Using Takt Time for Generating Income in Specialist Outpatient Clinic in Kemang Medical Care (KMC)

2016 ◽  
Author(s):  
A Heri Iswanto
Keyword(s):  
Medical Care ◽  
Outpatient Clinic ◽  
Takt Time ◽  
Specialist Outpatient Clinic

scholarly journals Irreducible Dislocation of the Great Toe Interphalangeal Joint Secondary to an Incarcerated Sesamoid

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Hamid Rahmatullah Bin Abd Razak ◽  
Zi-Yang Chia ◽  
Hwee-Chye Andrew Tan
Keyword(s):  
Outpatient Clinic ◽  
Orthopaedic Surgery ◽  
Kirschner Wire ◽  
Axial Loading ◽  
Interphalangeal Joint ◽  
Return To Sports ◽  
Great Toe ◽  
Field Hockey ◽  
Kirschner Wire Fixation ◽  
Specialist Outpatient Clinic

Irreducible dorsal dislocation of the interphalangeal (IP) joint of the great toe is rare. We report a case of a 29-year-old gentleman who presented to the Orthopaedic Surgery Specialist Outpatient Clinic with an irreducible IP joint of the great toe that had been untreated for 4 weeks. The mechanism of injury is believed to be a combination of axial loading with a hyperdorsiflexion force when the patient fell foot first into a drain. As the patient did not report severe symptoms and a true lateral radiograph was not ordered, the dislocation was missed initially at the emergency department. The patient had continued to run and play field hockey prior to visiting us. Incarceration of the sesamoid became a block to manipulation and reduction at the specialist outpatient clinic 3 weeks later. The patient was treated with open surgical exploration, resection of the interposed sesamoid, and Kirschner-wire fixation of the IP joint followed by occupational therapy for mobilization exercises. The operative course was uneventful. At 6 months after surgery, the patient could walk, run, and return to sports.

scholarly journals Management Complaints and claims system and its influence on the quality of medical care in an outpatient clinic Albrecht Hospital Trujillo

2021 ◽  
Vol 17 (3) ◽  
pp. 37-43
Author(s):  
Ángel Pedro Ruiz Méndez ◽  
Yoni Mateo Valiente Saldaña ◽  
Frank Alexander Díaz Valiente
Keyword(s):  
Medical Care ◽  
Outpatient Clinic ◽  
Quality Of Medical Care

scholarly journals IMPROVEMENT OF MUNICIPAL OUTPATIENT ACTIVITY ON THE BASIS OF LEAN TECHNOLOGIES

2020 ◽  
Vol 8 (4) ◽  
pp. 481-494
Author(s):  
V.A. Evdakov ◽  
◽  
A.M. Allenov ◽  
G.B. Artemyeva ◽  
D.P. Lvova ◽  
...  
Keyword(s):  
Medical Care ◽  
Outpatient Clinic ◽  
Swot Analysis ◽  
High Efficiency ◽  
Lean Production ◽  
Outpatient Setting ◽  
Medical Organization ◽  
Number Of Patients ◽  
Standard Operating ◽  
Flow Map

Background. The world practice shows a high efficiency of lean production technologies both in the industrial and in social sectors. This determines the relevance of the research devoted to the analysis of the results of implementing a process approach based on the concept of lean produc-tion, in improving the activities of an outpatient medical organization. Aim. To identify resources of a municipal outpatient clinic in improvement of organization and effectiveness of realization of prophylactic programs, organization of work with patients and conduct of technological processes. Materials and Methods. To determine the aims of strategic development of a medical organiza-tion and identify the key trends for improvements on the basis of the concept of lean technolo-gies, SWOT analysis was used. A full-design study was conducted for assessment of the results of introduction of the concept of lean production in the period from January 2019 to December 2019, the respective parameters of the activity of an outpatient clinic were acquired and pro-cessed. The results obtained were compared with analogous results of 2018. Results. Introduction of the lean production concept helped to increase the availability of outpa-tient care, reduce the waiting time for examination and visiting medical specialists, improve the effectiveness of the health Center, increase the number of patients examined under preventive programs (+14.1%) from the planned level in comparison with the previous reporting period, from 83.0% in 2018 to 97.1% in 2019. A new form of public notification, the information flow map, has been developed and put into practice, and new standard operating maps (SOC) and standard operating procedures (SOP) have been developed and implemented. Improvement in the provision of medical care in the outpatient setting based on the concept of lean production has significantly improved several parameters of the organization: the coverage of the population with prophylactic medical examination (+14.1%) in comparison with the previous year, attraction of more individuals of the working age to the prophylactic examination: in the group of 21-39 years of age (+25.9%), in the group of 40-60 years of age (+18.9%). Conclusions. The results obtained confirm effectiveness of the concept of lean production in the improvement of the processes of medical organization providing medical care to the population in the outpatient setting. The block of presented approaches and tools of lean production may be used with taking into account adaptation to individual operating processes in a particular medical organization.

