Working inside the walls

2015 ◽  
Author(s):  
Bruce C. Gage
Keyword(s):  
Program Development ◽  
Physical Environment ◽  
Clinical Work ◽  
Personal Safety ◽  
Behaviorally Disordered ◽  
Correctional Setting ◽  
Correctional Settings ◽  
Degree Of Isolation ◽  
Clinical Problems

This chapter is a pragmatic discussion of the experience of working as a psychiatrist in correctional settings, whether jails or prisons. To work inside the walls, the psychiatrist must come to terms with the realities of the correctional setting in order to be secure, satisfied with the work, and clinically effective. There is no monolithic correctional culture. Each system and facility has its own unique culture and has evolved in some degree of isolation, emphasizing different philosophical approaches to the correctional mission and to criminal causation. This chapter examines the context in which clinical work is embedded: physical environment and security, correctional culture, personal safety, typical stressors, and individual liability. It is clearly not for everybody but the rewards can be tremendous. The quality of care in many facilities, especially prisons, is superior to care in the community. The clinical problems are unendingly fascinating. And, despite its downsides, having a setting with limited access to drugs that provides food, clothing, shelter, and medical care can allow a degree of patient improvement that may be difficult to realize in the community. Opportunities for creativity in treatment and program development are unparalleled. In many ways, correctional psychiatry is poised to lead the way in the treatment of some of the most ill and behaviorally disordered members of society.

Applying Expanded Servicescape to the Hotel Industry

2021 ◽  
pp. 109634802110115
Author(s):  
Seonjeong (Ally) Lee ◽  
Ning-Kuang Chuang
Keyword(s):  
Quality Of Life ◽  
Customer Loyalty ◽  
Physical Environment ◽  
Online Survey ◽  
Hotel Industry ◽  
Holistic Approach ◽  
Environmental Cues ◽  
Practical Implications

The physical environment plays an essential role in customers’ hotel stay experiences. Hotels offer a differentiated atmosphere that creates favorable customers’ evaluations. Based on the significant role of environmental cues, this study investigates the effects of an expanded servicescape on customers’ evaluations, including customer satisfaction, quality of life, and customer loyalty, in the context of the hotel industry. To test the proposed research framework, this study collects data from previous hotel customers and conducts a self-administered, online survey. Findings identified ambience, interactions with employees, authenticity, and fascination positively influenced customers’ satisfaction, which further influenced customer loyalty. Only ambience and fascination positively influenced quality of life, which in turn influenced customer loyalty. Results contributed to the application of expanded servicescape in the hotel context. Results also suggested practical implications of the holistic approach of servicescape in the hotel industry.

scholarly journals Quality in Assisted Living: Does It Lie in the Eyes of the Beholder?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 726-727
Author(s):  
Diana White ◽  
Tunalilar Ozcan ◽  
Serena Hasworth ◽  
Jaclyn Winfree
Keyword(s):  
Quality Indicators ◽  
Residential Care ◽  
Assisted Living ◽  
Physical Environment ◽  
Sampling Strategy ◽  
Perceived Quality ◽  
Two Stage ◽  
Regulatory Perspective ◽  
To Receive

Abstract Quality is defined in multiple ways and by different stakeholders (e.g., residents, regulators, informed observers). Using a two-stage stratified sampling strategy, we collected data from N=241 residents living in 31 assisted living and residential care communities (AL/RC) in Oregon. Residents rated their overall satisfaction and satisfaction with the AL/RC as a place to live and to receive care. Each interviewer completed a facility profile summarizing their observations about the setting, including quality of staff-resident interactions and physical environment. Residents and interviewers were also asked whether they would recommend the community to others. Finally, we used deficiency citations given during regular inspections by the licensing agency to proxy regulatory perspective. Results show that perceived quality varied by stakeholder (e.g., residents’ assessments differed from deficiency citations). Given this variation, findings suggest that efforts to make quality indicators publicly available should include multiple measures and perspectives, especially residents.

scholarly journals 106 - Environmental Influences on the Cognitive and Psychological Well Being of Older Adults with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 15-16
Author(s):  
William E. Reichman ◽  
L. Bradford Perkins ◽  
Hilde Verbeek
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Physical Environment ◽  
Culture Change ◽  
Long Term Care ◽  
Small Scale ◽  
Term Care

