Regina K. Saylor, Andrea Blome, D. Isenberg, Daniel A. DelPortal, W. Satz, Kraftin E Schreyer
Objective: Optimizing resource utilization is critical to reducing healthcare costs. Our study aims to review trends in overall patient volume, acuity, time of presentation, and use of resources in the emergency department (ED) during the COVID-19 pandemic.Methods: We compared ED utilization from a 30-day period during the height of the COVID-19 pandemic (April 1, 2020-April 30, 2020) to the same 30-day period in the preceding calendar year (April 1, 2019-April 30-2019). Data were grouped into outcome measures focusing on ED throughput and utilization of ancillary ED services.Results: While the absolute number of patients in or arriving to the ED at any given time was significantly lower during the COVID-19 pandemic (p < .01), the hourly patterns of patient census, arrivals, and admissions all aligned with pre-pandemic values. Also, patient acuity, as measured by ESI level, did not significantly change. The absolute number of admissions for bothsites was similar to the pre-pandemic time period, but the percentage of patients admitted over the 30-day period increased. The absolute number of radiographic and laboratory studies ordered in the ED also changed significantly (p < .05), but the hourly pattern did not.Conclusions: Our study shows significantly lower patient volumes, increased admission rates, and no significant change in the hourly throughput of the ED. Thus, our analysis suggests that shift times should not be adjusted, nor should the number or composition of providers on each shift in academic and community ED sites during the COVID national lockdown.
{"title":"Emergency department utilization during the COVID-19 pandemic","authors":"Regina K. Saylor, Andrea Blome, D. Isenberg, Daniel A. DelPortal, W. Satz, Kraftin E Schreyer","doi":"10.5430/jha.v9n6p25","DOIUrl":"https://doi.org/10.5430/jha.v9n6p25","url":null,"abstract":"Objective: Optimizing resource utilization is critical to reducing healthcare costs. Our study aims to review trends in overall patient volume, acuity, time of presentation, and use of resources in the emergency department (ED) during the COVID-19 pandemic.Methods: We compared ED utilization from a 30-day period during the height of the COVID-19 pandemic (April 1, 2020-April 30, 2020) to the same 30-day period in the preceding calendar year (April 1, 2019-April 30-2019). Data were grouped into outcome measures focusing on ED throughput and utilization of ancillary ED services.Results: While the absolute number of patients in or arriving to the ED at any given time was significantly lower during the COVID-19 pandemic (p < .01), the hourly patterns of patient census, arrivals, and admissions all aligned with pre-pandemic values. Also, patient acuity, as measured by ESI level, did not significantly change. The absolute number of admissions for bothsites was similar to the pre-pandemic time period, but the percentage of patients admitted over the 30-day period increased. The absolute number of radiographic and laboratory studies ordered in the ED also changed significantly (p < .05), but the hourly pattern did not.Conclusions: Our study shows significantly lower patient volumes, increased admission rates, and no significant change in the hourly throughput of the ED. Thus, our analysis suggests that shift times should not be adjusted, nor should the number or composition of providers on each shift in academic and community ED sites during the COVID national lockdown.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74339349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kim D., O’Connor S.J., Williams J.H., Opoku-Agyeman W., Chu D.I., Choi S.
Health literacy has become an important topic to discuss in the US healthcare system. Almost nine out of ten adults in the United States lack the knowledge and skills required to manage their health and prevent disease. While studies have shown the importance of health literacy, not may have explored its’ history and conceptual roots. Hence, the purpose of this study is to address the gap in the literature by reviewing studies related to the past, present, and the effect of health literacy. The results have shown that inadequate health literacy does affect patients’ general health and performance of the US healthcare system.
