TO EVALUATE THE PERFORMANCE OF A TEACHING HOSPITAL BY COMBINING THE HOSPITAL INDICES USING THE PABON LOSSO MODEL DURING THE SURVEILLANCE BY AUTHORITIES:HAWTHORNE EFFECT

2021 ◽  
pp. 75-77
Author(s):  
C. Narender Kumar
Keyword(s):  
Teaching Hospital ◽  
Public Hospital ◽  
Quality Care ◽  
Hospital Performance ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Hawthorne Effect ◽  
Cross Sectional ◽  
Policy Makers ◽  
The Public

BACKGROUND:The patients' health care choice is diverting from the private health provider to the public hospital due to introduction of various schemes and incentives by the policy makers. The limited resources are posing a challenge to the hospital administrator in escalating demands, diversity and complexity of diseases of patients. The hospital performance enhances steadily by the monitoring authorities' surveillance. It is an effective method for improving quality care in the public hospital. The Hawthorne effect is a term referring to the tendency of people to work harder and increases in effectiveness of organization when they are being observed. OBJECTIVES: 1. To assess the performance of a teaching hospital during surveillance by calculating the hospital indices, using the Pabon Losso Model. 2. To evaluate whether the Hawthorne effect is the cause of the increase in the effectiveness of hospital. MATERIALS AND METHODS: The study was a prospective and record based cross-sectional study and conducted at Government teaching hospital over a period of 18 months. RESULTS: st A total of 18 months period census report was recorded from January 2016 to June 2017and hospital indices were estimated. The 1 phase of surveillance (January- 2016 to May -2016), where immense supervision was present, with performance feed- back, BOR was 88.65, nd ALOS was 3.932, BTR was 7.074 and BTI was 0.54, 2 phase of surveillance which was intensied with communication and committee meetings rd (June-2016 to October- 2016), BOR was 95.59, ALOS was 3.49, BTR was 7.03 and BTI was 0.886, 3 phase weaning period, where a little th supervision (November -2016 to February-2017) BOR was 87.8, ALOS was 4.1, BTR was 6.413 and BTI was 0.5725 and 4 phase self sustain stage or no observations phase, BOR was 92.6, ALOS was 3.47, BTR was 6.547 and BTI was 0.28. CONCLUSION: The surveillance of higher authorities over the hospital had increased the performance. Hospital efciency is reected by increased hospital indices. The cause and effect is the “Hawthorne effect”. Therefore it is concluded that the surveillance increases the performance and efciency of the public hospitals.

scholarly journals Comparative analysis of cesarean section using the Robson's Ten-Group Classification System (RTCGS) in private and public hospitals, Addis Ababa, Ethiopia

2021 ◽  
Vol 4 (2) ◽  
pp. 081-091
Author(s):  
Assefa Endalkachew Mekonnen ◽  
Janbo Adem ◽  
Ghiwot Yirgu
Keyword(s):  
Cesarean Section ◽  
Public Hospital ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Classification Systems ◽  
Public Hospitals ◽  
Cross Sectional ◽  
The Public ◽  
Private And Public

Objectives: We analyzed the indications of cesarean section (CS) using Robson Ten-Group. Classification Systems (RTGCS) and comparison between private and public health facilities in Addis Abeba hospitals, Ethiopia, 2017. Methods: Facility-based retrospective cross-sectional study was carried out between January 1 and December 31, 2017, including 2411 mothers who delivered by CS were classified using the RTGCS. Data were entered into SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of the CS. Results: The overall CS rate was 41% (34.8% and 66.8% in public & private respectively, p < .0001). The leading contributors for CS rate in the private were Robson groups 5,1,2,3 whereas in the public 5,1,3,2 on descending order. Robson group 1 (nulliparous, cephalic, term, spontaneous labor) and group 3 [Multiparous (excluding previous cesarean section), singleton, cephalic, ≥ 37 weeks’ gestation& spontaneous labor], the CS rate was over two-fold higher in the private than the public sector. Women in Robson groups 1, 2, 5 & 9 are two and more times higher for the absolute contribution of CS in private than public. The top medical indications of CS were non-reassuring fetal status (NRFS, 39.1%) and repeat CS for previous CS scars (39.4%) in public and private respectively. Mothers who delivered by CS in private with history of previous CS scar (AOR 2.9, 95% CI 1.4-6.2), clinical indications of maternal request (AOR 7.7, 95% CI 2.1-27.98) and pregnancy-induced hypertension (AOR 4.2, 95% CI 1.6-10.7), induced labor (AOR 2.5, 95% CI 1.4-4.6) and pre-labored (AOR 2.2, 95% CI 1.6-3.0) were more likely to undergo CS than in public hospital. Conclusion: The prevalence of CS was found to be high, and was significantly higher in private hospitals than in a public hospital. Having CS scar [having previous CS scar, Robson group 5(Previous CS, singleton, cephalic, ≥ 37 weeks’ gestation) and an indication of repeat CS for previous CS scar] is the likely factor that increased the CS rate in private when compared within the public hospital. Recommendation: It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS, encouraging vaginal birth after CS (VBAC). Policies should be directed at the private sector where CS indication seems not to be driven by medical reasons solely.

