scholarly journals UNDERSTANDING SYSTEM FAILURE IN HEALTH CARE: A MENTAL MODEL FOR DEMAND MANAGEMENT

2021 ◽  
Vol 32 (2) ◽  
Author(s):  
Dieter Hartmann ◽  
John Bicheno ◽  
Bruno Emwanu ◽  
Teresa Sharon Hattingh
Keyword(s):  
Health Care ◽  
Demand Management ◽  
Waiting Times ◽  
Significant Proportion ◽  
System Failure ◽  
Academic Assessment ◽  
Reducing Costs ◽  
Diagnostic Framework ◽  
Insight Into

The load on health systems caused by systemic overburden leads to heightened costs, longer waiting times, a reduced quality of care, andassociated problems. This may be caused by ’failure demand’; however, its definition is inadequate for a complex hierarchical system. Although accounting for a significant proportion of load in other industries, the academic assessment of failure demand in health care remains limited. We present a novel way of identifying repeat consumption, which we loosely equate with failure demand. We present a framework that can be used to identify ‘system failure’, the trigger for later repeat consumption. This provides new insight into understanding whether common events represent system failure. A diagnostic framework was developed from observations, the literature, and brainstorming. Commonly observed exit scenarios in health care were tested against the framework to create a system-failure list. The framework and the categorisation table were shared with eight international Lean health-care experts. Following feedback, the framework and categorisations were fine-tuned and consensus was achieved via member-checking. Identifying and managing failure demand for these settings can lead to a reduced system load, thus reducing costs and increasing system efficiency and quality.

Knowledge Management in Healthcare

2010 ◽  
pp. 490-510 ◽  
Author(s):  
Christo El Morr ◽  
Julien Subercaze
Keyword(s):  
Health Care ◽  
Knowledge Management ◽  
Evidence Based ◽  
Delivery Of Care ◽  
Public Health Decision ◽  
Health Decision ◽  
Based Medicine ◽  
Evidence Based Decision Making ◽  
Insight Into

While knowledge management (KM) is becoming an established discipline with many applications and techniques, its adoption in health care has been challenging. Though, the health care sector relies heavily on knowledge and evidence based medicine is expected to be implemented in daily health care activities; besides, delivery of care replies on cooperation of several partners that need to exchange their knowledge in order to provide quality of care. In public health decision is mainly based on data and a shift is needed towards evidence based decision making. It is obvious that health care can profit from many advantages that KM can provide. Nevertheless, several challenges are ahead, some are proper to KM and other particular to the health care field. This chapter will overview KM, its methods and techniques, and provide and insight into health care current challenges and needs, discuss applications of KM in health care and provide some future perspectives for KM in health care.

Zufriedenheit mit der Gesundheitsversorgung: Gibt es strukturelle Unterschiede?

2018 ◽  
Vol 67 (3) ◽  
pp. 288-307
Author(s):  
Katharina Lima de Miranda ◽  
Daniel Prosi ◽  
Ulrich Schmidt ◽  
Hanna Wecker
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Statutory Health Insurance ◽  
Waiting Times ◽  
Private Insurance ◽  
Public And Private ◽  
Structural Differences ◽  
Urban And Rural Areas ◽  
Care Costs

Abstract This study examines structural differences in the subjective quality of health care in Germany using a newspaper survey. We find that there are significant differences between urban and rural areas as well as between public and private insurance. In rural areas, the provision of general practitioners, specialists and hospitals are considered as worse than in cities. In particular, public insured individuals asses the provision of specialized doctors and hospitals as lower than private insured and criticize long waiting times for appointments and lacking coverage of health care costs by the statutory health insurance.

