Objective: Implementation of the affordable care act (ACA) resulted in an increased number of insured individuals and a shortage of primary care physicians. Physician Assistants (PAs) are poised to address this shortage since the PA profession is grounded in teamwork exemplified by the Accountable Care Organizations supported by the ACA. This study assesses the perception of the ACA by PAs providing healthcare services during implementation of the ACA.Methods: In this repeated cross-sectional study, alumni from a Midwest PA program were surveyed in 2014, 2016 and 2018 on knowledge and perception of the ACA. Questions addressed the ACA impact on the PA profession and on patients’ access to healthcare.Results: During the initial four years of ACA implementation, the following increases in perception were seen: 1) 32% increase in positive outlook of healthcare; 2) 37% increase in positive influence on PA practice; 3) 30% increase in positive impact of practice autonomy; 4) 64% increase in positive impact for patients; and 5) 33% increase in patient access to care. Additionally, the inability to choose a provider increased by 18%.Conclusions: Over the last four years PAs have perceived positive effects pertaining to their practice and regarding the impact on their patients despite an increase in the inability to choose a provider. Inability to choose a provider may in part be due to the rising number of narrow-network plans. The findings of greater autonomy and increased compensation for PAs are contrary to physicians who perceive the ACA to decrease their autonomy and their compensation.
{"title":"Perceptions of the affordable care act by Physician Assistants","authors":"Martina Reinhold, T. Bacon-Baguley","doi":"10.5430/IJH.V5N1P33","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P33","url":null,"abstract":"Objective: Implementation of the affordable care act (ACA) resulted in an increased number of insured individuals and a shortage of primary care physicians. Physician Assistants (PAs) are poised to address this shortage since the PA profession is grounded in teamwork exemplified by the Accountable Care Organizations supported by the ACA. This study assesses the perception of the ACA by PAs providing healthcare services during implementation of the ACA.Methods: In this repeated cross-sectional study, alumni from a Midwest PA program were surveyed in 2014, 2016 and 2018 on knowledge and perception of the ACA. Questions addressed the ACA impact on the PA profession and on patients’ access to healthcare.Results: During the initial four years of ACA implementation, the following increases in perception were seen: 1) 32% increase in positive outlook of healthcare; 2) 37% increase in positive influence on PA practice; 3) 30% increase in positive impact of practice autonomy; 4) 64% increase in positive impact for patients; and 5) 33% increase in patient access to care. Additionally, the inability to choose a provider increased by 18%.Conclusions: Over the last four years PAs have perceived positive effects pertaining to their practice and regarding the impact on their patients despite an increase in the inability to choose a provider. Inability to choose a provider may in part be due to the rising number of narrow-network plans. The findings of greater autonomy and increased compensation for PAs are contrary to physicians who perceive the ACA to decrease their autonomy and their compensation.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91343069","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: As legislative changes limiting access to prescription opioids were enacted, the population of opioid use disorder patients seeking private residential treatment also changed. This study is designed to examine some of the specific changes that were observed between opioid used disorder patients entering treatment before and after the legislative restrictions were enacted.Study design: Retrospective cross-sectional cohort design.Results: Significant changes from Group 1 (patients presenting for treatment in 2009-2011) to Group 2 (patients presenting for treatment in 2014) include a substantial decrease in the usage of prescription opiates. Alongside this reduction, a significant increase was shown in reported heroin abuse with concurrent polysubstance abuse (Cannabis, Amphetamines, and Sedatives), as well as noted employment and family issues.Conclusions: The identified patient presenting to treatment for Opioid Use Disorder has changed over the last several years and treatment should reflect those changes. Not only has this disease become one of opioid usage but of polysubstance abuse and disruption in other areas of life as heroin usage becomes more prominent in patients.
