scholarly journals Identifying Service Gaps Between Patients and Providers in a Native American Outpatient Clinic

2021 ◽  
Author(s):  
Robert Dorsey ◽  
David Claudio ◽  
Maria A. Velazquez ◽  
Polly Petersen
Keyword(s):  
Native American ◽  
Health Services ◽  
Outpatient Clinic ◽  
Healthcare Services ◽  
Patient Expectations ◽  
Indian Reservation ◽  
Staff Members ◽  
Patient Interviews ◽  
Service Expectations ◽  
Level Satisfaction

Abstract Background: Native American communities in Montana reservations have reported low-level satisfaction in health services. This research explored if the services provided at a Blackfeet Indian Reservation outpatient clinic were designed to meet patient expectations. Methods: Staff and patient interviews and surveys allowed service expectations to be assessed according to the clinic’s ability to meet those expectations. A total of 48 patients and ten staff members (83% of the staff at this clinic) participated in the study voluntarily. Results: We found a disconnect between what patients anticipate for care and what staff think they are anticipating. We also found a discontent between what staff believes patients need versus what the patients feel is needed. Conclusions: These gaps combine to increase the breach between patient expectations and perceptions of their healthcare services. With better insight that captures what patients are looking for from a service, the potential to meet those needs increases and patients feel that their voice is respected and that they are valued.

scholarly journals Assessment of the e-health system in the Kaunas City Outpatient Clinic

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Kaseliene ◽  
L Blazeviciute ◽  
O Mesceriakova-Veliuliene
Keyword(s):  
Health Services ◽  
Health System ◽  
Outpatient Clinic ◽  
Medical Staff ◽  
Wide Spectrum ◽  
High Quality ◽  
Electronic Prescription ◽  
Quality Health Care ◽  
Staff Members ◽  
Structural Funds

Abstract Background The Lithuanian National Electronic Health (e-health) System was only launched in 2015. The aim of this study is to evaluate the e-health system in the Kaunas City Outpatient Clinic using a system of balanced performance indicators. Methodology The survey was carried out from October until December, 2018, at the Kaunas City Outpatient Clinic (Lithuania). The study included 264 medical staff members and 384 patients. Results 62% of the patients and 100% medical staff of the clinic used various e-health system services. The most often used services by the patients were SMS reminder (75.5%), online registration (70.8%) and electronic prescription (59.3%). The physicians took the most advantage of assigning electronic prescriptions (88.2%), filling the sickness certificates (78.9%), booking laboratory tests and receiving their results electronically (63.9%). Majority of the medical staff and patients stated that the e-health services are of high quality (77.6 and 89.5%, respectively), reliable (86 and 90.8%) and have a wide spectrum of services (75.3 and 93.7%). The most common problems that patients faced when using the e-health system services were the malfunctions and failures of the system (68.9%) or missing health data of the patient (59.7%). According to the medical staff, e-health system technologies do not cover the needs of employees in full extent (95.1%), also, the e-health system is still not completely reliable (97.7%). Only 56.7% specialists stated, that they have enough skills to work with the e-health system, 77.7% would like to improve their professional qualifications in this field. The Clinic used the funds of the institution, municipality or EU structural funds to develop the e-health system, update the computer equipment and software, and acquire licenses. Conclusions More efficient and effective e-health services and developing the capacity of the e-health usage are required to promote high-quality health care in Lithuania. Key messages Although majority of the patients and medical staff members use various e-health system services and are satisfied with their quality, there still are problems with the operation of the system. Specialists feel the lack of skills to work with the e-health system.

scholarly journals An evaluation of the provision of oncology rehabilitation services via telemedicine using a participatory design approach

2021 ◽  
Author(s):  
Grainne Brady ◽  
Kate Ashforth ◽  
Siobhan Cowan-Dickie ◽  
Sarah Dewhurst ◽  
Natalie Harris ◽  
...  
Keyword(s):  
Participatory Design ◽  
Healthcare Services ◽  
Patient Choice ◽  
Design Approach ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cancer Centre ◽  
Staff Members ◽  
Patient Interviews ◽  
Effective Delivery

Abstract Background The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. Purpose We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. Methods Experience-based co-design methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-min “trigger film”. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred. Staff and patients watched the trigger film and as partners, agreed areas for change and developed groups for service co-design. Results Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. Conclusion Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.

