scholarly journals Improved Inpatient Care through Greater Patient–Doctor Contact under the Hospitalist Management Approach: A Real-Time Assessment

Author(s):  
Wonjeong Chae ◽  
Dong-Woo Choi ◽  
Eun-Cheol Park ◽  
Sung-In Jang

Objective: To examine the difference between hospitalist and non-hospitalist frequency of patient–doctor contact, duration of contact, cumulative contact time, and the amount of time taken by the doctor to resolve an issue in response to a medical call. Research Design and Measures: Data from 18 facilities and 36 wards (18 hospitalist wards and 18 non-hospitalist wards) were collected. The patient–doctor contact slip and medical call response slips were given to each inpatient ward to record. A total of 28,926 contacts occurred with 2990 patients, and a total of 8435 medical call responses occurred with 3329 patients. Multivariate logistic regression analyses and regression analyses were used for statistical analyses. Results: The average frequency of patient–doctor contact during a hospital stay was 10.0 times per patient for hospitalist patients. Using regression analyses, hospitalist patients had more contact with the attending physician (β = 5.6, standard error (SE) = 0.28, p < 0.0001). Based on cumulative contact time, hospitalists spent significantly more time with the patient (β = 32.29, SE = 1.54, p < 0.0001). After a medical call to resolve the issue, doctors who took longer than 10 min were 4.14 times (95% CI 3.15–5.44) and those who took longer than 30 min were 4.96 times (95% CI 2.75–8.95) more likely to be non-hospitalists than hospitalists. Conclusion: This study found that hospitalists devoted more time to having frequent encounters with patients. Therefore, inpatient care by a hospitalist who manages inpatient care from admission to discharge could improve the care quality.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hasan Tutar ◽  
Ahmet Tuncay Erdem ◽  
Ömer Karademir

Purpose There has been a rapid generational change in the business world in Turkey recently, and X generation managers are rapidly leaving their place to Y generation managers. In countries with relatively young populations such as Turkey, management in family businesses passes into the hands of Generation Y. This study aims to examine the moderator role of the difference between old and new generation Y in the effect of self-efficacy perceptions on decision-making strategies. Design/methodology/approach This research, which was designed according to the quantitative research method, was designed according to the cross-sectional survey model, one of the general survey models. The research data were collected from a sample of 441 family business managers determined according to the simple random sampling technique. The data were analyzed and interpreted with various statistical techniques. Data analysis was done with AMOS. 20 and International Business Machines statistical package for the social sciences 22 data analysis programs. Findings According to the analysis findings, there is a significant relationship between the participants’ self-efficacy perceptions and decision-making strategies. Research findings old and new generation Y managers have different decision strategies. The research results showed that the dominant self-efficacy perceptions of the Y generation affect their decision-making strategies. Research limitations/implications This research only examines whether the old and new generation Y perceptions have a moderator function in the relationship between the participants’ self-efficacy perceptions and decision-making strategies. The research is quantitative research limited to family businesses. The results can be compared by repeating the research with other variables and in different samples, for example, by researching in public institutions. In addition, the way of reflecting the differences in perception to the management can be subjected to deeper analysis with mixed studies. Practical implications One of the important reasons for the difference in people’s approaches to events is their personality structure. Generational differences, which have been discussed primarily in recent years, make themselves felt in working life. The new working models arising from the different perspectives of the Y generation differ from the traditional business models. Today, in traditional business models, the manager profile is usually the X generation. However, the process is moving toward gaining essential positions in the management levels of the new Y generation. They put traditional managers in a difficult situation with their impatient behavior and desire to climb the career ladder quickly. Social implications In the studies conducted on the Y generation, it is understood that they do not favor the classical management approach based on the command-command relationship. The sense of loyalty of the Y generation is low compared to other generations and their organizational commitment levels are weak. There are determinations that they attach importance to flexible working style and want to do business using digital technologies. They are highly motivated in setting vision and participating in strategic decisions in organizations. These features differ significantly from the X-generation managers who adopt the traditional management approach. Originality/value Both emotional and cognitive characteristics influence decision-making behavior. The generation gap which shows common personality structures in a certain period is an important predictor of decision-making strategy. Research results and related studies significantly affect the decision strategies of the generation gap. No research has been found comparing the old and new Y generations. In this respect, it is thought that the research will contribute to theory, practice and method.