{"title":"Opioid usage trends in treatment – Trends from the field","authors":"J. Wheeler, Siobhan A. Morse, Brian E Bride","doi":"10.5430/IJH.V5N1P29","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P29","url":null,"abstract":"Objective: As legislative changes limiting access to prescription opioids were enacted, the population of opioid use disorder patients seeking private residential treatment also changed. This study is designed to examine some of the specific changes that were observed between opioid used disorder patients entering treatment before and after the legislative restrictions were enacted.Study design: Retrospective cross-sectional cohort design.Results: Significant changes from Group 1 (patients presenting for treatment in 2009-2011) to Group 2 (patients presenting for treatment in 2014) include a substantial decrease in the usage of prescription opiates. Alongside this reduction, a significant increase was shown in reported heroin abuse with concurrent polysubstance abuse (Cannabis, Amphetamines, and Sedatives), as well as noted employment and family issues.Conclusions: The identified patient presenting to treatment for Opioid Use Disorder has changed over the last several years and treatment should reflect those changes. Not only has this disease become one of opioid usage but of polysubstance abuse and disruption in other areas of life as heroin usage becomes more prominent in patients.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81821809","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}
Marti Harder, Jessie Johnson, C. Macdonald, Andrea Ingstrup, Marc J. Piche
Educational institutions, including schools of nursing, find themselves in significant times, as they work to Indigenize programs, and strive to repair and heal relationships with Indigenous peoples as recommended in the Truth and Reconciliation Commission of Canada (2015). Educators question where to begin the process, how such Indigenization should occur, and what the curricular end result should look like. In response, the authors considered many aspects from the literature, specific to nursing programs. The following themes were explored: partnering with community, cultural relevance, and faculty development. Through the utilization of a “two-eyed seeing” approach, institutional administrators need to partner with Indigenous Elders and community members to facilitate relationships required to provide the knowledge necessary to bring about change within educational programs. It is through such an approach that nursing curricula can be designed to be culturally safe and relevant for both Indigenous and non-Indigenous learners, and faculty can be supported in their growth and development in Indigenous knowledge. The authors propose that through “two-eyed seeing” and the integration of the Aboriginal Nurses Association of Canada (2009) core competencies, Indigenization of nursing curricula may ultimately move forward in a culturally reciprocal and respectful way.
{"title":"A “two-eyed seeing” approach to Indigenizing nursing curricula","authors":"Marti Harder, Jessie Johnson, C. Macdonald, Andrea Ingstrup, Marc J. Piche","doi":"10.5430/IJH.V5N1P23","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P23","url":null,"abstract":"Educational institutions, including schools of nursing, find themselves in significant times, as they work to Indigenize programs, and strive to repair and heal relationships with Indigenous peoples as recommended in the Truth and Reconciliation Commission of Canada (2015). Educators question where to begin the process, how such Indigenization should occur, and what the curricular end result should look like. In response, the authors considered many aspects from the literature, specific to nursing programs. The following themes were explored: partnering with community, cultural relevance, and faculty development. Through the utilization of a “two-eyed seeing” approach, institutional administrators need to partner with Indigenous Elders and community members to facilitate relationships required to provide the knowledge necessary to bring about change within educational programs. It is through such an approach that nursing curricula can be designed to be culturally safe and relevant for both Indigenous and non-Indigenous learners, and faculty can be supported in their growth and development in Indigenous knowledge. The authors propose that through “two-eyed seeing” and the integration of the Aboriginal Nurses Association of Canada (2009) core competencies, Indigenization of nursing curricula may ultimately move forward in a culturally reciprocal and respectful way.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"2005 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89927974","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}
Background: In nursing education, clinical practice is a crucial process for students to learn and practice knowledge and skills for becoming healthcare professionals.Objective: To investigate the effects of the experience of incivility on nursing students’ stress and self-efficacy in clinical settings.Methods: A descriptive cross-sectional study was conducted using self-administered surveys by a convenience sample of 195 nursing students in South Korea. The surveys included sociodemographic questions, the 13-item Korean version of Uncivil Behavior in Clinical Nursing Education (K-UBCNE), the 24-item Korean versions of Beck-Srivastava Stress Inventory (K-BSSI), and the 24-item of Academic Self-Efficacy (ASE).Results: The average age of our sample was 22.33 years (± 2.39). Among 195 study participants, junior students were 123 (63.1%) and senior students were 72 (36.9%). Mean score of total incivility by the K-UBCNE among the seniors was significantly higher than the juniors (t = -2.985, p = .002). Pearson correlations results indicated that the nursing students’ incivility experience was positively correlated with the K-BSSI (r = .679, p < .01), and the ASE (r = .680, p < .01). Lastly, Clinical Education Environment (t = 1.985, p = .049), Undesired Role Model (t = 6.650, p = .000) and Interpersonal Conflict (t = 2.486, p = .014) from K-BSSI were the predictors for incivility, F(7, 195) = 28.110, p = 000.Conclusions: Incivility adversely influences students’ learning. Nurse educators and RNs should recognize the serious implications of incivility and develop effective interventions to combat incivility. Further studies of stress, self-efficacy, and incivility in the clinical sites are warranted.