Knowledge Attitudes and Practice of Breast Milk Expression and Storage Among Working Mothers With Infants Under 6 Months of Age in Public Well Baby Clinics

2020 ◽  
Author(s):  
PRISCILLAH wanini EDEMBA ◽  
Grace Irimu ◽  
RACHEL MUSOKE
Keyword(s):  
Breast Milk ◽  
Working Mothers ◽  
Tertiary Education ◽  
Working Women ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Study Objective ◽  
The Public ◽  
And Storage

Abstract Background: Many studies show that working mothers are unable to exclusively breastfeed successfully. Expression and storage of breastmilk is a strategy that ensures continued breastmilk consumption in the event of temporary separation of an infant from the mother. The 2017 Kenyan Health Act mandates employers to provide lactation rooms with guidance for appropriate utilization.Methodology: The study objective was to assess knowledge attitude and practice of breastmilk expression and storage among working women with infants below six months of age in Public Well Baby Clinics. This was a cross sectional study among 395 working women attending two large public hospitals in Nairobi Kenya. A structured questionnaire with open and closed ended questions was used to establish the knowledge and practice while a Likert scale was used to explore attitudes of the mothers towards expression and storage of breast milk. Results: Only 161(41%) were expressing breast milk. Those with tertiary education and those working in the public sector had significantly higher odds of having satisfactory knowledge OR4.47(95%CI 2.01-11.07) and OR2.26(95%CI 1.33-3.85) respectively. Attaining tertiary education was significantly associated with a possibility of expressing and storing breastmilk OR3.6(95% CI 1.81-7.95). The workplace did not provide adequate equipment to facilitate breastmilk expression. Challenges experienced were breast pain and cumbersome nature of expressing milk.Conclusion: The study revealed knowledge gaps in expression and storage of breastmilk that need to be addressed to enable the mothers fully utilize the lactation rooms when they become available at the workplace.

scholarly journals Significant differences in cesarean section rates between a private and a public hospital in Brazil

2008 ◽  
Vol 24 (12) ◽  
pp. 2909-2918 ◽  
Author(s):  
Sueli de Almeida ◽  
Heloisa Bettiol ◽  
Marco Antonio Barbieri ◽  
Antônio Augusto Moura da Silva ◽  
Valdinar Sousa Ribeiro
Keyword(s):  
Public Hospital ◽  
Protective Factor ◽  
Private Hospital ◽  
Early Morning ◽  
Cross Sectional Study ◽  
Cesarean Sections ◽  
Cross Sectional ◽  
The Public ◽  
The City ◽  
Maternity Clinic

This paper evaluates the association of maternal variables and of variables related to prenatal and delivery care with cesarean sections at a public and at a private maternity. A retrospective cross-sectional study was performed at a public maternity clinic (2,889 deliveries) and at a private maternity clinic (2,911 deliveries) in the city of Ribeirão Preto, São Paulo State, Brazil. The prevalence of cesarean sections was 18.9% at the public maternity clinic and 84.3% at the private one. The factors associated with cesarean sections at both hospitals were: mothers from other cities, aged > 25 years and with hypertension. Having more than one child was a protective factor. At the public hospital, cesarean sections were more frequent on Wednesdays and from 12:00 to 23:59 hours of any day of the week, whereas at the private hospital they occurred on any day, though were less common on Sundays, and at any time except in the early morning. At the private hospital, cesarean sections were more frequent when performed by the doctor who had provided the prenatal care. Non-medical factors were more associated with cesarean sections in the private maternity clinic than biological or clinical factors related to pregnancy.