scholarly journals USE OF EXPRESS TESTS IN THE PRACTICE OF FAMILY DOCTORS AND PEDIATRICIANS

2021 ◽  
Vol 121 (1) ◽  
pp. 51-64
Author(s):  
Liudmyla Gospodarenko ◽  
Tetiana Klets ◽  
Ganna Gnyloskurenko ◽  
Roman Terletskyi ◽  
Diana Kononenko
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Outpatient Clinic ◽  
Secondary Care ◽  
Group A Streptococcus ◽  
Rapid Test ◽  
Diagnostic Methods ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group A

Rapid diagnosis significantly reduces the patient's expectation of effective medical care. As a result, rapid or POC-tests are becoming increasingly important in the world. However, the frequency of their use, the availability of tests in medical facilities, the awareness of physicians about diagnostic capabilities and the need for them are currently unclear. The aim of our study was to determine the level of awareness of physicians about the use of rapid tests for influenza, RS-virus, ꞵ-hemolytic group A streptococcus  and laboratory markers of inflammation in the form of POC-tests in daily practice. The study was conducted by interviewing 78 pediatricians and family physicians in Kyiv and Kyiv region who work at the primary and secondary levels of medical care. A questionnaire from EAPRASnetT (European Academy of Pediatric Research in the network of outpatient settings) was used for the survey. Our research has shown that hospital physicians are more informed about the use of rapid diagnostics and are more willing to use it in the treatment and diagnostic process. A rapid antigen test for influenza is available to the vast majority of inpatients (78%) and only half of outpatients (46.3%). Half of primary care physicians (56.1%) and the vast majority of secondary care professionals (73%) are willing to use this test in practice if it is available. The results of our study also showed a higher adherence to this rapid test of inpatients, as only 2.7% of them would like to confirm the results of POC-tests by laboratory tests (compared to 22% of outpatients). Most doctors in both outpatient clinics (61%) and inpatients (75.7%) are ready to use a rapid test for respiratory syncytial virus. Only 2.7% of hospital doctors would like to have a laboratory version, and outpatients would be completely satisfied with a quick test. However, due to the lack of trust in 14.6% of cases, they would like to confirm its results by laboratory testing. About a third of physicians (39%) use the rapid test for ꞵ-hemolytic group A streptococcus in the outpatient clinic, but half (51.2%) stated the need for this test and its unavailability. In the hospital, the data obtained were the opposite: half of doctors already use this test (59.5%), and another third would like to have it (35.1%). Rapid C-reactive protein testing is poorly used by physicians in both health care settings (12.2% in the outpatient setting and 29.7% in the inpatient setting) due to low security and lack of awareness. This is confirmed by the fact that 75.6% of primary and 64.9% of secondary care physicians stated that the test is not available, but they are ready to use this test if available. POC-test for C-reactive protein is used more in the hospital than in the outpatient clinic. At the outpatient stage, 12.2% of physicians do not consider it appropriate to use C-reactive protein in the diagnosis of diseases, in the hospital of such physicians 5%. About 10% of doctors in both groups expressed distrust in the rapid CRP-test, as they would like to use only the laboratory version. Doubts about the accuracy of almost twice as many outpatients, as more often would like to check it with a laboratory version (19.5% vs. 10.8% of inpatients). Therefore, one in five physicians in the outpatient clinic would use both the laboratory and POC versions. The rapid test for procalcitonin is used by every 5th doctor in the hospital and only 7% of the primary care, which can be attributed to the low availability of the test in medical practice, poor provision of medical institutions with POC-tests, as 62.2% and 78% of doctors the hospital and the clinic replied that they would use it if it was available. As for the complete general analysis of blood with leukocyte formula, only 17.1% and 35.5% of doctors of the polyclinic and hospital would like to use its POC version. Interviewed physicians would prefer a laboratory version of the test.It is necessary to raise awareness of physicians, especially primary care, about modern diagnostic methods, namely the practice of POC-tests and make them more accessible, which would significantly improve the diagnosis and treatment of patients, would have a positive impact on public health and significant economic effect.