背景:在护理教育中，临床实习是学生学习和实践成为医疗保健专业人员的知识和技能的关键过程。目的:探讨临床环境中不礼貌经历对护生压力和自我效能的影响。方法:采用自填问卷的方法对195名韩国护理专业学生进行描述性横断面研究。调查内容包括社会人口学问题、临床护理教育中的不文明行为(13项)韩文版、贝克-斯里瓦斯塔瓦压力量表(K-BSSI)韩文版、学术自我效能(ASE) 24项。结果:本组患者平均年龄22.33岁(±2.39岁)。195名研究对象中，初中生123人(63.1%)，高中生72人(36.9%)。高年级学生K-UBCNE总分总分显著高于低年级学生(t = -2.985, p = .002)。Pearson相关结果显示，护生不文明经历与K-BSSI (r = 0.679, p < 0.01)、ASE (r = 0.680, p < 0.01)呈正相关。最后，临床教育环境(t = 1.985, p = 0.049)、不良榜样(t = 6.650, p = 0.000)和人际冲突(t = 2.486, p = 0.014)是K-BSSI中不文明行为的预测因子，F(7,195) = 28.110, p = 0.000。结论:不文明行为对学生的学习有不利影响。护士教育者和注册护士应该认识到不文明行为的严重影响，并制定有效的干预措施来对抗不文明行为。在临床场所对压力、自我效能和不文明行为进行进一步的研究是必要的。
{"title":"Relationships between incivility and stress and self-efficacy among nursing students in clinical settings","authors":"E. Hong, H. Lee, V. Dee, Younglee Kim","doi":"10.5430/IJH.V5N1P16","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P16","url":null,"abstract":"Background: In nursing education, clinical practice is a crucial process for students to learn and practice knowledge and skills for becoming healthcare professionals.Objective: To investigate the effects of the experience of incivility on nursing students’ stress and self-efficacy in clinical settings.Methods: A descriptive cross-sectional study was conducted using self-administered surveys by a convenience sample of 195 nursing students in South Korea. The surveys included sociodemographic questions, the 13-item Korean version of Uncivil Behavior in Clinical Nursing Education (K-UBCNE), the 24-item Korean versions of Beck-Srivastava Stress Inventory (K-BSSI), and the 24-item of Academic Self-Efficacy (ASE).Results: The average age of our sample was 22.33 years (± 2.39). Among 195 study participants, junior students were 123 (63.1%) and senior students were 72 (36.9%). Mean score of total incivility by the K-UBCNE among the seniors was significantly higher than the juniors (t = -2.985, p = .002). Pearson correlations results indicated that the nursing students’ incivility experience was positively correlated with the K-BSSI (r = .679, p < .01), and the ASE (r = .680, p < .01). Lastly, Clinical Education Environment (t = 1.985, p = .049), Undesired Role Model (t = 6.650, p = .000) and Interpersonal Conflict (t = 2.486, p = .014) from K-BSSI were the predictors for incivility, F(7, 195) = 28.110, p = 000.Conclusions: Incivility adversely influences students’ learning. Nurse educators and RNs should recognize the serious implications of incivility and develop effective interventions to combat incivility. Further studies of stress, self-efficacy, and incivility in the clinical sites are warranted.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87067137","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}
Purpose: The Department of Veterans Affairs (VA) provides surgical care and services through a network of Veterans Health Administration (VHA) Surgical Programs. This study examined the impact of benchmarking on improvements in VHA surgery program operating room efficiency.Methods: The VA National Surgery Office (NSO) developed the operating room (OR) Efficiency Matrix with four common metrics that characterize OR processes. The OR Efficiency Matrix assigned a performance level to each VHA Surgery Program identified in the NSO Quarterly Report. The NSO Quarterly Report provided ongoing and regular feedback allowing VHA Surgery Programs to develop action plans and improve performance.Results: Beginning with the Fiscal Year (FY) 2013 Quarter (Q) 2 NSO Quarterly Report, the NSO has been reporting to VHA Surgery Programs on the OR