scholarly journals A case study of systems analysis to improve service in a multidisciplinary outpatient clinic

2012 ◽  
Vol 1 (1) ◽  
pp. 15 ◽  
Author(s):  
Abhijit Basu
Keyword(s):  
Service Delivery ◽  
Systems Analysis ◽  
Action Plan ◽  
District General Hospital ◽  
Service Improvement ◽  
Successful Implementation ◽  
Analysis Tool ◽  
Outpatient Services ◽  
Contributing Factors ◽  
Large Patient

Background/objective: Innovative ways of improving service delivery often requires testing new ideas. Systems analysis is a validated tool to investigate adverse incidents. This paper describes an innovative usage of this tool for service improvement and redesign in an out-patient setting involving a multidisciplinary team treating women with diabetes in pregnancy at an outer metropolitan health facility in Australia. Methods: Systems analysis tool was chosen to determine the probable causes for prolongation of clinic time causing dissatisfaction amongst the service users and the staff. It provided the template for an action plan regarding work and environmental, organizational process, team, individual, task and patient factors. Remedial actions were implemented over a six month period following this analysis. Timely completion of clinic was the chosen indicator of successful implementation. Results: Several interlinked layers of contributory factors were identified through systems analysis. The large patient load regardless of disease severity was the major contributor. Space restriction for consultation, lesser continuity in the team structure, dated guideline and limited communication between the team members were other factors. Changes implemented included redistribution of patients, adopting new evidence based guidelines, better patient selection accessing the dedicated one-stop clinic and a small change in capacity involving human resources. The service delivery process was restructured in tandem over six months. As a result of these interventions the clinics finished on time generating much greater level of satisfaction among the women attending the clinic and the staff. Conclusions: Redesigning service is an ongoing quality improvement process linked to user and provider satisfaction. Systems analysis is a tool designed to address adverse incidents and identify contributing factors. This study describes an innovative use of the systems analysis tool to improve outpatient services at a district general hospital. 

Delivering water services during protracted armed conflicts: How development agencies can overcome barriers to collaboration with humanitarian actors

2019 ◽  
Vol 101 (912) ◽  
pp. 1067-1089
Author(s):  
Edoardo Borgomeo
Keyword(s):  
Service Delivery ◽  
Armed Conflict ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Contributing Factors ◽  
Emergency Relief ◽  
Organizational Goals ◽  
Post Conflict ◽  
Development Agencies ◽  
Sub Saharan

AbstractThis note discusses the challenges of water service delivery before, during and after protracted armed conflict, focusing on barriers that may impede successful transition from emergency to development interventions. The barriers are grouped according to three major contributing factors (three “C”s): culture (organizational goals and procedures), cash (financing practices) and capacity (know-how). By way of examples, the note explores ways in which development agencies can overcome these barriers during the three phases of a protracted armed conflict, using examples of World Bank projects and experiences in the Middle East and Sub-Saharan Africa. Before the crisis, development agencies need to work to prevent armed conflict. In a situation of active armed conflict or when conflict escalates, development agencies need to remain engaged as much as possible, as this will speed up post-conflict recovery. When conflict subsides, development agencies need to balance the relative effort placed on providing urgently needed emergency relief and water supply and sanitation services with the effort placed on re-establishing sector oversight roles and capacity of local institutions to oversee and manage service delivery in the long term.

scholarly journals 307 Improving Compliance with Standard of Care Guidelines for Suspected Cauda Equina Syndrome Across A District General Hospital Network

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Richardson ◽  
F Greenway ◽  
A Mostofi ◽  
E Pereira
Keyword(s):  
Cauda Equina Syndrome ◽  
Guideline Implementation ◽  
Cauda Equina ◽  
Clinical Information ◽  
Standard Of Care ◽  
District General Hospital ◽  
Service Improvement ◽  
Local Policy ◽  
National Guidelines ◽  
Care Guidelines