{"title":"Health literacy: What we know and don’t know - A literature perspective","authors":"Kim D., O’Connor S.J., Williams J.H., Opoku-Agyeman W., Chu D.I., Choi S.","doi":"10.5430/jha.v9n6p12","DOIUrl":"https://doi.org/10.5430/jha.v9n6p12","url":null,"abstract":"Health literacy has become an important topic to discuss in the US healthcare system. Almost nine out of ten adults in the United States lack the knowledge and skills required to manage their health and prevent disease. While studies have shown the importance of health literacy, not may have explored its’ history and conceptual roots. Hence, the purpose of this study is to address the gap in the literature by reviewing studies related to the past, present, and the effect of health literacy. The results have shown that inadequate health literacy does affect patients’ general health and performance of the US healthcare system.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88119279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At the start of 2020, hospitals around the world were trying to adapt during the COVID-19 pandemic. From the resilience engineering perspective, this outbreak would be a significant test as healthcare institutions try to tolerate and manage this major disruption. This paper shares insights on what a stand-alone paediatric hospital in Singapore had done to stay ahead since the beginning of the outbreak. Observations were conducted from 25-Jan-20 to 25-Mar-20 to capture evidence of resilient behavior, notably in the form of improvisations. Findings revealed adaptations made across various organization levels: at the macrosystem to create capacity to isolate safely, at the mesosystem to facilitate teamwork, and at the microsystem to manage compromises at the frontlines. Juxtaposing this episode with other examples of organizational resilience, this paper maps out common resilience engineering themes in the hospital’s response to COVID-19, but also questions what defines an organization’s success in being
{"title":"Resilience engineering in practice: Reflecting on a pediatric hospital’s preparation for unknown coronavirus outbreak","authors":"Shanqing Yin, C. Chong, K. Ng, K. Lee","doi":"10.5430/jha.v9n6p1","DOIUrl":"https://doi.org/10.5430/jha.v9n6p1","url":null,"abstract":"At the start of 2020, hospitals around the world were trying to adapt during the COVID-19 pandemic. From the resilience engineering perspective, this outbreak would be a significant test as healthcare institutions try to tolerate and manage this major disruption. This paper shares insights on what a stand-alone paediatric hospital in Singapore had done to stay ahead since the beginning of the outbreak. Observations were conducted from 25-Jan-20 to 25-Mar-20 to capture evidence of resilient behavior, notably in the form of improvisations. Findings revealed adaptations made across various organization levels: at the macrosystem to create capacity to isolate safely, at the mesosystem to facilitate teamwork, and at the microsystem to manage compromises at the frontlines. Juxtaposing this episode with other examples of organizational resilience, this paper maps out common resilience engineering themes in the hospital’s response to COVID-19, but also questions what defines an organization’s success in being","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"14 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72826397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peng Zhang, Lina Ma, Liquan Wang, P. An, Xiaohui Li, Shu-me Zhao
Objective: Currently, the medical adverse events stem in part from a lack of significant risk management in preoperative evaluation. This study was to apply the systematic risk management —AS/NZS 4360:2004 to perform the project of preoperative evaluation. Methods: With the idea of risk management, the doctor’s classification and surgery’s groups were graded to lay the foundation for project management. Then a preoperative evaluation center was established as a screening role in health management based on AS/NZS 4360:2004. Results: A total of 144 out of 1,436 patients were identified as ones with much risk mainly including clinical characteristics such as abnormal test (n = 27), cardiovascular disease (n = 27) and fever (n = 23) from pediatric (35%), general surgery (20%) and trauma (15.66%) department. Finally, the potential risk was reduced in the medical process meanwhile the quality of treatment was improved. Conclusions: This study shows that risk management could be applied into all aspects of hospital management as a drastic and practiced tool.