2021 ◽  
pp. 174498712110161
Author(s):  
Ann-Marie Cannaby ◽  
Vanda Carter ◽  
Thomas Hoe ◽  
Stephenson Strobel ◽  
Elena Ashtari Tafti ◽  
...  

Background The association between the nurse-to-patient ratio and patient outcomes has been extensively investigated. Real time location systems have the potential capability of measuring the actual amount of bedside contact patients receive. Aims This study aimed to determine the feasibility and accuracy of real time location systems as a measure of the amount of contact time that nurses spent in the patients’ bed space. Methods An exploratory, observational, feasibility study was designed to compare the accuracy of data collection between manual observation performed by a researcher and real time location systems data capture capability. Four nurses participated in the study, which took place in 2019 on two hospital wards. They were observed by a researcher while carrying out their work activities for a total of 230 minutes. The amount of time the nurses spent in the patients’ bed space was recorded in 10-minute blocks of time and the real time location systems data were extracted for the same nurse at the time of observation. Data were then analysed for the level of agreement between the observed and the real time location systems measured data, descriptively and graphically using a kernel density and a scatter plot. Results The difference (in minutes) between researcher observed and real time location systems measured data for the 23, 10-minute observation blocks ranged from zero (complete agreement) to 5 minutes. The mean difference between the researcher observed and real time location systems time in the patients’ bed space was one minute (10% of the time). On average, real time location systems measured time in the bed space was longer than the researcher observed time. Conclusions There were good levels of agreement between researcher observation and real time location systems data of the time nurses spend at the bedside. This study confirms that it is feasible to use real time location systems as an accurate measure of the amount of time nurses spend at the patients’ bedside.


2018 ◽  
Vol 8 (12) ◽  
pp. 333-336 ◽  
Author(s):  
James M. Stone ◽  
Simon Roux ◽  
David Taylor ◽  
Paul D. Morrison

Background: The development of long-acting injectable formulations (LAIs) of second-generation antipsychotic drugs (SGAs) has been suggested as having advantage over first-generation antipsychotic (FGA) LAIs. In this study, we investigated the hypothesis that there was a longer time to relapse in patients with schizophrenia started on SGA LAI versus FGA LAI. Methods: Patients with a diagnosis of schizophrenia or schizoaffective disorder who were started on an SGA LAI while on an inpatient ward were identified through searching of the anonymised historical medical records at the South London and Maudsley NHS Foundation Trust. Patients starting FGA LAIs matched for diagnosis, age and date of hospital admission were identified. Time to readmission, discontinuation of LAI or death were identified. Kaplan–Meier plots were generated for each group, and the difference between groups analysed using log-rank methods. Results: There were 157 patients identified in each group. There was no difference in time to readmission, medication discontinuation or death in patients on SGA LAI versus FGA LAI. Conclusions: We found no evidence of advantage in terms of maintaining response in SGA LAI versus FGA LAI. Prescriber choice should be guided by other factors such as side-effect profile, patient acceptability and price.


2012 ◽  
Vol 28 (5) ◽  
pp. 1085 ◽  
Author(s):  
Dana Hollie ◽  
Shaokun Carol Yu

While SFAS No. 131 is intended to increase the transparency of financial reporting using a management approach, it may reduce shareholders ability to interpret segment disclosures relative to the industry approach employed under SFAS No.14. This study investigates whether segment reconciliation differences affect stock prices and whether abnormal returns can be earned using information about two components of earnings: aggregated segment earnings and segment earnings reconciliations. We compute reconciliations as the difference between firm-level consolidated earnings and aggregated segment-level earnings. Firms that report negative SERs have greater sales and profitability, greater return on equity, as well as more operating cash flows and firm growth. This suggests that firms that report aggregated segment earnings greater than firm-level consolidated earnings may be better off financially. Our findings show that mispricing does occur when firms report positive SERs by the market, underestimating the segment earnings reconciliation component of earnings persistence. Investors can also earn positive abnormal returns when investors take a long (short) position with the portfolio with the highest (lowest) absolute SERs. On the contrary, we find investors earn negative abnormal returns when firms report negative SERs. Collectively, this study provides evidence that mispricing occurs and that investors over/underestimate the importance and/or persistence of segment earnings reconciliations.