This symposium will review the latest data on the influence of environmental design and its attributes on the cognitive and psychological wellbeing of older adults living with dementia. The presenters will cover the myriad ways in which the physical environment of care can adapt to the changing demands of older adults with sensory, motor and cognitive deficits and foster optimal functioning and quality of life. The role of emerging technologies will also be reviewed as they complement the contribution of the design of the physical environment to the wellbeing of older adults with cognitive impairment. Information will be offered through a review of the existing research literature as well as case studies that illustrate the impact of environmental modification on fostering wellbeing and minimizing the emergence of the behavioral and psychological symptoms of dementia. The presenters will represent and integrate sensibilities that have emerged from the fields of architecture, cognitive neuroscience and psychology.How the Principles of the Culture Change Movement Inform Environmental Design and the Application of Technology in the Care of Older Adults Living with DementiaWilliam E. ReichmanThe culture change movement informs a number of principles that have been applied to more contemporary design concepts for the congregate care of older adults living with dementia. This talk will review the core tenets of the Culture Change Movement as exemplified by the Greenhouse, Dementia Village and other innovative models of congregate long-term care. Specific reference will be made to how these tenets have been operationalized around the world into the design of programming and the creation of residential care environments that foster a better quality of life for older adults and an enhanced work environment for care providers. This talk will also include the emerging role of technologies that complement innovative design of the environment and which foster optimized social and recreational functioning of older adults living with dementia.A Better Life Through a Better Nursing Home DesignL. Bradford PerkinsOver the last 20 years there has been extensive experimentation related to the role of the environment in the housing, care and treatment of persons with Alzheimer’s and other age related dementias. Prior to that time the typical housing and care environment was a locked unit in a skilled nursing or other restrictive senior living facility. In 1991 the Presbyterian Association on Aging in Western Pennsylvania opened Woodside Place on its Oakmont campus. This small 36 bed facility was designed to incorporate the latest research and care experience with persons suffering from these issues. This one small project, as well as the long post occupancy research led by Carnegie Mellon University, clearly demonstrated that individuals with Alzheimer’s and related forms of dementia could lead a healthier, happier, higher quality of life in a more residential, less restrictive environment. Not everything in this pioneering project worked, and five generations of living and care models have followed that have refined the ideas first demonstrated by Woodside Place. Bradford Perkins, whose firm designed Woodside Place and over 100 other related projects, will discuss what was learned from Woodside Place as well as the five generations of projects (and post occupancy research) that followed.Innovative dementia care environments as alternatives for traditional nursing homes: evidence and experiences from the NetherlandsHilde VerbeekKey goals of the dementia care environment focus on increasing autonomy, supporting independence and trying to enable one’s own lifestyle for as long as possible. To meet these goals, innovative, small-scale and homelike care environments have been developed that have radically changed the physical, social and organizational aspects of long-term care in the Netherlands. This presentation discusses various Dutch models that have implemented small-scale and homelike care environments, including green care farms, dementia village and citizen initiatives. The models reflect a common care concept, focusing on residents’ remaining strengths, providing opportunity for choice and aiming to sustain a sense of self and control. A small number of residents (usually 6 to 8) live together in a homelike environment and nursing staff are part of the household. Residents are encouraged to participate in daily household activities, emphasizing normalization of daily life with person-centred care. The physical environment resembles an archetypal home. This talk presents the scientific evidence on the impact and effects of these small-scale, homelike models on residents, their family caregivers and staff. Furthermore, the presentation will highlight working approaches and how these initiatives have positively influenced routine care across the long-term care spectrum.

scholarly journals Design features that reduce the use of seclusion and restraint in mental health facilities: a rapid systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046647
Author(s):  
Sanne Oostermeijer ◽  
Catherine Brasier ◽  
Carol Harvey ◽  
Bridget Hamilton ◽  
Cath Roper ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Environment ◽  
Critical Appraisal ◽  
Physical Restraint ◽  
Health Facilities ◽  
Rapid Review ◽  
Cochrane Library ◽  
Design Features ◽  
Mental Health Facilities

Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint in mental health facilities. Recent literature recognises the importance of the physical environment in supporting better outcomes in mental health services. This rapid review scoped the existing literature studying what physical design features of mental health facilities can reduce the use of seclusion and physical restraint.DesignA rapid review of peer-reviewed literature.MethodsPeer-reviewed literature was searched for studies on architectural design and the use of restraint and seclusion in mental health facilities. The following academic databases were searched: Cochrane Library, Medline, PsycINFO, Scopus and Avery for English language literature published between January 2010 and August 2019. The Joanna Briggs Institute’s critical appraisal tool was used to assess the quality of included studies.ResultsWe identified 35 peer-reviewed studies. The findings revealed several overarching themes in design efforts to reduce the use of seclusion and restraint: a beneficial physical environment (eg, access to gardens or recreational facilities); sensory or comfort rooms; and private, uncrowded and calm spaces. The critical appraisal indicated that the overall quality of studies was low, as such the findings should be interpreted with caution.ConclusionThis study found preliminary evidence that the physical environment has a role in supporting the reduction in the use of seclusion and restraint. This is likely to be achieved through a multilayered approach, founded on good design features and building towards specific design features which may reduce occurrences of seclusion and restraint. Future designs should include consumers in a codesign process to maximise the potential for change and innovation that is genuinely guided by the insights of lived experience expertise.

Influence of community satisfaction with individual happiness: comparative study in semi-urban and rural areas of Tikapur, Nepal

2017 ◽  
Vol 25 (3) ◽  
pp. 22-32 ◽  
Author(s):  
Myung-Bae Park ◽  
Chun-Bae Kim ◽  
Chhabi Ranabhat ◽  
Chang-Soo Kim ◽  
Sei-Jin Chang ◽  
...  
Keyword(s):  
Rural Areas ◽  
Physical Environment ◽  
Urban Areas ◽  
Positive Relationship ◽  
National Level ◽  
Medical Services ◽  
Community Satisfaction ◽  
Critical Factors ◽  
Urban And Rural Areas

Happiness is a subjective indicator of overall living conditions and quality of life. Recently, community- and national-level investigations connecting happiness and community satisfaction were conducted. This study investigated the effects of community satisfaction on happiness in Nepal. A factor analysis was employed to examine 24 items that are used to measure community satisfaction, and a multiple regression analysis was conducted to investigate the effects of these factors on happiness. In semi-urban areas, sanitation showed a positive relationship with happiness. In rural areas, edu-medical services were negatively related to happiness, while agriculture was positively related. Gender and perceived health were closely associated with happiness in rural areas. Both happiness and satisfaction are subjective concepts, and are perceived differently depending on the socio-physical environment and personal needs. Sanitation, agriculture (food) and edu-medical services were critical factors that affected happiness; however, the results of this study cannot be generalized to high-income countries.

scholarly journals Measuring Customer Satisfaction When Dining at a Casual Restaurant: An Application of Kisang's Model

2020 ◽  
Vol 6 (2) ◽  
pp. 1
Author(s):  
Soomro Dr. Raheem Bux ◽  
Brohi Noor Ahmed ◽  
Memon Khair Muhammad ◽  
Gilal Rehman Gul
Keyword(s):  
Customer Satisfaction ◽  
Service Quality ◽  
Food Quality ◽  
Physical Environment ◽  
Perceived Value ◽  
Average Temperature ◽  
Environment Quality ◽  
Customer Perceived Value ◽  
Quality Dimensions

The culinary business is being increased rapidly in Pakistan. Usually, Pakistani consumers prefer to eat meals at homes cooked by female members owing to cultural, social and religious reason. In order to bridge up the gap in existing hospitality literature, the objective of this research manuscript is to find out the relation among dimensions of quality (food quality, service quality and quality of physical environment), customer satisfaction, restaurant image, behavioral intentions and customer perceived value in casual restaurants in Sukkur city. Data for this research study have been collected from customers of restaurants located in Sukkur city through convenience sampling. SPSS (24) and Smart PLS (3.0) versions were used for data analysis. Service quality dimensions of causal restaurant were found important determinants of the restaurant image and customer perceived value followed by physical environment and service quality; whereas, the physical environment quality was not found to be a significant factor of perceived value of customer. Additionally, food quality is measured as an important restaurant’s product. Another outcome of the present study exhibited that quality of physical environment holds a substantial positive effect on restaurant image. The findings indicate quality in food and service is highly important to satisfy customers and make their behavior positive about casual restaurant. Further, as an average temperature remains above 400 in Sukkur city, internal environment of the restaurant is significant as it will affect the mood and perception of customers when they dine in the casual restaurant.

scholarly journals Factors Associated with the Quality of Life of People Living with HIV/AIDS

10.3823/2627 ◽  
2020 ◽  
Vol 13 ◽  
Author(s):  
Maria Sandra Andrade ◽  
Clarissa Mourão Pinho ◽  
Aline Ferreira Targino Soares ◽  
Eduardo Tavares Gomes ◽  
Cynthia Angélica Ramos de Oliveira Dourado ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Physical Environment ◽  
Sample Selection ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Stepwise Method ◽  
Living With Hiv