scholarly journals Reduction in Specialist Outpatient Clinic Visits with an Integrated Care Programme for Frequent Admitters in Singapore

2018 ◽  
Vol 18 (s2) ◽  
pp. 246
Author(s):  
Ian Yi Han Ang ◽  
Chuen Seng Tan ◽  
Milawaty Nurjono ◽  
Shermin Tan ◽  
Hubertus Johannes Maria Vrijhoef ◽  
...  
Keyword(s):  
Integrated Care ◽  
Outpatient Clinic ◽  
Care Programme ◽  
Specialist Outpatient Clinic ◽  
Clinic Visits

scholarly journals Why people select the outpatient clinic of medical centers: a nationwide analysis in Taiwan

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9829
Author(s):  
Ming-Hwai Lin ◽  
Hsiao-Ting Chang ◽  
Tzeng-Ji Chen ◽  
Shinn-Jang Hwang
Keyword(s):  
Factor Analysis ◽  
Medical Care ◽  
Exploratory Factor Analysis ◽  
Outpatient Clinic ◽  
Medical Center ◽  
Outpatient Clinics ◽  
Medical Centers ◽  
Regular Family ◽  
High Tier ◽  
Selection Of

Introduction In contrast to other countries, Taiwan’s National Health Insurance (NHI) program allows patients to freely select the specialists and tiers of medical care facility without a referral. Some medical centers in Taiwan receive over 10,000 outpatients per day. In the NHI program, the co-payment was increased for high-tier facilities for outpatient visits in 2002, 2005, and 2017. However, the policies only mildly reduced the use of high-tier medical care facilities. The main purpose of this study was to evaluate the factors contributing to the patients’ selection of the outpatient clinic of medical centers without a referral. Methods An online anonymous survey was conducted by using the Google Forms platform utilizing a self-constructed questionnaire from September to October 2018. A nationwide sample in Taiwan was recruited using convenience sampling through social media. Based on a literature review and a focus group, 20 factors that may affect the choice of the outpatient institution were constructed. The associations between items that affect the patients selection of outpatient clinics were assessed using exploratory factor analysis. Principal axis factoring was performed to identify the major factors affecting the decision. Multiple logistic regression was performed to determine which factors satisfactorily explained “visiting the outpatient clinic of the medical center for an illness without a referral.” Results During the survey period, 5,060 people browsed the online survey, and 1,003 responded and completed the online questionnaire. Therefore, the response rate was 19.8%. A total of 987 valid responses was collected. Exploratory factor analysis revealed that three main factors, namely the “physician factor”, “image and reputation factor”, and “facility and medication factor”, affected the selection of outpatient clinics. A series of logistic regressions indicated that patients who reported that hospital facilities, high-quality drugs, and diverse specialties were very important were more likely to select the outpatient clinic of a medical center (OR = 2.218, 95% CI [1.514–3.249]). Patients who reported that physician factors were very important were less likely to select a medical center (OR = 0.717, 95% CI [0.523–0.984]). Patients who were previously satisfied with their experience of the primary clinics or had a regular family doctor were less likely to choose a medical center (OR = 0.509, 95% CI -0.435–0.595] and OR = 0.676, 95% CI [0.471–0.969]). Conclusion In Taiwan, patients with good primary medical experience and regular family physicians had significantly lower rates by selecting the outpatient clinic of a medical center. The results of this study support that the key to establishing graded medical care is to prioritize the strengthening of the primary medical system.

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