Lean transformation framework for treatment-oriented outpatient departments

2021 ◽  
pp. 1-15
Author(s):  
Ting Yu ◽  
Kudret Demirli ◽  
Nadia Bhuiyan
Keyword(s):  
Lean Transformation ◽  
Outpatient Departments

scholarly journals Perception and Willingness to Maintain Continuity of Care by Parents of Children with Asthma in Taiwan

2021 ◽  
Vol 18 (7) ◽  
pp. 3600
Author(s):  
Christy Pu ◽  
Yu-Chen Tseng ◽  
Gau-Jun Tang ◽  
Yen-Hsiung Lin ◽  
Chien-Heng Lin ◽  
...  
Keyword(s):  
Health Care ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Continuity Of Care ◽  
Care Providers ◽  
Exact Matching ◽  
Extra Effort ◽  
Referral Management ◽  
Children With Asthma ◽  
Outpatient Departments

To investigate caregivers’ attitudes toward continuity of care (COC) and their willingness to maintain continuity for their children with asthma under a national health insurance (NHI) system without strict referral management. We sampled 825 individuals from six pediatric outpatient departments in different parts of Taiwan from 2017 to 2018. We used a contingent valuation with a payment card method. Post-stratification weighting adjustment and coarsened exact matching were utilized. Multiple logistic regression was used to compare the willingness to pay and spend extra time maintaining continuity by parents. More than 80% of caregivers in the asthma group believed having a primary pediatrician was important for children’s health. Only 27.5% and 15.8% of caregivers in the asthma and control groups, respectively, believed changing pediatricians would negatively affect therapeutic outcomes. Regression analysis showed that the predicted willingness to pay for the asthma and non-asthma groups were NT$508 (SD = 196) and NT$402 (SD = 172), respectively, and there was a significant positive dose–response relationship between household income and willingness to pay for maintaining health care provider continuity. Caregivers’ free choices among health care providers may reduce willingness to spend extra effort to maintain high COC. Caregivers should be educated on the importance of COC.

scholarly journals Practice Patterns for Older Adult Patients With Advanced Cancer: Physician Office Versus Hospital Outpatient Setting

2019 ◽  
Vol 15 (1) ◽  
pp. e30-e38 ◽  
Author(s):  
Allison Lipitz-Snyderman ◽  
Coral L. Atoria ◽  
Stephen M. Schleicher ◽  
Peter B. Bach ◽  
Katherine S. Panageas
Keyword(s):  
Older Adult ◽  
Advanced Cancer ◽  
Odds Ratio ◽  
Hierarchical Modeling ◽  
Outpatient Setting ◽  
Adult Patients ◽  
Medicare Beneficiaries ◽  
Hospital Outpatient ◽  
Outpatient Departments ◽  
Retrospective Comparative Study

PURPOSE: A shift in outpatient oncology care from the physician’s office to hospital outpatient settings has generated interest in the effect of practice setting on outcomes. Our objective was to examine whether medical oncologists’ prescribing of drugs and services for older adult patients with advanced cancer is used more in physicians’ offices compared with hospital outpatient departments. METHODS: This was a retrospective comparative study. SEER-Medicare data (2004 to 2011) were used to identify Medicare beneficiaries diagnosed with advanced breast, colon, esophagus, non–small-cell lung, pancreatic, or stomach cancer. Between physicians’ offices and hospital outpatient departments, we compared use of selected likely low-value supportive drugs, low-value therapeutic drugs, chemotherapy-related hospitalizations, and hospice. We used hierarchical modeling to assess differences between settings to account for correlation within physicians. RESULTS: Compared with patients treated in a hospital outpatient department, those treated in a physician’s office setting were more likely to receive erythropoiesis-stimulating agents (odds ratio, 1.72; 95% CI, 1.53 to 1.94) and granulocyte colony–stimulating factors (odds ratio, 1.28; 95% CI, 1.18 to 1.38). For combination chemotherapy and nanoparticle albumin-bound–paclitaxel in patients with breast cancer, there was a trend toward higher use in physicians’ offices, although this was not statistically significant. Chemotherapy-related hospitalizations and hospice did not vary by setting. CONCLUSION: We found somewhat higher use of several drugs for patients with advanced cancer in physicians’ office settings compared with hospital outpatient departments. Findings support research to dissect the mechanisms through which setting might influence physicians’ behavior.

