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Article
Publication date: 14 June 2021

Rimantas Stašys, Gintautas Virketis and Daiva Labanauskaitė

The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers

Abstract

Purpose

The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers. Scientific research and statistical data show the increased number of interhospital transportation services; therefore, timely and qualified patient transportation between different health-care institutions must be considered, the activity that directly and significantly impacts the patient’s health status and overall quality of the health-care services. The successful patient transportation from the smaller hospitals to the health-care institutions with advanced intensive care or urgent care units can be enhanced through the partnership between private and public health-care institutions.

Design/methodology/approach

The methodology included quantitative method, statistical data analysis and theoretical data generalization. Both primary and secondary data were collected and analyzed during the research. Expert quantification was performed using the survey research method. The survey was conducted in Lithuania. The respondents were selected to be the general managers of the health-care and urgent care institutions, the chief doctors of the reanimation and intensive care department also the chief doctors of the emergency department.

Findings

Because of the centralization and regionalization of health-care services, the number of patients transferred between hospitals by the emergency medical services (EMS) and personal health-care institutions has increased. University hospitals are not sufficiently prepared to accept an increasing flow of patients in accordance with the Ministry of Health orders. Not all regional or district hospitals have the right to provide such assistance, which increases transportation time and costs as well as requires additional human resources. The five EMS categories could be used to improve the patient transfer between different levels of health-care institutions. To increase partnership between private and public health-care organizations, incentives should be provided for the development of private health-care organizations, as well as encouraging actions should be taken to increase the demand for private health-care services by Lithuanian patients.

Practical implications

Five EMS categories identified in this paper could be used to ensure a smooth mechanism for the patient transfer between different levels of the personal health-care institutions. The proposed categories should also be used in the pre-stationary emergency phase (for reducing the interhospital patient transportation amount).

Social implications

Properly organized secondary and tertiary interhospital patient transfers influence the availability and quality of the EMS and reduce inequalities in the provided services and social exclusion.

Originality/value

This paper presents the classification of the interhospital transfer issues, determines the main reasons for the patient interhospital transfer, creates the model for the EMS patient process flows and defines five EMS categories for the assessment of patient conditions. Therefore, the research conducted and the results obtained have both theoretical and social-practical value.

Details

International Journal of Organizational Analysis, vol. 29 no. 6
Type: Research Article
ISSN: 1934-8835

Keywords

Content available
Article
Publication date: 12 November 2021

Fiorella Pia Salvatore, Simone Fanelli, Francesco Contò and Mariantonietta Fiore

Abstract

Details

International Journal of Organizational Analysis, vol. 29 no. 6
Type: Research Article
ISSN: 1934-8835

Article
Publication date: 14 August 2023

Manas Pokhrel, Dayaram Lamsal, Buddhike Sri Harsha Indrasena, Jill Aylott and Remig Wrazen

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a…

Abstract

Purpose

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a tertiary hospital in Nepal. This research was undertaken as part of a Hybrid International Emergency Medicine Fellowship programme (Subedi et al., 2020) across UK and Nepal, incorporating a two-year rotation through the UK National Health Service, via the Medical Training Initiative (MTI) (AoMRC, 2017). The WHO TCC can improve outcomes for trauma patients (Lashoher et al., 2016); however, significant barriers affect its implementation worldwide (Nolan et al., 2014; Wild et al., 2020). This article reports on the implementation, barriers and recommendations of WHO TCC implementation in the context of Nepal and argues for Transformational Leadership (TL) to support its implementation.

Design/methodology/approach

Explanatory mixed methods research (Creswell, 2014), comprising quasi-experimental research and a qualitative online survey, were selected methods for this research. A training module was designed and implemented for 10 doctors and 15 nurses from a total of 76 (33%) of clinicians to aid in the introduction of the WHO TCC in an emergency department in a hospital in Nepal. The quasi-experimental research involved a pre- and post-training survey aimed to assess participant’s knowledge of the WHO TCC before and after training and before the implementation of the WHO TCC in the emergency department. Post-training, 219 patients were reviewed after four weeks to identify if process measures had improved the quality of care to trauma patients. Subsequently six months later, a qualitative online survey was sent to all clinical staff in the department to identify barriers to implementation, with a response rate of 26 (n = 26) (34%) (20 doctors and 6 nurses). Descriptive statistics were used to evaluate quantitative data and the qualitative data were analysed using the five stepped approach of thematic analysis (Braun and Clarke, 2006).