{"title":"Apply the systematic risk management—AS/NZS 4360:2004 to operate the project of preoperative evaluation","authors":"Peng Zhang, Lina Ma, Liquan Wang, P. An, Xiaohui Li, Shu-me Zhao","doi":"10.5430/jha.v9n5p38","DOIUrl":"https://doi.org/10.5430/jha.v9n5p38","url":null,"abstract":"Objective: Currently, the medical adverse events stem in part from a lack of significant risk management in preoperative evaluation. This study was to apply the systematic risk management —AS/NZS 4360:2004 to perform the project of preoperative evaluation. Methods: With the idea of risk management, the doctor’s classification and surgery’s groups were graded to lay the foundation for project management. Then a preoperative evaluation center was established as a screening role in health management based on AS/NZS 4360:2004. Results: A total of 144 out of 1,436 patients were identified as ones with much risk mainly including clinical characteristics such as abnormal test (n = 27), cardiovascular disease (n = 27) and fever (n = 23) from pediatric (35%), general surgery (20%) and trauma (15.66%) department. Finally, the potential risk was reduced in the medical process meanwhile the quality of treatment was improved. Conclusions: This study shows that risk management could be applied into all aspects of hospital management as a drastic and practiced tool.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"39 1","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82737437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra M. Villagran, Janet Malek, Sophie Schneider, Christi J. Guerrini
As the Coronavirus Disease 2019 pandemic continues, increased attention has been given to its mental health impacts on frontline health care workers. There is a consensus, consistent with established standards applicable to the duty to treat, that health care workers who are especially vulnerable to risk of physical harm should be provided job accommodations to reduce their risk of disease exposure, but it is unclear whether health care workers should be provided similar accommodations if their vulnerability relates specifically to mental health concerns. Especially given emerging evidence that the pandemic is taking a heavy toll on the mental health of health care workers, this issue should be included in policy conversations involving support of health care workers and provision of resources to them during the pandemic. Arguments in favor of expanding accommodations to those with mental health concerns include institutions’ ethical duty to protect vulnerable workers and not discriminate against their employees, as well as broader consideration of the consequences of not providing accommodations, both for health care workers and patients.
{"title":"Should health care institutions provide job accommodations for health care workers with serious mental health concerns during the COVID-19 pandemic?","authors":"Alexandra M. Villagran, Janet Malek, Sophie Schneider, Christi J. Guerrini","doi":"10.5430/jha.v9n5p31","DOIUrl":"https://doi.org/10.5430/jha.v9n5p31","url":null,"abstract":"As the Coronavirus Disease 2019 pandemic continues, increased attention has been given to its mental health impacts on frontline health care workers. There is a consensus, consistent with established standards applicable to the duty to treat, that health care workers who are especially vulnerable to risk of physical harm should be provided job accommodations to reduce their risk of disease exposure, but it is unclear whether health care workers should be provided similar accommodations if their vulnerability relates specifically to mental health concerns. Especially given emerging evidence that the pandemic is taking a heavy toll on the mental health of health care workers, this issue should be included in policy conversations involving support of health care workers and provision of resources to them during the pandemic. Arguments in favor of expanding accommodations to those with mental health concerns include institutions’ ethical duty to protect vulnerable workers and not discriminate against their employees, as well as broader consideration of the consequences of not providing accommodations, both for health care workers and patients.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"103 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2020-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79147125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The US healthcare system has been facing pressures from stakeholders to reduce costs and improve quality. The purpose of this paper is to develop a conceptual model to illustrate the approaches used in healthcare quality management (Continuous Quality Improvement/Total Quality Management, Lean, and Six Sigma) weaved into the underlying framework of scientific management theory. This paper employs scientific management theory to explain the healthcare quality tenets that influence the quality of care in our healthcare organizations. The father of scientific management, Frederick Taylor, and other key contributors collectively created scientific management principles, which are widely used for quality improvement purposes both in the engineering and the healthcare field. Healthcare quality is also discussed with examples of the application of scientific management principles. Shared themes between scientific management principles and healthcare quality tenets, as given in CQI/TQM, Six Sigma-Lean, and Donabedian Model, were developed. To understand the three pillars of quality (structure, process, outcome) in relation to the underpinnings of scientific management principles, we incorporated insights of scientific management theory into Donabedian’s healthcare quality model. It is recommended that selection of personnel play a more significant role among human resources practices in organizations; strategy formulation must include a careful assessment of organizations’ strengths and weaknesses with regard to continuous quality improvement, with organizations striving to achieve standardization to attain efficiency and reduce costs.
