Discharge planning in a cardiology out-patient clinic: a clinical audit

2014 ◽  
Vol 27 (7) ◽  
pp. 573-580 ◽  
Author(s):  
Shirley Ingram ◽  
Barkat Khan
Keyword(s):  
Planning Process ◽  
Performance Indicator ◽  
Discharge Planning ◽  
Clinic Visit ◽  
Nurse Specialist ◽  
Content Type ◽  
Audit Period ◽  
Cardiology Clinic ◽  
Return Visits ◽  
Recommended Action

Purpose – The purpose of this paper is to audit the active discharge (DC) planning process in a general cardiology clinic, by pre-assessing patients’ medical notes and highlighting those suitable for potential DC to the clinic physician. Design/methodology/approach – The cardiology clinical nurse specialist (CNS) identified patients’ for nine- to 12-month return visits one week prior to attendance. The previous consultation letter was accessed and information was documented by the CNS in the medical record. The key performance indicator (KPI) used was patient DCs for each clinic visit. The process was audited at three separate times to reflect recommended action carried out. Findings – The CNS pre-assessment and presence at the clinics significantly increased total DCs during the first period compared to usual care, 11 vs 34 per cent (p<0.0001). During the third audit period, DCs fell (9 per cent) with a reduction in CNS pre-assessed DCs (10 per cent). Recommendations were implemented. The process was continued by clinic administration staff, colour coding all nine- to 12-month returns, resulted in a 19 per cent DC rate in 2012. Practical implications – CNS pre-assessment and highlighting DC suitability increased the number of patient DCs. As the CNS presence at the clinic reduced so did the rate of DC. Specific personnel need to be responsible for monitoring and reminding staff of the process; this does not always have to be medical or nursing. Originality/value – Implementing positive discharging procedures is aimed at improving quality, increasing efficiency and accessibility of services for patients. This audit describes a process to promote DC planning from cardiology outpatients.

Power distribution reforms

2019 ◽  
Vol 17 (2) ◽  
pp. 226-250 ◽  
Author(s):  
Praveer Sinha ◽  
Ravi Shankar ◽  
Prem Vrat ◽  
Shweta Mathur
Keyword(s):  
Value Chain ◽  
Power Distribution ◽  
Planning Process ◽  
Performance Indicator ◽  
Environmental Scanning ◽  
Success Factor ◽  
Strategy Formulation ◽  
Content Type ◽  
Limited Application ◽  
Sustainability Challenges

Purpose Distribution and retail supply of electricity is the most important cog in the power sector value chain. Despite several reforms, most of the Discoms are facing huge financial losses and resorting to a tariff hike which may not be a viable solution. The purpose of this paper is to analyze a case study of Tata Power Delhi Distribution Ltd (Tata Power-DDL) which inoculated itself against the financial ills, and demonstrates how a utility can nurture itself and manage the key stakeholder expectation with innovation, ethics, safety, transparency and agility being its cornerstone. Design/methodology/approach The study analyses the situation for Tata Power-DDL which needs to realign its strategy to meet emerging sustainability challenges. The case covers the aspect of strategic management, strategy formulation and change management system deployment using tools such as strength, weakness, opportunities, threat (SWOT), political economical social technological legal environment (PESTLE), critical success factor and key performance indicator cascade. It touches upon the emerging need for distribution utilities to look beyond economic signals and take social and environmental impacts into the strategy planning process. Findings It viewed the distribution business beyond its conventional responsibility of making power available to consumers and to provide quality service. A well thought out adaption and adoption of upgraded technology can be a game changer even for a market which is highly regulated and dominated by players in their respective defined territories. Research limitations/implications Since the sector is regulated and each utility has a pre-defined set of area of operation with no competition within its licensed area, hence, there is a limited application of applied strategy tools such as SWOT and PESTLE. Practical implications Since the sector is regulated and each utility has a pre-defined set of area of operation with no competition within its licensed area, hence, there is a limited application of applied strategy tools such as SWOT and PESTLE. Originality/value India as a market is evolving in energy space and utilities are still struggling to have a fundamental structure to meet the agenda of “power to all.” The paper provides the valuable insights into the process of environmental scanning and formulation of organizational strategy to meet the needs of existing and future energy markets.

