Search results

1 – 10 of 76
To view the access options for this content please click here
Article
Publication date: 1 June 2005

Sandra A. Mathers, Graham A. McKenzie and Rosemary A. Chesson

The main purpose of the study was to investigate practices relating to informed consent for radiological procedures.

Abstract

Purpose

The main purpose of the study was to investigate practices relating to informed consent for radiological procedures.

Design/methodology/approach

All Health Boards in Scotland (15) were included in the survey and 62 hospitals were contacted. A questionnaire was developed and sent to superintendent radiographers and radiology managers. Quantitative data were entered in to SPSS‐PC for analysis.

Findings

A response rate of 95.2 per cent (59/62) was achieved. A total of 15 hospitals described having a trust policy document on consent and six hospitals reported departmental policies. The majority of hospitals used consent forms for interventional procedures, but not for conventional procedures, although two hospitals obtained informed consent for intravenous urography, and one for barium enemas. All departments (n=25/25) using consent forms required the patient to sign the consent form and 20 departments retained the form. Nine departments placed these in the patient's medical records.

Research implications/limitations

The survey demonstrated considerable diversity in hospital practices regarding informed consent for radiological procedures. The findings have significant implications for clinical governance, especially regarding risk management. Some staff may be putting themselves at risk in an increasingly litigious society. The transferability of this Scottish study needs to be established through surveys in other parts of the UK.

Practical implications

The study reports diversity in practice when gaining informed consent for radiological procedures and the lack of standardisation for this process.

Originality/value

No previous UK empirical studies on informed consent for radiological procedures has been published.

Details

Clinical Governance: An International Journal, vol. 10 no. 2
Type: Research Article
ISSN: 1477-7274

Keywords

To view the access options for this content please click here
Book part
Publication date: 23 February 2015

Maria Cristina Longo

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships…

Abstract

Purpose

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations.

Methodology/approach

In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC – Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies.

Findings

The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable.

Originality/value

The recognition of ISMETT’s good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

To view the access options for this content please click here
Article
Publication date: 1 June 2021

Ibrahim Alghanimi

This paper aims to summarize the radiological interventions that can be used by obstetricians and gynecologists.

Abstract

Purpose

This paper aims to summarize the radiological interventions that can be used by obstetricians and gynecologists.

Design/methodology/approach

E-health systems apply in all hospital sectors in the world; interventional radiology (IR) now includes transcatheter and percutaneous techniques that can be applied to various organ systems, including the female reproductive system and pelvis. Interventional radiologists can now offer many services to obstetricians and gynecologists. With the advent of new procedures and refinement of existing techniques, there are now a number of procedures that can be used to treat both vascular and non-vascular diseases. This review summarizes the radiological interventions that can be used by obstetricians and gynecologists.

Findings

This review is intended to help gynecologists and obstetricians understand the role of IR in their specialty. Many valuable vascular and nonvascular interventional services can be provided by radiologists for both obstetric and gynecological indications. Many of these IR procedures are minimally invasive with less risk to the patients.

Originality/value

IR is now being used to treat some conditions encountered in obstetrics and gynecology, in particular, uterine leiomyomas, placenta accreta, postpartum hemorrhage and pelvic congestion syndrome. Moreover, with the help of IR, radiologists can also manage several nonvascular pathologies, including drainage of pelvic abscesses, fallopian tube recanalization, image-guided biopsy and fluid collections involving ovarian lesions. The major challenges faced when performing obstetric IR procedures are reduction of radiation exposure for the patient and fetus and preservation of fertility. This review highlights the role of IR in the treatment of various vascular and nonvascular pathologies encountered in obstetrics and gynecology.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

To view the access options for this content please click here
Book part
Publication date: 16 October 2014

Susan Moffatt-Bruce, Ann Scheck McAlearney, Alison Aldrich, Tina Latimer and Edmund Funai

Clinical front-line staff are best positioned within the organizations to identify patient safety problems and craft solutions. However, in traditional models, safety…

Abstract

Purpose

Clinical front-line staff are best positioned within the organizations to identify patient safety problems and craft solutions. However, in traditional models, safety committees are led by senior executives who are not clinically responsible for patients. This top-down approach can result in missed opportunities to address patient-centered challenges and better manage the health of the defined populations served by these organizations.