{"title":"Improving healthcare quality in the United States healthcare system: A scientific management approach","authors":"Soumya Upadhyay, William Opoku-Agyeman","doi":"10.5430/jha.v9n5p19","DOIUrl":"https://doi.org/10.5430/jha.v9n5p19","url":null,"abstract":"The US healthcare system has been facing pressures from stakeholders to reduce costs and improve quality. The purpose of this paper is to develop a conceptual model to illustrate the approaches used in healthcare quality management (Continuous Quality Improvement/Total Quality Management, Lean, and Six Sigma) weaved into the underlying framework of scientific management theory. This paper employs scientific management theory to explain the healthcare quality tenets that influence the quality of care in our healthcare organizations. The father of scientific management, Frederick Taylor, and other key contributors collectively created scientific management principles, which are widely used for quality improvement purposes both in the engineering and the healthcare field. Healthcare quality is also discussed with examples of the application of scientific management principles. Shared themes between scientific management principles and healthcare quality tenets, as given in CQI/TQM, Six Sigma-Lean, and Donabedian Model, were developed. To understand the three pillars of quality (structure, process, outcome) in relation to the underpinnings of scientific management principles, we incorporated insights of scientific management theory into Donabedian’s healthcare quality model. It is recommended that selection of personnel play a more significant role among human resources practices in organizations; strategy formulation must include a careful assessment of organizations’ strengths and weaknesses with regard to continuous quality improvement, with organizations striving to achieve standardization to attain efficiency and reduce costs.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"304 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86796432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. S. R. Rosa Duque, P. Q. Mak, J. S. Wong, C. Chan, C. Chow, W. Chiu, W. Yeung, I. Lam, G. Chua, M. Ho, K. To, P. Ip, M. Kwan
The implication of gastrointestinal infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its transmission remains to be fully understood. We studied 4 paediatric patients with several weeks of faecal excretion of SARS-CoV-2 RNA who had only mild symptoms. International consensus on isolation practices is urgently needed.
{"title":"Discharging coronavirus disease 2019 (COVID-19) patients with faecal viral shedding and prolonged hospitalisation","authors":"J. S. R. Rosa Duque, P. Q. Mak, J. S. Wong, C. Chan, C. Chow, W. Chiu, W. Yeung, I. Lam, G. Chua, M. Ho, K. To, P. Ip, M. Kwan","doi":"10.5430/jha.v9n5p26","DOIUrl":"https://doi.org/10.5430/jha.v9n5p26","url":null,"abstract":"The implication of gastrointestinal infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its transmission remains to be fully understood. We studied 4 paediatric patients with several weeks of faecal excretion of SARS-CoV-2 RNA who had only mild symptoms. International consensus on isolation practices is urgently needed.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81225859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah S. Dhake, Jessica Folk, Adam Haag, P. Imas, Loretta Au, E. Wang
Objective: Combating Coronavirus 2019 has stretched hospital resources to the extreme. In an effort to cohort personnel and equipment, NorthShore University HealthSystem (NSUHS) designated Glenbrook Hospital (GBH) as our “COVID hospital”, which became public knowledge on April 6, 2020. We hypothesize that with this public declaration our emergency department (ED) total volumes and COVID-19 related visits would be affected. Methods: We performed a retrospective analysis of our total ED volumes and COVID-19 related ED visits from March 12, 2020 until April 30, 2020. The pre public declaration timeframe of March 12-April 5, 2020 acted as our control whereas the post-public declaration acted as the testing group (April 6-April 30, 2020). NSUHS four primary hospitals were included in the analysis. We ran a chi-squared analysis on both groups to determine if there was statistical significance. Results: Both total ED volumes and COVID-19 related ED visits, when comparing pre VS post-public declaration of GBH as the “COVID hospital”, showed statistical significance ( p < .001). Three of the four hospitals had a decrease in total ED volumes, whereas the COVID-19 related ED visits increased at two hospitals and decreased at the others. Conclusions: Our results support our hypothesis that after the public declaration of Glenbrook Hospital as the “COVID hospital”, patients’ decision making regarding which ED to visit was significantly affected. Certain limitations, including socioeconomic status and a small geographical footprint of NSUHS, may have affected our results. Further work should be done to reproduce these results to ensure replication.