A STUDY OF WASTE MANAGEMENT OF SAIDU TEACHING HOSPITAL

1969 ◽  
Vol 2 (1) ◽  
pp. 105-110
Author(s):  
Bushra Iftikhar ◽  
Muhammad Jan ◽  
Khurshid Ahmad ◽  
Satea Arif
Keyword(s):  
Waste Management ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Water Channel ◽  
Liquid Waste ◽  
Care Hospital ◽  
Operation Theatre ◽  
Blood Banks ◽  
Outpatient Departments ◽  
Infectious Waste

Objectives: The study was designed to find out the type and quantity of different type of wastes generated inthe two wings of Saidu Group of teaching Hospitals. The study also aimed at finding that whether facilitiesare available in different units for the segregation, storage, disinfection of infectious waste at the onset andmethods of disposal of waste within and outside the hospital. Also, types of items reused and their methodsof sterilization and the fate of used syringes was found out.Study Design: ObservationalMethodology: The study focus was Saidu Teaching Hospital (STH), a tertiary care hospital providingservices to the people of Swat, Malakand, Dir, Kohistan and areas far up to Chitral. Situated 1.5 Km apartSTH consists of two administrative units,Saidu Wing and Central Wing.A qualitative analysis of various aspects of waste management was done by reviewing the availableauthentic record and discussion with the sanitary and administrative staff of the hospital. All the data wascollected according to, and filled in a pre-designed questionnaire.Results: It was found that Saidu Teaching Hospital generates more than 550 Kg of solid waste and 1295liters of liquid waste per day, which makes 1.2 Kg/bed/day. As a whole 80% of the waste generated wasordinary garbage, 12% was infectious, 4% was Pharmacological, 3% pathological and 0.8% consisted ofsharps.The provision of facilities for the segregation of waste at outpatient departments, Wards, Operation theatreand Laboratories/Blood Banks were 7.5%, 7%, 20% and 28.5% respectively and for storage of waste beforedisposal at outpatient departments, Wards, Operation theatre and Laboratories / Blood Banks were 22%,8%, 0% and 28.5% respectively.Disinfection of infectious waste at outpatient departments, wards, operation theatre and laboratories / bloodbanks was 10%, 12%, 0% and 17% respectively. Methods used were treatment with phenyl and burning inopen air.About the removal of waste from hospital premises, 78% mentioned sweepers, 17% said rig pickers while5% said that there is no one to take away the waste.54% admitted that they threw the syringes as such in thebins.The study found that 80% of the waste went to the municipal corporation land fills, the rest was either burntor thrown as such into the water channel passing through the hospital (12% & 8% respectively). 67% blamedthe administration, 25 % held the doctors responsible, 37% charged the nursing staff and 67% blamed thesweepers for the faulty management of hospital waste.Conclusion: It is thus concluded that Saidu Teaching Hospital generates huge amount of solid and liquidwaste, which is not properly disposed off currently, therefore it needs modern and scientific waste disposalsystems.Keywords: Waste Management, hospital waste management, waste disposal

PATIENT CARE AND STUDENT LEARNING IN A PEDIATRIC CLINIC

PEDIATRICS ◽  
1972 ◽  
Vol 50 (6) ◽  
pp. 847-848
Author(s):  
Robert J. Haggerty
Keyword(s):  
Patient Care ◽  
Student Teaching ◽  
Effective Management ◽  
Patient Dissatisfaction ◽  
Complex Problems ◽  
Teaching Objectives ◽  
Recruitment Procedure ◽  
Outpatient Departments ◽  
Selection For ◽  
Definition Of

