scholarly journals Simulation of the Impact on the Workload of the Enlargement of the Clinical Staff of a Specialistic Reference Center

2021 ◽  
Author(s):  
Noemi Giordano ◽  
Samanta Rosati ◽  
Federica Valeri ◽  
Alessandra Borchiellini ◽  
Gabriella Balestra
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Standard Care ◽  
High Standard ◽  
Clinical Staff ◽  
Agent Based ◽  
Reference Center ◽  
The Impact ◽  
Staff Workload

Quality of care and patient satisfaction are important aspects of high standard care. If clinical staff is subject to an elevated workload there is a possible decrease of both. This justifies the development of tools to quantify the workload and to find organizational changes that will normalize it. We have previously developed a simulation system to quantify the workload of the staff working in a regional reference center for the treatment of bleeding and hemorrhagic disorders. The goal of this new work is to simulate, through an agent-based model, the impact of adding a physician to the staff. Ten sets of initial parameters were defined to simulate ten typical weeks. Results show that the introduction of the new physician together with a second ambulatory room can reduce the workload of all the staff to the expected 8-hour. In this situation, in which the staff workload does not exceed the daily capacity, we may suppose that an increase in the quality of care and patient satisfaction will be possible.

Perceptions of nurses on the impact of accreditation on quality of care

2014 ◽  
Vol 19 (2) ◽  
pp. 69-82 ◽  
Author(s):  
Ahmet Yildiz ◽  
Sidika Kaya
Keyword(s):  
Regression Analysis ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Positive Impact ◽  
Pearson Correlation ◽  
High Rate ◽  
Content Type ◽  
Independent Variables ◽  
The Impact

Purpose – This article aims to investigate perceptions of Turkish nurses on the impact of accreditation on quality of care and the effect of accreditation on quality results. Design/methodology/approach – This study was performed as a cross-sectional, questionnaire-based survey on 258 nurses who started working in the hospital before it was accredited and continued to work during and after accrediation and who therefore knew both the hospital's pre-accrediation and post-accreditation periods. In this study, descriptive statistical analyses (means and standard deviations) were carried out to explore the views of the participants on “quality results,” “benefits of accreditation” and “participation of employees.” “Quality results” was considered to be the dependent variable, while “benefits of accreditation” and “participation of employees” were accepted as the independent variables. The relationship between the dependent variable and the independent variables was tested using Pearson correlation and multiple regression analysis. External patient satisfaction data collected by the quality department of the hospital before and after accreditation were also investigated. Findings – It was found that nurses had generally high scores for the items concerning the benefits of accreditation. There was a statistically significant positive correlation between the dependent variable (quality results) and the independent variables (benefits of accreditation and participation of employees). Regression analysis indicated that R2=0.461 and the extent to which the independent variables explained the dependent variable was 46.1 per cent, which is a high rate. Patient satisfaction scores increased after accreditation. Practical implications – Our study suggest that providing support for nurses, especially nurses with administrative responsibilities and incorporating employees into the process are important for exercising quality standards. Originality/value – Hospital accreditation has a positive impact on quality results especially on quality of care provided to patients and patient satisfaction. Study findings could guide policy makers and hospital managers in Turkey and in other countries who are preparing or implementing accreditation.

scholarly journals Investigations of agent-based modelling for inpatient healthcare systems

2021 ◽  
Author(s):  
Amirkiarash Kiani
Keyword(s):  
Quality Of Care ◽  
Recovery Time ◽  
Well Being ◽  
Patient Acuity ◽  
Agent Based ◽  
Agent Based Modelling ◽  
Novel Approach ◽  
Research Plan ◽  
The Impact

The goal of this research was to investigate the possibility of using Agent-based Modelling, a novel approach in computerized simulation, to assess the effects of staff ratio on recovery time and to develop an empirical research plan based on an inpatient unit. By creating a virtual unit, the researcher was able to develop an adjustable model to test several scenarios based on empirical evidence; to comprehend the impact of changes to staff ratio and patient acuity on nurses’ workload and quality of care to patients. This investigation found that acuity indices of patients have no significant effect on available recovery time or the number of unperformed activities. On the contrary, nurse/patient ratio has substantial effects on both available recovery time and the number of unperformed activities; which asserts the significant effect of insufficient nurse staffing on the well-being of nurses as well as quality of care to patients.

scholarly journals The Effect of Ethiopia’s Community-Based Health Insurance Scheme on Revenues and Quality of Care

2020 ◽  
Vol 17 (22) ◽  
pp. 8558
Author(s):  
Zemzem Shigute ◽  
Anagaw D. Mebratie ◽  
Robert Sparrow ◽  
Getnet Alemu ◽  
Arjun S. Bedi
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
Access To Health Care ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Community Based Health Insurance ◽  
The Impact

