scholarly journals Optimisation of maintenance in delivery systems for cytostatic medicines

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
María Carmen Carnero ◽  
Andrés Gómez
Keyword(s):  
Health Care ◽  
Preventive Maintenance ◽  
Delivery Systems ◽  
Spare Parts ◽  
Care Staff ◽  
Human Beings ◽  
The Real ◽  
Maintenance Policies ◽  
Decision Group

Abstract Background The real-world application of maintenance in organisations brings together a number of maintenance policies in order to achieve the desired availability, efficiency and profitability. However, the literature mostly chooses a single maintenance policy, and so the decision process is not suited to the real conditions in the company to which it is applied. Our study takes a combination of maintenance policies as alternatives, and so conforms to the actual practice of maintenance in organisations. Furthermore, it introduces the possibility of including extra spare parts, or outsourcing maintenance policies. Although the selection of maintenance policies has been applied to many kinds of business and of machine, there is almost no instance of its application to hospitals, and it has never been applied to delivery systems for cytostatic drugs. Methods The model uses the fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), which is recognised as being highly suitable for solving group decision-making problems in a fuzzy environment. Fuzzy set theory is also considered to be more proficient than crisp numbers for handling the ambiguity, imprecisions, data scarcity, and uncertainty inherent in decisions made by human beings. The judgements required were obtained from a decision group comprising the heads of facilities maintenance, maintenance of medical equipment, health and safety at work, environment, and programming-admission. The group also included care staff; specifically, the heads of the main clinical services, and the medical supervisors. The model includes original criteria, such as Quality of health care, which measures impact on care as a function of mean availability of each alternative. It also considers Impact on hospital management via the criteria: Working environment in the organisation and Impact on health care; the former criterion measures equality among care services in the hospital, while the latter assesses the effect on regional health cover. The model was built using real data obtained from a state hospital in Spain. The model can also be easily applied to other national and international healthcare organisations, providing weights specific to the criteria. These are produced by a decision group from each healthcare organisation and the alternatives are updated in accordance with what is considered important in each hospital. Results The results obtained from the model recommend changing the alternative that is currently in use, Corrective and Preventive Maintenance, to Corrective and Preventive Maintenance plus two spare hoods. This alternative would lead to an availability of 1 (the highest possible) in the systems for preparing personalised cytotoxic drugs, and so the quality of service is therefore very high. Additionally, it could offer services to all the users of the hospital, and also offer cover in the preparation of cytotoxic medicines to other hospitals in the catchment area. Conclusions The results suggest the possibility that improvements to the support and logistical systems, which include maintenance, traditionally held to have no effect on quality of care, may be key to improving care quality, but also in reducing risk to patients, care and non-care staff, and the environment.

Factors influencing the quality of care learning disabled patients receive in hospital

2020 ◽  
Vol 25 (2) ◽  
pp. 83-92
Author(s):  
Alice Durrant
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Quality Of Care ◽  
General Hospital ◽  
Learning Disabled ◽  
Care Staff ◽  
Content Type ◽  
Increased Risk ◽  
Disabled Patients

Purpose In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care. Design/methodology/approach A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital. Findings The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff. Originality/value Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.

scholarly journals Physician perceptions of the types of roles interpreters play in limited English proficient pediatric encounters and how they evaluate the quality of interpretation

2019 ◽  
Vol 20 ◽  
Author(s):  
Rebecca J. Schwei ◽  
Natalie Guerrero ◽  
Alissa L. Small ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Limited English Proficient ◽  
Health Care Systems ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Team Members ◽  
Medical Interpreters ◽  
Care Systems