Efficiency Matrix through several tables and figures in the NSO Quarterly Report. Overall, raw metric rates have improved nationally, with most improvements coming in the metrics of OR first time starts and surgical case cancellation.Conclusions: The NSO developed and implemented the OR Efficiency Matrix, representing four well recognized metrics, to assess, track, and report OR efficiency at 137 VHA Surgery Programs. This internal benchmarking process and data reporting was associated with sustainable improvements in OR efficiency over time.
{"title":"The impact of benchmarking operating room efficiency within the Veterans Health Administration","authors":"M. Lynn, Douglas A. Bronson, W. Gunnar","doi":"10.5430/IJH.V5N1P8","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P8","url":null,"abstract":"Purpose: The Department of Veterans Affairs (VA) provides surgical care and services through a network of Veterans Health Administration (VHA) Surgical Programs. This study examined the impact of benchmarking on improvements in VHA surgery program operating room efficiency.Methods: The VA National Surgery Office (NSO) developed the operating room (OR) Efficiency Matrix with four common metrics that characterize OR processes. The OR Efficiency Matrix assigned a performance level to each VHA Surgery Program identified in the NSO Quarterly Report. The NSO Quarterly Report provided ongoing and regular feedback allowing VHA Surgery Programs to develop action plans and improve performance.Results: Beginning with the Fiscal Year (FY) 2013 Quarter (Q) 2 NSO Quarterly Report, the NSO has been reporting to VHA Surgery Programs on the OR Efficiency Matrix through several tables and figures in the NSO Quarterly Report. Overall, raw metric rates have improved nationally, with most improvements coming in the metrics of OR first time starts and surgical case cancellation.Conclusions: The NSO developed and implemented the OR Efficiency Matrix, representing four well recognized metrics, to assess, track, and report OR efficiency at 137 VHA Surgery Programs. This internal benchmarking process and data reporting was associated with sustainable improvements in OR efficiency over time.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89564076","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}
Background: Hamad Medical Corporation (HMC) has a goal to achieve Magnet designation. Magnet status is a worldwide international award given to hospitals which demonstrate excellent quality of patient care, innovative professional nursing practices and effective nurse recruitment and retention patterns. To date, only 3 other hospitals in the Middle East have achieved this recognition; two in Saudi Arabia and one in Lebanon. Achieving Magnet status is highly influenced by nurses’ job satisfaction and commitment to their organization.Purpose: A literature review was used to identify factors contributing to nurses’ job dissatisfaction that may impede the adoption of the Magnet Program at HMC hospitals in Qatar.Findings: Five themes emerged from the review of literature representing the predominant factors that influence nurses’ job dissatisfaction. They include: (1) nurse staffing; (2) work and professional practice environments; (3) work relationships; (4) management styles; (5) professional development and career advancement opportunities.Conclusions: Understanding the factors contributing to nurses’ job dissatisfaction is essential in order to identify barriers which may impede the achievement of a Magnet hospital designation.