Purposes: Evaluate the quality of life and the associated factors in people living with HIV. Methods: This is a cross-sectional study with a quantitative approach and random sample selection, carried out in two Specialized Assistance Services, with 356 people living with HIV. The comparison between the domain scores was performed using the student t test, ANOVA and Pearson’s correlation. Multiple linear regression was used to assess the contribution of variables to the outcome quality of life using the stepwise method. Results: The domains that showed the best results in averages were Psychological (17.0), Social Relations (14.9) and Level of Independence (14.0). The domain that had the greatest determination was the Psychological (R² = 0.49), followed by Social Relations (R² = 0.434), the lowest determination was the Spirituality domain (R² = 0.270). No domain had a score considered high. Conclusion: The quality of life presented unsatisfactory results, especially in the Physical, Environment and Spirituality domains. The need to formulate strategies aimed at coping with HIV and increasing the quality of life of people living with HIV is evident.

scholarly journals Changes in Physician Telemedicine Use during COVID-19: Effects of Practice Setting, Demographics, Training, and Organizational Policies

2021 ◽  
Vol 18 (19) ◽  
pp. 9963
Author(s):  
Bradford S. Pierce ◽  
Paul B. Perrin ◽  
Alan W. Dow ◽  
Natalie D. Dautovich ◽  
Bruce D. Rybarczyk ◽  
...  
Keyword(s):  
Clinical Work ◽  
Academic Medical Centers ◽  
Group Practice ◽  
Practice Setting ◽  
Patient Volume ◽  
Organizational Policies ◽  
Medical Centers ◽  
Academic Medical ◽  
Quality Of Patient Care

Telemedicine use increased during the COVID-19 pandemic, but uptake was uneven and future use is uncertain. This study, then, examined the ability of personal and environmental variables to predict telemedicine adoption during the COVID-19 pandemic. A total of 230 physicians practicing in the U.S. completed questions concerning personal and environmental characteristics, as well as telemedicine use at three time points: pre-pandemic, during the pandemic, and anticipated future use. Associations between use and characteristics were determined to identify factors important for telemedicine use. Physicians reported that telemedicine accounted for 3.72% of clinical work prior to the pandemic, 46.03% during the pandemic, and predicted 25.44% after the pandemic ends. Physicians within hospitals reported less increase in telemedicine use during the pandemic than within group practice (p = 0.016) and less increase in use at hospitals compared to academic medical centers (p = 0.027) and group practice (p = 0.008). Greater telemedicine use was associated with more years in practice (p = 0.009), supportive organizational policies (p = 0.001), organizational encouragement (p = 0.003), expectations of greater patient volume (p = 0.003), and perceived higher quality of patient care (p = 0.032). Characteristics such as gender, number of physicians, and level of telemedicine training were not significant predictors. Organizations interested in supporting physicians to adopt telemedicine should encourage its use and create policies supporting its use. More senior physicians had a greater degree of telemedicine uptake, while training programs did not predict use, suggesting that efforts to develop telemedicine competency in younger physicians may be ineffective and should be re-examined.

scholarly journals Quality and safety by design

2006 ◽  
Vol 15 (suppl 1) ◽  
pp. i1-i3 ◽  
Author(s):  
J B Battles
Keyword(s):  
Healthcare Delivery ◽  
Clinical Work ◽  
Design Methods ◽  
Quality And Safety ◽  
Healthcare Organizations ◽  
Patient Centered ◽  
Framework Design ◽  
Design Attributes ◽  
Centered Care

Rather than continuing to try to measure the width and depths of the quality chasm, a legitimate question is how does one actually begin to close the quality chasm? One way to think about the problem is as a design challenge rather than as a quality improvement challenge. It is time to move from reactive measurement to a more proactive use of proven design methods, and to involve a number of professions outside health care so that we can design out system failure and design in quality of care. Is it possible to actually design in quality and design out failure? A three level conceptual framework design would use the six quality aims laid out in Crossing the quality chasm. The first or core level of the framework would be designing for patient centered care, with safety as the second level. The third design attributes would be efficiency, effectiveness, timeliness, and equity. Design methods and approaches are available that can be used for the design of healthcare organizations and facilities, learning systems to train and maintain competency of health professionals, clinical systems, clinical work, and information technology systems. In order to bring about major improvements in quality and safety, these design methods can and should be used to redesign healthcare delivery systems.

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