AbstractPurposeThe purpose of this study is to understand different roles that interpreters play in a pediatric, limited English proficient (LEP) health care encounter and to describe what factors within each role inform physicians’ assessment of the overall quality of interpretation.BackgroundLanguage barriers contribute to lower quality of care in LEP pediatric patients compared to their English-speaking counterparts. Use of professional medical interpreters has been shown to improve communication and decrease medical errors in pediatric LEP patients. In addition, in many pediatric encounters, interpreters take on roles beyond that of a pure language conduit.MethodsWe conducted 11 semi-structured interviews with pediatricians and family medicine physicians in one health system. Transcripts were audio-recorded and transcribed verbatim. We analyzed our data using directed content analysis. Two study team members coded all transcripts, reviewed agreement, and resolved discrepancies.FindingsPhysicians described four different interpreter roles: language conduit, flow manager, relationship builder, and cultural insider. Within each role, physicians described components of quality that informed their assessment of the overall quality of interpretation during a pediatric encounter. We found that for many physicians, a high-quality interpreted encounter involves multiple roles beyond language transmission. It is important for health care systems to understand how health care staff conceptualize these relationships so that they can develop appropriate expectations and trainings for medical interpreters in order to improve health outcomes in pediatric LEP patients.

Burn-in and Maintenance Policies

1994 ◽  
Vol 26 (1) ◽  
pp. 207-221 ◽  
Author(s):  
Jie Mi
Keyword(s):  
Preventive Maintenance ◽  
Minimal Repair ◽  
Maintenance And Repair ◽  
Cost Structures ◽  
Related Cost ◽  
Optimal Maintenance ◽  
Maintenance Policies ◽  
Quality Of Products ◽  
Age Replacement

Burn-in is a widely used method to improve quality of products after they have been produced. For a repairable component there are two common types of repair, complete repair and minimal repair. Preventive maintenance policies such as age replacement and block replacement are often employed in field operation. The present paper takes burn-in, maintenance and repair into consideration at the same time and considers related cost structures. The properties of the corresponding optimal burn-in times and optimal maintenance policies are discussed.

scholarly journals Quality of life of elders in the primary health care in Uberaba, MG

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Giovanna Gaudenci Nardelli ◽  
Eliana Maria Gaudenci ◽  
Rodrigo Eurípedes Da Silveira ◽  
Álvaro da Silva Santos ◽  
Camila Cristina Neves Romanato Ribeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Social Impact ◽  
Linear Regression Analysis ◽  
Sexual Life ◽  
Human Beings ◽  
Primary Health

This study aimed to evaluate social and economic predictors, as well social behavior and its influence on the quality of life of elders who use the primary health care network of Uberaba, Minas Gerais. Methods: Descriptive, exploratory, cross-sectional and quantitative study, conducted with 248 60 year old or older subjects, from November 2016 to May 2017. A structured questionnaire was applied to evaluate sociodemographic data, health conditions and life habits as well the WHOQOL-Bref and the WHOQOL-Old. The analysis were conducted through relative frequencies and t-test as well multiple linear regression were used to associate variables. The study was approved by the Committee of Ethics in Researches with Human Beings of the Federal University of the Triângulo Mineiro (CEP/UFTM). Results: Most elders were women, catholic, with 4 years or more of formal education, had partners, a sexually inactive life, and were retired. The linear regression analysis, found a positive and light or moderate association between sexual life and the physical, social, and environmental domains, and the past, present and future activities facet. The educational level variable had a positive and light association with the psychological domain, whereas the variable occupation had a negative and light association with the death and dying facet. Conclusions: The results found show an important social impact regarding the studied population, making it clear that public policies should be created and executed as to offer subsidies for actions which are specifically targeted at the QoL of elders.

Benchmarking of the Maintenance Service in Health Care Organizations

2017 ◽  
pp. 1-25
Author(s):  
María Carmen Carnero
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Health Care Organization ◽  
Care Quality ◽  
Care Staff ◽  
Care Organization ◽  
Analytic Hierarchy ◽  
Maintenance Service ◽  
Hierarchy Process

The support services of health care organizations, such as maintenance, have not traditionally been considered important from the perspective of care quality. Nevertheless, the degree of excellence in maintenance significantly influences availability, maintenance costs and safety of facilities, medical equipment, patients and care staff. Thus, it would be of great importance for health care organizations to apply benchmarking to their maintenance processes, as do other processing companies, in order to determine the quality of maintenance provided, and compare it to other, similar, organizations. This would also allow all the continuous improvement processes to be controlled, and actions for radical improvement to be carried out by comparing performance with that of companies in other sectors. This chapter describes a multicriteria model integrating a fuzzy Analytic Hierarchy Process with utility theory to obtain a valuation for the Maintenance Service of a Health Care Organization over time.