Abstract Introduction Cauda equina syndrome (CES) is a spinal emergency that cannot be reliably detected through clinical examination alone and as a result requires prompt MR imaging to provide a diagnosis. This audit examined compliance to standard of care following service improvements in line with the updated SBNS/BASS national guidelines for CES. Method A retrospective analysis of 200 patients referred to neurosurgery for suspected CES: 100 pre- and 100 post-service improvement SBNS guideline implementation. The online neurosurgical database was reviewed, cases assessed for completeness of referral information (including appropriate exam and pre-referral MRI) with patient demographics, referring hospital and outcome also recorded. Results Prior to the SBNS guidelines only 19 patients received MRI prior to referral, 70% of all referrals were incomplete or contained erroneous clinical information. Post-service improvements there was a 68% increase of pre-referral MRI (32 cases), and an improvement in quality of clinical information with only 19% of referrals providing insufficient or unreliable information. Conclusions Through relatively simple changes to local policy, patient care flow and education of emergency department clinicians we have significantly improved pre-referral MRI rates as well as overall referral quality across the whole DGH network.

scholarly journals Experiences of school health nurses regarding the provision of the school health service delivery in the Tshwane district

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Selebetswe T. Dibakwane ◽  
Mmapheko D. Peu
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
School Health ◽  
Basic Education ◽  
Health Service Delivery ◽  
Successful Implementation ◽  
Main Role ◽  
School Health Service ◽  
School Health Programme ◽  
School Health Nurses

Background: Irrespective of the provision of an integrated school health policy, the school health nurses continue to experience multiple challenges regarding the provisioning of school health service delivery.Aim: The aim of this paper was to explore and describe the experiences of school health nurses regarding school health service delivery in the Tshwane district.Setting: Schools in the Tshwane district in Pretoria were used in the study.Methods: A qualitative and descriptive phenomenological design was used to conduct the study. Purposive sampling techniques were used to select a sample from the population of school health nurses employed in the Tshwane district and conduct the enquiry because of their knowledge and experience of school health services. The researchers collected data by means of unstructured, one-on-one in-depth interviews. The Tesch data analysis method was used by the researcher and co-coder. The researcher identified categories, subcategories and themes and these were reduced into grouping topics that were related to one another.Results: Positive and negative experiences of school health nurses emerged. It was evident from the findings of the study that the factors affecting the quality of the integrated school health programme (ISHP) provided were interrelated. Most of these factors negatively affected service delivery.Conclusion: It was recommended that the partnership between the National Department of Health and National Department of Basic Education as the main role players should be sustained at all times to ensure the successful implementation of the ISHP.

scholarly journals Experiential Learning Curriculum Delivery Approach for Quality Improvement in Resource Limited Settings: Mobile Learning for Point-of-Care Technologies

2019 ◽  
Vol 11 (13) ◽  
pp. 158
Author(s):  
Nkosinothando Chamane ◽  
Tivani Phosa Mashamba-Thompson
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Experiential Learning ◽  
Service Delivery ◽  
Point Of Care ◽  
Service Improvement ◽  
Quality Service ◽  
Resource Limited Settings ◽  
Primary Health ◽  
Resource Limited

BACKGROUND: Despite impressive progress that has been made in the provision of health care services to all, the issue of quality service delivery still remains a challenge particularly for point-of-care (POC) diagnostics in resource-limited-settings. Poor competency of primary health care workers in these settings has been shown to be amongst the main contributors to poor quality service delivery. FINDINGS: Participatory-based continuous professional development (CPD) strategies to support technology advancements in health care are recommended. Experiential learning approaches have been shown to be efficient in supplementing traditional teaching methods for both health care students and professionals. These approaches have been shown to further contribute towards continuous skills development and lifelong learning. CONCLUSION: This review therefore provided an overview of literature on experiential learning as one of CPD approaches in relation to health care service improvement in resource-limited setting. In addition, this review has recommended a mobile-based experiential learning approach to help deliver a quality POC technology curriculum to Primary health care-based workers in resource-limited settings.

