Medicine and Health Sciences Commons^™

A Hybrid System Dynamics, Discrete Event Simulation And Data Envelopment Analysis To Investigate Boarding Patients In Acute Hospitals, Leila Keshtkar, Wael Rashwan, Waleed Abo Hamad, Amr Arisha

Articles

Timely access to health services has become increasingly difficult due to demographic change and aging people growth. These create new heterogeneous challenges for society and healthcare systems. Congestion at acute hospitals has reached unprecedented levels due to the unavailability of acute beds. As a consequence, patients in need of treatment endure prolonged waiting times as a decision whether to admit, transfer, or send them home is made. These long waiting times often result in boarding patients in different places in the hospital. This threatens patient safety and diminishes the service quality while increasing treatment costs. It is argued in the …

Informing Quality In Emergency Care: Understanding Patient Experiences, Esmat Swallmeh, Vivienne Byers, Amr Arisha

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Purpose: Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED).

Design/methodology/approach: The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. …

Health Care For All In Ireland? The Consequences Of Politics For Health Policy, Vivienne Byers

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The Irish health-care system is a complicated mix of public and private providers, with inequitable and unclear routes for health-service users to access and navigate the system. In 2011, the Irish Government committed to significant health reform to develop a universal single-tier health system. In line with other European nations this was to be underpinned by the principle of social solidarity, with equitable access based on need rather than ability to pay. The road to this reform and its recent collapse highlights the practical implications of political and policy choices in health care, and has implications for financing and delivery, …

Using Rapid Reviews In Nursing And Midwifery Research: An Example From A Study Commissioned To Inform Policy-Making, Denise O'Leary, Mary Casey, Laserina O’Connor, Diarmuid Stokes, Gerard Fealy, Denise O’Brien, Rita Smith, Martin Mcnamara, Claire Egan

Articles

Aim: To illustrate the potential use of rapid review approaches in nursing and midwifery research by presenting a worked example from a study conducted to inform policy decision making.

Background: Rapid reviews, which can be defined as outputs of a knowledge synthesis approach that involves modifying or omitting elements of a systematic review process due to limited time or resources, are becoming increasingly popular in health research. This paper provides guidance on how a rapid review can be undertaken and discusses the strengths and challenges of the approach.

Data source and research design: Data from a rapid …

Bayesian Exponential Random Graph Modelling Of Interhospital Patient Referral Networks, Alberto Caimo, Francesca Pallotti, Alessandro Lomi

Articles

Using original data that we have collected on referral relations between 110 hospitals serving a large regional community, we show how recently derived Bayesian exponential random graph models may be adopted to illuminate core empirical issues in research on relational coordination among healthcare organisations. We show how a rigorous Bayesian computation approach supports a fully probabilistic analytical framework that alleviates well-known problems in the estimation of model parameters of exponential random graph models. We also show how the main structural features of interhospital patient referral networks that prior studies have described can be reproduced with accuracy by specifying the system …

Exploring The Importance Of Team Psychological Safety In The Development Of Two Interprofessional Teams, Denise O'Leary

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It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without …

Perspective: Massachusetts' Health Care Reform And Emergency Department Utilization, Christopher Chen, Gabriel Scheffler, Amitabh Chandra

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No abstract provided.

A Generic Approach To Computer-Based Clinical Practice Guideling Management Using The Eca Rule Paradigm And Active Databases, Bing Wu, Kudakwashe Dube

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The increasing demand for reduced cost and improved quality of service in healthcare has prompted the call for better management of medical knowledge. The main emphasis has been on knowledge that is acquired through experience and medical research and then formalised into Clinical Practice Guidelines (CPGs). This paper presents a generic approach to CPG information and knowledge management that uses the Event-Condition-Action (ECA) rule paradigm and active databases within a unified management framework. The paper focuses on an approach for facilitating the use and management of CPGs by clinicians through delivering the CPGs at the point-of-care by a computerised mechanism.

Planning In The Irish Healthcare System; Legislative Strategy Or Administrative Control?, Vivienne Byers

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Although strategic planning in healthcare has been in evidence in many OECD countries since the 1970s, it did not emerge in Ireland until the advent of legislatively mandated service planning in the 1990s. This occurred in the context of significant managerial, organisational and environmental change. One of the central mechanisms of the Strategic Management Initiative is the devolution of accountability and responsibility from the centre to the periphery. Service planning in the health sector in Ireland is seen as part of this strategic planning ethos. This paper reports on part of a wider study that examined both the intent and …

Mapping The Literature Of Health Care Management, Mary K. Taylor, Meseret D. Gebremichael, Cassie Wagner

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Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature.

Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering.

Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care …