Burn-in and Maintenance Policies

1994 ◽  
Vol 26 (01) ◽  
pp. 207-221 ◽  
Author(s):  
Jie Mi
Keyword(s):  
Preventive Maintenance ◽  
Minimal Repair ◽  
Maintenance And Repair ◽  
Cost Structures ◽  
Related Cost ◽  
Optimal Maintenance ◽  
Maintenance Policies ◽  
Quality Of Products ◽  
Age Replacement

Burn-in is a widely used method to improve quality of products after they have been produced. For a repairable component there are two common types of repair, complete repair and minimal repair. Preventive maintenance policies such as age replacement and block replacement are often employed in field operation. The present paper takes burn-in, maintenance and repair into consideration at the same time and considers related cost structures. The properties of the corresponding optimal burn-in times and optimal maintenance policies are discussed.

scholarly journals Current developments in delivering customized care: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Etienne Minvielle ◽  
Aude Fourcade ◽  
Thomas Ricketts ◽  
Mathias Waelli
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Scoping Review ◽  
Care Delivery ◽  
Patient Characteristics ◽  
Delivery Systems ◽  
Segmentation Analysis ◽  
Health Care Delivery Systems

Abstract Background In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. Methods Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included “care customization”, “personalized service and health care”, individualized care” and “targeting population” in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. Results We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. Conclusions There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.

scholarly journals Experiences of Older Persons in Seeking Care at a Private Hospital in Urban India

2020 ◽  
Vol 6 ◽  
pp. 233372142091063
Author(s):  
Sachin Ganorkar ◽  
Zarina Nahar Kabir ◽  
Nasreen Rustomfram ◽  
Harshad Thakur
Keyword(s):  
Health Care ◽  
Older Persons ◽  
Private Hospital ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Urban India ◽  
Complex Health Problems ◽  
Payment Mechanisms

Objective: The study aims to describe the experiences of older persons in seeking health care in a private hospital in urban India. Methods: Semi-structured interviews were conducted with 50 older persons admitted in or visiting a private hospital in Hyderabad city in India between the period November 2017 and April 2018. The data were analyzed using Content Analysis. Results: Dimensions related to payment mechanisms, quality of health care staff, and hospital quality were reported to be important for the older persons. Payment mechanisms were related to discounts, insurance support, and reducing out-of-pocket expenditure. Quality of care was related to optimizing hospital operational processes like discharge time, standard of treatment, and trustworthiness of the medical staff. Discussion: Payment mechanism can be made friendly for the older persons. Quality of hospital including its staff can be enhanced by developing geriatric-specific competencies which can help them to understand and treat complex health problems specific for the older population.

scholarly journals Mindfulness for Healthcare Professionals

2020 ◽  
Vol 12 (1) ◽  
pp. 33
Author(s):  
Mita Mistry
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Potential Role ◽  
Working Environment ◽  
Good News ◽  
Care Staff ◽  
Health Care Staff ◽  
Number Of Patients ◽  
Reducing Stress

Heavy demands on health care staff include dealing with a large number of patients, long hours, restricted control over the working environment and ongoing organisational changes. Such conditions have been directly associated with growing stress levels and symptoms of burnout amongst health care professionals, and consequently, affecting the quality of care delivered to patients. 1 The good news is that this is now increasingly recognised and is indeed a catalyst for change in the development of awareness aimed at building self-care skills for clinicians. In particular, there is a growing body of evidence in Mindfulness-based interventions, which have a potential role in reducing stress and burnout.

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