scholarly journals Assessment of surgical capacity in Chiapas, Mexico: a cross-sectional study of the public and private sector

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044160
Author(s):  
Lina Roa ◽  
Ellie Moeller ◽  
Zachary Fowler ◽  
Fernando Carrillo ◽  
Sebastian Mohar ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Public Hospitals ◽  
Surgical Volume ◽  
Sectional Study ◽  
Surgical Capacity ◽  
Catastrophic Expenditure ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public

IntroductionSurgical, anaesthesia and obstetric (SAO) care are essential, life-saving components of universal healthcare. In Chiapas, Mexico’s southernmost state, the capacity of SAO care is unknown. This study aims to assess the surgical capacity in Chiapas, Mexico, as it relates to access, infrastructure, service delivery, surgical volume, quality, workforce and financial risk protection.MethodsA cross-sectional study of Ministry of Health public hospitals and private hospitals in Chiapas was performed. The translated Surgical Assessment Tool (SAT) was implemented in sampled hospitals. Surgical volume was collected retrospectively from hospital logbooks. Fisher’s exact test and Mann-Whitney U test were used to compare public and private hospitals. Catastrophic expenditure from surgical care was calculated.ResultsData were collected from 17 public hospitals and 20 private hospitals in Chiapas. Private hospitals were smaller than public hospitals and public hospitals performed more surgeries per operating room. Not all hospitals reported consistent electricity, running water or oxygen, but private hospitals were more likely to have these basic infrastructure components compared with public hospitals (84% vs 95%; 60% vs 100%; 94.1% vs 100%, respectively). Bellwether surgical procedures performed in private hospitals cost significantly more, and posed a higher risk of catastrophic expenditure, than those performed in public hospitals.ConclusionCapacity limitations are greater in public hospitals compared with private hospitals. However, the cost of care in the private sector is significantly higher than the public sector and may result in catastrophic expenditures. Targeted interventions to improve the infrastructure, workforce availability and data collection are needed.

scholarly journals An Assessment of Work Environment Factors Correlating with Burnout Status of Physicians Employed with the Public Hospitals Authority in The Bahamas

2021 ◽  
Author(s):  
Merrilyn Wallace-Bain
Keyword(s):  
Work Environment ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Public Hospitals ◽  
Burnout Syndrome ◽  
The Bahamas ◽  
Cross Sectional ◽  
The Public ◽  
Study Participants

Objective To identify the prevalence and factors associated with the Burnout Syndrome in physicians working in the Public Hospitals Authority (PHA), Nassau, Bahamas. Methods A cross-sectional study was done in 2014 utilising a self-administered survey comprising of demographics, general health, work environment, and Maslach Burnout Inventory items to assess burnout among physicians working in nine (9) departments of PHA. The IBM SPSS (v. 20.0 or more current) Statistical Analyses software was used for data analysis. Results The study participants were 153 physicians. Their mean age was 35.84 (± 7.09) years old; median 34.00 (IQR: 31.00, 40.00) years old, 99 (64.7%) were females. No associations were found among these, other socio-demographic variables measured and burnout status. Physicians in the department of Internal Medicine represented 34 (22.2%), Family Medicine 31 (20.3%), Emergency Medicine 30 (19.6%), Paediatrics 21 (13.7%), and physicians in other departments 34 (22.3%). Of the physicians employed under the PHA, 55.7% collectively exhibited burnout. Poor balance of family life, 15 work environment potential stressors and 4 potential stress relievers were found to each be weakly or very weakly related to burnout status. Postgraduate programme year, irregular sleep pattern and lack of appreciation were moderately strong positively related. Logistic regression analysis showed the key predictors of burnout status to be lack of appreciation (OR=1.69, p=.002) and number of years worked post-internship (OR=.94, p=.039). Conclusion: Physician’s sense of appreciation and number of years post internship were clear predictors of burnout.

scholarly journals Perceptions of hospital staff on the performance of Quality Improvement teams in the regional referral hospitals in Tanzania: A cross sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246927
Author(s):  
Godfrey Kacholi ◽  
Ozayr H. Mahomed
Keyword(s):  
Logistic Regression ◽  
Quality Improvement ◽  
Quality Care ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Referral Hospitals

