Health and Medical Administration Commons^™

Testing Cost Containment Of Future Healthcare With Maintained Or Improved Quality—The Costcares Project, Karl Swedberg, Desmond Cawley, Inger Ekman, Heather L. Rogers, Darijana Antonic, Daiga Behmane, Ida Björkman Ida Björkman, Nicky Britten, Sandra C. Buttigieg, Vivienne Byers, Mats Börjesson, Kirsten Corazzini, Andreas Fors, Bradi Granger, Boban Joksimoski, Boban Joksimoski, Roman Lewandowski, Virgilijus Sakalauskas, Einav Srulovici, Jan Törnell, Sara Wallström, Axel Wolf, Helen M. Lloyd

Other resources

Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies.

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 …

A Multi-Method Scheduling Framework For Medical Staff, Wael Rashwan, John Fowler, Amr Arisha

Conference Papers

Hospital planning teams are always concerned with optimizing staffing and scheduling decisions in order to improve hospital performance, patient experience, and staff satisfaction. A multi-method approach including data analytics, modeling and simulation, machine learning, and optimization is proposed to provide a framework for smart and applicable solutions for staffing and shift scheduling. Factors regarding patients, staff, and hospitals are considered in the decision. This framework is piloted using the Emergency Department(ED) of a leading university hospital in Dublin. The optimized base staffing patterns and shift schedules actively contributed to solving ED overcrowding problem and reduced the average waiting time for …

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

Articles

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. …

Patient Experience Informs Health Care Strategies In Irish Hospitals, Heba Habib

Doctoral

Patients are central to health care facilities and institutions; therefore, a dire need arises to include feedback of their experience in the decision-making process. Patient experience is increasingly recognised as one of the three pillars of quality in healthcare alongside clinical effectiveness and patient safety. A comprehensive literature review (more than 2500 peer-reviewed articles) has identified five key frameworks for patient experience including: UK Picker Institute Principles and US H-CAHPS. The frameworks have enabled the identification of a potential range of patient experience dimensions and helped in grouping them into nine categories. However, there are still opportunities to address research …

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

Articles

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

Articles

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 …

Evaluation Of Smoking Cessation Services In Ireland: Design And Pilot Of A Smoking Cessation Treatment Database, Sheila Keogan

Masters

A reduction in tobacco use is one of the stated aims of the National Health Promotion Strategy
(2000-2005) (Department of Health and Children, 2000a) as well being the core activity of
membership for all health promoting hospitals (HPH).
AIMS OF THE STUDY

1. To develop a database of smoking cessation services in Ireland.

2. Do a census of the smoking cessation services in Ireland and evaluate the range and
availability of them.
3. Develop a database for use in smoking cessation treatment services which would schedule
consultations with patients and gather all relevant demographics, treatments and their outcomes,
(cessation treatment …

Assessment Of Fire Safety And Evacuation Management In Nursing Homes, John Moore

Masters

Methodology Seventeen nursing homes in Ireland were recruited to take part in this research.Ownership varies with seven private homes and ten Health Service Executive (HSE) administered homes involved. The homes were surveyed between May 2007 andNovember 2008. The methodology consisted of the following three elements: A building survey to establish fire safety facilities: An analysis of fire related documentation: Interviews with staff to establish existing fire safety procedures. Results None of the seventeen nursing homes showed an adequate ability to prevent fire or evacuate residents to a place of safety. None of the nursing homes carried out adequate fire risk …

Renewing Health Services Management Research: Redrawing The Citizen-Client In Irish Health Care Policy, Vivienne Byers

Conference Papers

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be …

Revitalisation, Rigour And Relevance: The Citizen-Client And Planning In The Health Services., Vivienne Byers

Conference Papers

Whereas, in many OECD countries strategic planning in health care has been in evidence since the 1970s, in Ireland the emergence of strategic management processes in health care planning didn’t occur until the 1990s.

This paper reports on part of a comparative study of health services planning in Ireland and in Canada. How can the strategic management of the Irish health services in the form of service planning be implemented? The focus of this paper is the identification of two key stumbling blocks to success in this endeavour. These include the limitations of the control mechanism, the legislation, underpinning service …

Strategic Change In The Irish Health Services: Comparative Case Studies In Planning, Vivienne Byers

Conference Papers

This paper reports on a study of the implementation of service planning in the Irish health services in the context of significant organisational change. One of the central mechanisms of the Strategic Management Initiative (SMI) is the devolution of accountability and responsibility from the centre to executive agencies. Service planning in the Irish health care sector is seen as part of this strategic planning ethos.

This study in examining the function and implementation of the service plan in the Irish health care system drew comparisons with the Canadian experience. A multiple case study design was utilised. Key research questions were …

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

Articles

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

Articles

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 …

Patient-Centred Laboratory Validation Using Software Agents, John Mcgrory, Jane Grimson, Frank Clarke, Peter Gaffney

Conference Papers

Guidelines are self-contained documents which healthcare professionals reference to obtain knowledge about a specific condition or process. They interface with these documents and apply known facts about specific patients to gain useful supportive information to aid in developing a diagnosis or manage a condition. To automate this process a series of Standard Operating Procedures (SOP) and workflow processes are constructed using the contents of these documents in order to manage the validation flow of a patient sample. These processes decompose the guidelines into workflow plans, which are then called using condition triggers controlled by a centralised management engine. The software …

An Event-Driven Approach To Computerizing Clinical Guidelines Using Xml, Bing Wu, Essam Mansour, Kudakwashe Dube, Jianxin Li

Conference Papers

Clinical events form the basis of patient care practice. Their computerization is an important aid to the work of clinicians. Clinical guidelines or protocols direct clinicians and patients on when and how to handle clinical problems. Thus, clinical guidelines are an encapsulation of clinical events. Hence, an event-driven approach to computerizing the management of clinical guidelines is worthy of investigation. In our framework, called SpEM, the main clinical guideline management dimensions are specification, execution, and manipulation. This paper presents an event-driven approach, within the context of the SpEM framework, to manage clinical guidelines. The event-driven approach is based on the …

An Integrated Risk Assessment Tool To Evaluate The Existing Risk Managment System Within A Health Care Facility, Laura F. Breen

Masters

Risk assessment is a method used to identify risks within an organisation. It is required by the Safety Health and Welfare at Work Act, 189 for the purpose of safety management. No one method can effectively identify all types of hazard and risks within organisations. The insufficiency of individual risk assessment techniques to generate objective data as to the level of risk, is now generally accepted as an issue in risk management. Therefore, a combination of risk assessment techniques, best suited for the organisation, could improve risk assessments. This study set out to develop and combine a number of risk …