2011 ◽  
Vol 11 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Hasri Hasri ◽  
Mudasir Mudasir ◽  
Nurul Hidayat Aprilita ◽  
Roto Roto

An application of Saccharomycess cereviceae biomass immobilized on chitosan (SC-Chi adsorbent) for Pb(II) ion removal was demonstrated. Adsorption experiment was conducted at various mass ratio of Saccharomycess cereviceae biomass to chitosan, contact time, pH of solution and concentration of cation. Total Pb(II) metal ion adsorbed was calculated from the difference of the amount of metal ion before and after adsorption which was measured by AAS. The results showed that optimum condition for adsorption of Pb(II) ion by the SC-Chi was achieved using mass ratio of Saccharomycess cereviceae to chitosan of 50% (w/w), pH solution of 7, contact time of 60 min and concentration of 25 mgL-1. The hydroxyl (-OH) and amino (-NH2) functional groups are believed to be responsible for the adsorption of Pb(II) ion by the adsorbent.


2020 ◽  
Vol 56 (2) ◽  
pp. 118-139
Author(s):  
Mehmet Yasar ◽  
Ender Gerede

AbstractCompetitive tension refers to pressure that is considered to exist among firms operating in a competitive market and that forces them to take competitive action against each other. An imaginary upper limit of competitive tension symbolizes the difference between whether to take competitive action or not. The antecedents of competitive tension are examined in this study. Within this scope, market commonality and resource similarity are the variables studied as components of competitor analysis; market concentration that provides clues for the competitive structure of competed markets; and finally, competitive asymmetry, presuming that the competition among the companies is not equal and rivals do not consider each other at the same level as competing firms, were taken as primary variables of competitive tension. In order to test whether these variables have an effect on competitive tension among airlines, airlines operating in the domestic air transport market in Turkey were examined in this study. The perceived competitive tension that was detected as a result of regression analyses was studied on three different dimensions, namely, internal tension, external tension, and total tension, and each dimension was analyzed as a different model. The findings of the study revealed that market commonality and market concentration have a significant effect on competitive tension. These effects were found to be positive for market commonality and negative for market concentration. Resource similarity and competitive asymmetry were found to have no significant effect.


2018 ◽  
Vol 7 (3.27) ◽  
pp. 500
Author(s):  
R Vasudevan ◽  
S Ramalakshmi

A new management approach for the reactive-power injections of Voltage supply Converters in High Voltage DC (VSC-HVDC) multi-terminal Systems to enhance grid transient stability. A reactive-power supplementary signal is provided for each convertor. Its worth is proportional to the frequency deviation of its consequent AC bus with admiration to the weighed-average frequency of the multiterminal system stations. The hope is to extend (decrease) the magnetism torsion of generators close to those terminals during which the frequency is superior to (below) the weighed-average frequency used. The AC frequency for all VSC stations is ever more accessible regionally for synchronization functions and will be utilized by a central controller. Simulations are allotted victimization PSS/E and therefore the outcome have revealed that transient stability is enlarged victimization this approach. Since this approach uses world capability of all VSC stations, the collision of the communication delays has been analyzed, concluding that the depressing consequence is modest, for realistic latency values. 


2020 ◽  
Vol 8 (2) ◽  
pp. 112
Author(s):  
Kurnia Rahmawati ◽  
Anisah Ardiana ◽  
Dicky Endrian Kurniawan

Quality of service is a service that suits your needs, affordable, effective, efficient, and no risk to save on expenses. This study aimed to analyze the description of BPJS patient satisfaction with the quality of nursing service at inpatient ward of hospital in Jember. This was a cross sectional study. The subjects of this study were BPJS patients at inpatient ward at hospital in Jember. There were 120 respondents choosed by purposive sampling. Data were collected using the Patient Satisfaction with Nursing Care Quality Questionnaire (PNSCQQ). This study showed that the patient satisfaction is not optimal. Indicators of general perception of patients in each statement showed that 80 patients (63.5%) said the overall quality of health service received was good. The overall quality of nursing service was also said to be good by 80 patients (63.5%). As many as 90 patients (71.5%) agreed that they wanted to recommend one of the hospital in Jember to family and friends who needed help in terms of health service. This research showed that it is important to improve the quality of nursing service to increase patient satisfaction. Nurses need to improve nursing care. This research can be used as a reference and illustration for hospital management, and nurses are expected to implement and improve quality nursing service in order to achieve better health service so patient satisfaction will be increase.