Design/methodology/approach

To foster teamwork, enhance empowerment, and improve the patient care environment, Operations Councils led by trained front-line staff were deployed in 15 clinical areas at the Ohio State University Wexner Medical Center (OSUWMC) as a performance improvement tool.

Findings

Standardized training of Council facilitators was designed and implemented to guide the performance improvement process. Balanced scorecards were developed in each Council based on the risks and concerns of that particular clinical area. After initial implementation of the Operations Councils, patient safety events declined and team engagement improved by over 34% across the medical center; the highest changes were seen in areas where Operations Councils had been deployed. Additionally, outcome metrics including area-specific and system-wide mortality and readmissions improved after implementation.

Originality/value

We suggest that this type of approach may be an appropriate strategy to consider in other health care organizations as such institutions are challenged to better manage the health of their defined patient populations.

Details

Population Health Management in Health Care Organizations
Type: Book
ISBN: 978-1-78441-197-8

Keywords

To view the access options for this content please click here
Article
Publication date: 1 July 2006

D.B. Freedman and E. Swanson

The purpose of the paper is to provide healthcare organisations with an example of how the implementation of new interventional procedures and NICE guidance can be…

Abstract

Purpose

The purpose of the paper is to provide healthcare organisations with an example of how the implementation of new interventional procedures and NICE guidance can be improved by adopting a synergistic approach.

Design/methodology/approach

The paper shows that following the introduction of the Interventional Procedure Programme (NICE) and the issue of Department of Health advice in 2003, it was considered that the hospital's process for implementing new interventional procedures should be revised and would be more effectively managed by integrating with the well established process for implementing NICE guidance. The strategy for implementing NICE guidance and the new interventional procedure ratification process at the Luton and Dunstable Hospital NHS Trust are outlined and describe individual and corporate roles and responsibilities that promote local ownership.

Findings

The paper provides information on how the Trust incorporated the national perspective into a local model, which ensures a well‐coordinated multidisciplinary approach to introducing innovative clinical practice safely.

Practical implications

This paper demonstrates a useful tool that may be adapted by other healthcare organisations and clinical governance professionals responsible for implementing new interventional procedures into local practice. The role of the Interventional Procedure Governance Committee in supporting the application, review, ratification and monitoring processes is explained.

Originality/value

The paper identifies a practical approach, ensuring that practice follows recommendations within guidance already published by NICE or are reported to the Interventional Procedure Programme if the procedure is not already included within the work programme.

Details

Clinical Governance: An International Journal, vol. 11 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

To view the access options for this content please click here
Article
Publication date: 4 April 2016

Naglaa Mostafa Elsayed Abdallah

The purpose of this paper is to highlight the relation between radiology and sustainable development with emphasis on the UK and European countries, and to spotlight its…

Abstract

Purpose

The purpose of this paper is to highlight the relation between radiology and sustainable development with emphasis on the UK and European countries, and to spotlight its possible application in the developing countries.

Design/methodology/approach

This is a review paper where data about sustainable development and radiology are collected from selected journals, websites, articles and conferences, e.g. Royal College of Radiology, European Society of Radiology, World Health Organization and other different radiology societies.

Findings

Adoption of sustainable diagnostic radiology by many countries in Europe and the UK helps to provide imaging services efficiently and effectively, with simultaneous preservation of the natural resources, patient health and environment much better than before. The developing and underdeveloped countries should follow this knowledge hoping to reach the same goals.

Practical implications

Limiting the use of radiologic examinations, guide the clinicians to use clinical skills before rushing to radiology examinations will save money, preserve equipment and protect patients from possible radiation hazards. The use of teleradiology will indirectly reduce global warming, and will deliver medical services to poor countries.

Social implications

Improving the health of people of poor countries will improve their socioeconomic level.

Originality/value

This paper focuses on the value of applying sustainable development in radiology not only in general medicine.

Details

World Journal of Science, Technology and Sustainable Development, vol. 13 no. 2
Type: Research Article
ISSN: 2042-5945

Keywords

To view the access options for this content please click here
Article
Publication date: 14 October 2020

Eloise Radcliffe, Maria Kordowicz, Caroline Mak, Guy Shefer, David Armstrong, Patrick White and Mark Ashworth

The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective.

Abstract

Purpose

The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective.

Design/methodology/approach

An in-depth 33 month ethnographic study, using observation and qualitative interviews, examined the process of lean implementation as part of an improvement programme.