{"title":"The influence of nurses job dissatisfaction on adoption of Magnet status within hospitals","authors":"S. Manea, Jessie Johnson, C. Wolsey","doi":"10.5430/IJH.V5N1P1","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P1","url":null,"abstract":"Background: Hamad Medical Corporation (HMC) has a goal to achieve Magnet designation. Magnet status is a worldwide international award given to hospitals which demonstrate excellent quality of patient care, innovative professional nursing practices and effective nurse recruitment and retention patterns. To date, only 3 other hospitals in the Middle East have achieved this recognition; two in Saudi Arabia and one in Lebanon. Achieving Magnet status is highly influenced by nurses’ job satisfaction and commitment to their organization.Purpose: A literature review was used to identify factors contributing to nurses’ job dissatisfaction that may impede the adoption of the Magnet Program at HMC hospitals in Qatar.Findings: Five themes emerged from the review of literature representing the predominant factors that influence nurses’ job dissatisfaction. They include: (1) nurse staffing; (2) work and professional practice environments; (3) work relationships; (4) management styles; (5) professional development and career advancement opportunities.Conclusions: Understanding the factors contributing to nurses’ job dissatisfaction is essential in order to identify barriers which may impede the achievement of a Magnet hospital designation.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78278559","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}
In order to aid health workforce planning, we measured the number of hours worked by general practitioners (GPs). The twofold aim of this study consisted of assessing the feasibility, validity and reliability of an innovative method to measure working time and, second, to analyse differences in hours worked between six types of GPs divided by the combination of their gender and employment position. Our method was based on multiple time point observations using SMS text messaging. On average 19 GPs participated every week for 57 weeks. In total 1,051 GPs participated resulting in 61,320 valid measurements of time use. On average, GPs worked 44 hours per week. About 56% of this time was spent on direct patient-related activities, 26% to indirect patient-related activities, and 18% to activities not related to patients. There were substantial differences in working hours between male and female self-employed, those drawing a salary from a duo or group practice and locum GPs. For example, male self-employed GPs worked 51.6 hours per week, whereas male locum GPs worked 26.7 hours per week. Generally, differences in hours worked with regard to gender and employment position are smaller if we relate these hours to the number of FTE they worked. Furthermore, we conclude that the method of SMS text messaging based on the time sampling technique presents a limited degree of interference to the participants’ work and achieved reliable and valid results.
{"title":"Identifying differences in GPs’ working hours according to gender and employment position: A time sampling study using SMS text messaging","authors":"D. Hassel, L. V. D. Velden, R. Batenburg","doi":"10.5430/IJH.V4N2P64","DOIUrl":"https://doi.org/10.5430/IJH.V4N2P64","url":null,"abstract":"In order to aid health workforce planning, we measured the number of hours worked by general practitioners (GPs). The twofold aim of this study consisted of assessing the feasibility, validity and reliability of an innovative method to measure working time and, second, to analyse differences in hours worked between six types of GPs divided by the combination of their gender and employment position. Our method was based on multiple time point observations using SMS text messaging. On average 19 GPs participated every week for 57 weeks. In total 1,051 GPs participated resulting in 61,320 valid measurements of time use. On average, GPs worked 44 hours per week. About 56% of this time was spent on direct patient-related activities, 26% to indirect patient-related activities, and 18% to activities not related to patients. There were substantial differences in working hours between male and female self-employed, those drawing a salary from a duo or group practice and locum GPs. For example, male self-employed GPs worked 51.6 hours per week, whereas male locum GPs worked 26.7 hours per week. Generally, differences in hours worked with regard to gender and employment position are smaller if we relate these hours to the number of FTE they worked. Furthermore, we conclude that the method of SMS text messaging based on the time sampling technique presents a limited degree of interference to the participants’ work and achieved reliable and valid results.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81198245","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}
Throughout the world there is an on-going effort to determine quality in healthcare settings. The very definition of “quality”, particularly in healthcare, is rather elusive. The aim of this critique is to analyze the Balance Scorecard method to measure quality as it relates to patient safety in healthcare organisations. Analysis of the Balanced Scorecard in this context determined that the objectivity, both in its measurements and its ability to link together the organization’s quality and financial goals, is indeed beneficial. However, this methodology was also found to be unduly focused on systems and administration rather than on the actual health and safety of patients. The result is a tool that measures “quality” in financial and organizational terms, as sought by healthcare management, and this will continue to be the case until there is a fundamental shift towards defining quality of healthcare in terms of the patients that utilize healthcare services.
