Factors affecting the performance of public out-patient services

2019 ◽  
Vol 43 (3) ◽  
pp. 294
Author(s):  
Ugenthiri Naiker ◽  
Gerry FitzGerald ◽  
Joel M. Dulhunty ◽  
Michael Rosemann
Keyword(s):  
Qualitative Research ◽  
Health Service ◽  
Conceptual Framework ◽  
Case Studies ◽  
Waiting Times ◽  
Hospital Setting ◽  
Essential Element ◽  
System Reform ◽  
The Public ◽  
Sustainable Improvement

Objective The delivery of public out-patient services is an essential part of complex healthcare systems, but the contribution of public out-patient services is often ill defined and poorly evaluated. The aim of this study was to identify and better understand those factors that may affect the performance of out-patient services to provide health service managers, clinicians and executives with a conceptual framework for future decision-making processes. Methods The present qualitative research involved five exploratory case studies. These case studies were conducted across two specialties at hospitals in the Metro North Hospital and Health Service in Queensland. Data were obtained from 38 interviews and 15 focus groups, and were analysed to identify common themes. Further analysis helped identify the most significant factors and build a conceptual framework for understanding the relationships between those factors and their effect on performance. Results Across both specialties there were 10 factors (scheduling, performance, service framework, categorisation or prioritisation of patients, internal and external stakeholders, resources, service demand, culture, system challenges and medical stakeholders) identified that may affect the performance of out-patient services. These factors were condensed into five core domains: culture, stakeholders, resources, demand and system reform. Conclusion Strategies to address the five core domains identified may provide a framework for sustainable improvement in the delivery of out-patient services. What is known about the topic? The provision of specialist out-patient services is an essential element of health service delivery. Access to specialist services in the public sector is challenging because of the escalating demand associated with an increasing and aging demographic. The factors that may affect the delivery of out-patient services need to be addressed for long-term sustainable improvement. What does this paper add? This paper provides a conceptual framework grounded in rigorous qualitative data analysis for understanding the internal and external factors that affect waiting times for specialist out-patient services. The results of this qualitative research indicate that there are five core domains that may influence waiting times in the public out-patient setting. When these domains are addressed at the strategic, tactical and operational levels, they have the potential to provide significant improvement in the delivery of out-patient services. What are the implications for practitioners? This paper guides the attention of relevant stakeholders towards the five core domains identified (culture, stakeholders, resources, demand and system reform) that influence the performance of waiting times at the operational, tactical and strategic levels within the public hospital setting.

The Cassel Hospital, London

1996 ◽  
Vol 30 (5) ◽  
pp. 672-680 ◽  
Author(s):  
Paul Coombe
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Case Studies ◽  
Complex Network ◽  
Nursing Care ◽  
Historical Development ◽  
Public Hospital ◽  
Structure And Function ◽  
The Public ◽  
And Function

This paper is an account of the principles and practices of treatment offered at the Cassel Hospital, London, with a particular focus on the Inpatient Families Unit. The Cassel Hospital is an internationally renowned therapeutic community, the operation of which is based on psychoanalytic principles and which has operated within the British National Health Service for nearly 50 years. An account of the historical development of the hospital is given as well as a description of its structure and function. The following three innovative structures are elaborated: a complex network within which patients can develop, Cassel-style nursing care, and nurse-therapist supervision. Theoretical underpinnings are outlined, which together with two case studies facilitate an appreciation of the capacity of the therapeutic network to foster the successful treatment of a range of severely disordered individuals and families. Such treatment may approach a level perhaps otherwise unattainable and which is widely applicable in the public hospital and clinic settings in Australia.

scholarly journals Queue analysis of public healthcare system to reduce waiting time using flexsim 6.0

2020 ◽  
Vol 1 (2) ◽  
pp. 101
Author(s):  
Putri Amalia ◽  
Nur Cahyati
Keyword(s):  
Health Service ◽  
Healthcare System ◽  
Waiting Time ◽  
Low Cost ◽  
Waiting Times ◽  
Simulation Method ◽  
Public Healthcare ◽  
Public Healthcare System ◽  
The Public ◽  
The Government

