scholarly journals Appointment Lead Time Policy Development to Improve Patient Access to Care

2016 ◽  
Vol 07 (04) ◽  
pp. 954-968 ◽  
Author(s):  
Sarah Bach ◽  
Yu-Li Huang
Keyword(s):  
Access To Care ◽  
Health Care Providers ◽  
Policy Development ◽  
Lead Time ◽  
Lead Times ◽  
Patient Access ◽  
Care Providers ◽  
Data Driven Approach ◽  
The Difference ◽  
Improve Patient

Summary Background Patient access to care has been a known and continuing struggle for many health care providers. In spite of appointment lead time policies set by government or clinics, the problem persists. Justification for how lead time policies are determined is lacking. Objectives This paper proposed a data-driven approach for how to best set feasible appointment target lead times given a clinic’s capacity and appointment requests. Methods The proposed approach reallocates patient visits to minimize the deviation between actual appointment lead time and a feasible target lead time. A step-by-step algorithm was presented and demonstrated for return visit (RV) and new patient (NP) types from a Pediatric clinic excluding planned visits such as well-child exam and the same day urgent appointments. The steps are: 1. Obtain appointment requests; 2. Initialize a target lead time; 3. Set up an initial schedule; 4. Check the feasibility based on appointment availability; 5. Adjust schedule backward to fill appointment slots earlier than the target; 6. Adjust schedule forward for appointments not able to be scheduled earlier or on target to the later slots; 7. Trial different target lead times until the difference between earlier and later lead time is minimized. Results The results indicated a 59% lead time reduction for RVs and a 45% reduction for NPs. The lead time variation was reduced by 75% for both patient types. Additionally, the opportunity for the participating clinic to achieve their organization’s goal of a two-week lead time for RVs and a twoday lead time for NPs is discussed by adjusting capacity to increase one slot for NP and reduce one slot for RV. Conclusions The proposed approach and study findings may help clinics identify feasible appointment lead times. Citation: Huang Y, Bach SM. Appointment lead time policy development to improve patient access to care.

How Well were Asthmatic Patients Educated about Their Asthma? A Study at the Emergency Department

2004 ◽  
Vol 16 (1) ◽  
pp. 45-49 ◽  
Author(s):  
P.Y. Lee ◽  
E.M. Khoo
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Teaching Hospital ◽  
Care Providers ◽  
Self Medication ◽  
Asthmatic Patients ◽  
Management Plans ◽  
Acute Asthma Exacerbation ◽  
The Difference ◽  
Bronchodilator Treatment

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.

scholarly journals A Spatiotemporal Convolutional Gated Recurrent Unit Network for Mean Wave Period Field Forecasting

2021 ◽  
Vol 9 (4) ◽  
pp. 383
Author(s):  
Ting Yu ◽  
Jichao Wang
Keyword(s):  
Lead Time ◽  
Wave Period ◽  
Data Driven ◽  
Lead Times ◽  
Proposed Model ◽  
Data Driven Approach ◽  
Mean Wave Period ◽  
Scattering Index ◽  
Gated Recurrent Unit ◽  
Methods Numerical

Mean wave period (MWP) is one of the key parameters affecting the design of marine facilities. Currently, there are two main methods, numerical and data-driven methods, for forecasting wave parameters, of which the latter are widely used. However, few studies have focused on MWP forecasting, and even fewer have investigated it with spatial and temporal information. In this study, correlations between ocean dynamic parameters are explored to obtain appropriate input features, significant wave height (SWH) and MWP. Subsequently, a data-driven approach, the convolution gated recurrent unit (Conv-GRU) model with spatiotemporal characteristics, is utilized to field forecast MWP with 1, 3, 6, 12, and 24-h lead times in the South China Sea. Six points at different locations and six consecutive moments at every 12-h intervals are selected to study the forecasting ability of the proposed model. The Conv-GRU model has a better performance than the single gated recurrent unit (GRU) model in terms of root mean square error (RMSE), the scattering index (SI), Bias, and the Pearson’s correlation coefficient (R). With the lead time increasing, the forecast effect shows a decreasing trend, specifically, the experiment displays a relatively smooth forecast curve and presents a great advantage in the short-term forecast of the MWP field in the Conv-GRU model, where the RMSE is 0.121 m for 1-h lead time.

