OF PANCHAKARMA CLINICS AND HOSPITALS – A REVIEW.

2021 ◽  
Vol 5 (02) ◽  
Author(s):  
Dr. Madhuri Prakash Kubal ◽  
Dr. Archana Raman Belge
Keyword(s):  
Continuous Quality Improvement ◽  
Medical Tourism ◽  
Quality Care ◽  
Health Sector ◽  
Safety Assurance ◽  
Accreditation Standards ◽  
Ancient Science ◽  
Continuous Quality ◽  
Quality Health ◽  
Quality Health Services

Ayurveda, emerging as an ancient science of life globally, highlighting India as a native drawing attention from every corner of world. Panchakarma, Yoga Science, Marmachikitsa, Ksharsutra, Rasaushadhi etc. are super specialities of Ayurveda, having no other alternative at all, are becoming attractions, raising medical tourism in India. In this era, evaluation of organization as per their performance & quality has become integral part of health sector of India. NABH has established standards by keeping in mind, enhancement of health system & promotion of continuous quality improvement & patient safety. Objective- To have a review of NABH accreditation standards in perceptive of Panchakarma clinics & hospitals. Design- NABH accreditation standards for Ayurveda hospitals second edition is referred to have review in perceptive of Panchakarma clinics & hospitals. Results- Ayurveda hospital accreditation standards consist of 10 chapters, further divided into 98 standards, incorporation of 590 objective elements. These standards are requirements led by NABH which facilitate safe high quality care. These standards provide framework for quality health facilities, mainly defining Panchakarma facility very precisely, right from documentation to staff awareness. Conclusion- Patients well aware about quality health services, especially in terms of medical tourism expects standard & safety assurance. These NABH accreditation standards setting benchmark for AYUSH hospitals, helps in enhancing significance in health sector in India. KEYWORDS- Accreditation, Medical Tourism, NABH, Panchakarma, Quality Assuarance.

scholarly journals Organizational Citizenship Behavior on Nurses : The Role of Organizational Climate and Commitment

2021 ◽  
Vol 17 (1) ◽  
pp. 32-41
Author(s):  
Abdhy Aulia Adnans ◽  
Sherry Hadiyani ◽  
Siti Zahreni ◽  
Fahmi Fahmi
Keyword(s):  
Organizational Commitment ◽  
Organizational Climate ◽  
Organizational Citizenship ◽  
Organizational Citizenship Behavior ◽  
Quantitative Research ◽  
Citizenship Behavior ◽  
Quality Health ◽  
Simultaneous Influence ◽  
Quality Health Services

Abstract Hospitals in organizing excellent quality health services require human resources committed to the organization and a positive and conducive organizational climate. This study aims to determine the effect of organizational climate and organizational commitment to organizational citizenship behavior of nurses at USU Hospital. In this study, there are two independent variables: organizational climate and organizational commitment, and one dependent variable: organizational citizenship behavior. This research is quantitative research conducted using samples from the population of nurses at USU Hospital, where a sample of 125 nurses was obtained. The data analysis method used in this study is a statistical analysis with multiple regression analysis methods. Findings. The result of this study indicates a simultaneous influence between organizational climate and organizational commitment to organizational citizenship behavior.

Better visual outcome associated with early vitrectomy in the management of endophthalmitis

2021 ◽  
pp. bjophthalmol-2020-316846
Author(s):  
Sarah Welch ◽  
Riyaz Bhikoo ◽  
Nancy Wang ◽  
Martin J Siemerink ◽  
William Shew ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Vision Loss ◽  
Endogenous Endophthalmitis ◽  
Health Board ◽  
Surgical Trauma ◽  
District Health ◽  
Early Vitrectomy ◽  
Younger Age ◽  
Severe Vision Loss ◽  
Culture Positive

AimsTo examine the role of early vitrectomy in the management of endophthalmitis from all causes.MethodsRetrospective study of 290 consecutive subjects diagnosed with endophthalmitis at Auckland District Health Board between 1 January 2006 and 31 July 2019. Main outcome measure was visual acuity at 9-month follow-up and proportion of subjects with severe vision loss (≤20/200).ResultsMedian age at presentation was 70.4 years and 151 subjects (52.1%) were women. Cataract surgery was the most common cause of endophthalmitis in 92 subjects (31.7%) followed by intravitreal injection in 57 (19.7%), endogenous endophthalmitis in 48 subjects (16.6%), non-surgical trauma in 42 subjects (14.5%), glaucoma surgery in 24 subjects (8.3%), vitrectomy in 22 subjects (7.6%) and corneal in 5 subjects (1.7%). Culture was positive in 136 (46.9%) with gram-positive organisms most common (76.5%). Early vitrectomy was performed in 82 subjects (28.3%). Median visual acuity at 9 months was 20/100 (IQR 20/30 to light perception), and severe vision loss occurred in 100 (43.5%). Retinal detachment occurred in 35 eyes (12.1%) and 26 eyes were enucleated. On multivariate analysis, younger age, poor presenting visual acuity and culture-positive endophthalmitis were associated with worse outcomes, and early vitrectomy was associated with better outcomes.ConclusionsEarly vitrectomy (within 24 hours) is associated with better visual outcomes at 9 months, while younger age, poor presenting visual acuity and culture-positive endophthalmitis are associated with poorer visual acuity outcomes.

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