Ethiopia’s Community-Based Health Insurance (CBHI) scheme was established with the objectives of enhancing access to health care, reducing out-of-pocket expenditure (OOP), mobilizing financial resources and enhancing the quality of health care. Previous analyses have shown that the scheme has enhanced health care access and led to reductions in OOP. This paper examines the impact of the scheme on health facility revenues and quality of care. This paper relies on a difference-in-differences approach applied to both panel and cross-section data. We find that CBHI-affiliated facilities experience a 111% increase in annual outpatient visits and annual revenues increase by 47%. Increased revenues are used to ameliorate drug shortages. These increases have translated into enhanced patient satisfaction. Patient satisfaction increased by 11 percentage points. Despite the increase in patient volume, there is no discernible increase in waiting time to see medical professionals. These results and the relatively high levels of CBHI enrollment suggest that the Ethiopian CBHI has been able to successfully negotiate the main stumbling block—that is, the poor quality of care—which has plagued similar CBHI schemes in Sub-Saharan Africa.

scholarly journals A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department

CJEM ◽  
2007 ◽  
Vol 9 (04) ◽  
pp. 286-295 ◽  
Author(s):  
Alix J.E. Carter ◽  
Alecs H. Chochinov
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Nurse Practitioners ◽  
Census Data ◽  
Medical Community ◽  
Wait Times ◽  
The Impact

ABSTRACT Introduction: US emergency personnel cared for 106% more patients in 1990 than they did in 1980, and national emergency department census data show that 60%–80% of those patients presented with non-urgent or minor medical problems. The hiring of nurse practitioners (NPs) is one proposed solution to the ongoing overcrowding and physician shortage facing emergency departments (EDs). Methods: We conducted a systematic review of MEDLINE and Cinahl to find articles that discussed NPs in the ED setting, looking specifically at 4 key outcome measures: wait times, patient satisfaction, quality of care and cost effectiveness. Results: Although some questions remain, a review of the literature suggests that NPs can reduce wait times for the ED, lead to high patient satisfaction and provide a quality of care equal to that of a mid-grade resident. Cost, when compared with resident physicians, is higher; however, data comparing to the hiring additional medical professionals is lacking. Conclusion: The medical community should further explore the use of NPs, particularly in fast track areas for high volume departments. In rural areas, NPs could supplement overextended physicians and allow health centres to remain open when they might otherwise have to close. These strategies could improve access to care and patient satisfaction for selected urban and rural populations as well as make the best use of limited medical resources.

scholarly journals Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review

2019 ◽  
Vol 69 (682) ◽  
pp. e294-e303 ◽  
Author(s):  
Poompong Sripa ◽  
Benedict Hayhoe ◽  
Priya Garg ◽  
Azeem Majeed ◽  
Geva Greenfield
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Outcomes ◽  
Direct Access ◽  
Cochrane Library ◽  
Patients With Cancer ◽  
The Impact

BackgroundGPs often act as gatekeepers, authorising patients’ access to specialty care. Gatekeeping is frequently perceived as lowering health service use and health expenditure. However, there is little evidence suggesting that gatekeeping is more beneficial than direct access in terms of patient- and health-related outcomes.AimTo establish the impact of GP gatekeeping on quality of care, health use and expenditure, and health outcomes and patient satisfaction.Design and settingA systematic review.MethodThe databases MEDLINE, PreMEDLINE, Embase, and the Cochrane Library were searched for relevant articles using a search strategy. Two authors independently screened search results and assessed the quality of studies.ResultsElectronic searches identified 4899 studies (after removing duplicates), of which 25 met the inclusion criteria. Gatekeeping was associated with better quality of care and appropriate referral for further hospital visits and investigation. However, one study reported unfavourable outcomes for patients with cancer under gatekeeping, and some concerns were raised about the accuracy of diagnoses made by gatekeepers. Gatekeeping resulted in fewer hospitalisations and use of specialist care, but inevitably was associated with more primary care visits. Patients were less satisfied with gatekeeping than direct-access systems.ConclusionGatekeeping was associated with lower healthcare use and expenditure, and better quality of care, but with lower patient satisfaction. Survival rate of patients with cancer in gatekeeping schemes was significantly lower than those in direct access, although primary care gatekeeping was not otherwise associated with delayed patient referral. The long-term outcomes of gatekeeping arrangements should be carefully studied before devising new gatekeeping policies.

scholarly journals Modeling the impact of hospital logistics on quality of care and patient satisfaction: Results of a survey in three public healthcare facilities in Fez, Morocco

2020 ◽  
Vol 13 (2) ◽  
pp. 296
Author(s):  
Youness Frichi ◽  
Fouad Jawab ◽  
Said Boutahari
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Large Scale ◽  
Scale Validation ◽  
Healthcare Facility ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
The Impact ◽  
Physical Accessibility