Background To ensure patient-centered quality care for all citizens, Quality Improvement (QI) teams have been established across all public hospitals in Tanzania. However, little is known about how hospital staff perceive the performance of hospital QI teams in Tanzania. This study assessed the perceptions of hospital staff of the performance of QI teams in selected regional referral hospitals in Tanzania. Methods This cross-sectional study was conducted in four selected regional referral hospitals between April and August 2018. A self-administered questionnaire was used to collect data from 385 hospital staff in the selected hospitals. Measures of central tendency, proportions and frequencies were used to assess level of perception of hospital staff. Bivariate and multivariate logistic regression was used to test the association between the perceptions of hospital staff of the performance of QI teams and their socio-demographic factors. Results The overall mean perception score of the performance of QI teams was 4.84 ± 1.25. Hospital staff aged 35 and over (n = 130; 68%), female hospital staff (n = 144; 64%), staff in clinical units (n = 136; 63%) and staff with post-secondary education (n = 175; 63%) perceived that the performance of QI teams was good. Improved hospital cleanliness was viewed as strength of QI teams, whilst inadequate sharing of information and inadequate reduction in patient waiting time were considered as weaknesses of QI team performance. Bivariate and multivariate logistic regression analyses showed that there was no statistical association between the perceptions of hospital staff and their socio-demographic characteristics. Conclusion The overall perception of hospital staff of the performance of QI teams was good, with the main limitation being sharing of hospital QI plans with hospital staff. Hospital staff should be involved in the development and implementation of hospital QI plans, which would promote a positive perception of staff of the performance of QI teams and enhance sustainability of QI teams.

Discharge against medical advice from a Tehran emergency department

2016 ◽  
Vol 29 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Azar Hadadi ◽  
Patricia Khashayar ◽  
Mojgan Karbakhsh ◽  
Ali Vasheghani Farahani
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
Medical Advice ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Policy Makers ◽  
Content Type ◽  
Discharge Against Medical Advice

Purpose – The purpose of this paper is to identify the main reasons for discharge against medical advice (DAMA) in the emergency department (ED) of a teaching hospital in Tehran, Iran. Design/methodology/approach – This cross-sectional study was conducted on all the patients who left the ED of a referral teaching hospital against medical advice (AMA) in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving AMA. Findings – In total, 12.8 percent of the patients left the hospital AMA. Dissatisfaction with being observed in the ED, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital AMA. Practical implications – Like many other centers, the results showed that poor communication skill and work overload were the main contributing factors to DAMA. The center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in the reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from the results to adopt effective approaches to reduce DAMA rate. Originality/value – To the knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian EDs.

FACTORS INFLUENCING THE JOB SATISFACTION AMONG NURSES AND MIDWIVES WORKING IN THE PUBLIC HOSPITALS IN QUANG TRI PROVINCE

2017 ◽  
pp. 135-141
Author(s):  
Lam Chi Ha ◽  
Van Thang Vo ◽  
Thi Hue Man Vo
Keyword(s):  
Job Satisfaction ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
The Public ◽  
Satisfaction Rate ◽  
Clinical Departments ◽  
Nurses And Midwives ◽  
Caring Service

Introduction: Caring service provided by nurses was one of the main factor of medical service system of Viet Nam. During recent years, nurses and midwives service had made significant progress in improving the quality of health caring service. However, jobs of nurses and midwives in Vietnam were still facing some problems and challenges: lack of both quality and quantity, discrepant structure. This study aimed to evaluate the human resource situation as well as the satisfaction level of nurse and midwife staff in state –run local hospitals, which would be the foundation for the plan of developing nurse and midwife system in order to satisfy the healthcare need of the patients. Objectives: To investigate the satisfaction rate and satisfaction involved factors with particular jobs of nurses and midwives at treatment systems in the public hospitals in Quang Tri province in year 2015. Data was collected using self-administrative questionnaires and entered and analysed by the statistical software of SPSS Version 20.0. Methodology: A cross sectional study was carried out in Dec. 2015 on a total of 433 nurses, midwives working at clinical departments of 12 governmental hospitals in Quang Tri province. Results: General job satisfaction rate with the particular jobs was 52.9%. Factors involving satisfaction of nurses, midwives with their jobs included: working position, hospital level of care, clinical departments, and monthly income getting from hospital (p<0.05). Conclusions: It was highly necessary to improve working conditions and environment, and income, to ensure treatment regimens and policies, to make further training and higher working position feasible, to heighten role and responsibility on working and to develop hospital in order to raise the satisfaction rate of nurses and midwives, and hence to enhance the quality of patient care in hospitals. Key words: Nurses, midwives, satisfaction, quality of care

scholarly journals A cross sectional study of tobacco use among the college students of B. G. Nagara, Karnataka