An Evaluation of the Provision of Oncology Rehabilitation Services via Telemedicine Using a Participatory Design Approach

2021 ◽  
Author(s):  
Grainne Carmel Brady ◽  
Kate Ashforth ◽  
Siobhan Cowan-Dickie ◽  
Sarah Dewhurst ◽  
Natalie Harris ◽  
...  
Keyword(s):  
Participatory Design ◽  
Healthcare Services ◽  
Patient Choice ◽  
Design Approach ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cancer Centre ◽  
Staff Members ◽  
Patient Interviews ◽  
Effective Delivery

Abstract Background The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. Purpose We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. Methods Experience based co-design (EBCD) methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received or delivered therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-minute summary video. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred, where staff could see the video and with patients as partners, agree areas for change and develop groups for service co-design. Results Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. Conclusion Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.

Utilization Of Healthcare Services To General Patient At Inpatient Unit of Anutapura General Hospital, Palu City

2020 ◽  
Vol 10 (1) ◽  
pp. 35-44
Author(s):  
Fausiah Fausiah
Keyword(s):  
Health Services ◽  
General Hospital ◽  
Health Beliefs ◽  
Secondary Data ◽  
Healthcare Services ◽  
Primary Data ◽  
Utilization Of Health Services ◽  
The People ◽  
Quantitative Descriptive ◽  
Utilization Of Healthcare

The number of inpatient visits in RSU Anutapura Palu, where in 2015 inpatient visits of 5,640, then in 2016 patient visits decreased to 5,451, in 2017 also decreased to 3,999 and in 2018 also decreased Drastic to 1,146 patient visits. This research aims to determine the utilization of health services in patients in general hospitalization in RSU Anutapura Palu. This type of research is quantitative descriptive. Research was conducted from May-June 2019. The population in the study is a visitor (number of hospitalizations) at the General Hospital (RSU) Anutapura Palu. In this case the people who use health services in the General Hospital (RSU) Anutapura Palu recorded as many as 1,146 visitors (patients) in the year 2018. Primary data collection is through questionnaires and secondary data through the study of patient record documents and other supporting documents. The utilization of health services in patients in general hospitalization in RSU Anutapura Palu is well from the aspects of health beliefs, abilities and needs. RSU Anutapura Palu is expected to be able to improve the promotion of health services so that people use the health services provided.  

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

scholarly journals Effect of the COVID-19 on perceptions of health, anticipated need for health services, and cost of healthcare

2021 ◽  
pp. 1-28
Author(s):  
Natalia Rekhter ◽  
Natalia Ermasova
Keyword(s):  
Health Services ◽  
Healthcare Services ◽  
Care Seeking ◽  
Financial Barriers ◽  
Health Concerns ◽  
Anova Test ◽  
Targeted Interventions ◽  
Early Stages ◽  
Care Seeking Behavior ◽  
Related Stress

Abstract Objective: This article investigates how perceived vulnerability to the COVID-19 pandemic at its early stages is associated with people’s perception of their health, the need for healthcare services, and expenses related to addressing the COVID-19 impact on their health. Methods: The results are based on the analysis of surveys that were distributed among members of 26 random Facebook groups in April-May, 2020. Perceived COVID-19 pandemic related stress and health concerns were examined by using the ANOVA test. Results: Among 315 respondents, 64% have experienced COVID-19 related stress and identified anxiety, headache, insomnia, and weight gain as their primary health concerns. The ANOVA test revealed that females are more impacted by the COVID-19 stress than males. Around 40% of respondents believed that the COVID-19 would lead to an increase in the cost of health services, and 20% of respondents anticipated that the COVID-19 pandemic would increase their need for health services. Conclusions: Learning about how people perceive the COVID-19 pandemic impact on their health, particularly in the pandemic’s early stages can allow health professionals to develop targeted interventions that can influence pandemic preventative behaviors among different population groups. This study can help understand utilization patterns and mitigate financial barriers that could interfere with patients’ care-seeking behavior.

scholarly journals Evaluation of e-health (Seha) application: a cross-sectional study in Saudi Arabia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abeer Alharbi ◽  
Joharah Alzuwaed ◽  
Hind Qasem
Keyword(s):  
Saudi Arabia ◽  
Health Services ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Advanced Technology ◽  
Sectional Study ◽  
Cross Sectional ◽  
Technical Problems ◽  
Significant Difference ◽  
Ease Of Access

