scholarly journals Psychiatric Crisis Management in the Emergency Care Hospital Network

2015 ◽  
Vol 25 (60) ◽  
pp. 95-104 ◽  
Author(s):  
Magda Diniz Bezerra Dimenstein ◽  
Viktor Gruska ◽  
Jader Ferreira Leite
Keyword(s):  
Emergency Services ◽  
Psychosocial Care ◽  
Public Hospitals ◽  
Care Hospital ◽  
Structured Interviews ◽  
Work Processes ◽  
Local Hospital ◽  
Chemical Restraint ◽  
Psychiatric Crisis ◽  
Psychiatric Conditions

Since psychiatric crisis treatment is crucial in mental health care, this study aimed to characterize the psychiatric crisis in the hospital emergency services of Natal/RN. Semi-structured interviews were conducted with 33 professionals employed in four local public hospitals. The results revealed the absence of adequate beds for psychiatric conditions, scarcity of psychiatric drugs, lack of clarity regarding diagnostic criteria, treatment based on chemical restraint and inpatient care as a priority strategy. Furthermore, there is fragmentation of the work processes with physician centrality in the management of crisis, disarticulation between hospitals and other services of the psychosocial care network and systematic referrals to psychiatric hospital. We conclude that the configuration of the local hospital network does not present satisfactory responsiveness to psychiatric crisis situations and its clinical and institutional weaknesses reflect the process of psychiatric reform in the region.

scholarly journals A Qualitative Study on Concerns, Needs, and Expectations of Hospital Patients Related to Climate Change: Arguments for a Patient-Centered Adaptation

2021 ◽  
Vol 18 (11) ◽  
pp. 6105
Author(s):  
Benedikt Lenzer ◽  
Christina Hoffmann ◽  
Peter Hoffmann ◽  
Ursula Müller-Werdan ◽  
Manuel Rupprecht ◽  
...  
Keyword(s):  
Climate Change ◽  
Climate Change Adaptation ◽  
Tertiary Care ◽  
Climatic Conditions ◽  
Care Hospital ◽  
Structured Interviews ◽  
Work Processes ◽  
Patient Centered ◽  
Hospital Patients ◽  
Centered Care

This study explores the concerns, needs, and expectations of inpatients with the goal to develop a patient-centered climate change adaptation agenda for hospitals. Statements of patients from geriatrics, internal medicine, psychiatry, and surgery (N = 25) of a German tertiary care hospital were analyzed using semi-structured interviews and the framework method. Areas of future adaptation were elaborated in joint discussions with transdisciplinary experts. Concerns included the foresight of severe health problems. The requested adaptations comprised the change to a patient-centered care, infrastructural improvements including air conditioning, and adjustments of the workflows. Guidelines for the behavior of patients and medical services appropriate for the climatic conditions were demanded. The patient-centered agenda for adaptation includes the steps of partnering with patients, reinforcing heat mitigation, better education for patients and medical staff, and adjusting work processes. This is the first study demonstrating that hospital patients are gravely concerned and expect adjustments according to climate change. Since heat is seen as a major risk by interviewees, the fast implementation of published recommendations is crucial. By synthesizing inpatients’ expectations with scientific recommendations, we encourage patient-centered climate change adaptation. This can be the start for further collaboration with patients to create climate change resilient hospitals.

scholarly journals Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  
Keyword(s):  
Health Workers ◽  
Positive Impact ◽  
Qualitative Evaluation ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Future Research ◽  
Care Seeking ◽  
Structured Interviews ◽  
The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

Clinician and healthcare managers’ perspectives on the delivery of secondary and tertiary pediatric weight management services

2021 ◽  
pp. 136749352110521
Author(s):  
Jennifer Cohen ◽  
Shirley Alexander ◽  
Christina Signorelli ◽  
Kathryn Williams ◽  
Kyra A Sim ◽  
...  
Keyword(s):  
Weight Management ◽  
Holistic Approach ◽  
Models Of Care ◽  
Public Hospitals ◽  
High Risk Population ◽  
Management Service ◽  
Structured Interviews ◽  
Optimal Care ◽  
Pediatric Weight Management ◽  
Management Services