Every pediatrician who has taught or worked in university pediatric outpatient departments recognizes the syndrome presented by Duff et al. in this issue of Pediatrics. The diagnosis is clear: effective student teaching is not occurring. The etiology of this problem is complex and not so clear. Some of the causes are inappropriate patient selection for beginning students, lack of effective administrative organization to achieve even limited teaching objectives, and lack of appropriate techniques to diagnose and manage the complex sociomedical problems presented. As a result, student, faculty, and patient dissatisfaction is very high. Effective management of the syndrome is even less clear. As with most complex problems, a clearer definition of the goals is the first step to a solution. What do we want the student to learn? How to gather information from families with such complex social and medical difficulties? Skills in diagnosis and management of common or rare health problems? Change of attitudes? Until each ambulatory program defines its teaching objectives more clearly in behaviorally measurable terms, effective management of the disease "poor patient care and teaching" will continue to elude us. I would, however, suggest the following considerations: 1. The first direct patient experiences which students have in ambulatory settings should be with patients who present considerably less complex problems than those available in most of our outpatient departments, and there should be a wider social class selection for the student's initial experience. To achieve this will require either a different patient recruitment procedure or the use of different settings for such education.

Access to Medical Care for Children and Adolescents in the United States

PEDIATRICS ◽  
1990 ◽  
Vol 86 (5) ◽  
pp. 666-673 ◽  
Author(s):  
David L. Wood ◽  
Rodney A. Hayward ◽  
Christopher R. Corey ◽  
Howard E. Freeman ◽  
Martin F. Shapiro
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Children And Adolescents ◽  
The United States ◽  
Emergency Rooms ◽  
Community Clinics ◽  
Hospital Outpatient ◽  
Regular Source ◽  
Outpatient Departments ◽  
Source Of Care

To evaluate access to health care for American children and adolescents, a telephone survey of a national random sample of households was conducted in which 2182 children 17 years or younger were studied. Approximately 10% had no medical insurance; 10% had no regular source of care; and 18% identified emergency rooms, community clinics, or hospital outpatient departments as their usual site of medical care. Children who were uninsured, poor, or nonwhite were less likely to have seen a physician in the past year (P < .001), and uninsured children were less likely to have up-to-date immunizations. Logistic regression analyses revealed that poor, uninsured, or nonwhite children less frequently had a regular source of care; more frequently used emergency rooms, community clinics, and hospital outpatient departments as their regular providers; and more frequently encountered financial barriers to health care. Low-income or nonwhite children had much less access to care compared with children from more affluent or white families, independent of insurance status or health status.

scholarly journals Perceptions of professional nurses regarding introduction of the Batho Pele principles in State hospitals

Curationis ◽  
2015 ◽  
Vol 38 (1) ◽  
Author(s):  
Sindiwe James ◽  
Thenjiwe M. Miza
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Group Discussions ◽  
State Hospitals ◽  
African Health ◽  
Outpatient Departments ◽  
Field Notes ◽  
Professional Nurses

Background: The South African health care delivery system has shifted focus to primary health care since 1994. For this purpose the Batho Pele principles were introduced. Nurses claim, however, that since the introduction of these principles patients and their families have been making unnecessary and sometimes impossible demands of nursing staff. This article presents the perceptions of the professional nurses regarding the introduction of the Batho Pele principles in their workplace.Objectives: To describe the perceptions of professional nurses regarding introduction of the Batho Pele principles and to recommend guidelines to facilitate measures to realise the objects of these principles.Method: A qualitative, exploratory, descriptive and contexual research design was used. Six audio-taped focus group discussions and field notes were used to collect data from purposively sampled participants who have worked in the outpatient departments of hospitals in thePort Elizabeth Hospital Complex. Guba’s model of trustworthiness was used to confirm integrity of the study, whilst the participants were kept anonymous, protected from harm and participated voluntarily. Data analysis was done using Tesch’s data analysis spiral and with the involvement of an independent-coder.Results: Three themes emerged, revealing that the professional nurses perceived the objectives of the Batho Pele principles as difficult to uphold due to the inadequate planning prior to their implementation. Inadequacy of human and material resources aggravated this perception.Conclusion: Professional nurses are not happy with how things are in terms of introduction of the Batho Pele principles, but are optimistic of a positive change in the near future.

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