scholarly journals A STUDY OF EFFICIENCY MANAGEMENT IN NEW ZEALAND PUBLIC HOSPITAL SERVICES

2021 ◽  
Author(s):  
◽  
Ajit Manorai Arulambalam
Keyword(s):  
New Zealand ◽  
Performance Improvement ◽  
Public Hospital ◽  
Qualitative Data ◽  
Public Hospitals ◽  
Service Improvement ◽  
Hospital Service ◽  
Performance Information ◽  
Management Information ◽  
Service Managers

<p>There is increasing policy interest in ensuring that resources are used efficiently within New Zealand public hospitals which are under increasing constraint. This thesis presents a narrative based on a qualitative analysis of the impact of the regular provision of efficiency management information on manager behaviour and achievements based on a single exploratory case study research of 11 senior service managers in New Zealand’s largest public hospital. How performance information is currently used by service managers is unknown. The research questions seek to understand to what extent managers’ use the information, what behaviours and actions result, if these managers know what they need to learn to improve performance, and what barriers impede their actions.  A qualitative research design was used to collect data from hospital service managers over a six month period. A model for a three stage information response was re-developed from existing processes and applied to the service managers who all received the hospital’s routine monthly performance information; while some participants also received specific efficiency related information. In each of the months, the participant’s perceptions of the performance information and the management of service improvement was obtained. The methodological approach is inductive using both observational and ethnographic approaches to collect qualitative data from regular surveys and interviews with participants. The findings appear to show enhanced collaboration in performance improvement discussions by managers who are provided with the specific performance information than is seen in those managers provided with the routine hospital management information. The enhanced collaboration appears to lead to greater improvements in service efficiency. The qualitative data provides a rich supplementary database of the participant managers’ experience of using performance management information, and from applying a formal Thematic Analysis (TA), management themes are identified to define the experience of the hospital service managers in using performance information. The TA provides a deeper understanding of the use of performance information by hospital service managers. The four themes were identified as: (1) direct leadership, (2) operational feedback; (3) performance signal; and (4) management development. These provide contextual meaning to purposeful management response and performance improvement.</p>

scholarly journals A STUDY OF EFFICIENCY MANAGEMENT IN NEW ZEALAND PUBLIC HOSPITAL SERVICES

2021 ◽  
Author(s):  
◽  
Ajit Manorai Arulambalam
Keyword(s):  
New Zealand ◽  
Performance Improvement ◽  
Public Hospital ◽  
Qualitative Data ◽  
Public Hospitals ◽  
Service Improvement ◽  
Hospital Service ◽  
Performance Information ◽  
Management Information ◽  
Service Managers

<p>There is increasing policy interest in ensuring that resources are used efficiently within New Zealand public hospitals which are under increasing constraint. This thesis presents a narrative based on a qualitative analysis of the impact of the regular provision of efficiency management information on manager behaviour and achievements based on a single exploratory case study research of 11 senior service managers in New Zealand’s largest public hospital. How performance information is currently used by service managers is unknown. The research questions seek to understand to what extent managers’ use the information, what behaviours and actions result, if these managers know what they need to learn to improve performance, and what barriers impede their actions.  A qualitative research design was used to collect data from hospital service managers over a six month period. A model for a three stage information response was re-developed from existing processes and applied to the service managers who all received the hospital’s routine monthly performance information; while some participants also received specific efficiency related information. In each of the months, the participant’s perceptions of the performance information and the management of service improvement was obtained. The methodological approach is inductive using both observational and ethnographic approaches to collect qualitative data from regular surveys and interviews with participants. The findings appear to show enhanced collaboration in performance improvement discussions by managers who are provided with the specific performance information than is seen in those managers provided with the routine hospital management information. The enhanced collaboration appears to lead to greater improvements in service efficiency. The qualitative data provides a rich supplementary database of the participant managers’ experience of using performance management information, and from applying a formal Thematic Analysis (TA), management themes are identified to define the experience of the hospital service managers in using performance information. The TA provides a deeper understanding of the use of performance information by hospital service managers. The four themes were identified as: (1) direct leadership, (2) operational feedback; (3) performance signal; and (4) management development. These provide contextual meaning to purposeful management response and performance improvement.</p>