{"title":"COVID-19 hospital designation: Effect on emergency department patient self-selection and volume","authors":"Sarah S. Dhake, Jessica Folk, Adam Haag, P. Imas, Loretta Au, E. Wang","doi":"10.5430/jha.v9n5p14","DOIUrl":"https://doi.org/10.5430/jha.v9n5p14","url":null,"abstract":"Objective: Combating Coronavirus 2019 has stretched hospital resources to the extreme. In an effort to cohort personnel and equipment, NorthShore University HealthSystem (NSUHS) designated Glenbrook Hospital (GBH) as our “COVID hospital”, which became public knowledge on April 6, 2020. We hypothesize that with this public declaration our emergency department (ED) total volumes and COVID-19 related visits would be affected. Methods: We performed a retrospective analysis of our total ED volumes and COVID-19 related ED visits from March 12, 2020 until April 30, 2020. The pre public declaration timeframe of March 12-April 5, 2020 acted as our control whereas the post-public declaration acted as the testing group (April 6-April 30, 2020). NSUHS four primary hospitals were included in the analysis. We ran a chi-squared analysis on both groups to determine if there was statistical significance. Results: Both total ED volumes and COVID-19 related ED visits, when comparing pre VS post-public declaration of GBH as the “COVID hospital”, showed statistical significance ( p < .001). Three of the four hospitals had a decrease in total ED volumes, whereas the COVID-19 related ED visits increased at two hospitals and decreased at the others. Conclusions: Our results support our hypothesis that after the public declaration of Glenbrook Hospital as the “COVID hospital”, patients’ decision making regarding which ED to visit was significantly affected. Certain limitations, including socioeconomic status and a small geographical footprint of NSUHS, may have affected our results. Further work should be done to reproduce these results to ensure replication.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"47 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82702674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hisahiro Ishijima, Masashi Teshima, Yasuko Kasahara, N. Miyamoto, Fares Masaule, R. John
Hospital managers in Tanzania have always been expected to manage and deliver quality services to patients under resource constrained situation. In the organizational structure of regional referral hospitals (RRHs) in Tanzania, including, clinicians with very limited knowledge of and skills in management hold over 80% of the managerial positions. The Ministry of Health, Community Development, Gender, Elderly and Children of Tanzania has identified the strengthening of management at RRHs as a key to improving efficiency and effectiveness in health service delivery. The ministry launched a five-year project for strengthening hospital management in RRHs in collaboration with the Japan International Cooperation Agency. The project provided a series of training courses for capacitating RRH management Team (RRHMT), and developed and introduced several planning, monitoring, and evaluation tools. This study was conducted to identify the positive factors and approaches for strengthening management of RRHs. Necessary information and data were collected through the intervention and analyzed to measure the effectiveness of the interventions. RRHMT members obtained basic knowledge of and skills for hospital management through the project interventions with those deferent management tools to improve the completion of their hospital management tasks. Based on the findings, it can be concluded that the interventions were effective in strengthening the managerial capacity of RRHMTs. The study also confirmed that the strategy to improve hospital management was on the right track for improving health service delivery in efficient and effective manners. The lessons learned from the project can be adjusted for the management of lower healthcare facilities.