Public healthcare is a health service facility from the government at a low cost. The problem is the long queue, which makes long patients’ waiting times. The patients are waiting for a maximum of more than 3 hours in the general polyclinic. Besides, the registration counter is almost busy all the time. The utilization is about 96.96%. Therefore, the objective of this research is to reduce the patients’ waiting time using the simulation method. Flexsim 6.0 software is employed to develop the public healthcare system and also develop some alternatives to improve the problem. The simulation model has been verified and validated. The result shows the waiting time is decreased by more than 80% by adding the resource in the registration counter. For managerial insight, this research could help the public healthcare system in satisfying the patients.

scholarly journals Service user engagement and health service reconfiguration: a rapid evidence synthesis

2015 ◽  
Vol 3 (17) ◽  
pp. 1-106 ◽  
Author(s):  
Jane Dalton ◽  
Duncan Chambers ◽  
Melissa Harden ◽  
Andrew Street ◽  
Gillian Parker ◽  
...  
Keyword(s):  
Health Service ◽  
Case Studies ◽  
Systematic Reviews ◽  
Service User ◽  
Evidence Synthesis ◽  
Decision Makers ◽  
User Engagement ◽  
The Public ◽  
Service Change ◽  
Research Studies

BackgroundUK NHS organisations are required to consult patients and the public about proposals for major changes to services. The evidence base for current UK guidance is unclear.ObjectivesTo assess what is known about effective patient and public engagement in reconfiguration processes and to identify implications for further research.DesignRapid evidence synthesis.SettingHealth services affected by reconfiguration proposals in the UK (particularly the English) NHS and similar health systems.ParticipantsMembers of the public and their representatives, patients and patient groups.InterventionsAny intervention to encourage patients and the public and their representatives to be involved in discussions about proposals for major service change.Main outcome measuresAny measure of ‘successful’ engagement as reported by health service decision-makers, patients and public representatives. We were also interested in the outcome of controversial reconfiguration proposals.Data sourcesWe carried out separate searches for systematic reviews, primary research studies and grey literature. Database searches were limited to material published in English from 2000 to March 2014.Review methodsFinal decisions on study inclusion were made by two reviewers independently. We used EPPI-Reviewer 4 (Evidence for Policy and Practice Information and Co-ordinating Centre, University of London, London, UK) to record decisions and for data extraction and quality assessment. We carried out a narrative synthesis using multiple frameworks (including pre-specified research questions and current guidance). In synthesising the case studies, we selected a number of ‘exemplars’ based on quality of reporting and some evaluation of the process of engagement.ResultsEight systematic reviews, seven empirical research studies and 24 case studies (six exemplars) were included. Methods of engagement varied in nature and intensity, and generally involved a mixed methods approach. There was no evidence on the isolated impact of any particular engagement method or collection of methods. In general, engagement was most likely to be successful when the process started at an early stage, offered opportunities for genuine interaction and was led and supported by clinicians involved in delivering the relevant services. The impact of engagement was variably measured and demonstrated. Impact was more frequently defined in terms of process measures than success or failure of reconfiguration. Little was reported on the potential negative impact of service user engagement.ConclusionsPatients and the public could be engaged through a wide variety of methods. In selecting which methods to employ locally, decision-makers should take into account the nature of the local population and of the proposed service changes. Problems often arose because decision-makers paid insufficient attention to issues considered important by the public. NHS England guidance could be a helpful practical framework for future engagement activity.Future workClearly reported evaluations of interventions are needed including those that test the sustainability of methods of engagement and their impact over time. The NHS England guidance on planning and delivering service change may provide a foundation for the design of future research.FundingCommissioned by the National Institute for Health Research Health Service and Delivery Research (HSDR) programme from the University of York HSDR Evidence Synthesis Centre (project no. 13/05/11).

scholarly journals Inovasi Pelayanan Kesehatan Kelas Imud Di Puskesmas Padang Pasir, Kecamatan Padang Barat, Kota Padang, Sumatera Barat

