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The purpose of this paper is to assess causal relations between the implementation of the 5S approach and the reduction of patients’ waiting time at out patient departments (OPDs) of hospitals in Tanzania.

Patients’ waiting time was measured under the cluster randomized control trial (c-RCT). In all, 16 hospitals were chosen and divided into treatment and control groups using block randomization. Before the intervention, a baseline study was conducted at OPDs in all 16 hospitals. After one year of the intervention, the end-line study was carried out in both the groups. A comparison of the average waiting time reduction and Difference-in-Difference (DID) analysis was carried out to see the effect of the 5S approach on the reduction of patients’ waiting time.

Statistical significance in reduction of patients’ waiting time was seen in the medical records sections (p=0.002) and consultation rooms (p=0.020) in the intervention group. The same trend was also seen using DID analysis (−15.66 min in medical record, −41.90 min in consultation rooms).

This study has the following limitations in terms of the data. The data were collected for only three days at the time of baseline survey, and again for three days at the time of the end-line survey from 16 hospitals. Moreover, piloted areas for the implementation of the 5S approach vary from hospital to hospital. There might be a bias in the measurement of a patient’s waiting time. Caveats are therefore needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for implementing quality improvement programs in Tanzania and in other African countries for improvement of time factors.

This study used c-RCT, and has proven the effectiveness of the 5S approach in improving the working environment and reducing patients’ waiting time at OPDs in several hospitals at district level in Tanzania.

Mothers with a dual diagnosis (mental ill health and substance use) have delays in accessing services, or their care may be interrupted prior to therapeutic relationships being formed. The purpose of this paper is to explore and describe how engagement merges in the context of mothers with a dual diagnosis.

This is a qualitative, focused ethnographic study at a low-threshold service for substance abusing families. The data contain interviews, observations, field notes, and reflections. The analysis followed several systematic steps.

Engagement is the co-creation of possibilities between workplace staff and the client in different interfaces. It is not a single act, emotion, or verbal communication, but a complex intertwined system of events that can awaken or enable the client to get a grasp on life. The sensitivity of the worker is one tool for engaging the client in manifold ways in different interfaces: even the smallest events with connection are viewed as valuable. Engagement involves the intentional client in the process of interaction: the client needs to participate and become an acting and sensing part of the change, which occurs on an experiential level. The process is described with the metaphor of a seed.

Engagement as inner involvement challenges the current working methods, and requires sensitivity, because the mothers with a dual diagnosis may not have verbalisable goals when arriving to the services.

In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.

The purpose of this paper is to describe the components, structure and theoretical underpinnings of a cognitive remediation intervention that was delivered within a supported education program for mental health survivors.

In total, 21 participants enrolled in the course Strengthening Memory, Concentration and Learning (PREP 1033 at George Brown College (GBC)) with the diagnosis of depression, anxiety, PTSD, ED and substance use disorder were included in the research. After a baseline assessment, participants completed 14 week cognitive remediation training (CRT) protocol that included six essential components that were integrated and implemented within the course structure of the supported education program at GBC. This was followed by a post-training assessment.

Analysis of the participants’ performance on CRT protocol using computerized games showed little significant progress. However, the research found a positive change in the self-esteem of the participants that was statistically significant and the findings also aligned with the social and emotional learning framework.

One of the limitations in the research was the use of computer-assisted cognitive remediation in the form of the HappyNeuron software. The value and relevance of computer assisted needs are to be further examined. It seems that the implementation of the course that explicitly address cognitive challenges creates a supportive environment can be helpful.

Despite the mixed results and the few limitations associated with the CRT intervention reported in the research, the study offers reminders of the complexity of cognitive remediation and all the factors involved that need to be taken into consideration.

This research created explicit space for addressing some of the implicit assumptions about the cognitive abilities when in post-secondary education.

This work is based on author’s previous work on cognitive remediation research within the supported education setting.

The purpose of this paper is to investigate changes in, and associations between, sense of coherence (SOC) and emotional distress in women who participated in an accredited motivational program (VINN) in correctional institutions in five countries.

A prospective study with a pre- and post-test design included 316 participants from Sweden, Estonia, Denmark, Russia and Norway. Global emotional distress was measured by the Hospital Anxiety and Depression Scale. SOC was measured using the 13-item Orientation to Life Questionnaire. One-way analysis of variance and multilevel regression models were used in the statistical analyses.

An increase in SOC was associated with a decrease in emotional distress. Emotional distress decreased significantly −3.80 points (95 percent CI (−4.61, −2.97)), and SOC significantly improved from pre- to post-measurement by 1.82 points (95 percent CI (0.72, 2.92)), regardless of country and correctional institution.

The results add new knowledge regarding a coherent theoretical foundation of a motivational program for women. The ability of a program promoting health is important for researchers, health-care workers and facilitators delivering programs for women in correctional facilities. An increase in SOC can act as a protective factor in order to manage stressors and risk factors among women serving in correctional facilities.

The present study indicates that enhancing women’s coping resources and providing income alternatives to crime is fundamental to their capacity to desist from criminal behavior.

This study investigates the association between interim audits and final audits. The authors focus on whether interim audits affect the audit time lag and the risk of restatement associated with final audits.

Two regression models are established to empirically test if an interim audit helps to reduce the audit time lag and the restatement risk on annual reports based on a sample of Chinese listed firms.

The authors find that performing interim audits helps to reduce the audit time lag. This result suggests that final audits can be completed more efficiently when interim audits are performed during the same period. The authors also find that the decision to audit interim reports is associated with a lower risk of restating annual reports. The lower risk of restatement in turn suggests more effective final audit results.

Together, the results from this study demonstrate that interim audits could benefit final audits, which highlight the value and importance of the continuous auditing.