{"title":"Comprehensive approach for strengthening the management of regional referral hospitals in Tanzania","authors":"Hisahiro Ishijima, Masashi Teshima, Yasuko Kasahara, N. Miyamoto, Fares Masaule, R. John","doi":"10.5430/jha.v9n5p1","DOIUrl":"https://doi.org/10.5430/jha.v9n5p1","url":null,"abstract":"Hospital managers in Tanzania have always been expected to manage and deliver quality services to patients under resource constrained situation. In the organizational structure of regional referral hospitals (RRHs) in Tanzania, including, clinicians with very limited knowledge of and skills in management hold over 80% of the managerial positions. The Ministry of Health, Community Development, Gender, Elderly and Children of Tanzania has identified the strengthening of management at RRHs as a key to improving efficiency and effectiveness in health service delivery. The ministry launched a five-year project for strengthening hospital management in RRHs in collaboration with the Japan International Cooperation Agency. The project provided a series of training courses for capacitating RRH management Team (RRHMT), and developed and introduced several planning, monitoring, and evaluation tools. This study was conducted to identify the positive factors and approaches for strengthening management of RRHs. Necessary information and data were collected through the intervention and analyzed to measure the effectiveness of the interventions. RRHMT members obtained basic knowledge of and skills for hospital management through the project interventions with those deferent management tools to improve the completion of their hospital management tasks. Based on the findings, it can be concluded that the interventions were effective in strengthening the managerial capacity of RRHMTs. The study also confirmed that the strategy to improve hospital management was on the right track for improving health service delivery in efficient and effective manners. The lessons learned from the project can be adjusted for the management of lower healthcare facilities.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"59 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79911804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: In many advanced economies patients wait on elective surgery waiting lists longer than clinically recommended times. This results from either a demand and capacity differential or challenges with the chronological management of patient bookings. This paper describes a novel algorithm that calculates elective surgery capacity and demand imbalances at a surgeon and urgency category level.Methods: An algorithm was developed that is surgeon-specific, sensitive to clinical urgency, relates to patient- and procedure level, and is scalable, dynamic and efficient. The novel measure designated the “Nominal Waiting List Maximum”, uses historic waiting list removal rates to approximate waiting list capacity at a surgeon- and urgency category-level. This measure can then be compared to the actual patients on each surgeon’s waiting list for each urgency category at a given point in time to measure imbalances.Results: In 2014, the algorithm was automated and implemented across a large Hospital and Health Service (HHS), in QLD, Australia, within an analytics solution. The solution extracts current and historic elective surgery waiting list episode-level data from underlying repositories and calculates “Nominal Waiting List Maximum” for every surgeon at an urgency category level with daily data flows.Conclusions: The solution helped the large tertiary hospital group to identify demand and capacity imbalances at a surgeon and urgency category level to improve theatre session allocations. With the aid of this measure, the HHS achieved zero patients waiting longer than clinically recommended times and was able to hold this position for more than 2 years demonstrating the value of this algorithm. The solution was subsequently rolled out to 55 hospitals across QLD, Australia and anonymised views provided to the hospitals’ governing body.
{"title":"How many patients can each surgeon have on their waiting list and still treat them all in time?","authors":"M. Connor, Danielle Ben Bashat, C. Ogg","doi":"10.5430/jha.v9n4p39","DOIUrl":"https://doi.org/10.5430/jha.v9n4p39","url":null,"abstract":"Objective: In many advanced economies patients wait on elective surgery waiting lists longer than clinically recommended times. This results from either a demand and capacity differential or challenges with the chronological management of patient bookings. This paper describes a novel algorithm that calculates elective surgery capacity and demand imbalances at a surgeon and urgency category level.Methods: An algorithm was developed that is surgeon-specific, sensitive to clinical urgency, relates to patient- and procedure level, and is scalable, dynamic and efficient. The novel measure designated the “Nominal Waiting List Maximum”, uses historic waiting list removal rates to approximate waiting list capacity at a surgeon- and urgency category-level. This measure can then be compared to the actual patients on each surgeon’s waiting list for each urgency category at a given point in time to measure imbalances.Results: In 2014, the algorithm was automated and implemented across a large Hospital and Health Service (HHS), in QLD, Australia, within an analytics solution. The solution extracts current and historic elective surgery waiting list episode-level data from underlying repositories and calculates “Nominal Waiting List Maximum” for every surgeon at an urgency category level with daily data flows.Conclusions: The solution helped the large tertiary hospital group to identify demand and capacity imbalances at a surgeon and urgency category level to improve theatre session allocations. With the aid of this measure, the HHS achieved zero patients waiting longer than clinically recommended times and was able to hold this position for more than 2 years demonstrating the value of this algorithm. The solution was subsequently rolled out to 55 hospitals across QLD, Australia and anonymised views provided to the hospitals’ governing body.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"132 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86724727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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