Findings

The evaluation of the implementation of the WHO TCC showed an improvement in care for trauma patients in an emergency setting in a tertiary hospital in Nepal. There were improvements in the documentation in trauma management, showing the training had a direct impact on the quality of care of trauma patients. Notably, there was an improvement in cervical spine examination from 56.1% before training to 78.1%; chest examination 125 (57.07%) before training and 170 (77.62%) post-training; abdominal examination 121 (55.25%) before training and 169 (77.16%) post-training; gross motor examination 13 (5.93%) before training and 131 (59.82%) post-training; sensory examination 4 (1.82%) before training and 115 (52.51%) post-training; distal pulse examination 6 (2.73%) before training and 122 (55.7%) post-training. However, while the quality of documentation for trauma patients improved from the baseline of 56%, it only reached 78% when the percentage improvement target agreed for this research project was 90%. The 10 (n = 10) doctors and 15 (n = 15) nurses in the Emergency Department (ED) all improved their baseline knowledge from 72.2% to 87% (p = 0.00006), by 14.8% and 67% to 85%) (p = 0.006), respectively. Nurses started with lower scores (mean 67) in the baseline when compared to doctors, but they made significant gains in their learning post-training. The qualitative data reported barriers, such as the busyness of the department, with residents and medical officers, suggesting a shortened version of the checklist to support greater protocol compliance. Embedding this research within TL provided a steer for successful innovation and change, identifying action for sustaining change over time.

Research limitations/implications

The study is a single-centre study that involved trauma patients in an emergency department in one hospital in Nepal. There is a lack of internationally recognised trauma training in Nepal and very few specialist trauma centres; hence, it was challenging to teach trauma to clinicians in a single 1-h session. High levels of transformation of health services are required in Nepal, but the sample for this research was small to test out and pilot the protocol to gain wider stakeholder buy in. The rapid turnover of doctors and nurses in the emergency department, creates an additional challenge but encouraging a multi-disciplinary approach through TL creates a greater chance of sustainability of the WHO TCC.

Practical implications

International protocols are required in Nepal to support the transformation of health care. This explanatory mixed methods research, which is part of an International Fellowship programme, provides evidence of direct improvements in the quality of patient care and demonstrates how TL can drive improvement in a low- to medium-income country.

Social implications

The Nepal/UK Hybrid International Emergency Medicine Fellowships have an opportunity to implement changes to the health system in Nepal through research, by bringing international level standards and protocols to the hospital to improve the quality of care provided to patients.

Originality/value

To the best of the authors’ knowledge, this research paper is one of the first studies of its kind to demonstrate direct patient level improvements as an outcome of the two-year MTI scheme.

Details

Leadership in Health Services, vol. 37 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 5 December 2023

Manoj Kumar Verma and Mayank Yuvaraj

In recent years, instant messaging platforms like WhatsApp have gained substantial popularity in both academic and practical domains. However, despite this growth, there is a lack…

Abstract

Purpose

In recent years, instant messaging platforms like WhatsApp have gained substantial popularity in both academic and practical domains. However, despite this growth, there is a lack of a comprehensive overview of the literature in this field. The primary purpose of this study is to bridge this gap by analyzing a substantial dataset of 12,947 articles retrieved from the Dimensions.ai, database spanning from 2011 to March 2023.

Design/methodology/approach

To achieve the authors' objective, the authors employ bibliometric analysis techniques. The authors delve into various bibliometric networks, including citation networks, co-citation networks, collaboration networks, keywords and bibliographic couplings. These methods allow for the uncovering of the social and conceptual structures within the academic discourse surrounding WhatsApp.

Findings

The authors' analysis reveals several significant findings. Firstly, the authors observe a remarkable and continuous growth in the number of academic studies dedicated to WhatsApp over time. Notably, two prevalent themes emerge: the impact of coronavirus disease 2019 (COVID-19) and the role of WhatsApp in the realm of social media. Furthermore, the authors' study highlights diverse applications of WhatsApp, including its utilization in education and learning, as a communication tool, in medical education, cyberpsychology, security, psychology and behavioral learning.