2019 ◽  
Vol 6 (9) ◽  
pp. 4019
Author(s):  
N. Sabari Raja
Keyword(s):  
College Students ◽  
Tobacco Use ◽  
Cross Sectional Study ◽  
Male Students ◽  
Sectional Study ◽  
Cross Sectional ◽  
Policy Makers ◽  
The Public ◽  
Plant Grown ◽  
Structured Questionnaire

Background: Tobacco is a leafy plant grown around the world with its addictive substance nicotine. It becomes the need of the hour to provide enough evidence on the correlates of tobacco use in the community to assist government policy makers, health professionals and the public in developing realistic models towards effective tobacco control to cater to sections of community in need. The present study was conducted to determine the prevalence and the pattern of tobacco use among the college students and to find out the reasons for the tobacco use among the college students.Methods: A descriptive cross sectional study was conducted among various college students of B. G. Nagara with 1003 subjects selected. Data was collected with a pre-tested, semi-structured questionnaire and analysed. Results were expressed in percentages and proportions.Results: The overall prevalence of tobacco use among the study subjects was found to be 5.8% and was exclusively among male students only. Cigarette smoking was the most commonly used form of tobacco, used by 89.7% of the tobacco users and the major reasons for initiation of tobacco use were due to friends (58.6%).Conclusions: Present study showed that the prevalence of tobacco use (5.8%) was lower when compared to state and national average. But since majority of users were in the age group of 19 to 21 years and were away from their homes, strict measures should be enforced in hostel and college premises banning its use and sale.

scholarly journals Assessment of drug use pattern using WHO core drug use indicators in selected general hospitals: a cross-sectional study in Tigray region, Ethiopia

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045805
Author(s):  
Segen Gebremeskel Tassew ◽  
Haftom Niguse Abraha ◽  
Kidu Gidey ◽  
Abadi Kahsu Gebre
Keyword(s):  
Drug Use ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
General Hospitals ◽  
The Public ◽  
Tigray Region ◽  
Use Pattern ◽  
Drug Use Pattern

ObjectiveInappropriate use of medicine is a global challenge with greater impact on developing countries. Assessment of drug use pattern is used to identify gaps in medicine utilisation to implement strategies for promoting rational drug use. This study aimed to assess drug use pattern using the WHO drug use indicators in selected general hospitals in Tigray region, Ethiopia.DesignA cross-sectional study was conducted using WHO drug use indicators in two public hospitals located in Tigray.SettingPrescriptions recorded from 1 January 2017 to 1 June 2019 were randomly selected, and participants who visited the public hospitals from 1 March 2019 to 30 August 2019 and hospital pharmacies were interviewed.Participants100 patients who visited both outpatient clinics and hospital pharmacy departments of the public hospitals.ResultsThe average number of medicines per prescription was 1.69 (±0.81). Prescriptions containing antibiotics and injectables were 58.2% and 15.9%, respectively. The percentages of medicines prescribed with a generic name from essential medicines list of Ethiopia were 97.5% (974) and 88.1% (970) in Mekelle Hospital and Quiha Hospital, respectively. The patients spent an average of 6.6(±3.5) min with their general practitioners, while only 22.8 (±21.7) s with their pharmacists. Of the patients interviewed, 56.9% knew their dosing regimen and 32.7% of them had their medication labelled.ConclusionThe finding of the present study revealed deviation of drug use pattern from the WHO optimal levels suggesting the hospitals had limitations in appropriate utilisation of medicines. Understanding the factors attributed to the observed gaps and implementing corrective measures are required to conform with the recommended standards of appropriate drug utilisation.

Sign in / Sign up

Export Citation Format

Share Document