scholarly journals Lean Management: organizational innovations in hematological Day-Hospitals

ABOUTOPEN ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. 62-69
Author(s):  
Caterina Bianciardi ◽  
Jacopo Guercini
Keyword(s):  
Health Care ◽  
Case Studies ◽  
Central Italy ◽  
Health Care Facilities ◽  
Health Care Environment ◽  
Lean Thinking ◽  
Care Environment ◽  
Day Hospitals ◽  
Poor Management

Background. Lean Thinking is a management method which, despite its industrial origins, has spread in the health-care environment too. Objective. To describe the path followed and the results reached implementing Lean Thinking in four case studies.  Methods. Such case studies were conducted in as many hematological Day-Hospitals (DHs), located in Central-Italy. At the beginning of each study, the DH internal processes, activity volumes and patient flows were analyzed and satisfaction questionnaires were administered to both operators and patients. Based on the returned questionnaires, deficiencies were focused on; for each deficiency data was collected and objectives defined. Following such definitions, the analysis of inefficiency causes was performed and countermeasures were identified. In the final meeting the results were assessed and monitoring/maintenance methods were defined. All these steps were supported by Lean Thinking instruments for analysis and solution.         Results. Activity organization and patient satisfaction improved everywhere. Time losses and workloads imbalances were minimized in two DHs, particularly through higher standardization in the management of clinical-administrative documents. In another DH, the output capacity of the hospital pharmacy and the workflows in the DH were aligned with respect to the course of the day, so reducing delays in the delivery of therapies.  Appointment planning was improved in the fourth DH, standardizing time slots (15-minutes) necessary for each therapy, so optimizing the number of stations (beds and chairs) used. Conclusions. Poor management of health care facilities can affect efficiency, security and quality of services provided. Lean Thinking is a valid method to address such problems.

Response to a Fire Incident in the Operation Room: A Cautionary Tale

2019 ◽  
Vol 14 (2) ◽  
pp. 284-288
Author(s):  
Raman Sharma ◽  
Ashok Kumar ◽  
Vipin Koushal
Keyword(s):  
Health Care ◽  
Operating Room ◽  
Real Life ◽  
Health Care Facilities ◽  
Health Care Environment ◽  
Continuous Training ◽  
Care Environment ◽  
Fire Incident ◽  
Life Challenges ◽  
Precautionary Measures

ABSTRACTHealth care facilities are always seen as places of haven and protection for managing external incidents, but situations become difficult and challenging when such facilities themselves are affected by internal hazards. Such incidents are arguably more disruptive than external incidents, because patients are dependent on supportive measures and are neither in position to respond to such crisis situation nor do they know how to respond. Operating room fires are rare but potentially catastrophic, involving loss of costly resources and possibly lives. This case report details a true operating room fire incident in an emergency operating room and details the real-life challenges encountered by operating room staff in preserving both life and property. As a result of this work, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer health care environment for every worker and patient.

scholarly journals Modelling the Mediating Effect of Health Care Healing Environment on Core Health Care Delivery and Patient Satisfaction in Ghana

2019 ◽  
Vol 13 ◽  
pp. 117863021985211 ◽  
Author(s):  
Oti Amankwah ◽  
Choong Weng-Wai ◽  
Abdul Hakim Mohammed
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Teaching Hospital ◽  
Care Delivery ◽  
Mediating Effect ◽  
Health Care Environment ◽  
Care Environment ◽  
Healing Environment ◽  
Patients Satisfaction

Objective: The multifaceted nature of health care delivery has led to the need to incorporate strategies that will help to enhance performance and maintain the quality of the health care environment. However, even though dedicated health care staffs contribute to patients’ satisfaction of health care delivery, the health care environment must ensure the safety and well-being of patients. Like most developing countries, many public hospitals in Ghana are faced with challenges in the area of health care healing environment. Therefore, this article investigates the mediating effect of health care healing environment between health care core business and patients’ satisfaction. Method: This is a cross-sectional study involving adult patients of Komfo Anokye Teaching Hospital, Tamale Teaching Hospital, and Cape Coast Teaching Hospital in Ghana. A questionnaire survey based on the ‘A Staff and Patient Environment Calibration Toolkit (ASPECT)’ dimensions and health care core service dimensions was used to collect data from 622 patients. SmartPLS was used to analyse the data collected. Results: The findings of the study show that the quality of health care healing environment mediates the relationship between patients’ satisfaction and all of the constructs under the core health care delivery. Conclusion: Stakeholders of the Ghanaian health care sector should take initiatives to constantly improve the quality of health care healing environment as it has an influence on patient satisfaction of the overall core health care delivery.

