Search results

The orthopaedic trauma session is almost universally adopted as a means of coping with non‐elective orthopaedic demand. Here patients who can be stabilised are treated in a weekday planned theatre session. It allows for greater consultant involvement and a reduction in out‐of‐hours operating. The utilisation of trauma theatre time is typically low. However, there is an opportunity to make better use of this time by including some “deferrable elective patients” in the session. These are elective patients who have been offered earlier treatment in return for accepting the possibility of postponement, if the trauma demand on the day of the appointment is high. Simulation of patient demand was used to explore the balance between maximising the utilisation of the theatre sessions, avoiding too many overruns and ensuring a reasonable quality of care in a typical hospital in the UK.

The paper aims to empirically test a framework to predict the desire and intention to engage with an elective health-care procedure and implement a methodology to test the anticipated positive and negative emotions in hedonic adaptation to an elective procedure.

Two studies in USA and Australia (N = 1,200) confirmed the psychometric properties of the key constructs under the chemical peel condition. Two further studies in the USA and Australia (N = 1,100) explored the research question and hypotheses in the adapted model of goal-directed behaviour under the Botox condition. A survey was self-administered to online panels who had previously engaged in such elective procedures.

The findings highlighted the pragmatic implications for communication and activation strategies to safeguard consumer interests and retain their loyalty.

From the authors’ best understanding, neither a methodology nor a theoretical framework exists to explore hedonic adaptation to recurring engagement with elective health care. A methodology and theoretical framework will highlight the mood states and factors that predict desire and intention to engage. This can advance the research on hedonic adaptation and decision-making and offer pragmatic suggestions for communication and activation strategies to safeguard consumer interests and retain their loyalty.

Presents a model designed to explore the stochastic nature of non‐elective admissions. Using historic data taken from the patient administration system of a large district general hospital situated in Plymouth, England, the model shows the importance of understanding the profile of risk behind non‐elective planning. This understanding may lead to more robust waiting times planning, promoting open dialogue between the trust and its commissioners on how such risk is managed. It also allows for the setting of clear goals for admission avoidance and early discharge schemes. At a strategic level, an understanding of the stochastic nature of non‐elective admissions raises questions about the potential cost of entirely ring‐fencing elective workload, disallowing the sharing of beds in times of peak demand. As a specific policy manifestation of this proposed ring‐fencing, the development of “diagnostic and treatment centres” may need to be more pragmatic than the “purist” view being expressed in the NHS Plan if overall efficiency is not to be significantly reduced.

The purpose of this paper is to examine the activity of a purpose‐built elective surgery unit in a busy district general hospital and the patient journey associated with same day admission to the elective surgery unit.

This paper describes the layout of the elective surgery unit in a busy district general hospital and the associated patient journey. Early challenges are identified and potential cost savings calculated.

The potential for cost savings in the NHS with purpose‐built units for elective surgery are immense.

An elective surgery unit has not been described in detail before. Apart from its value to the NHS, hospitals in developing countries can benefit from knowing about the early challenges, described in the paper, that were faced.

The purpose of this paper is to outline the importance of social network effects in influencing the elective (courses) selection among masters of business administration (MBA) students and its role in influencing the efficacy of MBA. As such, given the enormous time and investment required for students to pursue an MBA and the role of electives in forming the student’s knowledge base, it is important to consider the decision process of students while selecting elective courses as they pursue their degree.

This study explores the relevance of network characteristics in the elective selection phenomena through questionnaires administered personally to 50 MBA students from a premier b-school in India. Thereby, it seeks to link the implications with MBA efficacy.

In the sample, the authors found that social network connections in terms of homophily and heterophily (similar and dissimilar others) had the strongest association with elective course decisions. Further, the role of tie strength (the level of intensity of the social relationship between two individuals) in governing the phenomena was not confirmed.

The authors discuss the linkage of elective selection phenomena with the efficacy of MBA. Specifically, the authors focus on a possible risk where network influences may prompt a student to select electives by surpassing his or her academic interests and thereby may hamper the efficacy. The authors also outline implications from the perspective of students, professors, and administrators.

The study is among the initial studies to present preliminary evidence on the efficacy of MBA from the perspective of elective selection phenomena and the role of social network effects.

Medical tourism, characterized by patients leaving their home community to seek health-care services elsewhere, is on the rise globally. In New York state, approximately 5% of the 35,661,559 hospital visits in 2018 were non-residents. Although some are visiting New York for other reasons, and unintentionally wind up hospitalized – a percentage of this population come to New York intentionally to seek care. Understanding the make-up, needs and patterns of this population allows hospitals to tailor investments in marketing, technological resources and culturally responsive initiatives to prepare for broadening their patient population and remain competitive globally.

Using a rich all-hospital discharge data set, the authors identify patterns in diagnoses, treatment and hospital choice of patients who intentionally travel across borders for health care. The authors model the characteristics associated with “elective” admit patients with a multivariate logistic regression approach.

The authors find that among non-resident patients in New York, domestic travelers, those using insurance plans for payment and women are positively associated with seeking elective inpatient care across border. There are clear patterns of type of treatment that is more likely to be sought, with care for musculoskeletal concerns accounting for more than one-third of all non-resident elective admissions. Proximity also matters, both in terms of patients being more likely to live in a travel zone adjacent to the state, as well as being more likely to seek care from hospitals in counties closest to the borders.

To the best of the authors’ knowledge, this is the first study, using a large set of claims data, that is able to empirically differentiate between patients who travel to NY for the primary purpose of obtaining health care versus those who emergently must access care while traveling for other reasons. This approach can inform future studies seeking to better understand patient migration patterns and strategic educational and marketing initiatives to motivate consumers to cross borders to seek care.