The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Louisa Walsh ◽  
Nerida Hyett ◽  
Jayne Howley ◽  
Nicole Juniper ◽  
Chi Li ◽  
...  
Keyword(s):  
Social Media ◽  
Quality Improvement ◽  
Patient Experience ◽  
Public Hospital ◽  
Service Providers ◽  
Service Design ◽  
Public Hospitals ◽  
Hospital Service ◽  
Consumer Engagement ◽  
Risks And Benefits

Abstract Background Engaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders’ experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use. Methods Semi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study. Results Twenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1) overcoming barriers to engagement, 2) consumer-initiated engagement; 3) breadth vs depth of engagement, 4) organisational transparency vs control and 5) users causing harm. Conclusions Social media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.

Survey of Electronic Health Record (EHR) Systems in Kenyan Public Hospitals: A mixed-methods survey (Preprint)

2018 ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Mike English ◽  
Hamish Fraser ◽  
...  
Keyword(s):  
Management Information System ◽  
Health Management ◽  
Public Hospitals ◽  
Health Management Information System ◽  
Adoption Process ◽  
Management Information ◽  
Health Records ◽  
Hospital Administrators ◽  
Ehr Adoption ◽  
Electronic Health

BACKGROUND As healthcare facilities in Low- and Middle-Income Countries (LMICs) such as Kenya adopt Electronic Health Record (EHR) systems to improve hospital administration and patient care, it is important to understand the adoption process, identify the key stakeholders, and assess the capabilities of the systems in use. OBJECTIVE To describe the level of adoption of Electronic Health Records systems in public hospitals and understand the process of adoption from Health Management Information System (HMIS) system vendors and system users. METHODS We conducted a survey of County Health Records Information Officers (CHRIOs) in Kenya to determine the level of adoption of Electronic Health Records systems in public hospitals. We conducted site visits to hospitals to view systems in use and to interview hospital administrators and end users. We also interviewed Health Management Information System (HMIS) system vendors to understand the adoption process from their perspective. RESULTS From the survey of CHRIOs, all facilities mentioned had adopted some form of EHR. Hospitals commonly purchased systems for patient administration and hospital billing functions. Radiology and laboratory management systems were commonly standalone systems. There were varying levels of interoperability within facilities that had more than one system in operation. We only saw one in-patient EHR system in use although many vendors and hospital administrators we interviewed were planning to adopt or support such systems. From the user perspective, issues such as system usability, adequate training, availability of adequate infrastructure and system support emerged. From the vendor perspective, a wide range of services was available to the hospital though constrained by funding and the need to computerise service areas that were deemed as priority. Additionally, vendors were unable to implement some data sharing modules linking to national HMIS due to lack of appropriate policies to facilitate this and users’ lack of confidence in new technologies such as cloud services. CONCLUSIONS EHR adoption in Kenya has been underway for some years, particularly in comprehensive care clinics, and hospitals are increasing purchasing systems to support administrative functions. Considerable support from government, donors and regional health informatics organisations will be required to enable hospitals to move to full EHR adoption for in-patient care.

scholarly journals Needs of psychopedagogical training for the care of children with chronic disease: perceptions of hospital nursing

2015 ◽  
Vol 49 (1) ◽  
pp. 37-43
Author(s):  
Maria Rosa Rosselló ◽  
Begoña De la Iglesia ◽  
Berta Paz-Lourido ◽  
Sebastià Verger
Keyword(s):  
Family Support ◽  
Public Hospital ◽  
Qualitative Data ◽  
Emotional State ◽  
Training Needs ◽  
Balearic Islands ◽  
Pediatric Nurses ◽  
Interdisciplinary Work ◽  
Hospital Nursing ◽  
Quantitative Results

OBJECTIVE To identify the psychopedagogical training needs of the pediatric nurses in the largest public hospital of the Balearic Islands, Spain. METHOD This study was developed with a quantitative and qualitative design, where 78 nurses (97.5% of the service) answered a questionnaire, and 15 participated in interviews that were analyzed via content analysis. RESULTS The quantitative results show gaps in the knowledge and psychopedagogical skills of the staff. These aspects could facilitate the development of tasks tailored to the personality and the psychoevolutional time of children with chronic diseases, as well as to the emotional state of families. The qualitative data was organized into four categories: family support; hospital and education; psychopedagogical training and difficulties in practice. The little communication between nurses and teachers is evident. CONCLUSION The data reinforces the need to implement training strategies and interdisciplinary work among health professionals, educators and families.

