Guardianship in hospitals: a collaborative pilot project

2020 ◽  
Vol 44 (2) ◽  
pp. 322
Author(s):  
Rob Hoffman ◽  
Sally Costar ◽  
Tass Kostopoulos ◽  
Justine Little ◽  
Aaron Livingstone ◽  
...  
Keyword(s):  
Health Services ◽  
Healthcare System ◽  
Patient Flow ◽  
Pilot Project ◽  
Wait Times ◽  
Control Group ◽  
Pilot Program ◽  
Control Group Design ◽  
Healthcare Resources ◽  
The Impact

Objectives This paper describes the development, implementation and preliminary results of a collaborative pilot project aimed at reducing the time hospital-based patients with cognitive impairments spend waiting for the allocation of legally appointed Advocate Guardian decision makers from the Office of the Public Advocate (OPA). The aim of the study was to investigate the effect of increased availability of public advocate guardians on guardian allocation waits, patient discharge outcomes and healthcare system demand. Methods A multi-institutional pilot program created a dedicated hospital guardian team within OPA, funded by the health networks, to reduce the time to guardian allocation for patients within each network. A multisite, quasi-experimental historical control group design was used, with initial data collection over 12 months, followed by study of 12-month post-implementation cohorts. Results Under the pilot program, the time from guardianship order lodgement to guardian allocation decreased significantly from 46.5 to 22.9 days, halving the average time hospital-based patients spend waiting for a guardian (difference –23.55 days, two-sample t(154) = –6.575, P < 0.0001, 95% confidence interval [–30.65, –16.48].). Mean total length of stay decreased from 163.2 to 148.5 days. The estimated value of the reduction in allocation wait time was A$15473 per patient, or A$5 of resources released per A$1 spent on increased staffing. Conclusions Direction of a small amount of resources from health services to staff within OPA appears to have created much greater savings for the health services involved. The pilot program has reduced the period of time vulnerable patients spend waiting in hospital for a guardian. What is known about the topic? Guardianship resources are under increasing stress, with demand outstripping funding and hospital-based applicants deprioritised due to assumptions of lower risk, leading to extensive wait times for guardian allocation. What does this paper add? The paper quantifies the impact of greater guardianship resourcing on access to both guardianship and healthcare resources, highlighting benefits for vulnerable patient groups, healthcare system sustainability and access to both guardianship and healthcare resources for the broader community. What are the implications for clinicians? Improving patient flow through healthcare systems may involve allocating resources to services that are managed outside the healthcare system where ‘bottlenecks’, such as wait times for guardian allocation, have been identified.

scholarly journals Improving patient flow and timeliness in the diagnosis and management of breast abnormalities: the impact of a rapid diagnostic unit

2016 ◽  
Vol 23 (3) ◽  
pp. 260 ◽  
Author(s):  
J.M. Racz ◽  
C.M.B. Holloway ◽  
W. Huang ◽  
N.J. Look Hong
Keyword(s):  
Care Delivery ◽  
Patient Flow ◽  
Wait Time ◽  
Definitive Treatment ◽  
Wait Times ◽  
Fisher Exact Test ◽  
Patient Anxiety ◽  
Diagnostic Unit ◽  
Clinical Investigations ◽  
The Impact

Background Efforts to streamline the diagnosis and treatment of breast abnormalities are necessary to limit patient anxiety and expedite care. In the present study, we examined the effect of a rapid diagnostic unit (RDU) on wait times to clinical investigations and definitive treatment.Methods A retrospective before–after series, each considering a 1-year period, examined consecutive patients with suspicious breast lesions before and after initiation of the RDU. Patient consultations, clinical investigations, and lesion characteristics were captured from time of patient referral to initiation of definitive treatment. Outcomes included time (days) to clinical investigations, to delivery of diagnosis, and to management. Groups were compared using the Fisher exact test or Student t-test.Results The non-RDU group included 287 patients with 164 invasive breast carcinomas. The RDU group included 260 patients with 154 invasive carcinomas. The RDU patients had more single visits for biopsy (92% RDU vs. 78% non-RDU, p < 0.0001). The RDU group also had a significantly shorter wait time from initial consultation to delivery of diagnosis (mean: 2.1 days vs. 16.7 days, p = 0.0001) and a greater chance of receiving neoadjuvant chemotherapy (37% vs. 24%, p = 0.0106). Overall time from referral to management remained statistically unchanged (mean: 53 days with the RDU vs. 50 days without the RDU, p = 0.3806).Conclusions Introduction of a RDU appears to reduce wait times to definitive diagnosis, but not to treatment initiation, suggesting that obstacles to care delivery can occur at several points along the diagnostic trajectory. Multipronged efforts to reduce system-related delays to definitive treatment are needed.