Cancelled operations are a major drain on health resources: 8 per cent of scheduled elective operations are cancelled nationally, within 24 hours of surgery. The aim of this study is to define the extent of this problem in one Trust, and suggest strategies to reduce the cancellation rate.

A prospective survey was conducted over a 12‐month period to identify cancelled day case and in‐patient elective operations. A dedicated nurse practitioner was employed for this purpose, ensuring that the reasons for cancellation and the timing in relation to surgery were identified. The reasons for cancellation were grouped into patient‐related reasons, hospital clinical reasons and hospital non‐clinical reasons.

In total, 13,455 operations were undertaken during the research period and 1,916 (14 per cent) cancellations were recorded, of which 615 were day cases and 1,301 in‐patients: 45 per cent (n=867) of cancellations were within 24 hours of surgery; 51 per cent of cancellations were due to patient‐related reasons; 34 per cent were cancelled for non‐clinical reasons; and 15 per cent for clinical reasons. The common reasons for cancellation were inconvenient appointment (18.5 per cent), list over‐running (16 per cent), the patients thought that they were unfit for surgery (12.2 per cent) and emergencies and trauma (9.4 per cent).

This study demonstrates that 14 per cent of elective operations are cancelled, nearly half of which are within 24 hours of surgery. The cancellation rates could be significantly improved by directing resources to address patient‐related causes and hospital non‐clinical causes.

This paper is of value in that it is demonstrated that most cancellations of elective operations are due to patient‐related causes and several changes are suggested to try and limit the impact of these cancellations on elective operating lists.

Elementary teachers' understanding of mathematics is a significant contributor to student success with mathematics. Consequently, teacher educators are frequently charged with the responsibility of supporting the development of prospective elementary teachers' mathematics content knowledge as they re‐learn concepts in ways they are required to teach. The purpose of this paper is to describe one teacher educator's efforts to support prospective elementary teachers' tenuous understanding of rational numbers.

Given the variety of factors influencing the development of teacher knowledge, a mixed method research design was utilized. Research participants were prospective elementary teachers enrolled in a nine‐week elective course who agreed to participate in the study (n=40); while the control group were prospective elementary teachers not enrolled in the elective course (n=35).

The results of this study indicate that it may be possible to improve prospective teachers' conceptual understanding of mathematics by providing additional short‐term support, such as an elective course and/or web‐based video clips. However, the program intervention can only build upon the existing knowledge that prospective teachers bring when they begin their Bachelor of Education programs.

For prospective teachers with a limited foundation in mathematics (e.g. less than four secondary school mathematics courses), short‐term support may be insufficient to compensate for their nebulous understanding of rational numbers. Based on this finding, one‐year Bachelor of Education programs might consider, either: including Grade 12 mathematics as a pre‐requisite for elementary teacher applicants; or mandating enrolment in a full‐year math content course similar to the elective course described in this paper.

The purpose of this paper is to investigate students’ attitude based on affective, behavioural and cognitive components. It will ascertain whether there is a link between the three components of attitude, which leads the possible classification of the elective courses.

The current study considers the students of the International Business Administration Department from Rustaq College of Applied Sciences, Ministry of Higher Education, Sultanate of Oman, during the academic year 2016–2017. The list of the elective courses was obtained from the existing study plan. A total of 101 students assessed elective courses’ affective and cognitive learning with the use of a web-based survey instrument.

An empirical analysis of the selection criterion was performed employing fuzzy set qualitative comparative analysis. The results of this study found that students rated 17 elective courses into 8 different configurations (triodes) based on various degrees assigned to attitudinal variables.

The present study explores the interaction between affective and cognitive factors in determining the selection behaviour of students. It is an investigation into the context of student choices regarding elective courses, especially the decision to select or not to select available courses.

The world of feelings and beliefs is always open to learning and self-development for the students. Students are continuously involved in taking charge of high-stakes decisions; one of them is the selection of elective courses. However, the critical components into the overall evaluations of their selection behaviour, such as feelings and beliefs, are not well studied.

The purpose of this paper is to find the incidence and medical reasons for cancellations of elective orthopaedic cases following admission for an operation in a district general hospital. The paper also aims to determine the deficiencies in the local preoperative assessment protocol.

This is a retrospective study. The elective orthopaedic surgeries cancelled following their admission into the hospital due to medical reasons between January 2003 and December 2004, were identified. These cases were reviewed using the preoperative assessment charts and case notes. The NHS Modernisation Agency's guidelines, National Good Practice Guidance on Preoperative Assessment for Inpatient Surgery, are taken as the benchmark for comparison.

The paper finds that 44 elective orthopaedic cases were cancelled due to medical reasons. Of these patients, 64 per cent did not have a pre‐operative assessment prior to the admission for the planned surgery; 6 per cent had inadequate documentation of relevant past medical history; and 30 per cent (patients with significant medical problems) were not referred to the anaesthetist for advice although these problems were identified during the pre‐operative assessment.

It is possible to stimulate good medical practice through audit.

Cancellation of an elective operation is not uncommon in hospital practice. This paper aims to highlight the possible avoidable causes for such cancellations. The paper identifies such deficiencies in the local preoperative assessment protocol and suggests remedies to improve the quality of care. These improvements and close adherence to the guidelines are important as preoperative assessment by nurse‐led clinics are being increasingly practised through out the UK.

The paper fulfils its aims of identifying the medical causes for cancellation of an operation and also the existing deficiencies in the preoperative assessment practice. The paper values the importance of adherence to NHS Modernising Agency's guidelines in preoperative assessment. It is useful not only to the Orthopaedic department but also to the department managers.