2020 ◽  
Vol 6 (1) ◽  
pp. 13
Author(s):  
Maisy Triwahyuni ◽  
Roni Ekha Putera ◽  
Wewen Kusumi Rahayu
Keyword(s):  
Public Health ◽  
Qualitative Research ◽  
Health Service ◽  
Health Center ◽  
Research Method ◽  
Mortality Rates ◽  
Relative Advantage ◽  
Public Health Center ◽  
The Public ◽  
Collection Methods

IMUD Class is an innovation in health service conducted by the Padang Pasir Public Health Center, Padang Barat District, Padang City, West Sumatera. The IMUD Class innovation is a platform for pregnant women and has a baby under the age of 20 years. This innovation aims to reduce maternal and infant mortality rates especially young mothers under the age of 20 years. The formulation of the problem of this study is how the IMUD Class initiated by the Padang Pasir Public Health Center, Padang Barat District, Padang City, West Sumatera. To describe and analyze IMUD Class using the theory Innovation of Attributes proposed by Everett. M. Rogers. Rogers said that five characteristics would be able to depict an innovation that would be accepted and adopted by the public. Those characteristics are relative advantage, compatibility, complexity, trialability, and observability. This study uses a descriptive qualitative research method with the data collection methods of interview, documentation, and observation about the innovation of the IMUD Class in Padang Pasir Public Health Center, Padang Barat District, Padang City, West Sumatera. Based on the theory attributes of change, the IMUD Class at Padang Pasir Public Health Center as a whole has fulfilled the characteristics that must be possessed by an innovation.

Implementasi Asas Keterbukaan pada Pengadaan Tanah bagi Pembangunan untuk Kepentingan Umum: Antara Harapan dan Kenyataan

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Priyo Katon Prasetyo ◽  
Rosye Villanova Christine ◽  
Sudibyanung Sudibyanung
Keyword(s):  
Information Asymmetry ◽  
Case Studies ◽  
Public Interest ◽  
Economic Inequality ◽  
Land Acquisition ◽  
The Public ◽  
Land Scarcity ◽  
Library Research ◽  
Role Of Information

Abstract: Based on Law Number 2 of 2012 concerning Land Acquisition for Development in the Public Interest, the Openness Principle is one of the ten principles as the basis of the implementation of development. This principle is significant because its complex role can lead to conflicts and disputes. In this paper, discussions are divided into two parts: 1) how the implementation is expected to be applied according to the acquisition procedure in theory; and 2) the reality that occurs in the field. The first discussion was conducted by reviewing the applicable regulations and the methods or concepts of development of the openness principle. Meanwhile, the second discussion about the reality on the field was conducted by elaborating case studies regarding problems in land acquisition. The results of this study indicate that there are gaps in the implementation of the openness principle between theory and reality in regards of land scarcity, economic inequality, and information asymmetry among the involved parties. In conclusion, the implementation of the openness principle is significant with the role of information in land acquisition.Intisari: Berdasarkan Undang Undang Nomor 2 Tahun 2012 tentang Pengadaan Tanah Bagi Pembangunan Untuk Kepentingan Umum, Asas Keterbukaan adalah salah satu dari sepuluh asas yang menjadi dasar pelaksanaannya. Asas ini menjadi signifikan karena perannya yang kompleks dapat menimbulkan konflik dan sengketa. Artikel ini akan membagi pembahasan menjadi dua bagian: pertama, bagaimana implementasi yang seharusnya diterapkan pada prosedur pengadaan secara harapan, dan kedua, membahas mengenai realita yang terjadi di lapangan. Secara harapan pembahasan dilakukan dengan melakukan library research atau studi terhadap peraturan yang berlaku dan metode-metode atau prinsip perkembangan dari asas keterbukaan. Realitas di lapangan akan dielaborasi dari studi kasus mengenai permasalahan dalam pengadaan tanah. Hasil dari penelitian ini menunjukkan ada gap dalam implementasi asas keterbukaan antara harapan dan realitas di lapangan yang bersumber dari kelangkaan sumber daya/tanah, ketimpangan ekonomi dan asimetri informasi di antara para pihak yang terlibat. Tulisan ini menyimpulkan bahwa implementasi asas keterbukaan signifikan dengan peran informasi dalam pengadaan tanah. 

