scholarly journals Hospital resilience after the 2015 earthquake in Nepal: results from semi-structured interviews with hospital staff

2020 ◽  
Author(s):  
Maria Moitinho de Almeida ◽  
Joris Adriaan Frank van Loenhout ◽  
Sunil Singh Thapa ◽  
KC Kumar ◽  
Deepak Prakash Mahara ◽  
...  
Keyword(s):  
Real Life ◽  
Hospital Staff ◽  
University Teaching ◽  
Standards Of Care ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Disaster Plan ◽  
Individual Resilience ◽  
Hospital Systems

Abstract Background “Safe and resilient hospitals” are increasingly recognized as a cornerstone of disaster reduction in global policies such as the Sendai Framework for Action. However, current hospital resilience frameworks emerged from pre-disaster conceptualizations, and have not been verified in real-life disaster contexts nor in the frontlines. Our aim was to study a tertiary hospital’s resilience after the 2015 earthquake in Nepal, as experienced by its staff. Methods We undertook a qualitative study in the Tribhuvan University Teaching Hospital (TUTH), where we conducted 18 semi-structured interviews with hospital staff. We inductively created themes to describe the earthquake burden to the hospital, and to analyze individual resilience of hospital staff. In addition, we deductively documented the resilience of the hospital as a system, according to the system resilience dimensions: means of resilience (redundancy and resourcefulness), and ends of resilience (robustness and rapidity).Results TUTH faced material challenges, as well as challenges to healthcare provision, to management and coordination, and to hospital staff. In terms of robustness, TUTH increased its capacity for earthquake victims as elective activities were temporarily interrupted and quality of care was not a priority. Three stages of rapidity were identified: critical rapidity to address immediate needs, stabilizing rapidity until the hospital re-started routine activities, and recovery rapidity. In addition to the disaster plan, emerging adaptations played a major role in redundancy and resourcefulness. We found that individual resilience depended on three determinants: safety, meaningfulness, and sense of belonging.Conclusions Hospital resilience results from a complexity of emerging and planned adaptations, as well as from interdependencies with individual resilience. Ensuring workforce safety and sense of meaning directly contributes to hospital systems-level resilience. Hospitals should establish and test disaster plans and strategies to alter standards of care, while being flexible to emerging adaptations.

scholarly journals Hospital Resilience After the 2015 Earthquake in Nepal: Results From Semi-structured Interviews With Hospital Staff

2021 ◽  
Vol 9 ◽  
Author(s):  
Maria Moitinho de Almeida ◽  
Joris Adriaan Frank van Loenhout ◽  
Sunil Singh Thapa ◽  
K. C. Kumar ◽  
Deepak Prakash Mahara ◽  
...  
Keyword(s):  
Disaster Response ◽  
Real Life ◽  
Well Being ◽  
Hospital Staff ◽  
University Teaching ◽  
Structured Interviews ◽  
Disaster Plan ◽  
Individual Resilience ◽  
Improve Hospital

Background: Resilient hospitals are increasingly recognized as a cornerstone of disaster reduction in global policies such as the Sendai Framework for Action. However, current hospital resilience frameworks emerged from pre-disaster conceptualizations, and have not been verified in real-life disaster contexts nor in the frontlines. Our aim was to study a tertiary hospital's resilience after the 2015 earthquake in Nepal, as experienced by its staff.Methods: We undertook a qualitative study in the Tribhuvan University Teaching Hospital (TUTH), where we conducted 18 semi-structured interviews with hospital staff. We inductively created themes to describe the earthquake burden to the hospital, and to analyze individual resilience of hospital staff. In addition, we deductively documented the resilience of the hospital as a system, according to the system resilience dimensions: means of resilience (redundancy and resourcefulness), and ends of resilience (robustness and rapidity).Results: In terms of robustness, TUTH increased its capacity for earthquake victims as elective activities were temporarily interrupted and quality of care was not a priority. Three stages of rapidity were identified: critical rapidity to address immediate needs, stabilizing rapidity until the hospital re-started routine activities, and recovery rapidity. In addition to the disaster plan, emerging adaptations played a major role in redundancy and resourcefulness. We found that individual resilience depended on three determinants: safety, meaningfulness, and sense of belonging.Conclusions: Hospital resilience results from a complexity of emerging and planned adaptations, as well as from interdependencies with individual resilience. Frameworks and plans to improve hospital resilience must reflect flexibility of response, and a concern for well-being of hospital staff is central for sustainable disaster response and improved resilience.