Originality/value

This paper contributes to the field by offering a comprehensive overview of the scholarly research landscape related to WhatsApp. The findings not only illuminate the burgeoning interest in WhatsApp among researchers but also provide insights into the diverse domains where WhatsApp is making an impact. The analysis of bibliometric networks offers a unique perspective on the social and conceptual structures within this field, shedding light on emerging trends and influential research. This study thus serves as a valuable resource for scholars, practitioners and policymakers seeking to navigate the evolving landscape of WhatsApp research. The study will also be useful for researchers interested in conducting bibliometric analysis using Dimensions.ai, a free database.

Details

Library Hi Tech, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0737-8831

Keywords

Article
Publication date: 1 April 1996

JENNIFER MACDOUGALL, J. MICHAEL BRITTAIN and ROBERT GANN

This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the…

Abstract

This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the areas of application, the impact of evidence based medicine and other professional issues, integrated information systems, and the needs of the public, patients and their carers. While medical informatics certainly comprises a major part of health informatics it is not the main focus of this paper. Medical informatics is the older term and involves the use of information technology and computing specifically for medical science research, and the diagnosis and treatment of disease involving, for example, X‐rays, imaging, resonance, and magnetic scanning techniques. Rather, the scope of this review is the literature relating to the wider concept of the management of information through the interdisciplinary application of information science and technology for the benefit of patients, scientists, managers, staff, and carers involved in the whole range of healthcare activity.

Details

Journal of Documentation, vol. 52 no. 4
Type: Research Article
ISSN: 0022-0418

Article
Publication date: 1 July 1996

Melanie Maxwell, Tom Kennedy and Alan Spours

Describes the way benchmarking data are used in a district general hospital to influence clinical practice. Wirral Hospital Trust is a site for the Electronic Patient Record…

524

Abstract

Describes the way benchmarking data are used in a district general hospital to influence clinical practice. Wirral Hospital Trust is a site for the Electronic Patient Record Project; as such there is a large amount of patient‐based data available for research and internal benchmarking. Includes working examples of internal benchmarking which have been used by both clinicians and hospital management to improve hospital effectiveness. Discusses the ways in which this information is being used to develop initiatives such as clinical pathway development.

Details

International Journal of Health Care Quality Assurance, vol. 9 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 13 January 2023

Hasan Bağcı and Seyhan Çil Koçyiğit

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the…

Abstract

Purpose

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.

Design/methodology/approach

Data envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.

Findings

According to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.

Practical implications

Providing administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.

Originality/value

This study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.

Details

Benchmarking: An International Journal, vol. 30 no. 10
Type: Research Article
ISSN: 1463-5771

Keywords

Abstract

Details

Knowledge Risk and its Mitigation: Practices and Cases
Type: Book
ISBN: 978-1-78973-919-0

Abstract

Details

The Handbook of Road Safety Measures
Type: Book
ISBN: 978-1-84855-250-0

Book part
Publication date: 10 November 2005

Jon A. Chilingerian and Grant T. Savage

To underscore the significance of international health care management, we focus on three themes: the problem of global blindness; global health care challenges and opportunities;…

Abstract

To underscore the significance of international health care management, we focus on three themes: the problem of global blindness; global health care challenges and opportunities; and learning from international health care management. The problem of global blindness highlights how health care managers’ inattentional blindness to competitors’ operational performance and market strategies lead to avoidable and expensive failures. To address global challenges and opportunities, health care organizations are employing two different strategies: (1) building and marketing a world-class health care facility internationally, and (2) organizing and integrating multinational health care operations. The first strategy exploits the medical-tourism market. The second strategy requires either multinational health care networks or transnational health care organizations. One of the lessons to be learned from international health care management is that an organization can create a meta-national competitive advantage. Another lesson is that by examining best practices from around the world, health care organizations can obtain new insights and become more innovative within their home markets. A corollary and third lesson is that while health care organizations can learn a great deal from examining international best clinical practices, sometimes the most important management lessons are lost in clinical translations. The fourth and last lesson is that worst cases – serious international management failures – offer perhaps the most valuable insights into the role of culture, complexity, and leadership for health care organizations.

Details

International Health Care Management
Type: Book
ISBN: 978-0-76231-228-3

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