Clinician and healthcare managers' (HCMs) views on weight management service delivery are imperative for informing the nature of future services to treat children with obesity. This qualitative study used semi-structured focus groups and one-on-one semi-structured interviews. Participants were 27 clinicians (medical, nursing, or allied health) and nine HCMs (senior executives in the hospital) who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. Clinicians reported that using a combination of group and individual sessions improved engagement with families and reduced attrition rates. Clinicians and HCMs recommended integrating clinics into community centers and providing specific programs for sub-groups, such as children from culturally and linguistically diverse communities or children with developmental delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. To improve the likelihood of future funding for pediatric weight management clinics and to optimize models of care, centers must embed research into their practice. Addressing common barriers to current pediatric weight management services and designing future models of care based on key stakeholders’ preferences is critical to achieving optimal care provision for this high-risk population.

scholarly journals Violence against children and adolescents: the perspective of Primary Health Care

2017 ◽  
Vol 70 (3) ◽  
pp. 511-518 ◽  
Author(s):  
Diene Monique Carlos ◽  
Elisabete Matallo Marchesini de Pádua ◽  
Maria das Graças Carvalho Ferriani
Keyword(s):  
Health Care ◽  
Qualitative Research ◽  
Children And Adolescents ◽  
Structured Interviews ◽  
Work Processes ◽  
Violence Against Children ◽  
Primary Health ◽  
Agents Of Change ◽  
The Look ◽  
Basic Health Units

ABSTRACT Objective: To analyze the care provided by Basic Health Units (BHU) to families involved in domestic intrafamily violence against children and adolescents. Method: Qualitative research, based on the Paradigm of Complexity. Data collection was performed with 41 professionals through focus groups and semi-structured interviews. Results: The following categories emerged from data analysis: 'Everything comes here', which reflects the legitimate place of BHUs for the population and the actions taken to build care for families; and 'We only do what is really necessary', which brings the look to violence still based on the positivist and biomedical paradigm. Final considerations: The model of understanding and construction of work processes in the BHU is structured in the aforementioned paradigm. Nurses have the possibility to become agents of change, both in professionals' training and in the care thought and provided to communities.

scholarly journals Waiting time in public hospitals: case study of total joint replacement in Hong Kong

2018 ◽  
Vol 21 (2) ◽  
pp. 120-133 ◽  
Author(s):  
Yee-man Tsui ◽  
Ben Y.F. Fong
Keyword(s):  
Hong Kong ◽  
Waiting Time ◽  
Joint Replacement ◽  
Process Management ◽  
Emergency Services ◽  
Total Joint Replacement ◽  
Care Quality ◽  
Public Hospitals ◽  
Content Type

Purpose The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives. Design/methodology/approach The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study. Findings The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed. Originality/value The ‬over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.

scholarly journals Nurses and the collective care practices within the family health strategy: salud de la familia

2011 ◽  
Vol 19 (3) ◽  
pp. 581-588 ◽  
Author(s):  
Cinira Magali Fortuna ◽  
Silvia Matumoto ◽  
Maria José Bistafa Pereira ◽  
Silvana Martins Mishima ◽  
Lauren Suemi Kawata ◽  
...  
Keyword(s):  
Traditional Approach ◽  
Family Health ◽  
Collective Actions ◽  
Structured Interviews ◽  
Work Processes ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy ◽  
Care Practices ◽  
Analyze Data

This qualitative study identifies and analyzes the practices of nurses regarding collective care interventions in the context of the Family Health Strategy (FHS) and its knowledge development. Semi-structured interviews were held with nurses working in the FHS and thematic analysis was used to analyze data. The theoretical framework was based on the theories of institutional analysis and work processes. The results are arranged into two main themes: Conceptions that support collective care practices and Practices of nurses in collective care. The conclusion is that nurses actively participate both in proposing, coordinating, performing and monitoring these collective actions, though they are still predominantly guided by the traditional approach to health in general and specifically to health education.

scholarly journals Institutional care for children and adolescents that use drugs