Coding in Qualitative Research

2018 ◽  
Author(s):  
Mohammad Yaghi
Keyword(s):  
Qualitative Research ◽  
Case Studies ◽  
Qualitative Data ◽  
Doctoral Dissertation ◽  
Sufficient Data ◽  
Trial And Error ◽  
Amount Of Information ◽  
Potential Problems

In this chapter, Yaghi offers detailed suggestions on how to code qualitative data after they have been gathered. Based on his doctoral dissertation, this chapter explains that the logic behind coding qualitative data is to turn a significant amount of information into categories that can be used to explain a phenomenon, reveal a concept, or render the data comparable across different case studies. It also elaborates through examples from author’s fieldwork in Tunisia, Egypt, and Jordan on four potential problems that may face researchers in coding qualitative data. These are the questions of preparation, categorization, consistency, and saturation. The chapter concludes by asking researchers to be flexible, and open to the process of trial and error in coding, to confront the data with questions before categorization, and to gather sufficient data on their topics before running their qualitative surveys.

The Propaganda Feedback Loop

2018 ◽  
Author(s):  
Yochai Benkler ◽  
Robert Faris ◽  
Hal Roberts
Keyword(s):  
Case Studies ◽  
Feedback Loop ◽  
The Other ◽  
Hillary Clinton ◽  
Donald Trump ◽  
The Public ◽  
False Reporting ◽  
Media Ecosystem ◽  
Crowd Out ◽  
Selection Of

This chapter presents a model of the interaction of media outlets, politicians, and the public with an emphasis on the tension between truth-seeking and narratives that confirm partisan identities. This model is used to describe the emergence and mechanics of an insular media ecosystem and how two fundamentally different media ecosystems can coexist. In one, false narratives that reinforce partisan identity not only flourish, but crowd-out true narratives even when these are presented by leading insiders. In the other, false narratives are tested, confronted, and contained by diverse outlets and actors operating in a truth-oriented norms dynamic. Two case studies are analyzed: the first focuses on false reporting on a selection of television networks; the second looks at parallel but politically divergent false rumors—an allegation that Donald Trump raped a 13-yearold and allegations tying Hillary Clinton to pedophilia—and tracks the amplification and resistance these stories faced.

Museum Studies

2020 ◽  
pp. 516-537
Author(s):  
Erica L. Tucker
Keyword(s):  
Qualitative Research ◽  
Natural History ◽  
Case Studies ◽  
Research Design ◽  
Museum Studies ◽  
Historic Sites ◽  
Design Data ◽  
Museum Visitors ◽  
Ethnographic Fieldwork ◽  
Data Analyses

This chapter describes and discusses the major qualitative research methods used to study museums. These methods include analyses of visual displays and reconstructions; interviews with museum visitors, professionals, and stakeholders; as well as ethnographic fieldwork in museum settings. The chapter explores how these methods can be adapted to the study of exhibits, galleries, programs, and museums as knowledge-generating institutions from a range of case studies conducted by museum practitioners, anthropologists, historians, and other museum studies scholars at a variety of museums. Case studies are drawn from works that examine ethnographic, natural history, art and community museums as well as historic sites. Approaches to research design, data analyses, and writing up are also examined.

Write–Reach–Repeat

2020 ◽  
pp. 1083-1093
Author(s):  
Robin M. Boylorn
Keyword(s):  
Qualitative Research ◽  
Public Sphere ◽  
The Internet ◽  
The Public ◽  
The Future ◽  
Private And Public ◽  
The Relationship

This chapter considers the role, importance, and impact of public intellectualism on the future of qualitative research. The chapter argues that the move toward technology and the public dissemination of information via the internet requires a shift in how and what we research with an expressed intention of reaching a broader and nonacademic audience. The chapter considers the relationship between the private and public sphere, and the so-called “bastardization” of intellectualism to explain the role and rise of public intellectualism in qualitative research. By considering issues such as personal subjectivity, accountability, representation, and epistemological privilege, the chapter discusses how public contexts inform qualitative research and, conversely, how qualitative research can inform the public.

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