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Book part
Publication date: 19 August 2017

Farah Nabi, Stephen Gallay, Erik Hellsten, Joel Lobo and Jesse Slade Shantz

The Canadian healthcare system is recognized as one of the best health systems in the world. However, recent social and economic conditions have placed significant pressure on…

Abstract

The Canadian healthcare system is recognized as one of the best health systems in the world. However, recent social and economic conditions have placed significant pressure on system administrators to demonstrate value-for-money for the investments made with an increased scrutiny on service delivery and cost structures. Challenges in providing more efficient healthcare often resonate two key constraints: the shortage of overall funding and barriers to accessing appropriate service providers in a timely fashion. The most common solution is simply to increase service provider manpower and invest further financial resources.

In Ontario, Canada’s largest province, The Shoulder Centre (TSC) has introduced a transformative solution to address system constraints through the development of an innovative and comprehensive model of care which builds on (1) novel partnerships between community providers and the Centre’s clinical team, (2) A Patient-Centered Specialty Practice (PCSP) and (3) Leveraging technology solutions.

TSC’s model of care suggests that many challenges in healthcare are attributed to the inappropriate management of human capital and the under-development of social capital. As a solution, TSC has transformed the organizational structure of its health services by converting service providers into partners with shared accountabilities, resulting in economic value through human capital optimization and improved system efficiencies through the building of social capital. TSC’s performance results demonstrate measured system savings, increased patient and provider satisfaction, targeted knowledge growth and confirms that the healthcare system contains a greater than expected abundance of human and financial resources to provide access to appropriate and timely care without any further system investment.

Details

Human Capital and Assets in the Networked World
Type: Book
ISBN: 978-1-78714-828-4

Keywords

Article
Publication date: 21 June 2013

Julie Coe and Fang Qian

The purpose of this paper is to examine how limited care patients and comprehensive care patients differ in terms of consumers' behavior in the dentist selection process, in order…

Abstract

Purpose

The purpose of this paper is to examine how limited care patients and comprehensive care patients differ in terms of consumers' behavior in the dentist selection process, in order to help healthcare providers and marketers better promote their practice depending on their patient type.

Design/methodology/approach

A survey of 1,150 dental school faculty private practice patients who recently chose their dentist was conducted and 221 responded. The respondents were divided to comprehensive care patients (n=120) and limited care patients (n=90) by self‐perceived need.

Findings

The comprehensive care patients were younger and more likely to be highly educated, have a healthcare related profession, and have private dental insurance (p<0.001). The comprehensive care patients were more likely to use information sources such as clinic website, the internet, and the insurance directory (p<0.05), while the limited care patients were more likely to use other dentists. Comprehensive care patients put more value on attributes such as, the dentist is in my insurance network and convenient physical location (p<0.05). In conclusion, comprehensive care patients and limited care patients differed significantly in characteristics and how and why they chose their dentist.

Originality/value

Healthcare marketers can use this study's findings to better promote their practice by selecting appropriate communication channels and focus on attributes that consumers value the most. It is important to apply different strategies to different consumer groups.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 7 no. 2
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 3 June 2014

Brandon Vachirasudlekha, Agnes Cha, Leonard Berkowitz and Bupendra Shah

The purpose of this paper is to gauge patients’ service perceptions of an interdisciplinary human immunodeficiency virus (HIV) clinic, which uses infectious disease physicians…

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Abstract

Purpose

The purpose of this paper is to gauge patients’ service perceptions of an interdisciplinary human immunodeficiency virus (HIV) clinic, which uses infectious disease physicians, medical residents, clinical pharmacists, nurses, social workers and students in HIV primary-care delivery.

Design/methodology/approach

Adult patients coming to the HIV clinic for a return visit to the interdisciplinary team completed a questionnaire based on a previously validated HIV-specific patient satisfaction study (n=104). Fourteen modified items assessing overall care-quality and ten original items assessing interdisciplinary services were included.

Findings

Respondents reported high satisfaction levels with the clinic's services. The mean score for the care-quality items was 3.79 (possible 4). The interdisciplinary care items mean score was 3.69 (possible 4). For non-physician disciplines, respondents indicated that nurses, pharmacists and social workers played important roles in their clinic care.

Research limitations/implications

Bias associated with patient selection and survey methods limit the generalizability. The study has implications for measuring interdisciplinary care provided at HIV clinics.