{"title":"Balanced scorecard method for healthcare quality improvement: A critical analysis","authors":"M. K. Al-Hanawi","doi":"10.5430/IJH.V4N2P58","DOIUrl":"https://doi.org/10.5430/IJH.V4N2P58","url":null,"abstract":"Throughout the world there is an on-going effort to determine quality in healthcare settings. The very definition of “quality”, particularly in healthcare, is rather elusive. The aim of this critique is to analyze the Balance Scorecard method to measure quality as it relates to patient safety in healthcare organisations. Analysis of the Balanced Scorecard in this context determined that the objectivity, both in its measurements and its ability to link together the organization’s quality and financial goals, is indeed beneficial. However, this methodology was also found to be unduly focused on systems and administration rather than on the actual health and safety of patients. The result is a tool that measures “quality” in financial and organizational terms, as sought by healthcare management, and this will continue to be the case until there is a fundamental shift towards defining quality of healthcare in terms of the patients that utilize healthcare services.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86378110","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}
Purpose: The high prevalence of human papilloma virus (HPV) infection and its association with cervical cancer (as one of the leading causes of death in Namibia) makes it important to determine the level of understanding as well as beliefs of the public regarding HPV, especially that of young university female students. The purpose of the study was to determine awareness, knowledge, attitude and practices regarding HPV, among female students at the University of Namibia.Methods: A quantitative cross sectional research design was adopted using a convenient sample of 126 female students from the 534 females at the health sciences faculty, University of Namibia, Main Campus. Data was collected using a modified, adopted self-administered questionnaire and analysed using Microsoft Excel 2013.Results: The majority of participants were below 25 years (79.1%), single (91.7%) and nursing students (93.3%). HPV awareness was generally high with the majority aware of HPV infection (71%), cervical cancer (94.2%), genital warts (90%) and HPV vaccine (54.2%). Only 40% knew that HPV could be transmitted through skin to skin contact and only 9.2% knew that HPV was not associated with herpes. Attitude towards HPV was positive, 55% believed they were at risk of HPV and 82% were willing to receive the HPV vaccine. Practices regarding HPV were poor, 68% were sexually active, 40% reported using condoms sometimes, 7% never used condoms at all and 75% had never had a Pap smear test done.Conclusions: Level of awareness and knowledge of HPV, its related diseases and vaccines was moderate to high, attitude was generally positive whilst practice was poor among female students at the health sciences faculty, University of Namibia. Students need to be encouraged to engage in safe sexual practice to prevent and reduce risk of HPV infection.