Strategies for Increasing Knowledge Translation of Evidence-Based Practice in Athletic Training

2021 ◽  
pp. 1831-1840
Author(s):  
Brittany V. Allard ◽  
Michelle Lee D'Abundo
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Athletic Training ◽  
Diffusion Of Innovation ◽  
Health Care Professionals ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Aging Populations ◽  
Reducing Costs

The field of health care needs to change in order to address challenges such as rising health care costs, aging populations and the need to treat increasing numbers of people with chronic health conditions. All of this must be accomplished while reducing costs and maintaining quality of care. Health care professionals are being tasked with facilitating this change. Like many other health care professions, athletic training has turned to evidence-based practice to assure that athletic trainers are trained to deliver the highest quality of care in the most efficient way to their patients. The transition to integrating evidence-based practice will be challenging and will require a massive diffusion of innovation throughout the field of athletic training.

scholarly journals Primary Care Reform in Montenegro

2013 ◽  
Vol 52 (4) ◽  
pp. 247-254 ◽  
Author(s):  
Ljiljana Cvejanov Kezunović ◽  
Mara Drecun ◽  
Igor Švab
Keyword(s):  
Primary Care ◽  
Health Care ◽  
European Union ◽  
Waiting Times ◽  
Educational Interventions ◽  
Quality Of Services ◽  
Independent State ◽  
Primary Care Reform ◽  
Initial Results

Abstract Background: Montenegro is a newly independent state. As with many countries of that region, the country was faced with the need to reform its health care system. The overall aims of the reform were to improve the quality of services. This paper describes the process of implementation of the reform and its first achievements in patient satisfaction and quality of services since it has been introduced. Methods: The ministry of health introduced a series of steps that included changes to legislation, financing and manpower structure. Investments in primary care have been made and informatics support was developed. Educational interventions at the undergraduate and postgraduate levels were also introduced. Results: The initial results show that the changes have improved the quality of care provided: the composition of professionals in primary care has improved; preventive activities have remained high. Primary care is more accessible and organization of services is better, which can be seen in reduced waiting times for consultation in primary care and improved satisfaction with health care. Conclusions: The initial results show some progress since the reform was put into place. New measures aimed at raising the level of health care to reach European Union standards are still to be introduced.

scholarly journals Patient Mobility for Elective Secondary Health Care Services in Response to Patient Choice Policies: A Systematic Review

2016 ◽  
Vol 74 (4) ◽  
pp. 379-403 ◽  
Author(s):  
Ajay Aggarwal ◽  
Daniel Lewis ◽  
Malcolm Mason ◽  
Richard Sullivan ◽  
Jan van der Meulen
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Waiting Times ◽  
Significant Proportion ◽  
Patient Choice ◽  
Advanced Technology ◽  
Patient Mobility ◽  
Care Services ◽  
Lower Socioeconomic ◽  
Secondary Health Care

Our review establishes the empirical evidence for patient mobility for elective secondary care services in countries that allow patients to choose their health care provider. PubMed and Embase were searched for relevant articles between 1990 and 2015. Of 5,994 titles/abstracts reviewed, 26 studies were included. The studies used three main methodological models to establish mobility. Variation in the extent of patient mobility was observed across the studies. Mobility was positively associated with lower waiting times, indicators of better service quality, and access to advanced technology. It was negatively associated with advanced age or lower socioeconomic backgrounds. From a policy perspective we demonstrate that a significant proportion of patients are prepared to travel beyond their nearest provider for elective services. As a consequence, some providers are likely to be “winners” and others “losers,” which could result in overall decreased provider capacity or inefficient utilization of existing services. Equity also remains a key concern.

A Survey of Telemedicine in Italy

1995 ◽  
Vol 1 (3) ◽  
pp. 125-130 ◽  
Author(s):  
Domenico M Pisanelli ◽  
Fabrizio L Ricci ◽  
Riccardo Maceratini
Keyword(s):  
Health Care ◽  
Quality Of Health Care ◽  
Current Situation ◽  
National Plan ◽  
Reducing Costs ◽  
And Training

Italy has a tradition of experimental telemedicine which dates back to the early 1970s. However, despite promising experience, widespread diffusion of telemedicine services has not occurred. The Ministry of Research recognized the potential of telemedicine for improving the quality of health care and reducing costs, and has launched a national plan for financing research and training. The plan is expected to have a major impact on the organization of telemedicine research in Italy. In this paper we describe the current situation, outline the structure of the national plan, and survey various applications in different fields, such as teleconsulting, teleradiology and telemonitoring.

scholarly journals The health care system as a social determinant of health: qualitative insights from South Australian maternity consumers

2009 ◽  
Vol 33 (1) ◽  
pp. 62 ◽  
Author(s):  
Lareen A Newman
Keyword(s):  
Health Care ◽  
Demographic Data ◽  
Qualitative Interviews ◽  
Significant Proportion ◽  
South Australia ◽  
Social Determinant ◽  
Service Planning ◽  
Consumer Feedback ◽  
Relationship Health