Residents’ perception towards tourism impacts in Kashmir

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Asif Hamid Charag ◽  
Asif Iqbal Fazili ◽  
Irfan Bashir
Keyword(s):  
Planning Process ◽  
Economic Impacts ◽  
Tourism Development ◽  
Policy Framework ◽  
Social Implications ◽  
Cultural Economic ◽  
Tourism Impacts ◽  
Content Type ◽  
City Tourism ◽  
Significant Difference

Purpose The purpose of this study is to understand the residents’ perception towards environmental, social, cultural and economic impacts of tourism development in Kashmir. Design/methodology/approach The research instrument containing 27 items pertaining to six variables is adopted from the literature. A mix-method survey approach is used to solicit residents’ perceptions regarding environmental, social, cultural and economic impacts of the current level of tourism development. A total of 326 useful responses were subjected to descriptive statistics, analysis of variance (ANOVA) and post hoc analysis using SPSS (Version 22.0). Findings In general, the negative and positive impacts of tourism development are well perceived by the residents. The results indicate that the residents display positive perception regarding economic impacts, however, social and environmental impacts are negatively perceived. Furthermore, barring level of education, the study found no significant difference in the residents’ perception towards tourism impacts (environmental, social, cultural, economic, quality of life and cost of living). Research limitations/implications The paper identifies perceived impacts and issues of tourism development thereby, proposing possible mitigating measures. Also, the study identifies the need to develop a comprehensive policy framework addressing the issues related to the resident’s negative feelings towards tourism impacts. Further, the study envisages the need for engaging residents in developing a progressive and participatory planning process for future tourism activities in the area. Social implications The study offers critical social implications for city tourism development. It suggests a community-based approach should be adopted to sensitize residents about the positive benefits of tourism. Originality/value The study is a novel attempt concerning residents’ residents perceptual differences towards tourism impacts. Furthermore, this study investigated socio-cultural impacts of tourism under two separate categories for better understanding. in doing so, this study provides finer understanding of perception of residents towards tourism impacts in Indian context. The findings of the study will prove critical for different stakeholders in developing future tourism framework and policies in the region.

Extended and experimenting: library learning commons service strategy and sustainability

2016 ◽  
Vol 37 (4/5) ◽  
pp. 265-274 ◽  
Author(s):  
Jennifer Gunter King
Keyword(s):  
Planning Process ◽  
Academic Library ◽  
Historical Review ◽  
Academic Librarians ◽  
Content Type ◽  
Research Engagement ◽  
Learning Commons ◽  
Library Research ◽  
The Commons

Purpose – The purpose of this paper is to share a compelling example of a library’s willingness to develop and design itself as an open-ended process. Design/methodology/approach – The case study provides a historical review of the library’s founding design, and an overview of the process and approach to redesign. The study contextualizes the library within current academic library research and literature. Findings – This paper explores the research, engagement and planning process behind the library’s exploration of new models and service configurations. The project was an engaged, inclusive, transparent, library-led process. The commons reestablishes the library as the “nerve center” of the campus. Originality/value – The paper offers an update to a 1969 report, and later book by Robert Taylor on the Harold F. Johnson Library at Hampshire College, designed as a prototype of an academic library. This paper will be of value to academic librarians, administrators, and historians.

Minimizing supply chain disruption risk through enhanced flexibility

2009 ◽  
Vol 39 (5) ◽  
pp. 404-427 ◽  
Author(s):  
Joseph B. Skipper ◽  
Joe B. Hanna
Keyword(s):  
Supply Chain ◽  
Multiple Regression ◽  
Planning Process ◽  
Research Effort ◽  
Risk Exposure ◽  
Contingency Planning ◽  
Management Support ◽  
Supply Chain Disruption ◽  
Content Type ◽  
Disruption Risk

PurposeThe purpose of this paper is to examine the use of a strategic approach (contingency planning) to minimize risk exposure to a supply chain disruption. Specifically, the relationship between several attributes of a contingency planning process and flexibility are examined.Design/methodology/approachThis effort develops a model that will provide both researchers and practitioners a means of determining the attributes with the highest relationship to flexibility. The model is then tested using multiple regression techniques.FindingsBased on the sample used in this survey, top management support, resource alignment, information technology usage, and external collaboration provide the largest contributions to flexibility. Flexibility has been shown to enhance the ability to minimize risk exposure in the event of a supply chain disruption.Research limitations/implicationsIn this research effort, the multiple regression results produced an R2 of 0.45, indicating that additional variables of interest may need to be identified and investigated. Furthermore, a wider range of respondents could make the results more generalizable.Practical implicationsThis effort will help to allow managers at multiple levels to understand the primary planning attributes to use to increase flexibility.Originality/valueThe paper develops a model that can be used to identify the specific areas that can lead to improved flexibility. Based on the model, managers, and planners can develop appropriate strategies for minimizing risk exposure in the event of a supply chain disruption.