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

2018 ◽  
Vol 34 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Erin Relyea ◽  
Brooke MacDonald ◽  
Christina Cattaruzza ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Access To Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Scoping Review ◽  
End Of Life Care ◽  
Psychosocial Interventions ◽  
Life Care ◽  
Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

scholarly journals Viewpoint: Health literacy and patient portals

2015 ◽  
Vol 7 (2) ◽  
pp. 172 ◽  
Author(s):  
Yulong Gu ◽  
Martin Orr ◽  
Jim Warren
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Health Care Providers ◽  
Easy Access ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Health Consumer ◽  
Improve Patient

Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology?s potential.

scholarly journals Negotiating candidacy: ethnic minority seniors' access to care

2009 ◽  
Vol 29 (4) ◽  
pp. 585-608 ◽  
Author(s):  
SHARON KOEHN
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Ethnic Minority ◽  
Health Care Providers ◽  
Service Providers ◽  
Future Research ◽  
Care Providers ◽  
Optimal Care ◽  
Barriers To Access ◽  
Recommendations For Action

ABSTRACTThe ‘Barriers to Access to Care for Ethnic Minority Seniors’ (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of ‘candidacy’, which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

scholarly journals Nurses' Attitudes towards Drug-Seekers in the Emergency Room

2013 ◽  
Author(s):  
Megan Gernt
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Policy Development ◽  
Survey Design ◽  
Educational Programs ◽  
Chief Complaint ◽  
Care Providers ◽  
Drug Seeking ◽  
Emergency Department Patients ◽  
Descriptive Survey

<p>Emergency department patients often present with a chief complaint of pain. There is a unique population of patients who present with this chief complaint in an effort to obtain narcotics for non-medical use. This population is often referred to as drug-seekers and there is little information available to define what exactly nurses mean when they use this term. This study utilized a descriptive survey design to gain a better understanding of nurses’ use of the term drug-seeker. Respondents agreed on a variety of behaviors that lead them to identify patients as drug-seeking and expressed a frustration with this population of patients. Many respondents identified a lack of clear policies and education around this population as a challenge. By understanding how nurses use the term drug-seeking, and developing an understanding what some of their concerns are regarding this population, the opportunity presents itself for the development of educational programs in order to train health care providers to best care for this challenging population. Additionally, the opportunity exists for policy development and implementation around this population in order to provide safe, comprehensive, and satisfactory care<strong>.</strong></p>

scholarly journals Evaluating usability, effectiveness, and usage of telehealth technologies

2014 ◽  
Author(s):  
◽  
Mirna Becevic
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Care Providers ◽  
New Technologies ◽  
Care Delivery ◽  
Traditional Approach ◽  
Additional Stress ◽  
Care Providers ◽  
Medical Specialties ◽  
Number Of Patients