Originality/value

This HIV outpatient care interdisciplinary model is not widely in use. Results are important for those involved in HIV service development and improvement. Findings support integrating non-physician providers into routine outpatient HIV medical visits.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 5
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 November 2000

Yvonne Webb, Paul Clifford, Vanessa Fowler, Celia Morgan and Marie Hanson

The implementation of the Care Programme Approach (CPA) in English mental health services has been slow to proceed despite general support, both in England and in other countries…

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Abstract

The implementation of the Care Programme Approach (CPA) in English mental health services has been slow to proceed despite general support, both in England and in other countries, of its principles of good practice. This study set out to evaluate the implementation of the CPA directly from patients’ experience using the “Your Treatment and Care” assessment tool. The results of a survey of 503 patients across five NHS Trusts in England showed that many patients did not have a copy of their care plan and had not been involved in the care planning procedure. Many reported shortcomings in their experience of their key worker and their psychiatrist. However, there was substantial variation in experience across services. “Your Treatment and Care” showed good internal reliability, was acceptable to users, and appeared to be able to access actual experiences better than a traditional “satisfaction” item. It appears to be very useful as a benchmarking tool and is now being used in services across the UK, the USA and Australia.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 June 2010

Hannele Kerosuo

This paper seeks to take a patient‐centred perspective in exploring the treatment of multiple and chronic illnesses in inter‐organizational care practice in Finland.

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Abstract

Purpose

This paper seeks to take a patient‐centred perspective in exploring the treatment of multiple and chronic illnesses in inter‐organizational care practice in Finland.

Design/methodology/approach

The theoretical approach of the study is based on the sociology of translation and on cultural historical activity theory. The methodology of multi‐locale ethnography is used to research the translations in one patient's healthcare procedures in multiple care settings.

Findings

The care procedures emerge as unintegrated for the patient in the study. The patient has to take responsibility for his overall care since the medical professionals involved have only limited knowledge of other providers' care procedures. Despite their efforts to collaborate, professionals are lost in translation across healthcare boundaries.

Research limitations/implications

Single cases are problematic for advancing generalizations on a research topic. The case of this study presents an example of the translations in the care procedures for a patient with multiple and chronic illnesses.

Practical implications

Unintegrated care organization poses a difficult challenge to patient‐centred care if the ideals of consumerism are followed in the health care system. A patient, with limited medical knowledge, may not be able to master an overall pattern of chronic illness care in a sustainable way. Better management and coordination of specialized knowledge are required for patients with chronic illnesses.

Originality/value

In contrast with the many studies that report on patients' experiences of illness, the paper provides new insights into the patient experience of health care organization.

Details

International Journal of Public Sector Management, vol. 23 no. 4
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 8 June 2015

Virginia Minogue

“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and hospitalisation. As…

Abstract

Purpose

“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and hospitalisation. As his main carer, the author of the paper was struck, when visiting the hospital, by a small poster, on a notice board near to the entrance to the hospital ward, outlining the staff’s commitment to Compassion in Practice. Compassion in Practice was enshrined in the Compassion in Practice vision and strategy (Department of Health, NHS Commissioning Board, 2012) for building a culture of compassionate care across health and social care. A key element of the strategy was to make the values of care, compassion, courage, communication, competence and commitment, real and visible to patients and the public. The purpose of this paper is to seek to compare the values being stated with the care experience.

Design/methodology/approach

This paper records a personal perspective from a patient and their family carers of compassionate care in practice. This experience is one case study and does not seek to represent the experience of other patients and their families.

Findings

This highlights the importance of communication and demonstrates that care and compassion are human emotions and values that have to be lived in practice and are part of the interaction between patient, clinician and family. Simply believing in those core nursing values does not make them real for the patient in practice.

Originality/value

Both patient and the family carers had extensive experience of working in health and social care including the NHS. This account demonstrates the challenges of turning strategy into actions that can ultimately improve the patient experience of care.

Details

Quality in Ageing and Older Adults, vol. 16 no. 2
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 17 March 2020

Watchara Tabootwong and Frank Kiwannuka

Elderly patients requiring prolonged mechanical ventilation are treated with a tracheostomy. Oftentimes, the family caregivers need to participate in the care for elderly patients

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Abstract

Purpose

Elderly patients requiring prolonged mechanical ventilation are treated with a tracheostomy. Oftentimes, the family caregivers need to participate in the care for elderly patients with a tracheostomy during hospitalization. Therefore, this paper was conducted to acknowledge what family caregivers experience while caregiving for hospitalized elderly patients with a tracheostomy.