The Effects of Second Life on the Motivation of EFL Student Teachers

2019 ◽  
pp. 86-114 ◽  
Author(s):  
Galip Kartal ◽  
Cem Balçıkanlı
Keyword(s):  
Student Teachers ◽  
Second Life ◽  
Virtual World ◽  
Teaching And Learning ◽  
Real Life ◽  
Structured Interviews ◽  
Group Interviews ◽  
Free Environment

This study aimed at investigating the effects of using a virtual world, Second Life (SL), on the motivation of Turkish EFL student teachers. First, a 10-week real-life task syllabus was designed and conducted in SL. Focus-group interviews were utilized to enhance the quality of the tasks. Then, the effects of SL on motivation were tracked via qualitative research tools, namely semi-structured interviews, weekly evaluation forms, and observations. The findings showed that SL was effective in increasing motivation of the participating student teachers. The characteristics of the virtual world that were reported to have an effect on motivation were as follows: natural environment, realistic places, anxiety-free environment, excitement, and visual support. This chapter provides possibilities for those who are interested in employing virtual world technologies in foreign/second language teaching and learning and finally describes an investigation into the role of the virtual world in relation to affordances such technologies present across the globe.

scholarly journals A Performance-Centred Competency-Based Approach to Quality University Teaching

2019 ◽  
Vol 23 (3) ◽  
pp. 350-365
Author(s):  
Magda Francisca Cejas Martínez ◽  
Derling Jose Mendoza Velazco ◽  
Mercedes Navarro Cejas ◽  
José Lenin Rogel Villacis ◽  
Yanet Marisol Ortega Freire
Keyword(s):  
Higher Education ◽  
University Teaching ◽  
Structured Interviews ◽  
University Professors ◽  
Teacher Formation ◽  
Quality Of Higher Education ◽  
Working Environments ◽  
Flexible Working ◽  
Competency Based

Introduction. In order to encourage more flexible working environments and establish generators of sustainable development for participating countries through an educated society, various international organisations that intervene in the quality dimension within the framework of a systemic approach to Higher Education, including the World Bank, have made multiple efforts to establish various recognitions, certifications and credits pertaining to competency-based education. Materials and Methods. The research, featuring a study of theoretical-interpretative design, was based around the qualitative paradigm. Information was obtained by means of semi-structured interviews with 14 lecturers from different universities in the city of Quito in Ecuador. The data obtained were triangulated with a review of the literature carried out by the researchers. Results. The informants considered cognitive competencies to be the most relevant within the context of teacher formation. Research, planning and organisation skills were not established in importance due to university professionalisation. Additionally, the need to establish curricular changes in the Ecuadorian university pedagogy was confirmed. Discussion and Conclusion. After contrasting the opinions of university professors and formation theories, a theoretical reflection is presented in which the importance of unifying professional formation and investigative competencies is emphasised. This unification allows the quality of higher education centred around the teacher as the main actor to be increased.

scholarly journals Hospital resilience after the 2015 earthquake in Nepal: a qualitative study with hospital staff

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Moitinho de Almeida ◽  
J van Loenhout ◽  
R Singh ◽  
D P Mahara ◽  
D Guha-Sapir ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Health Workers ◽  
Early Stage ◽  
Community Support ◽  
Hospital Staff ◽  
Task Shifting ◽  
Structured Interviews ◽  
Basic Care ◽  
Individual Resilience ◽  
Life Saving