Researching moral distress among New Zealand nurses

2014 ◽  
Vol 22 (1) ◽  
pp. 117-130 ◽  
Author(s):  
Martin Woods ◽  
Vivien Rodgers ◽  
Andy Towers ◽  
Steven La Grow
Keyword(s):  
New Zealand ◽  
Nurse Educators ◽  
Moral Distress ◽  
Response Rate ◽  
Ethical Considerations ◽  
Optimal Care ◽  
Adequate Response ◽  
Human Ethics ◽  
Distress Scale ◽  
Service Managers

Background: Moral distress has been described as a major problem for the nursing profession, and in recent years, a considerable amount of research has been undertaken to examine its causes and effects. However, few research projects have been performed that examined the moral distress of an entire nation’s nurses, as this particular study does. Aim/objective: The purpose of this study was to determine the frequency and intensity of moral distress experienced by registered nurses in New Zealand. Research design: The research involved the use of a mainly quantitative approach supported by a slightly modified version of a survey based on the Moral Distress Scale–Revised. Participants and research context: In total, 1500 questionnaires were sent out at random to nurses working in general areas around New Zealand and 412 were returned, giving an adequate response rate of 27%. Ethical considerations: The project was evaluated and judged to be low risk and recorded as such on 22 February 2011 via the auspices of the Massey University Human Ethics Committee. Findings: Results indicate that the most frequent situations to cause nursing distress were (a) having to provide less than optimal care due to management decisions, (b) seeing patient care suffer due to lack of provider continuity and (c) working with others who are less than competent. The most distressing experiences resulted from (a) working with others who are unsafe or incompetent, (b) witnessing diminished care due to poor communication and (c) watching patients suffer due to a lack of provider continuity. Of the respondents, 48% reported having considered leaving their position due to the moral distress. Conclusion: The results imply that moral distress in nursing remains a highly significant and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.

National quality improvement indicators project: an initial descriptive study

2021 ◽  
pp. 0310057X2110278
Author(s):  
Daniel P Ramsay ◽  
Phillip Quinn ◽  
Veronica Gin ◽  
Timothy D Starkie ◽  
Robert A Fry ◽  
...  
Keyword(s):  
Quality Improvement ◽  
New Zealand ◽  
Respiratory Distress ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Public Hospitals ◽  
Nausea And Vomiting ◽  
Post Anaesthesia Care Unit ◽  
National Quality ◽  
Anaesthesia Care

Background Anaesthesia Quality Improvement New Zealand developed a set of five quality improvement indicators pertaining to postoperative nausea and vomiting, pain, respiratory distress, hypothermia and a prolonged post-anaesthesia care unit stay. This study sought to assess the proportion of eligible institutions that were able to measure and provide data on these indicators, produce an initial national estimate of these, and a measure of variability in the quality improvement indicators across hospitals in New Zealand. Methods All public hospitals that provide a representative to Anaesthesia Quality Improvement New Zealand were eligible for inclusion. Participating institutions were required to provide the number and proportion of patients with each of the five quality improvement indicators over a continuous 2-week period between 1 June 2019 and 25 October 2019. The overall percentage of patients and the median percentage with each outcome were calculated. Results A total of 79.2% of eligible hospitals participated. The median incidence of the indicators ranged from 1.67% for respiratory distress to 6.31% for prolonged post-anaesthesia care unit stay. The indicator with the largest interquartile range was hypothermia and the smallest was respiratory distress (13.48 and 2.29, respectively). A large variation was seen for prolonged post-anaesthesia care unit stay, hypothermia, pain and postoperative nausea and vomiting. Conclusion The majority of eligible institutions were able to measure and provide data on the quality improvement indicators. There was a low rate of respiratory distress with low variability. A large amount of variability was observed in the other indicators. Future studies are needed to explore the nature of this variability.