Abstract Background The Ministry of Health in Saudi Arabia is expanding the country’s telemedicine services by using advanced technology in health services. In doing so, an e-health application (app), Seha, was introduced in 2018 that allows individuals to have face-to-face visual medical consultations with their doctors on their smartphones. Objective This study evaluated the effectiveness of the app in improving healthcare delivery by ensuring patient satisfaction with the care given, increasing access to care, and improving efficiency in the healthcare system. Methods A cross-sectional study design was used to assess the perceptions of users of the Seha app and non-users who continued with traditional health services. The data were collected using an online survey via Google Forms between June 2020 and September 2020. Independent t tests and chi-square (χ2) tests were conducted to answer the research questions. Results There was a significant difference between users and non-users in terms of ease of access to health services (t =  − 9.38, p < 0.05), with app users having a higher mean score (4.19 ± 0.91) than non-users (3.41 ± 1.00); satisfaction with health services (t =  − 6.33, p < 0.05), with users having a higher mean score (3.96 ± 0.91) than non-users (3.45 ± 0.94); and efficiency (only one visit needed for treatment) (t =  − 3.20, p < 0.05), with users having a higher mean score (3.71 ± 0.93) than non-users (3.45 ± 0.93). There were significant associations between the use of the Seha app and age (χ2 = 8.79, p < 0.05), gender (χ2 = 22.19, p < 0.05), region (χ2 = 19.74, p < 0.05), and occupation (χ2 = 22.05, p < 0.05). There were significant relationships between the three items (on access, satisfaction, and efficiency) and experiencing technical issues (t = 4.47, t = 8.11, and t = 3.24, respectively, p < 0.05), with users who faced technical problems having significantly lower mean scores for all three items. Conclusion This study provided evidence that the Seha app improved the delivery of healthcare in Saudi Arabia. Users of the app had a better health experience in terms of their perceived ease of access to healthcare services; their satisfaction with healthcare services; and the efficiency of the system, measured by the number of required doctor visits. Other factors that appeared to influence the use of the app included age, gender, usual source of care, and technical difficulties.

scholarly journals The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenelle M. Clarke ◽  
Justin Waring ◽  
Simon Bishop ◽  
Jean Hartley ◽  
Mark Exworthy ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Services ◽  
Mixed Methods Research ◽  
Political Skill ◽  
Group Processes ◽  
Healthcare Services ◽  
Narrative Synthesis ◽  
Five Dimensions ◽  
Individual Level ◽  
Health System Change

Abstract Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature. Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services. Results Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes. Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

Dating Violence, Sexual Assault, and Sexual Harassment Victimization Among Girls on an Indian Reservation: An Examination of Rates and Risk and Protective Factors

2021 ◽  
pp. 107780122110120
Author(s):  
Katie M. Edwards ◽  
Laura Siller ◽  
Damon Leader Charge ◽  
Simone Bordeaux ◽  
Leon Leader Charge
Keyword(s):  
High School ◽  
Native American ◽  
Sexual Assault ◽  
Sexual Harassment ◽  
Dating Violence ◽  
Regression Analyses ◽  
Indian Reservation ◽  
Middle School Girls ◽  
High School Girls ◽  
School Girls

We documented the scope and correlates of past 6-month victimization among middle and high school girls on an Indian Reservation. Participants were 102 Native American girls in Grades 6-12. Rates of all forms of past 6-month victimization were higher for high school girls compared with middle school girls. In regression analyses, binge drinking related to higher rates of sexual assault and sexual harassment. Furthermore, connection to culture related to lower rates of sexual harassment, and efficacy to resist a sexual assault was related to lower rates of sexual assault and sexual harassment.

Understanding Reproductive Health Services in Eastern Uttar Pradesh, India: A Dalit Feminist Approach

2021 ◽  
pp. 2455328X2110281
Author(s):  
Priti Chandra
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Participant Observation ◽  
Uttar Pradesh ◽  
Healthcare Services ◽  
Indian Society ◽  
Reproductive Health Services ◽  
Qualitative Research Design ◽  
Dalit Women ◽  
Eastern Uttar Pradesh

The identity of women cannot be seen in isolation but one that exists along with other constituents that intersects with class, race, sexuality and caste also. Being a woman, a person is already at periphery, adding caste to it makes more vulnerable. Thus, Dalit women are more subjugated in Indian society whether it is about leading a normal life or availing reproductive health services. This study primarily draws from a Dalit feminist perspective to understand the subjectivity and nuisances of the Dalit women who avail reproductive health services. While availing reproductive health services, the sort of discrimination the Dalit women face are denial in providing reproductive health services, creating and observing distance with the Dalit women by the health practitioners, and also promotion of privatization of healthcare services. The study is based on qualitative research design basically, participant observation, in which the total 27 married women were selected for the in-depth interview, among them 16 women were from the Dalit community and 9 women were from the so-called upper caste community. This research was conducted from February to April 2015 in Mau district of Eastern Uttar Pradesh, India.

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