scholarly journals DETERMINING VALUE OF A CARDIOLOGY CLINIC VISIT

2021 ◽  
Vol 77 (18) ◽  
pp. 1656
Author(s):  
Tripti Gupta ◽  
Stephanie Madonis ◽  
Ivana Okor ◽  
Greg Desrosiers ◽  
Koyenum Obi ◽  
...  
Keyword(s):  
Clinic Visit ◽  
Cardiology Clinic

Abstract P273: Enhancing Documentation and Control of Lipids in a University-Based Cardiology Clinic

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Keerthana K Karumbaiah ◽  
Mazen B Omar ◽  
Bassam A Omar
Keyword(s):  
Clinic Visit ◽  
Lipid Profiles ◽  
Fasting State ◽  
Lipid Management ◽  
The Poor ◽  
Cardiology Clinic ◽  
Blood Pressures ◽  
Artery Disease ◽  
And Control ◽  
Risk Equivalent

Background: Non-compliance with laboratory appointments, separate from clinic visit appointments, for measuring fasting cholesterol may hinder documentation and control of patients’ lipids. Methods: A university-based cardiologist’s clinic notes, from a single year (yr 1), when patients were asked to have a fasting cholesterol a week prior to the clinic visit, were analyzed (100 patients). The poor compliance prompted a same day as the clinic visit measurement (fasting or non-fasting) of lipids, for patients who could not comply with their laboratory appointment, during the following year (yr 2; 130 patients). Lipid values were managed by a subsequent call to the patient. All patients had coronary artery disease or risk equivalent mandating LDL levels < 100 mg/dL. Results: In yr 1, 62% (62/100) of patients had documented lipid profiles compared to 83% (108/130) of patients in yr 2. The average LDL in yr 1 was 115 +/- 36 mg/dL compared with 96 +/- 31 mg/dL in yr 2 (P < 0.01). Only 22% of the patients in yr 1 reached goal of < 100 mg/dL, compared with 65% in yr 2. There were no significant differences in the HDL, TG levels or blood pressures documented during the concurrent visits. Conclusion: Better documentation and control of lipids may be obtained when lipid profiles are done on clinic visit day, with fewer burdens on the patients who cannot comply with a separate laboratory appointment. Although there were many non-fasting levels as a result, the triglyceride levels where not significantly different among the two groups, probably reflecting an overall more intensive lipid management in yr 2, commensurate with the better documentation. Therefore, as has been shown by others, a lipid profile does not necessarily have to be fasting, especially in patients being treated for stricter targets such as our cohort, which may decrease the burden on patients unable to comply with a fasting state or added clinic visits.

scholarly journals Lessons learned: intentional implementation of second makerspaces

2019 ◽  
Vol 47 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Heather Moorefield-Lang
Keyword(s):  
Design Methodology ◽  
Design Thinking ◽  
Planning Process ◽  
Research Participant ◽  
Lessons Learned ◽  
The Body ◽  
Planning Study ◽  
Content Type ◽  
Scholarly Publications ◽  
Study Results

Purpose What happens when a librarian outgrows their maker learning location or transfers to a new library? The purpose of this study is to explore the planning process for second and/or new library makerspaces. Is the planning more intentional? Is there more focus on how the makerspace should be put together for the community served? Is the community further involved? This study will explore those questions and more. Design/methodology/approach Using content analysis, the perspectives of practicing librarians in the achievement of subsequent makerspaces are examined. Data include librarian interviews, an analysis using NVivo 11 through the lens of design thinking, and a final review using member checking by each research participant. Findings Makerspaces continue to grow in popularity in school and public/community libraries. What is unexplored is the moving from a first makerspace to the implementation of a second and/or new maker learning location. More intentional planning is involved. The community served by the library is further engaged in the planning. Study results illustrate the value that community insight and intentional planning play in the design and implementation of makerspaces. Originality/value Makerspaces in libraries continue to grow in popularity; in turn, the body of peer-reviewed, scholarly publications also continues to grow. Librarians in the field are beginning to move from their first to second makerspaces. This study investigates those perspectives. Much can be gained from the experiences of those who have implemented their second or third makerspace.