{"title":"Awareness, knowledge, attitude and practices regarding human papilloma virus among female students at the University of Namibia","authors":"H. Amukugo, Blessing Rufaro Rungayi, A. Karera","doi":"10.5430/IJH.V4N2P51","DOIUrl":"https://doi.org/10.5430/IJH.V4N2P51","url":null,"abstract":"Purpose: The high prevalence of human papilloma virus (HPV) infection and its association with cervical cancer (as one of the leading causes of death in Namibia) makes it important to determine the level of understanding as well as beliefs of the public regarding HPV, especially that of young university female students. The purpose of the study was to determine awareness, knowledge, attitude and practices regarding HPV, among female students at the University of Namibia.Methods: A quantitative cross sectional research design was adopted using a convenient sample of 126 female students from the 534 females at the health sciences faculty, University of Namibia, Main Campus. Data was collected using a modified, adopted self-administered questionnaire and analysed using Microsoft Excel 2013.Results: The majority of participants were below 25 years (79.1%), single (91.7%) and nursing students (93.3%). HPV awareness was generally high with the majority aware of HPV infection (71%), cervical cancer (94.2%), genital warts (90%) and HPV vaccine (54.2%). Only 40% knew that HPV could be transmitted through skin to skin contact and only 9.2% knew that HPV was not associated with herpes. Attitude towards HPV was positive, 55% believed they were at risk of HPV and 82% were willing to receive the HPV vaccine. Practices regarding HPV were poor, 68% were sexually active, 40% reported using condoms sometimes, 7% never used condoms at all and 75% had never had a Pap smear test done.Conclusions: Level of awareness and knowledge of HPV, its related diseases and vaccines was moderate to high, attitude was generally positive whilst practice was poor among female students at the health sciences faculty, University of Namibia. Students need to be encouraged to engage in safe sexual practice to prevent and reduce risk of HPV infection.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89688807","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}
Background: The physician associate (PA) role was piloted in Dublin, Ireland between 2015 and 2017. However, the concept of a PA and the acceptance of their role in Ireland had not been explored.Objective: To investigate the willingness of Irish citizens to be seen by a PA based on medical scenarios in a typical clinical setting.Design: A mixed methods study was undertaken. A preference survey, with three medical scenarios, gave participants a choice to be treated by a PA or a doctor, with two time trade-off options offered. Responses were supported with qualitative text. Four hundred people were invited to participate as surrogate patients.Setting and participants: In 2017 a total of 270 respondents took part in the study (67.5%) in two hospitals (one private and one public) in Dublin. The mean age was 60; male (n = 142) and female (n = 128) respondents.Findings: In total, 95% of the respondents chose to see a PA over a doctor based on the scenarios presented and a wait time of 30 minutes. Wait time, trust, competency and the severity or seriousness of the medical condition were categorized into three themes for choosing the PA over the doctor. The “surrogate patient” decisions made by this sample were influenced by knowing that the PA is supervised and can check decisions with his/her supervizing physician.Conclusion: These findings are consistent with studies carried out in other countries where willingness to be seen by a PA is neither age nor gender specific. Patient preference seems to concur around the importance of trust and confidence in the medical provider.
{"title":"Patient willingness to be seen by a physician associate in Ireland","authors":"P. Joyce, R. Arnett, A. Hill, R. Hooker","doi":"10.5430/IJH.V4N2P41","DOIUrl":"https://doi.org/10.5430/IJH.V4N2P41","url":null,"abstract":"Background: The physician associate (PA) role was piloted in Dublin, Ireland between 2015 and 2017. However, the concept of a PA and the acceptance of their role in Ireland had not been explored.Objective: To investigate the willingness of Irish citizens to be seen by a PA based on medical scenarios in a typical clinical setting.Design: A mixed methods study was undertaken. A preference survey, with three medical scenarios, gave participants a choice to be treated by a PA or a doctor, with two time trade-off options offered. Responses were supported with qualitative text. Four hundred people were invited to participate as surrogate patients.Setting and participants: In 2017 a total of 270 respondents took part in the study (67.5%) in two hospitals (one private and one public) in Dublin. The mean age was 60; male (n = 142) and female (n = 128) respondents.Findings: In total, 95% of the respondents chose to see a PA over a doctor based on the scenarios presented and a wait time of 30 minutes. Wait time, trust, competency and the severity or seriousness of the medical condition were categorized into three themes for choosing the PA over the doctor. The “surrogate patient” decisions made by this sample were influenced by knowing that the PA is supervised and can check decisions with his/her supervizing physician.Conclusion: These findings are consistent with studies carried out in other countries where willingness to be seen by a PA is neither age nor gender specific. Patient preference seems to concur around the importance of trust and confidence in the medical provider.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90935607","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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