Switch Technologies

2010 ◽  
pp. 157-168
Author(s):  
Cindy Nankee
Keyword(s):  
Assistive Technology ◽  
Physical Therapists ◽  
Action Plan ◽  
Age Groups ◽  
Individualized Education Program ◽  
Case Managers ◽  
Background Information ◽  
Successful Implementation ◽  
Communication Devices ◽  
Senior Services

The purpose of this chapter is to provide information about the use of switches in the field of assistive technology. Information included in this chapter will benefit assistive technology professionals, case managers, educators, physical therapists, occupational therapists, speech and language pathologists, rehabilitation counselors as well as students of these professions and consumers. The information will apply to all age groups including birth to six, all levels of primary and secondary education, adulthood and senior services. This chapter will go from assessment to implementation. First this chapter will look at the background information including the what, why, when, and where of switches. Next, this chapter will provide instruction on a variety of assessments available to aid in matching an appropriate switch to a client’s skill set and task requirement. The chapter also discusses types of switches that can access toys, computers, communication devices, environmental controls, recreation, and mobility options. Finally, the chapter presents strategies for successful implementation including the prompt hierarchy, an action plan, data collection, and writing assistive technology into the Individualized Education Program.

eSME Slovenia

2011 ◽  
pp. 995-1022
Author(s):  
Andreja Pucihar ◽  
Gregor Lenart
Keyword(s):  
European Union ◽  
Growth And Development ◽  
Action Plan ◽  
European Union Country ◽  
Business Development ◽  
Successful Implementation ◽  
The European Union ◽  
Economic Growth And Development ◽  
Ministry Of Finance ◽  
Ministry Of Higher Education

This chapter introduces e-strategies, initiatives and action planes in the European Union intended for the successful implementation of the Lisbon Strategy, according to which Europe should become the most competitive and dynamic society based on knowledge by 2010. These strategies are the baseline for the national policies, strategies and initiatives in every European Union country. The chapter presents policies, legislation environment and initiatives being adopted in Slovenia. Moreover, data about e-business development in Slovenia is also presented. As in other EU countries, it is evident that SMEs are generally lagging behind large organizations as far as the adoption and usage of e-commerce is concerned. The situation was a background for the preparation of the eSMEs Slovenia initiative and action plan to accelerate e-business introduction and adoption in SMEs. The initiative and action plan consist of 12 actions, which are elaborated in this chapter. The initiative was supported by the ministers of the Ministry of Higher Education and Technology, the Ministry of Public Administration, the Ministry of Economy, the Ministry of Finance, the Ministry of Economic Growth and Development and other involved institutions. Thus, the initiative presents an important framework for the further uptake of e-business adoption by SMEs. The chapter is concluded by a summary of the chapter’s main contributions.

An Overview of Memory Provisioning in Real-Time Wireless Sensor Networks

2013 ◽  
Vol 5 (4) ◽  
pp. 73-91
Author(s):  
Jacqueline Stewart ◽  
Thomas McCabe ◽  
Robert Stewart ◽  
Sean Kennedy
Keyword(s):  
Wireless Sensor Networks ◽  
Sensor Networks ◽  
Service Delivery ◽  
Real Time ◽  
Service Providers ◽  
Wireless Sensor ◽  
Analysis Tool ◽  
Time Service ◽  
Main Challenge ◽  
Stack Analysis

Wireless Sensor Networks and the smart applications designed to operate upon them have enjoyed a rapid increase in popularity over the last decade. The main challenge currently is the provision of real-time service delivery for wireless sensor networks to cater for new applications with guaranteed Quality of Service (QoS) requirements. However each application has a different service requirement. In order to deliver real-time services the dimensioning of such networks is important to service providers in order to meet these service requirements. If packets cannot be stored due to insufficient memory they are lost. Lost packets result in the resending of the packets and hence an increase in delay in delivery of the application traffic. It is this memory provisioning of these wireless sensor networks that is the focus of the work presented in this paper. More specifically the relationship between the application design, implementation and memory resources required to run the service are explored using a stack analysis tool. This stack analysis tool enables the stack footprint to be measured. Results of memory usage for two different WSN applications are presented. Recommendations based on this study for efficient memory provisioning and ultimately real-time service delivery are given.

scholarly journals The FOCAC Process and Sino-African Strategic Partnership

2016 ◽  
Vol 02 (02) ◽  
pp. 259-276
Author(s):  
Garth Shelton
Keyword(s):  
Significant Contribution ◽  
Action Plan ◽  
Strategic Partnership ◽  
Social Aspects ◽  
Successful Implementation ◽  
Positive Outcomes ◽  
Future Challenges ◽  
To Come ◽  
Trade And Investment