scholarly journals The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments

CJEM ◽  
2009 ◽  
Vol 11 (05) ◽  
pp. 455-461 ◽  
Author(s):  
James Ducharme ◽  
Robert J. Alder ◽  
Cindy Pelletier ◽  
Don Murray ◽  
Joshua Tepper
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Emergency Departments ◽  
Patient Flow ◽  
Physician Assistants ◽  
Wait Times ◽  
Care Providers ◽  
Lengths Of Stay ◽  
Left Without Being Seen ◽  
The Impact

ABSTRACT Objective: We sought to assess the impact of the integration of the new roles of primary health care nurse practitioners (NPs) and physician assistants (PAs) on patient flow, wait times and proportions of patients who left without being seen in 6 Ontario emergency departments (EDs). Methods: We performed a retrospective review of health records data on patient arrival time, time of initial assessment by a physician, time of discharge from the ED and discharge status. Results: Whether a PA or NP was directly involved in the care of patients or indirectly involved by being on duty, the wait times, lengths of stay and proportion of patients who left without being seen were significantly reduced. When a PA or NP were directly involved in patients' care, patients were 1.6 (95% confidence interval [CI] 1.3–2.1, p &lt; 0.05) and 2.1 (95% CI 1.6–2.8, p &lt; 0.05) times more likely to be seen within the wait time benchmarks, respectively. Lengths of stay were 30.3% (95% CI 21.6%–39.0%, p &lt; 0.01) and 48.8% (95% CI 35.0%–62.7%, p &lt; 0.01) lower when PAs and NPs, respectively, were involved. When PAs and NPs were not on duty, the proportion of patients who left without being seen were 44% (95% CI 31%–63%, p &lt; 0.01) and 71% (95% CI 53%–96%, p &lt; 0.05), respectively. Conclusion: The addition of PAs or NPs to the ED team can improve patient flow in medium-sized community hospital EDs. Given the ongoing shortage of physicians, use of alternative health care providers should be considered. These results require validation, as their generalizability to other locations or types of EDs is not known.

scholarly journals Impact of Cognitive Restructuring and Token Economy Techniques on Truancy Reduction among Secondary School Students in Lagos State, Nigeria

2021 ◽  
Vol 4 (1) ◽  
pp. 21-32
Author(s):  
Afolasade Airat Sulaiman ◽  
Stella Ihuoma Uhuegbu
Keyword(s):  
Secondary School ◽  
Secondary School Students ◽  
Sampling Technique ◽  
Cognitive Restructuring ◽  
Token Economy ◽  
Control Group ◽  
School Students ◽  
Control Group Design ◽  
Lagos State ◽  
The Impact

This study examined the impact of cognitive restructuring and token economy techniques on the reduction of truancy among secondary school students in Lagos State, Nigeria. The study adopted a pre-test, post-test, control group design with a multistage sampling technique as the sampling method. Judgmental sampling technique was used to select two from the six Education Districts in Lagos State, simple random sampling technique was adopted to select six schools; three schools from each of the two Education Districts and 170 truants out of the 216 randomly selected based on the class attendance register completed the study. Truancy Behaviour Questionnaire (TBQ) with a reliability index of .87 was the instrument for the study. Data were analysed and presented with descriptive and ANOVA statistics at .05 level of significance. Findings showed that the two techniques were effective for the reduction of truancy but the token economy technique had a better effect. Sex had no significant effect on the reduction of truancy but females play truants more than males. Based on the findings, the token economy therapy was recommended as an ideal technique for counselling and guiding students against truancy.

scholarly journals From Dependence to Independence

2021 ◽  
Author(s):  
Intan Azura Mokhtar ◽  
Shaheen Majid ◽  
Schubert Foo
Keyword(s):  
Control Group ◽  
Mediated Learning ◽  
Control Group Design ◽  
Student Responses ◽  
Quasi Experimental ◽  
Information Skills ◽  
Group Interviews ◽  
Library Skills ◽  
The Impact ◽  
The Relationship

Although it is widely believed that information literacy (IL) competencies are useful in helping students perform better in their schoolwork and beyond, limited empirical evidence is available showing the relationship between IL competencies and IL education. While a lot of research has been done worldwide and most of the findings have proven that IL is a much-needed skill by students, little research has been conducted on IL teaching approaches or what is termed IL pedagogy. To date, studies on IL have mainly focused only on students’ information skills per se, on library skills or on ICT education. None of these studies has assessed the different approaches to IL education. This paper provides an overview of a research study that investigates the impact of an IL teaching approach in the form of personalised coaching, which is grounded in the pedagogy known as mediated learning, on students’ level and applicability of IL competencies. Through the application of a quasi-experimental pretest-posttest control-group design, as well as student responses in the post-experiment semi-structured group interviews, it was found that personalised coaching (or mediated learning) helps students perform better in the learning and application of IL competencies.