Clinical Programme Management: A Model of Promise?

1993 ◽  
Vol 60 (4) ◽  
pp. 200-205 ◽  
Author(s):  
Sue Baptiste
Keyword(s):  
Health Care ◽  
Work Place ◽  
Health Care Environment ◽  
Care Environment ◽  
Quality Of Working Life ◽  
Use Of Resources ◽  
Major Teaching Hospital ◽  
Major Teaching ◽  
Initial Idea

As professionals working within a rapidly changing health care environment, it becomes critical to recognize alternatives for the management of clinical services to maximize the use of resources. However, it is also critical to remain constantly aware of the needs of valued and valuable employees, ensuring that the quality of working life is considered whenever any decisions are being made which will affect the work place. This paper reviews some of the literature related to decentralized structural models for health care institutions, and details the selection and implementation of one model in a major teaching hospital. The process of development from the initial idea through to the actual operationalization of a clinical programme management model is outlined, providing a critique of strengths and weaknesses of the model in the context of this particular organization.

scholarly journals Influenza Vaccinationfor Health Care Workers: A Duty of Care

2000 ◽  
Vol 11 (5) ◽  
pp. 225-226 ◽  
Author(s):  
Pamela Orr
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Care Delivery ◽  
Health Care Facilities ◽  
Care Providers ◽  
Health Care Environment ◽  
Care Environment ◽  
Care Workers ◽  
Care Facilities

The medical literature has amply documented the transmission of influenza from patients to health care workers (HCWs) (1,2), from HCWs to patients (3) and between HCWs (4-9). The consequences of influenza transmission within the health care environment include morbidity and mortality among patients, most of who are at high risk for the complications of infection, and illness and absenteeism among health care providers. When outbreaks occur in health care facilities, absenteeism among HCWs may approach 30% to 40%, resulting in severe staff shortages, increased employment costs and the potential endangerment of health care delivery due to the scarcity of replacement workers (10-13).

scholarly journals Antibiotic-Selected Gene Amplification Heightens Metal Resistance

mBio ◽  
2021 ◽  
Vol 12 (1) ◽  
Author(s):  
David A. Hufnagel ◽  
Jacob E. Choby ◽  
Samantha Hao ◽  
Anders F. Johnson ◽  
Eileen M. Burd ◽  
...  
Keyword(s):  
Health Care ◽  
Bacterial Colonization ◽  
Multidrug Resistant ◽  
Metal Resistance ◽  
Health Care Facilities ◽  
Health Care Environment ◽  
Nickel Resistance ◽  
Care Environment ◽  
Content Type ◽  
Implanted Devices

ABSTRACT The increasing frequency of antibiotic resistance poses myriad challenges to modern medicine. Environmental survival of multidrug-resistant bacteria in health care facilities, including hospitals, creates reservoirs for transmission of these difficult to treat pathogens. To prevent bacterial colonization, these facilities deploy an array of infection control measures, including bactericidal metals on surfaces, as well as implanted devices. Although antibiotics are routinely used in these health care environments, it is unknown whether and how antibiotic exposure affects metal resistance. We identified a multidrug-resistant Enterobacter clinical isolate that displayed heteroresistance to the antibiotic colistin, where only a minor fraction of cells within the population resist the drug. When this isolate was grown in the presence of colistin, a 9-kb DNA region was duplicated in the surviving resistant subpopulation, but surprisingly, was not required for colistin heteroresistance. Instead, the amplified region included a three-gene locus (ncrABC) that conferred resistance to the bactericidal metal, nickel. ncrABC expression alone was sufficient to confer nickel resistance to E. coli K-12. Due to its selection for the colistin-resistant subpopulation harboring the duplicated 9-kb region that includes ncrABC, colistin treatment led to enhanced nickel resistance. Taken together, these data suggest that the use of antibiotics may inadvertently promote enhanced resistance to antimicrobial metals, with potentially profound implications for bacterial colonization and transmission in the health care environment. IMPORTANCE To inhibit bacterial transmission and infection, health care facilities use bactericidal metal coatings to prevent colonization of surfaces and implanted devices. In these environments, antibiotics are commonly used, but their effect on metal resistance is unclear. The data described here reveal that exposure of a human isolate of Enterobacter cloacae to a last-line antibiotic, colistin, resulted in a DNA amplification that does not confer antibiotic resistance but instead facilitates resistance to the toxic metal nickel. This highlights a novel aspect of antibiotic and metal interplay. Concerningly, these data suggest the use of antibiotics could in some cases promote bacterial survival and colonization in the health care environment and ultimately increase transmission and infection of patients.

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