Historical records confirm that China’s increasing engagement with Africa through growing trade and investment has been a major boost for African economies. China’s comprehensive commitment to Africa through the Forum on China-Africa Cooperation (FOCAC) has also made significant contribution to Africa’s overall economic development. The constructivist approach underpinning this paper suggests that FOCAC’s evolution can be positively shaped by all active participants toward increased mutual benefit and positive outcomes. With all the consensuses and commitments reached at the Johannesburg FOCAC summit (FOCAC VI) held in December 2015, a stronger Sino-African partnership is expected to take shape as both sides take efforts to enhance their win-win cooperation. The key future challenges for China and Africa are to implement the FOCAC VI Action Plan and develop a long-term FOCAC agenda which will broaden and strengthen win-win outcomes in the years to come. At the same time, Africa should try its best to ensure the successful implementation of FOCAC projects and facilitate China’s engagement, for a business-friendly environment in Africa, whether in policy, legal or social aspects, is the key to promoting the Sino-African strategic partnership and enhancing sustainable development of the African continent.

Knowledge-Based Scheduling Analysis Software for Highway Rehabilitation and Reconstruction Projects

2005 ◽  
Vol 1907 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Eul-Bum Lee ◽  
John T. Harvey ◽  
Michael M. Samadian
Keyword(s):  
Critical Path ◽  
Agency Cost ◽  
Road User ◽  
Successful Implementation ◽  
Analysis Tool ◽  
California Department ◽  
Pavement Rehabilitation ◽  
Knowledge Based ◽  
Urban Freeway ◽  
Rehabilitation Strategies

Most of California's highway infrastructure was built between 1955 and 1970. These pavements had 20-year design lives, and many now require frequent maintenance. In 1998, the California Department of Transportation (Caltrans) launched the Long-Life Pavement Rehabilitation Strategies (LLPRS) program to rebuild approximately 2,800 lane kilometers of high-traffic-volume urban freeway in the 78,000-lane kilometer state highway network over a 10-year period. Priorities identified for the successful implementation of LLPRS projects are the selection of construction schedules and the development of traffic management plans that minimize road user and agency costs. This paper presents a construction simulation program called CA4PRS (Construction Analysis for Pavement Rehabilitation Strategies). The program was developed as a scheduling and production analysis tool for LLPRS projects for use during the planning and design stages. CA4PRS estimates the optimized distance and duration of highway rehabilitation projects. It takes into account the constraints of scheduling interfaces, pavement design, lane closure tactics, and contractor logistics. As a knowledge-based computer system on a Microsoft Access database, it uses Monte Carlo simulation, critical path method analysis, and linear scheduling. CA4PRS is designed to help highway agencies and paving contractors make construction schedule decisions that balance rehabilitation productivity, traffic inconvenience, and agency cost. Application of the CA4PRS model to urban freeway rehabilitation projects in California, including the I-10 Pomona, I-710 Long Beach, and I-15 Devore projects, has demonstrated its value in saving millions of dollars for both Caltrans and road users.

scholarly journals Simulation and the simulation language SLAM II as a systems analysis tool

1989 ◽  
Vol 20 (3) ◽  
pp. 154-162
Author(s):  
P. S. Kruger ◽  
P. Lindeque ◽  
K. Adendorff
Keyword(s):  
Simulation Model ◽  
Systems Analysis ◽  
System Performance ◽  
Simulation Modelling ◽  
Analysis Tool ◽  
General Introduction ◽  
Materials Handling ◽  
Beer Brewing ◽  
Simulation Language ◽  
Loading And Unloading

This paper provides a general introduction to the simulation technique and the simulation language SLAM II. The use of simulation modelling and in particular SLAM II is demonstrated by way of an illustrative example consisting of the building and manipulation of a simulation model of a materials handling subsystem of a beer brewing and packaging plant. The purpose of the model is to investigate the influence of the number of loading and unloading docks on various measures of system performance.

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