scholarly journals The Impact of The Strategy Analog Thinking in acquiring Social Content Material Concepts of Fourth Primary Class Pupils

2019 ◽  
pp. 375-396
Author(s):  
Manal Taha Yaseen Al-Taʼie
Keyword(s):  
Experimental Design ◽  
Primary Schools ◽  
Control Group ◽  
Partial Control ◽  
Control Group Design ◽  
Social Content ◽  
Group Design ◽  
The Impact ◽  
Academic Year ◽  
Experimental Group

The present study aims the experimental design adopted in the present study is the partial control experimental design of a pre-post control group design. The present study has been limited to the fifth primary class pupils included with in the state primary schools in Baghdad during the academic year (2017-2018), The sample consists of 63 male and female 4th primary class pupils , distributed into 31 ones as an experimental group from Al-Mutanbi Primary school and 32 students as a control group Equalization. The instrument is constructing test measuring concepts acquisition consisted of (8) concepts which consists of (24) items. Experimental group pupils, who have been exposed to Strategy Analog Thinking, have been superior to those at the control group in social content material acquisition.

scholarly journals PENGARUH PENGGUNAAN MEDIA MOOD BOARD TERHADAP PENGETAHUAN DESAIN BUSANA PADA MAHASISWA PENDIDIKAN TEKNIK BUSANA

2016 ◽  
Vol 3 (2) ◽  
pp. 121
Author(s):  
Afif Ghurub Bestari ◽  
Ishartiwi Ishartiwi
Keyword(s):  
Learning Outcomes ◽  
Positive Influence ◽  
T Test ◽  
Fashion Design ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
And Control ◽  
The Impact ◽  
Learning By Using

Penelitian ini bertujuan untuk menguji (1) perbedaan pengaruh pembelajaran Desain Busana menggunakan media mood board dan media contoh gambar desain busana terhadap kreativitas dan hasil belajar Desain Busana mahasiswa;  (2) pengaruh positif pembelajaran Desain Busana dengan menggunakan media mood board dibandingkan menggunakan media contoh gambar desain busana terhadap kreativitas desain busana mahasiswa; (3) pengaruh positif pembelajaran Desain Busana dengan menggunakan media mood board dibandingkan dengan menggunakan media contoh gambar desain busana terhadap hasil belajar desain busana mahasiswa. Penelitian ini merupakan penelitian kuasi eksperimen dengan desain Pretest-Posttest, Nonequivalent Control Group Design. Penelitian ini menggunakan kelas eksperimen dan kelas kontrol. Populasi penelitian adalah mahasiswa kelas A dan D semester 2 di Pendidikan Teknik Busana FT UNY. Hasil t-test menunjukkan pretest mahasiswa kelas kontrol dan kelas eksperimen hampir sama. Data hasil belajar posttestmenunjukkan selisih skor rata-rata antara kelas eksperimen dan kelas kontrol berkategori sangat tinggi. Berdasarkan hasil nilai rata-rata diperoleh bahwa terjadi peningkatan hasil kreativitas mahasiswa yang signifikan.Kata kunci: media mood board, hasil belajar, desain busana THE IMPACT OF USING MOOD BOARD MEDIA TO  FASHION DESIGN KNOWLEDGE ON FASHION  DESIGN ENGINEERING STUDENTSAbstractThis research aimed to examine (1) the effect of differences in learning to use media Fashion Design mood board and fashion design drawings media examples in creativity and Fashion Design student learning outcomes; (2) the positive influence of learning by using media Fashion Design mood board than using media examples fashion design drawings for the creativity of fashion design students; (3) a positive influence of learning by using media Fashion Design mood board compared to using the media sample images for learning outcomes of Fashion Design student. This research is a quasi-experimental research with pretest-posttest design, Nonequivalent Control Group Design. This research uses experimental class and control class. The research population was a student of class A and D in the 2nd half of Technical Fashion Education Faculty of Engineering, Yogyakarta State of University. t-test results indicate student pretest control class and experimental class is almost the same. Data posttest study results show the difference in average scores between the experimental class and control class category is very high. Based on the results of the average value obtained that an increase in the creativity of the students are significant.Keywords: fashion mood boards, learning outcomes, fashion design

Physicians’ accounts of frontline tensions when implementing pilot projects to improve primary care