Hospital discharge planning for Canadians experiencing homelessness

2018 ◽  
Vol 22 (1) ◽  
pp. 4-14 ◽  
Author(s):  
Kristy Buccieri ◽  
Abram Oudshoorn ◽  
Tyler Frederick ◽  
Rebecca Schiff ◽  
Alex Abramovich ◽  
...  
Keyword(s):  
Health Care ◽  
Hospital Discharge ◽  
Online Survey ◽  
Discharge Planning ◽  
Policy Recommendations ◽  
Content Type ◽  
Non Profit ◽  
Key Stakeholders ◽  
Communication Privacy ◽  
E Mail

Purpose People experiencing homelessness are high-users of hospital care in Canada. To better understand the scope of the issue, and how these patients are discharged from hospital, a national survey of key stakeholders was conducted in 2017. The paper aims to discuss this issue. Design/methodology/approach The Canadian Observatory on Homelessness distributed an online survey to their network of members through e-mail and social media. A sample of 660 stakeholders completed the mixed-methods survey, including those in health care, non-profit, government, law enforcement and academia. Findings Results indicate that hospitals and homelessness sector agencies often struggle to coordinate care. The result is that these patients are usually discharged to the streets or shelters and not into housing or housing with supports. The health care and homelessness sectors in Canada are currently structured in a way that hinders collaborative transfers of patient care. The three primary and inter-related gaps raised by survey participants were: communication, privacy and systems pressures. Research limitations/implications The findings are limited to those who voluntarily completed the survey and may indicate self-selection bias. Results are limited to professional stakeholders and do not reflect patient views. Practical implications Identifying systems gaps from the perspective of those who work within health care and homelessness sectors is important for supporting system reforms. Originality/value This survey was the first to collect nationwide stakeholder data on homelessness and hospital discharge in Canada. The findings help inform policy recommendations for more effective systems alignment within Canada and internationally.

scholarly journals The Relationship Between Discharge Planning and The Quality of Life of Patients with Diabetic Ulcer

2019 ◽  
Vol 4 (1) ◽  
pp. 20
Author(s):  
Candra Kusuma Negara ◽  
Abd Basid ◽  
Sri Erliani ◽  
Inaya Turahman
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Planning Process ◽  
Discharge Planning ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Ex Post ◽  
Ex Post Facto ◽  
Ex Post Facto Study

Introduction: Diabetic ulcer is one of the chronic complications of diabetes mellitus. Several studies in Indonesia reported that the mortality rate of gangrene ulcers in people with diabetes ranged from 17-32%, and diabetic ulcers affected the quality of life of sufferers. All patients hospitalized require discharge planning. From the explanation above, it can be concluded that Diabetes Mellitus is a degenerative disease that indeed requires hospitalization. The purpose of this study is to find out whether the Discharge planning process has a relationship with the quality of life of patients with Diabetic Ulcers. Methods: With the Ex post facto study design, 28 respondentwho were in accordance obtained measurements of discharge planning processes using interview methods and measurements on quality of life using the WHOQOL-BREEF questionnaire with spearman rank non parametric correlation analysis methods. Results: The results of the value are obtained: a = 0.05 with = rs table (0.707), RHO count (0.949)>rs table then categorized in the table Relationship Strengths correlation results obtained in this category is very strong / near perfect with the value 0.76- 1.00. Conclusions:This shows that there is a significant relationship with the strength of a very strong / near-perfect relationship according to the table.

Factors affecting strategic plan implementation using interpretive structural modeling (ISM)

2018 ◽  
Vol 31 (5) ◽  
pp. 406-414 ◽  
Author(s):  
Mohammadkarim Bahadori ◽  
Ehsan Teymourzadeh ◽  
Hamidreza Tajik ◽  
Ramin Ravangard ◽  
Mehdi Raadabadi ◽  
...  
Keyword(s):  
Strategic Planning ◽  
Planning Process ◽  
Strategic Plan ◽  
Structural Modeling ◽  
Interpretive Structural Modeling ◽  
Plan Implementation ◽  
Content Type ◽  
Factors Affecting ◽  
Strategic Planning Process ◽  
The Relationship

PurposeStrategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM).Design/methodology/approachThe authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM.FindingsFive main factors affected strategic plan implementation. Although all five variables and factors are top level, “senior manager awareness and participation in the strategic planning process” and “creating and maintaining team participation in the strategic planning process” had maximum drive power. “Organizational structure effects on the strategic planning process” and “Organizational culture effects on the strategic planning process” had maximum dependence power.Practical implicationsIdentifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers.Originality/valueThe authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

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