Design/methodology/approach

This literature review identifies family caregiver participation in caregiving for the elderly patient, the impact of caregiving, and the needs of family caregivers.

Findings

Family caregivers participate in the planning and provision of care to elderly patients. Furthermore, they also collaborate in the therapeutic process for elderly patients as well. Albeit the former sentiments, they experience physical, psychological, social and financial consequences of caregiving. It has been revealed that during the process of caring for their loved ones, family caregivers often experience poor sleep quality, strain, reduction in social interaction and insufficient income. Thus, health-care professionals should support and provide care for the needs of family caregivers. This can be achieved through providing information on prognosis, the care plan, emotional support and collaboration during the therapeutic process to provide better care for elderly patients with a tracheostomy. In addition, family caregivers’ relatives can also provide financial support and rotation of caregiving schedules to avoid burnout.

Originality/value

The paper indicates that family caregivers experience the impacts of caregiving. They should be supported by health-care professionals and their relatives.

Details

Working with Older People, vol. 24 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 1 June 2010

Anu Kajamaa

This study seeks to challenge the notions of the standardized care pathway and patient‐centred care, both of which provide only a partial view of care as a complex system. In…

Abstract

Purpose

This study seeks to challenge the notions of the standardized care pathway and patient‐centred care, both of which provide only a partial view of care as a complex system. In exploring and contrasting the care pathway protocol and an actual care pathway, the study aims to analyze the conceptualizations of care that actors involved in the actual care pathway have. The study makes suggestions on how to expand care pathways and thereby improve patient care.

Design/methodology/approach

A care pathway protocol is contrasted with the actual care pathway of a patient at a university hospital in Finland. Observational ethnography is combined with a narrative approach and activity‐theoretical ideas.

Findings

The study depicts the gap between the care pathway protocol and an actual care pathway. The actual care pathway, rather than being a clear‐cut process, is ruptured and unpredictable. The conceptualizations of care (i.e. care‐objects) held by the doctors, nurses and the patient were fragmented and clashed in their practical work activity. The main message to hospital management is that in order to expand care pathways, the multiple care‐objects need to be placed in constructive interplay.

Research limitations/implications

A single actual care pathway is presented and the results are interpreted accordingly.

Originality/value

The study explores the idea of a care pathway and patient‐centred care in the analysis of care‐objects. A new discursive model is introduced that places different care‐objects into interplay and opens up the possibilities for the expansion of care pathways.

Details

International Journal of Public Sector Management, vol. 23 no. 4
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 1 September 1996

Kris Siddharthan, Walter J. Jones and James A. Johnson

Investigates the increased waiting time costs imposed on society due to inappropriate use of the emergency department by patients seeking non‐emergency or primary care. Proposes a…

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Abstract

Investigates the increased waiting time costs imposed on society due to inappropriate use of the emergency department by patients seeking non‐emergency or primary care. Proposes a simple economic model to illustrate the effect of this misuse at a public or not‐for‐profit hospital. Provides evidence that non‐emergency patients contribute to lengthy delays in the ER for all classes of patients. Proposes a priority queuing model to reduce average waiting times.

Details

International Journal of Health Care Quality Assurance, vol. 9 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 November 2003

Jafar A. Alasad and Muayyad M. Ahmad

This exploratory study investigated patients’ satisfaction with nursing care at a major teaching hospital in Jordan. A total of 266 in‐patients participated in the study. Patients

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Abstract

This exploratory study investigated patients’ satisfaction with nursing care at a major teaching hospital in Jordan. A total of 266 in‐patients participated in the study. Patients were recruited from the medical, surgical, and gynecological wards. Pearson correlation, one‐way analysis of variance, and logistic regression analyses were used. The findings showed that patients in surgical wards had lower levels of satisfaction than patients in medical or gynecological wards. Gender, educational level, and having other diseases were significant predictors for patients’ satisfaction with nursing care. Methodological challenges, implications to nursing practice, and recommendations to nursing research are discussed.

Details

International Journal of Health Care Quality Assurance, vol. 16 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

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