Affordable Care Act (ACA) has allowed more patients that did not previously have health care insurance to have coverage and access to care. This increase in the number of patients seeking medical care will only add additional stress to the existing disproportion of supply and demand for health care providers. In addition, rising health care costs have major effect on how, where, and even if consumers will get needed care. This study examined three different telehealth platforms in three different medical specialties in order to evaluate the perception that they would be appropriate vehicles for increasing access to care. I also wanted to find out what the users' perceptions of these technologies are, as that can be a driving factor in adoption of new technologies. The first study examined the usability and acceptance of new mobile application in teledermatology clinic. The second study focused on usability and acceptance of ICU Robots in a medical ICU. Finally, the third study evaluated if children and youth currently using telepsychiatry as a care delivery method would have other in-person options if telehealth was not available. The results of these three studies point at the complexity and richness of telehealth. The adoption and acceptance of mHealth was very fast and streamlined. In the same fashion, children might not have other appropriate options for care if telepsychiatry was not available in rural Missouri. Interestingly, though, the provider acceptance of ICU Robots was slow, with some provider disengagements observed. This research contributes to the field of health informatics and medical informatics by evaluating adoption and usability of technologies from the provider perspective, vs. the more traditional approach of examining patient satisfaction, or even provider satisfaction without fully understanding the implications of attitudes on the adoption itself. This study has focused purposefully on different groups of providers using different types of telehealth technologies so we could try to see the bigger picture of how telehealth actually contributes to the health care organizational structure.

scholarly journals Improving Patient-Centredness in Endometriosis Care: A Study Protocol for a Prospective Study with a Mixed-Methods Approach

2021 ◽  
pp. 1-7
Author(s):  
Anneke M.F. Schreurs ◽  
Charlotte I. van Schaijik ◽  
Bianca De Bie ◽  
Jacques W.M. Maas ◽  
Cornelis Lambalk ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care Providers ◽  
Study Protocol ◽  
Care Providers ◽  
Mixed Methods Approach ◽  
Improvement Plan ◽  
A Prospective Study ◽  
Improve Patient ◽  
Patient Centredness

<b><i>Objective:</i></b> Endometriosis is a chronic gynaecologic disease, causing pain and infertility. As there is no definitive cure, patients are subjected to long-term care. This study aimed to improve patient-centred endometriosis care. Patient-centredness of endometriosis care can be evaluated using the validated ENDOCARE questionnaire (ECQ), resulting in centre-specific targets for improvement. To understand how to tackle the targets for improvement as found by the ECQ, focus groups can be organized. <b><i>Design:</i></b> This protocol presents a prospective study with a mixed-methods approach to improve patient-centredness of endometriosis care. The study consists of 5 steps: (1) evaluating current patient-centredness of endometriosis care by using the ECQ, (2) understanding targets for improvement, (3) drafting an improvement plan, (4) implementing improvements, and (5) evaluating the improved patient-centredness of endometriosis care. The final evaluation will be performed 1.5 years after implementing the improvement plan. <b><i>Methods:</i></b> Patient-centredness will be evaluated using the ECQ by inviting women with endometriosis to participate (steps 1 and 5). To investigate step 2, focus groups will be organized. For these focus groups, women with endometriosis are asked to participate until data saturation is achieved. During focus groups, participants are motivated to discuss the found targets for improvement and stimulated to find ways to improve them. The drafting and implementing of the improvement plan (steps 3 and 4) will be organized with the help of health-care providers in close collaboration with the patient organization. To assess whether the implementation of the improvement plan was successful in improving endometriosis care, the results from the ECQ in step 5 will be compared to the results from the ECQ in step 1. Ethical approval was granted by the local Institutional Review Board (Ref 2018.438). <b><i>Setting:</i></b> The study was conducted in the university hospital in the Netherlands. <b><i>Limitations:</i></b> Both patients and health-care providers will be involved in drafting the improvement plan. By making the health-care providers responsible for improving care, the chance of succeeding is optimized. Whether this improvement strategy is successful will be investigated after the implementation of the improvement plan. The improvement plan is clinic specific and can possibly not be extrapolated to other endometriosis clinics. In order to aim to improve patient-centred endometriosis care elsewhere, the complete study protocol should be performed. <b><i>Conclusions:</i></b> This study protocol aimed to investigate focus groups as a strategy to identify possible interventions to improve patient-centred endometriosis care by investigating the underlying causes for poor performance on patient-centred care. This study protocol could be used in more endometriosis care centres in the future and might also be useful for improving patient-centredness in other chronic diseases.

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