Abstract Background Research on hospital resilience is scarce and favours top-down approaches, and evidence from the field and operational levels is lacking. The aim of our study was to understand the mechanisms of hospital and individual resilience experienced by staff from a tertiary hospital in Kathmandu, Nepal, after the 2015 Earthquake. Methods We conducted semi-structured interviews with different professionals in May 2018; undertook a deductive thematic analysis of hospital resilience using the framework proposed by Bruneau et al; and used an inductive thematic analysis for individual resilience. Results The earthquake caused different types of burden to the hospital and individuals. Redundancy was mostly influenced by linkages with lower levels of care. Resourcefulness consisted mostly of spontaneous adaptations, with task shifting the most important for human resources. External provision of resources enabled the transfer of part of the burden but precipitated accountability-related challenges. The hospital's robustness depended not only on its physical resistance, but also on the functional capacity to provide life saving care, although routine services were interrupted and quality decreased. The hospital ensured rapidity in providing life saving care to the victims and re-start of routine activities, but recovery to a sense of normality was more conflicting and dependent on the individual. Individual resilience was dictated by safety, a sense of meaningfulness, self and external appreciation, and community support. Conclusions Our study shows the importance of staff experiences to improve hospital resilience. Disaster plans should acknowledge the role of task shifting, and basic care should be taught to all, not just those with clinical functions. Health workers are extremely overwhelmed during disaster response, and disaster plans should engage staff at an early stage to ensure they feel safe and sufficiently supported. Key messages Our work is one of the first to study hospital resilience with field data from qualitative interviews with hospital staff. Hospital resilience strategies should also address individual resilience of hospital staff.

Quality of Life for Patients Detained in Hospital

1993 ◽  
Vol 162 (5) ◽  
pp. 611-620 ◽  
Author(s):  
Jeremy W. Coid
Keyword(s):  
Quality Of Life ◽  
Health Care Professionals ◽  
Hospital Staff ◽  
Poor Quality ◽  
Standards Of Care ◽  
Future Research ◽  
High Quality ◽  
Legal Principles ◽  
The Uk

The quality of life of detained patients has not received adequate attention despite the responsibilities placed on hospital staff and the special problems faced by these patients. Legal principles to ensure quality of life have not been formalised, and the acceptable standards that a patient can expect have not been tested in the UK courts. Contemporary models of ensuring quality are being imposed with increasing pressure on health care professionals, but high-quality management has sometimes lagged behind. This has led to a poor quality of life for certain patients. It is important for future research to overcome difficulties in developing objective measurements and set the appropriate standards of quality of life that detained patients should expect. This would provide a basis against which both appropriate standards of care and the necessary resource allocation could be measured.

scholarly journals Process redesign for time-based emergency admission targets

2016 ◽  
Vol 30 (6) ◽  
pp. 939-949 ◽  
Author(s):  
Sandra G. Leggat ◽  
Richard Gough ◽  
Timothy Bartram ◽  
Pauline Stanton ◽  
Greg J. Bamber ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Management Practices ◽  
Emergency Admission ◽  
Hospital Staff ◽  
Positive Outcome ◽  
Structured Interviews ◽  
Content Type ◽  
Process Redesign ◽  
The Impact

Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010. Non-probability sampling identified interview subjects who, through their participation in the redesign initiative, had a detailed understanding of the implementation and outcomes of the initiative. Between April 2012 and January 2013 26 in-depth semi-structured interviews were conducted and analysed with thematic content analysis. Findings There were four important findings. First, when asked to comment on the impact of the LSS implementation, without prompting the staff spoke of quality of care. Second, there was little agreement among the participants as to whether the project had been successful. Third, despite the recognition of the need for a coordinated effort across the hospital to improve ED access, the redesign process was not successful in reducing existing divides among clinicians and among managers and clinicians. Finally, staff expressed tension between production processes to move patients more quickly and their duty of care to their patients as individuals. Originality/value One of the first studies to explore the impact of process redesign through in-depth interviews with participating staff, this study adds further evidence that organisations implementing process redesign must ensure the supporting management practices are in place.

scholarly journals Protecting Women’s and Newborns’ Rights in a Public Maternity Unit During the COVID-19 Outbreak: The Case of Dra. Eloísa Díaz - La Florida Hospital in Santiago, Chile