Findings

Implementation of lean was more successful compared with other reports of lean in healthcare settings. Key enablers of lean were high levels of multidisciplinary staff involvement and engagement; the professional credibility of facilitators and clinicians as early adopters, all within a wider culture of relatively strong inter-professional relationships in the imaging department. These enablers combined with the more routinised and standardised nature of imaging pathways compared to some other acute specialties suggest that imaging is fertile ground for lean, linked to the manufacturing origins of lean.

Practical implications

When introducing lean within healthcare settings, special attention needs to be paid to the specific healthcare context and the existing cultures of inter-professional relationships. Fostering an improvement culture and engagement with training, together with adequate financial resource, are a key to contributing to the level of acceptability of an improvement tool such as lean.

Originality/value

This ethnographic study, bringing together rich multi-source data, has provided a detailed insight into the cultural workings of the process of lean implementation within a complex healthcare system.

Details

Journal of Health Organization and Management, vol. 34 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 10 June 2020

Matthew Bridgeman

Following is an overview of the open and affordable textbooks (OAT) program, strategies for outreach, as well as discuss approaches that faculty awardees have taken to…

Abstract

Purpose

Following is an overview of the open and affordable textbooks (OAT) program, strategies for outreach, as well as discuss approaches that faculty awardees have taken to designing their courses. This paper aims to address a couple issues such as the effectiveness of open educational resources (OER) resources, the process of creating OER resources and how faculty and instructors have updated their courses and adjusted their pedagogy.

Design/methodology/approach

This paper describes five cases where the faculty adopted open pedagogy. They include a general chemistry course, psychiatry clerkship, microbiology lab, a medical Spanish course and a radiology elective in a medical school.

Findings

The use of open pedagogy promotes two things: up-to-date resources and practical experience. Since the creation of the Rutgers OAT program, faculty and instructors have been rethinking how they teach their courses. Students enjoy the content more and faculty loves the increase in engagement. As the program continues to grow, the creativity fostered by open pedagogy improves education for everyone involved.

Originality/value

The paper offers a general overview of an effective open and affordable program at a public research university. It demonstrated the effectiveness of the program while also offering examples of novel course materials for interested librarians and faculty. It opens the possibility from just finding resources to creating them and how they improve education.

Details

Library Hi Tech News, vol. 37 no. 7
Type: Research Article
ISSN: 0741-9058

Keywords

To view the access options for this content please click here
Article
Publication date: 26 October 2018

Ariel Belasen and Alan T. Belasen

The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.

Abstract

Purpose

The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.

Design/methodology/approach

The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC.

Findings

The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor–patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals.

Research limitations/implications

More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse.

Practical implications

When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use.

Originality/value

The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.

Details

Journal of Health Organization and Management, vol. 32 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 4 November 2019

Hongwang Du, Wei Xiong, Haitao Wang and Zuwen Wang

Cables are widely used, and they play a key role in complex electromechanical products such as vehicles, ships, aircraft and satellites. Cable design and assembly…

Abstract

Purpose

Cables are widely used, and they play a key role in complex electromechanical products such as vehicles, ships, aircraft and satellites. Cable design and assembly significantly impact the development cycle and assembly quality, which is be-coming a key element affecting the function of a product. However, there are various kinds of cables, with complex geo-metric configurations and a narrow assembly space, which can easily result in improper or missed assembly, an unreasonable layout or interference. Traditional serial design methods are inefficient and costly, and they cannot predict problems in installation and use. Based on physical modeling, computer-aided cable design and assembly can effectively solve these problems. This paper aims to address virtual assembly (VA) of flexible cables based on physical modeling.

Design/methodology/approach

Much research has focused recently on virtual design and assembly-process planning for cables. This paper systematically reviews the research progress and the current state of mechanical models, virtual design, assembly-process planning, collision detection and geometric configuration and proposes areas for further research.

Findings

In the first instance, the main research groups and typical systems are investigated, followed by extensive exploration of the major research issues. The latter can be reviewed from five perspectives: the current state of mechanical models, virtual design, assembly-process planning, collision detection and geometric configuration. Finally, the barriers that prevent successful application of VA are also discussed, and the future research directions are summarized.

Originality/value

This paper presents a comprehensive survey of the topics of VA of flexible cables based on physical modeling and investigates some new ideas and recent advances in the area.

Details

Assembly Automation, vol. 40 no. 2
Type: Research Article
ISSN: 0144-5154

Keywords

1 – 10 of 76