2018 ◽  
Vol 32 (1) ◽  
pp. 39-55 ◽  
Author(s):  
Elizabeth Mansfield ◽  
Onil Bhattacharyya ◽  
Jennifer Christian ◽  
Gary Naglie ◽  
Vicky Steriopoulos ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Care Physicians ◽  
Pilot Project ◽  
Models Of Care ◽  
Structured Interviews ◽  
Pilot Projects ◽  
Additional Time ◽  
Content Type ◽  
The Impact

Purpose Canada’s primary care system has been described as “a culture of pilot projects” with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

scholarly journals The Impact of the Virtual Laboratory on Students’ Attitude in a General Physics Laboratory

2017 ◽  
Vol 13 (04) ◽  
pp. 20 ◽  
Author(s):  
Gülsüm Aşıksoy ◽  
Didem Islek
Keyword(s):  
Attitude Scale ◽  
Virtual Laboratory ◽  
Control Group ◽  
Structured Interviews ◽  
Control Group Design ◽  
Physics Laboratory ◽  
Positive Effects ◽  
Students Attitudes ◽  
Laboratory Experiences ◽  
The Impact

<p class="Default"><strong>Abstract:</strong> The purpose of this study is to investigate the impact of virtual laboratory experiences in physics laboratory attitudes of students. It also aims to determine the views of students’ on virtual laboratory. The study involved 42 students who was divided into two groups (21 experimental, 21 control). Students were randomly assigned to both groups. In the research, the pre-test and post-test control group design was used. The experimental group used the virtual laboratory. On the other hand the control group used physical laboratory. The research data were obtained via the “physics laboratory attitude scale” and semi-structured interviews. The result of this study carried out that virtual laboratory experiences made positive effects on students’ attitudes. In addition, semi-structured interviews were found out that they had positive opinions regarding the virtual physics laboratory experiences.</p><p class="Default"> </p>

scholarly journals Dietitian first gastroenterology clinic: an initiative to reduce wait lists and wait times for gastroenterology outpatients in a tertiary hospital service

2018 ◽  
Vol 10 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Rumbidzai N Mutsekwa ◽  
Russell Canavan ◽  
Anthony Whitfield ◽  
Alan Spencer ◽  
Rebecca L Angus
Keyword(s):  
Patient Flow ◽  
Wait Time ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Wait Times ◽  
Activity Data ◽  
Patient Journey ◽  
Service Activity ◽  
High Level ◽  
The Impact

ObjectiveThe demand for outpatient gastroenterology medical specialist consultations is above what can be met within budgetary and staffing constraints. This study describes the establishment of a dietitian first gastroenterology clinic to address this issue, the patient journey and its impact on wait lists and wait times in a tertiary gastroenterology service.DesignA dietitian first gastroenterology clinic model was developed and a mixed-methods approach used to evaluate the impact of the service over a 21-month period.SettingGold Coast University Hospital, Queensland, Australia (a public tertiary hospital).Patients658 patients were triaged to the clinic between June 2016 and March 2018.InterventionA dietitian first gastroenterology clinic for low-risk gastroenterology patients.Main outcome measuresWe examined demographic, referral, wait list, wait time and service activity data, patient satisfaction and patient journey.ResultsAt the time of audit, 399 new (67.9% female) and 307 review patients had been seen. Wait times for eligible patients reduced from 280 to 66 days and the percentage of those in breach of their recommended wait times reduced from 95% to zero. The average time from referral to discharge was 117.8 days with an average of 2.4 occasions of service. 277 patients (69.4%) had been discharged to the care of their general practitioner and 43 patients (10.7%) had an expedited specialist medical review. Patient surveys indicated a high level of satisfaction.ConclusionA dietitian first gastroenterology model of care helps improve patient flow, reduces wait times and may be useful elsewhere to address outpatient gastroenterology service pressures.

Empathy Intervention to Reduce Implicit Bias in Pre-Service Teachers

2018 ◽  
Vol 122 (2) ◽  
pp. 670-688 ◽  
Author(s):  
Denise K. Whitford ◽  
Andrea M. Emerson
Keyword(s):  
Implicit Bias ◽  
Linguistically Diverse ◽  
White Female ◽  
Future Research ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
Linguistically Diverse Students ◽  
The Impact

There have been long-term concerns regarding discriminatory discipline practices used with culturally and linguistically diverse students, with little research on the impact teacher-centered empathy interventions may have on this population. This randomized pretest–posttest control group design investigates the ability of a brief empathy-inducing intervention to improve the implicit bias of pre-service teachers, as measured by the Implicit Association Test. We found the empathy intervention statistically significant at decreasing the implicit bias of White female pre-service teachers toward Black individuals ( F = 7.55, η2 = 0.22, p = 0.01). Implications and future research are discussed, including extended intervention periods.

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