2021 ◽  
Vol 6 ◽  
Author(s):  
Gonzalo Leiva ◽  
Michelle Sadler ◽  
Camila López ◽  
Susana Quezada ◽  
Víctor Flores ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Negative Impact ◽  
Standards Of Care ◽  
Obstetric Outcomes ◽  
Structured Interviews ◽  
Health Crisis ◽  
Skin Contact ◽  
Significant Negative Impact ◽  
La Florida

The Maternity in Dra. Eloísa Díaz’ hospital, located in the municipality of La Florida and city of Santiago, Chile, opened its doors in 2014, and has integrated a humanistic model of care called the “Safe Model of Personalized Childbirth” since 2016. With around 3,000 births per year, it has been recognized as an example of excellence in maternity care in the country. The COVID-19 outbreak presented a big challenge to this Maternity: to maintain its quality of care standards despite the health crisis. This article presents the Maternity’s responses to the pandemic from March to July 2020, describing the strategies that were deployed and the obstetric outcomes achieved. Semi-structured interviews with midwives and OB-GYNs, and a retrospective review of the childbirth standards of care and outcomes of the 55 women who tested positive for SARS-CoV-2, were carried out. The results show how the Maternity's staff responded in order to avoid a significant negative impact on the rights of women and newborns. Protocols to reestablish the companion during labor and childbirth and skin-to-skin contact, which were suspended for almost three weeks at the beginning of the outbreak, and the creation of an Instagram account to communicate with the external community were some of the measures taken. After some initial weeks of adjustment, the standards of care for all women, included for those diagnosed with COVID-19, were reestablished almost to pre-pandemic levels. This case shows that quality of care can be maintained and the rights of women and newborns can be respected during health crisis such as the COVID-19 pandemic.

Qualitative assessment of equipment failure cause finding and removal

2018 ◽  
pp. 116-126
Author(s):  
E. A. Vakulin ◽  
A. I. Zayats ◽  
V. A. Beklemeshev ◽  
V. A. Ivashkevich ◽  
V. A. Khazhiev ◽  
...  
Keyword(s):  
Production Condition ◽  
Real Life ◽  
Open Pit Mine ◽  
Qualitative Assessment ◽  
Open Pit ◽  
Quality Level ◽  
Equipment Failure ◽  
Operation Conditions ◽  
Failure Investigation

Investigation of failures is one of the critical activities of mining and haulage equipment operability assurance in mining. Maintaining failure investigation at the required quality level, it is possible to identify provisions, rules and procedures that should be revised or changed, operation conditions that should be improved, additional personnel training, if required, etc. Investigation of failures in mines is under responsibility of machine men and electricians of maintenance and operation services. In reality, factory management and setup for production condition weak concernment of these workers in quality investigation aimed at finding of sources of equipment failures. This article describes real-life results achieved in development and use of maintenance service operation, technology and management monitoring. The requirements are substantiated for quality improvement in failure cause finding and removal in mining and haulage equipment at Chernogorsky open pit mine, SUEK-Khakassia. Causes of the present quality of failure investigation by machine men of Chernogorsky Repair and Engineering Works and Chernogorsky open pit mine are revealed. The proposed recommended practices will improve quality of mining and haulage equipment failure investigation.

The Relationship between the Development of Human Capital and the Agricultural Economy in Rural Areas

2020 ◽  
pp. 61-65
Author(s):  
B.A. Voronin ◽  
◽  
I.P. Chupina ◽  
Ya.V. Voronina ◽  
◽  
...  
Keyword(s):  
Human Capital ◽  
Rural Areas ◽  
Agricultural Production ◽  
Agricultural Sector ◽  
Real Life ◽  
Standard View ◽  
Household Factors ◽  
Economic Transformations ◽  
The Relationship

The article discusses a non-standard view of the formation of human capital for work in organizations of the agricultural sector of the economy, in the context of modern socio-economic transformations. In the classical sense, human capital for agriculture should be formed and developed in rural areas. But in real life, this is not always the case, because there are many factors that prevent the classical solution of this problem. First, the demographic factor affects, second, social and household factors, and third, in many rural areas there are no working agricultural organizations where qualified agricultural specialists can work. All these and other circumstances actualize the problem of the quality of human capital in rural areas in relation to the development of agricultural production.

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