Health systems and policies are important determinants of health because they influence the type and quality of health care available to a population. This study included semi-structured qualitative interviews and a questionnaire to collect demographic data and household details for a purposeful sample of 38 mothers and 24 fathers from four socioeconomic areas of metropolitan South Australia who had at least one child aged between 1 and 6 years of age. The participants reported that birth experiences within the predominantly medicalised maternity system were at odds with the expectations of a significant proportion of contemporary consumers that maternity care will leave them not only with a healthy mother and baby, but also with no undue adverse impacts on their physical, mental and relationship health. There appears to be no formal mechanism in place for regular consumer feedback of experiences into system and service planning.

An extensive review of patient health-care service satisfaction in Bangladesh

2020 ◽  
Vol 2 ◽  
pp. 5-16
Author(s):  
Abdul Kader Mohiuddin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Service Providers ◽  
Care Service ◽  
Waiting Times ◽  
Health Care Service ◽  
Care Providers ◽  
Care Services

Patient satisfaction is a useful measure for providing quality indicators in health-care services. Concern over the quality of health-care services in Bangladesh has resulted in a loss of faith in health-care providers, low use of public health facilities, and increased outflows of patients from Bangladesh to hospitals abroad. The main barriers to accessing health services are inadequate services and poor quality of existing facilities, shortage of medicine supplies, busyness of doctors due to high patient load, long travel distance to facilities, and long waiting times once facilities were reached, very short consultation time, lack of empathy of the health professionals, their generally callous and casual attitude, aggressive pursuit of monetary gains, poor levels of competence and occasionally, disregard for the suffering that patients endure without being able to voice their concerns. All of these service failures are frequently reported in the print media. Such failures can play a powerful role in shaping patients’ negative attitudes and dissatisfaction with health-care service providers and health-care itself.

scholarly journals Waiting times in cardiology and quality of care: analysis of performances in an Italian hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Olivero ◽  
F Bert ◽  
C Corezzi ◽  
P Rossello ◽  
P Alaria ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Services ◽  
Early Stage ◽  
Waiting Times ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Clinical Procedures ◽  
Care Services ◽  
Transluminal Coronary Angioplasty

Abstract Background The identification of diseases in an early stage is essential to improve prognosis and survival of patients. Consequently, waiting times for cardiological performances are widely recognized in Europe as evaluation items for healthcare quality. Our study aims to analyse waiting times of the main procedures in the cardiology ward of a huge hospital of Northern Italy and to compare them with the regional benchmark. Methods Data of the cardiology ward of “Molinette” hospital (Turin, Italy) about the waiting times for clinical procedures in the period 2016-2017 were collected. In particular, we gathered number of health care services and mean waiting times (MWT) for “Echocardiography” (EC), “First Cardiological Visit” (FCV), “Holter ECG” (HECG), “Percutaneous Transluminal Coronary Angioplasty performed within 2 days for people with myocardial infarction” (PTCA). We compared then our results with the benchmarks identified by the regional law. Results In the period considered, in “Molinette” hospital 11,565 ECs were performed, with a MWT of 31 days in 2016 and 16 days in 2017, well below the benchmark (40 days). The total number of FCVs was 5,156 with a MWT of 18 and 13 days in 2016 and 2017 respectively, again under the benchmark (30 days). The HECGs were 3,805, with a MWT of 53 (2016) and 32 (2017) days (benchmark 40 days). PTCAs performed within 2 days (benchmark 85%) were 160 (77.7%) in 2016 and 138 (85.2%) in 2017. Discussion In 2017, the waiting times of “Molinette” hospital were inferior to the regional benchmarks, for all the cardiological procedures considered. Shorter MWTs allow a more rapid planning of further diagnostic tests and treatments and, therefore, a consequent better quality of care. It’s important for European hospitals to assess and compare these indicators in order to guarantee a fast and appropriate care to their patients. Key messages Waiting times are an indicator of early diagnosis and treatment and are useful to assess the quickness and quality of health care provided in European hospitals. Cardiological procedures in “Molinette” hospital of Turin are provided with waiting times shorter than benchmarks. It would be interesting to compare these results with other big European hospitals.

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