Purpose: The objective of this research is to examine the role of hospital logistics in improving quality of care and patient satisfaction. Thus, the paper focuses on modeling and evaluating the relationship between these three constructs.Design/methodology/approach: In the present study, hospital logistics was specified as a second-order construct composed of five first-order constructs: physical accessibility, waiting time, consultation time, hospital hotel services, and administrative procedures. A questionnaire was developed and administered face-to-face to 384 hospitalized patients in three public healthcare facilities in Fez-Morocco. Collected data were processed and analyzed deploying the PLS-SEM method and using SmartPLS3 software. Data analysis was carried out by considering two types of patient circuits according to the admission modes in the healthcare facility: Urgent Patients Circuit and Scheduled Patients Circuit. Thus, two PLS-SEM models were evaluated and validated.Findings: Results highlighted the significant impact of hospital logistics on quality and satisfaction. In particular, the results of the two models showed that the most preponderant hospital logistics component is physical accessibility which consists of the availability and accessibility of ambulances, medical and nursing staff, support and guidance staff, technical facilities and equipment, etc. Thus, hospital managers and health system stakeholders should pay particular attention to hospital logistics activities in general and specifically to the physical accessibility to improve the quality of care and patient satisfaction.Research limitations/implications: This study only included patients from three public healthcare facilities in Fez-Morocco. Also, the model variables of hospital logistics construct are restricted and were applied in a specific context. Besides, the sample size was relatively reduced. Thus, results generalization might be limited. Further studies including more patients from other territories and including other logistics components are needed for large-scale validation of the proposed model. Originality/value: The results of this study contribute to the scientific literature on hospital logistics and its role as a lever for quality of care and patient satisfaction.

scholarly journals Measuring the Impact of Academic Cancer Network Development on Clinical Integration, Quality of Care, and Patient Satisfaction

2018 ◽  
Vol 14 (12) ◽  
pp. e823-e833 ◽  
Author(s):  
Anne C. Chiang ◽  
Jessica Lake ◽  
Naralys Sinanis ◽  
Debra Brandt ◽  
Jane Kanowitz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Clinical Care ◽  
Care Center ◽  
Tumor Board ◽  
Clinical Trial Accrual ◽  
Oncology Practice ◽  
The Impact

Purpose: Many US academic centers have acquired community practices to expand their clinical care and research footprint. The objective of this assessment was to determine whether the acquisition and integration of community oncology practices by Yale/Smilow Cancer Hospital improved outcomes in quality of care, disease team integration, clinical trial accrual, and patient satisfaction at network practice sites. Methods: We evaluated quality of care by testing the hypothesis that core Quality Oncology Practice Initiative measures at network sites that were acquired in 2012 were significantly different after their 2016 integration into the network. Clinical and research integration were measured using the number of tumor board case presentations and total accruals in clinical trials. We used Press-Ganey scores to measure patient satisfaction pre- and postintegration. Results: Mean Quality Oncology Practice Initiative scores at Smilow Care Centers were significantly higher in 2016 than in 2012 for core measures related to improvement in tumor staging ( z = 1.33; P < .05), signed consent and documentation plans for antineoplastic treatment ( z = 2.69; P < .01; and z = 2.36; P < .05, respectively), and appropriately quantifying and addressing pain during office visits ( z = 2.95; P < .05; and z = 3.1; P < .01, respectively). A total of 493 cases were presented by care center physicians at the tumor board in 2017 compared with 45 presented in 2013. Compared with 2012, Smilow Care Center clinical trial accrual increased from 25 to 170 patients in 2017. Last, patient satisfaction has remained at greater than the 90th percentile pre- and postintegration. Conclusion: The process of integration facilitates the ability to standardize cancer practice and provides a platform for quality improvement.

scholarly journals The Impact of Performance Enhancement on Value of Care in Hospitals

2021 ◽  
Vol 9 ◽  
Author(s):  
Peter Bertke ◽  
Martin Nufer
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Economies Of Scale ◽  
Performance Enhancement ◽  
Positive Impact ◽  
High Patient Satisfaction ◽  
Delivery Of Care ◽  
Scientific World ◽  
The Impact

Hospitals are facing big challenges: decreasing reimbursements are going alongside increasing costs and the necessity of investments. At the same time occurring, excellent quality of care, and high-patient satisfaction have to be assured. The dilemma of providing both with decreasing rather than increasing resources cannot be solved only by striving for economies of scale, but by optimizing supply chain management, or reduction of overhead. Possible effects of these measures most often are already exhausted and seldom have a positive impact on the quality of care or patient satisfaction. Management is tempted to use its best-known instruments to reduce costs, while medical staff's focus is on quality of care and often battle against management as a perceived enemy. The solution to this dilemma lies in focusing on medical core processes that are directly linked to patients' treatments and, thereby improving all the parameters of Michael Porter's value equation: costs, outcome, and patient satisfaction. This approach of performance enhancement presumes understanding, acceptance, and constructive collaboration of two usually separated worlds: The medical-scientific world involved in patient care and the financial world of management. In this article, the authors explain performance enhancement for optimized delivery of care and how the dilemma mentioned above can be solved. The authors explain how performance enhancement can be achieved in daily clinical practice, which kind of obstacles have to be overcome, which changes are necessary within a hospital, how medical staff can be motivated, and how the value of care equation can be influenced.

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