scholarly journals Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Lakshmi Rajeswaran ◽  
Valerie J. Ehlers
Keyword(s):  
Traffic Accident ◽  
Qualitative Data ◽  
Nurse Managers ◽  
Road Traffic ◽  
Public Hospitals ◽  
Staff Members ◽  
Nursing Experience ◽  
Hospital Units ◽  
Cardio Pulmonary Resuscitation ◽  
Medical Emergencies

Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources. The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana’s hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years’ nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts.Die slagoffers van padongelukke, asook persone wat hart- en ander mediese noodtoestande ervaar, kan hulle lewens verloor omdat daar nie opgeleide personeel met funksionele toerusting en voldoende hulpbronne beskikbaar is om effektiewe kardiopulmonale resussitasie (KPR) te doen nie. Die studie het ten doel gehad om eenheidsbestuurders se persepsies te bepaal oor uitdagings wat hulle in die gesig staan wanneer KPR-tussentredes plaasvind in die twee openbare hospitale in Botswana wat as verwysingshospitale dien. Die bevindings kan gebruik word om effektiewer KPR-strategieë vir Botswana se hospitale aan te beveel. Onderhoude bestaande uit twee kwantitatiewe afdelings met geslote vrae en een kwalitatiewe afdeling met semi-gestruktureerde vrae is met 22 eenheidsbestuurders gevoer. Die kwantitatiewe data het aangedui dat alle eenheidsbestuurders minstens agt jaar se verpleegervaring het en dat hulle die tekortkomings sover dit KPR in hulle hospitale aangaan, kon identifiseer. Slegs een persoon het nog nooit KPR toegepas nie. Die ontleding van die kwalitatiewe data dui daarop dat hospitaaleenhede soms te min personeel het en dat hulle nie ten volle toegeruste noodtrollies en/of toerusting het nie. Geen KPR-spanne en geen KPR-beleid of -riglyne bestaan nie. Verpleegkundiges en dokters het volgens die onderhoude ‘n gebrek aan KPR-kennis en -vaardighede. Geen ontlontingsdienste is na KPR-voorvalle vir die personeel beskikbaar nie. Die deelnemende hospitale behoort die uitdagings aan te spreek wat KPR-uitkomste kan beinvloed. Hierdie uitdagings sluit in personeeltekorte, oorbesetting in hospitaaleenhede, tekortkomings in die noodtrollies en toerusting, die gebrek aan KPR-beleid en -riglyne, die afwesigheid van KPR-spanne, dokters en verpleegsters se beperkte KPR-vaardighede en die feit dat ontlontingsdienste nie na KPR-pogings vir personeellede beskikbaar is nie.

scholarly journals Longitudinal Evaluation on the Operation Index Applied to Public Hospitals in Pudong New District of Shanghai, China

2018 ◽  
Vol 55 ◽  
pp. 004695801879059
Author(s):  
Shanshan Liu ◽  
Jiaoling Huang ◽  
Yanting Li ◽  
Jincheng Fan ◽  
Hong Liang ◽  
...  
Keyword(s):  
Financial Risk ◽  
Public Hospital ◽  
Risk Index ◽  
Condition Index ◽  
Public Hospitals ◽  
Operating Index ◽  
The Public ◽  
Management Condition ◽  
Service Operation ◽  
Public Hospital Reform

The public hospital reform has lasted 5 years in China; however, the operation development status and trends of public hospitals have not been systematically evaluated in Pudong New District. We first applied the technology of longitudinal index to assess the development of public hospitals there. The quantitative data were mainly gathered by taking health statistics database from 2009 to 2014. The results showed that overall operating index presented a down-up trend, with the highest point in 2014 and the lowest point in 2012. Overall operating index, development foundation index, and management condition index were found to be statistically different ( P = .010, P = .016, P = .031) in different years, whereas the service operation index and financial risk index were not so ( P = .543, P = .228). Moreover, the results demonstrated that no obvious difference was observed in the overall operating index between the general and specialized hospitals ( P = .327), which was the same in the 4 first-class indexes. However, there were statistical differences in the overall operating index and development foundation index among these 5 years ( P = .018, P = .036), but none in the service operation index, management condition index, and financial risk index ( P = .503, P = .062, P = .177). No interaction effects were discovered between year and hospital categories in the current study ( P = .673, P = .375, P = .885, P = .152, P = .288).

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