Barriers Against Providing Home Health Care Delivery to Ventilator-Dependent Patients: A Qualitative Content Analysis

Abstract Background The work of registered nurses in home health care is complicated and extensive, and information technology (IT) is used in everyday activities. Coordination between care and resource efficiency is important. There is a wealth of information that supports the notion of sustainable development, but what sustainable development means from the perspective of the registered nurse in home health care when using IT is limited. The term “sustainable development” is not clearly defined and is poorly researched in nursing. Sustainable development in this study includes the ecological, economic, social, technical and ethical dimensions. The aim of this study was to describe registered nurses’ experience of IT use in home health care through a sustainable development model. Methods This study was conducted using ten semi-structured lifeworld interviews with registered nurses. The method employed was a qualitative content analysis with a deductive approach. The deductive approach consisted of a model of sustainable development. Results Analysis of the interviews and the model of sustainable development provided categories: using IT from an ecological dimension, the registered nurses experienced reduced consumption and damage to the environment; using IT in the economical dimension, saving of time and resources was experienced; the use of IT affected social aspects such as the work environment and patient safety, and positive consequences, such as accessibility, were also mentioned; using IT from a technical dimension was characterized by the nurse’s attitude towards it – the registered nurses felt it improved the quality of care and gave users an overview of the organization; and from an ethical dimension, the registered nurses expressed the need for IT to be adaptable to the patient’s well-being and indicated that more awareness of risks in the care meeting may be needed. Conclusion The findings are discussed based on the synergies and conflicts that arise between the different dimensions of sustainable development. IT intertwines and overlaps with, and within, the environment, economy, society, technology and ethics. Registered nurses in home health care want to conduct good and safe care, while using IT could benefit patients.

Download Full-text

Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.312 ◽

2021 ◽

pp. 1-5

Author(s):

Hesam Seyedin ◽

Morteza Rostamian ◽

Fahimeh Barghi Shirazi ◽

Haleh Adibi Larijani

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Services ◽

Health Care Providers ◽

Health Care Delivery ◽

Qualitative Content Analysis ◽

Care Delivery ◽

Information Access ◽

Care Providers ◽

Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

Download Full-text

A network flow-based model for operations planning in home health care delivery

The International Journal of Logistics Management ◽

10.1108/ijlm-02-2020-0073 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Fabián Castaño ◽

Nubia Velasco

Keyword(s):

Health Care ◽

Home Health Care ◽

Care Delivery ◽

Real Life ◽

Home Health ◽

Planning Problem ◽

Multiple Time ◽

Content Type ◽

Proposed Model ◽

Care Workers

PurposeTo solve the problem, a mathematical model is proposed; it relies on a directed acyclic graph (DAG), in which arcs are used to indicate whether a pair of appointments can be assigned to the same route or not (and so to the same care worker). The proposed model aims at minimizing the personnel required to meet daily demand and balancing workloads among the workers while considering the varying traffic patterns derived from traffic congestion.Design/methodology/approachThis paper aims at providing solution approaches for addressing the problem of assigning care workers to deliver home health-care (HHC) services, demanding different skills each. First, a capacity planning problem is considered, where it is necessary to define the number of workers required to satisfy patients' requests and then, patients are assigned to the care workers along with the sequence followed to visit them, thus solving a scheduling problem. The benefits obtained by permitting patients to propose multiple time slots where they can be served are also explored.FindingsThe results indicate that the problem can be efficiently solved for medium-sized instances, that is, up to 100 daily patient requests. It is also indicated that asking patients to propose several moments when they can receive services helps to minimize the need for care workers through more efficient route allocations without affecting significantly the balance of the workloads.Originality/valueThis article provides a new framework for modeling and solving a HHC routing problem with multiskilled personnel. The proposed model can be used to identify efficient daily plans and can handle realistic characteristics such as time-dependent travel times or be extended to other real-life applications such as maintenance scheduling problems.

Download Full-text

Planning Strategies for Home Health Care Delivery

Asia Pacific Journal of Operational Research ◽

10.1142/s021759591650041x ◽

2016 ◽

Vol 33 (05) ◽

pp. 1650041 ◽

Cited By ~ 9

Author(s):

Mike Hewitt ◽

Maciek Nowak ◽

Nisha Nataraj

Keyword(s):

Health Care ◽

Home Health Care ◽

Computational Study ◽

Care Delivery ◽

A Priori ◽

Planning Horizon ◽

Home Health ◽

Long Time ◽

The Cost ◽

The Impact

In home health care (our motivating application), consistency is representative of the general health care principle of continuity of care, which is often correlated with quality of care. Much of the existing research involving consistency in routing uses planning horizons that are a week or shorter. Yet in many settings the relationship between an organization and its customers lasts much longer. Hence, this paper looks at how one should plan when seeking consistency in routes extends the impact of caregiver-patient assignments. Specifically, the paper examines appropriate planning horizon length and, with an extensive computational study, demonstrates that a long planning horizon can have significant potential for savings in terms of transportation costs and staffing levels. Initially, a deterministic setting is considered, with all patient requests during the planning horizon known a priori, and the routing cost of planning for two to three months is compared with the cost when planning is done on a weekly basis. With uncertainty inherent in planning for such a long time horizon, a methodology is presented that anticipates future patient requests that are unknown at the time of planning. Computational evidence shows that its use is superior to planning on a weekly, rolling horizon basis.

Download Full-text

Public Policy Out of Control: The Home Health Care Experience

Care Management Journals ◽

10.1891/1521-0987.1.4.258 ◽

1999 ◽

Vol 1 (4) ◽

pp. 258-266 ◽

Cited By ~ 2

Author(s):

Susan C. Schulmerich

Keyword(s):

Health Care ◽

Home Care ◽

Home Health Care ◽

Care Delivery ◽

Health Care Delivery System ◽

Home Health ◽

Patient Access ◽

Care Experience ◽

Health Care Experience ◽

Care At Home

The home health care delivery system is facing challenges that threaten its survival as well as its very essence. Currently, the federal government provides the threat of disaster for home care patients, staff, and organizations. The dangers are palpable and very real. Although the immediate survival threat is fiscal, there are two other areas which have the potential to be equally devastating. The first is reduced, in some instances absent, patient access to care at home. The second is the flight of professional and paraprofessional personnel from home care.

Download Full-text