2009 ◽  
Vol 66 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Dragana Milutinovic ◽  
Verica Milovanovic ◽  
Miroslava Pjevic ◽  
Mirjana Martinov-Cvejin ◽  
Tomislav Cigic

Background/Aim. Managing of acute postoperative pain should be of great interest for all hospital institutions, as one of the key components of patients satisfaction, which indicates quality, as well as the outcome of treatment. The aim of this study was to assess the quality of nursing care in managing acute postoperative pain and to establish factors which influence patients assessment of the same. Method. The investigation was conducted on the sample of 135 patients hospitalized in surgical clinics of the Clinical Centre of Vojvodina in Novi Sad in the form of cross-sectional study, by interviewing patients during the second postoperative day and collecting sociodemographic variables, type of surgical procedure and applied analgesic therapy which were taken from their medical documentation. The modified questionnaire of the Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP) was used as the instrument of the investigation. The data were processed with suitable mathematical statistics methods such as multivariate analyses of variance (MANOVA), discriminative and other parametric procedures and methods. Roy's test, Pearson's coefficient contingency (?), multiple correlation coefficient (R) were conducted amongst other invariant procedures. Results. The mean score for the individual items of SCQIPP questionnaire was between 2.0 and 4.7 (scale range 1-5) and the percentage of patients answers 'strongly agree' ranged from 4.4 to 77%. The smallest number of positive answers were given by the patients for the item 'In order to assess pain intensity, some of the staff asked me at least once in the morning, in the afternoon and in the evening to show the number from 0-10'. Most of the patients (57%) evaluated severe pain during the previous 24 hours, as moderate pain, which represents significantly greater number of patients which complain of severe pain and mild pain (p < 0.001). The analysis of patients evaluation (MANOVA p < 0.05 and discriminative p < 0.05) indicates the existence of significant difference between the assessment of nursing care quality in managing acute postoperative pain as regards to clinics as the place for pain management, patient's sex and his expectations. Evaluation from 'communication' subscale gives the greatest contribution (24.9%) to the difference between the observed clinics, and the greatest contribution (25.7%) to the difference in evaluation of nursing care quality as regards to patients' sex has the evaluations from 'procedure' subscale. Conclusion. The results of this study show a useful evidence and identify aspects of nursing care in postoperative management of acute pain which are still to be improved. According to the patients' answers the priority should be given to a regular assessment of the intensity of postoperative pain and evaluation of the effects of analgesic therapy.


2021 ◽  
Vol 9 (2) ◽  
pp. 149-158
Author(s):  
Sheida Akar ◽  
◽  
Bahareh Lorestani ◽  
Soheil Sobhanardakani ◽  
Mehrdad Cheraghi ◽  
...  

Background: In this study, the ferrous sulfate was used to remove Cr(VI) and Ni(II) ions from a real Ni-Cr plating industry wastewater. Methods: This is an applied study. The type of sampling was composite by three 5 L containers. Wastewater chemical and physical characteristics were measured in accordance with the standard methods. The concentration of un-removed metal ions was estimated by ICP-OES. The Jar test was used to carry out the chemical coagulation experiment. The results indicated that the rate of removal depended on the pH of 1.5-11, the diverse contact time of 30-120 min, and the coagulant measurement ranging from 0.5-2 g/l. Results: The optimum removal of Cr(VI) ions was observed at a pH of 7 up to 83.88% in 0.5 g/l of coagulant for 40 min. While the optimum removal of Ni(II) ions was found at a pH of 5 up to 56.33 % in 0.5 g/l of coagulant for 40 min. The scanning electron microscopy results revealed the difference between the coagulant surface while coagulation. Also, the Energy-Dispersive X-ray spectroscopy (EDX) analysis showed the presence of Cr(VI) and Ni(II) ions on the surface of the ferrous sulfate after coagulation. Conclusion: Ultimately, the results indicated that ferrous sulfate could be an operative chemical coagulant to remove Cr(VI) and Ni(II) ions from the plating industry wastewater, especially for Cr(VI) particles. The results of this study can be a useful guide to the real plating industry wastewater treatment operators.


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