2021 ◽  
Vol 38 ◽  
Author(s):  
Julia Corrêa GOMES ◽  
Fernanda Kimie Tavares MISHIMA-GOMES ◽  
Clarissa Mendonça CORRADI-WEBSTER
Keyword(s):  
Children And Adolescents ◽  
Thematic Analysis ◽  
Social Vulnerability ◽  
Participant Observation ◽  
Institutional Care ◽  
Psychosocial Care ◽  
Care Providers ◽  
Structured Interviews ◽  
Specific Population ◽  
A Current

Abstract The literature highlights the existence of weaknesses in the psychosocial care network, especially in the treatment of children and adolescents that use drugs. The study aimed to comprehend, based on the Winnicottian theoretical framework, how a Residential Care Unit has been providing care to children and adolescents with needs arising from drugs use in situations of social vulnerability. Semi-structured interviews, with eight care providers, and 65 hours of participant observation were carried out. From the thematic analysis, three themes were constructed: (1) Setting: regarding attention to basic needs and construction of a routine; (2) View: regarding empathy and expansion of perspectives; (3) Aggressiveness: regarding new ways of relating. Important actions are aimed at constructing care for this specific population, as this is a current theme with recent and weakly structured public policies.

scholarly journals Connecting home and hospital life : cultural influence in child life practice

2021 ◽  
Author(s):  
Jennifer E Butterly
Keyword(s):  
Large City ◽  
Psychosocial Care ◽  
Cultural Influence ◽  
Child Life ◽  
Structured Interviews ◽  
Child Life Specialists ◽  
Culturally Responsive Practices ◽  
Resource Needs ◽  
Barriers And Challenges ◽  
The Individual

The changing demographics of illness necessitate the provision of complex care practices designed to meet the individual needs of families from diverse backgrounds. Providing psychosocial care to paediatric patients, child life specialists integrate processes designed to better understand their patients, thus informing their plans of care. Through the use of Grounded Theory, this study involves 7 child life specialists from a large city in Ontario and explores the processes implemented by child life specialists in getting to know their patients and families. Data obtained from semi-structured interviews and a reflective journaling exercise was examined for evidence of cultural influence and a greater understanding of child life specialists' perceived comfort and ability was explored. The results of this study suggest child life specialists engage in culturally responsive practices, however several barriers and challenges exist. Resource needs are identified and implications for practice are examined.

scholarly journals Identifying executive challenges of performance-based payment from medical and educational hospitals managers’ perspective and offering solutions in Isfahan (2018)

2019 ◽  
Author(s):  
Alireza Jabbari ◽  
Nasrin Shaarbafchi Zadeh ◽  
Behrooz Maddahian
Keyword(s):  
Financial Incentives ◽  
Service Providers ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Educational Support ◽  
The Public ◽  
Health Service Providers ◽  
Research Population ◽  
Information And Communication ◽  
Correct Implementation

Introduction: Performance-based payment is a payment model that attempts to reward the measured dimensions of performance and encourages health service providers to achieve predetermined goals by financial incentives. This study aimed to identify executive challenges of performance-based payment from medical and educational hospitals managers’ perspective and offering solutions in Isfahan 2018. Methods: This study was a qualitative study. Semi structured interviews were used to collect data. The research population was 11 people (the managers of educational and medical hospitals in Isfahan) who were selected purposefully. All interviews were recorded and then written on a paper. The duration of the interviews varied between 45 to 60 minutes. The data were analyzed using MAXQDA120 software and based on thematic analysis. Results: In this study, , regarding executive challenges, seven themes and fifteen sub-themes were obtained, including the weakness of the performance-based payment project, weakness in education and educational support, low employee participation, weakness of information and communication technology, weakness of laws and regulations, unfavorable economic conditions of the public sector, and special conditions governing public hospitals.   Conclusion: performance-based payment, if implemented correctly, can lead to the improvement of quantitative and qualitative indicators related to employees’ performance. Correct implementation requires identifying challenges and obstacles and then corrective actions. This study was able to identify and present some of the operational challenges of the performance-based payment from the viewpoint of hospital managers.

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