Assessing the impact of environmental factors on emergency healthcare quality: A benchmarking approach

Quality of health care has been a subject of attention for many years in the USA and in Europe. Since the introduction of the new federal law on insurance in 1996 it has evolved to a progressively more important issue within the Swiss health care system. In this review, some theoretical concepts of quality of health care, variations, and surveillance systems are explored. Examples of quality of health care surveillance systems that have been developed successfully in the USA, in Canada, in Australia, and in Europe are discussed. They all demonstrate the interest in creating a large range of quality indicators in the surveillance system and in evaluating hospital performance using a benchmark approach. Currently, the measurement of quality with appropriate indicators is a subject of intense debate between the Swiss Hospitals Association (H+) and the Swiss Health Insurance Consortium (Santésuisse). Examples of existing surveillance systems in Switzerland are the Outcome Verein in Zurich and the quality of care program of the Canton of Valais. The FoQual association has also contributed to the debate by reviewing six indicators, which could be used nationally for a healthcare surveillance system. In this debate it is important to stress that ideal quality indicators intended for use as measures of quality in Swiss hospitals need to be both appropriate and valid. Only indicators that fulfil these conditions should be integrated in a Swiss health care surveillance system. Priority needs to be given to quality indicators and methods with the highest level of evidence and with a solid scientific basis.

Quality of health care has been a subject of attention for many years in the USA and in Europe. Since the introduction of the new federal law on insurance in 1996 it has evolved to a progressively more important issue within the Swiss health care system. In this review, some theoretical concepts of quality of health care, variations, and surveillance systems are explored. Examples of quality of health care surveillance systems that have been developed successfully in the USA, in Canada, in Australia, and in Europe are discussed. They all demonstrate the interest in creating a large range of quality indicators in the surveillance system and in evaluating hospital performance using a benchmark approach. Currently, the measurement of quality with appropriate indicators is a subject of intense debate between the Swiss Hospitals Association (H+) and the Swiss Health Insurance Consortium (Santésuisse). Examples of existing surveillance systems in Switzerland are the Outcome Verein in Zurich and the quality of care program of the Canton of Valais. The FoQual association has also contributed to the debate by reviewing six indicators, which could be used nationally for a healthcare surveillance system. In this debate it is important to stress that ideal quality indicators intended for use as measures of quality in Swiss hospitals need to be both appropriate and valid. Only indicators that fulfil these conditions should be integrated in a Swiss health care surveillance system. Priority needs to be given to quality indicators and methods with the highest level of evidence and with a solid scientific basis.

This article offers a case study of how an National Health Service trust specializing in neurology and neurosurgery used clinical performance information to underpin its quality improvement strategy. This involved developing a clinical effectiveness framework and identifying trust-specific clinical indicators, an exercise which involved both staff and patients. Writing from personal experience as clinical effectiveness manager, the author argues that clinical indicators can be powerful tools for monitoring the quality and effectiveness of health care at a system-wide level. In the case of nursing care, the use of appropriate, nursing-sensitive indicators can provide a valuable complement to the qualitative information generated by the benchmarking approach used in 'Essence of Care'. The article contains details of the sort of problems encountered along the way--such as resistance from clinicians and general managers, and difficulties with the existing information technology infrastructure--and suggests how other trusts might approach them.

The role of benchmarking for yardstick competition

Nowadays, concerns about environmental issues are increasing. Therefore, companies and producers are under pressure from government rules and regulations on one hand, and on the other hand, maintaining customer satisfaction concerning cares about the environment. Green supply chain management (GSCM) is a procedure to increase efficiency and decrease environmental effects for companies that collaborate with customers and suppliers. According to GSCM, there is some research about applying green aspects of purchasing, design, manufacture, distribution, packaging, marketing, and reverse logistics of supply chains to improve their company’s performance regarding environmental issues. Moreover, recently, DEA as a nonparametric model is used to evaluate the efficiency and performance of supply chains as decision-making units (DMUs). However, previous studies on efficiency improvement in GSCM did not investigate the effect of some economic and environmental factors together such as service level, emissions (CO2), and size of the supply chains (arcs) on the efficiency of the whole supply system. These factors are essential as they can affect the manager’s ability to distinguish the true performance of a green supply chain. Thus, evaluating the efficiency of GSCM by DEA models and imposing the green principles to find out the efficient ones for increasing management performance is vital. Fulfilling the mentioned research gap, this paper developed a benchmark approach to verifying efficient DMUs and potential efficient DMUs which may improve costs and efforts to become efficient. In the case study, the benchmarks and potentially efficient DMUs are found by DEA standard models and slight adjustment is conducted for potentially efficient DMUs to change their status to efficient DMUs. Moreover, the effect of some green principles on the efficiency value of DMUs is verified using Tobit regression before and after the mentioned modification. A set of realistic results provided for the priority of potential DMUs modification confirmed the applicability of the proposed procedure.

This study aims to explore how integrated pastoral care approach intended to serve patients, empower staff, and improve healthcare quality, lower costs and growth, which would naturally follow and promote high-level patient satisfaction. This case study seeks to investigate the pastoral care process and its mission to improve the efficiency and the productivity of the hospital in a competitive environment. This study uses an exploratory study in a large-sized Holy Family Hospital purposefully chosen as a case study site. The benchmarking approach is adapted, by using interview techniques along with non-participant observations in which the results have been unified. The study found that the philosophy of pastoral care is continuously reinforced through the mission of the hospital and investment in the personal development department. In particular, the success in providing efficient care can be attributed to the quality of patient care, patient satisfaction, staff productivity, and helps promote patient flow through pastoral care. Pastoral care focuses on socio-economic and community health issues, and health education. The hospital has increasingly relied on integrated pastoral care, which is a key to enhancing quality and efficiency. In a modern era, adoption of Pastoral Care educates, how hospitals should focus on prevention and promotional care while providing care and treatment. This set of integrated care approaches would play a major role in achieving efficiencies. Being a part of a system provides greater potential to enhance communication across providers, achieve economies of scale, smooth patient transitions across settings, and care for the whole patient across an episode of care.

Family Physicians' Experiences With Community Mental Health Centers: A Multilevel Analysis

Study of Russian researchers’ works, as well as official methods devoted to various issues of evaluating performance of enterprises, allowed us to conclude that these methods are generally not focused on environmental factors specific to the industry. Availability of strategic management tools to clearly identify enterprise’s position in the same industry segment is in high demand in the context of changes rate increase and ability to adjust the strategy. The study is based on methodological premise that in enterprises with corporate strategies have remained stable in conditions of crisis processes in economy. Using a toolkit based on benchmarking, gap analysis and process approach, and sets of key indicators of efficiency of the basic functional strategies implementation (financial, marketing, technological strategies and human resource management strategy), we have made an integral assessment of the results of corporate strategies implementation in Russian ferrous metallurgy enterprises in conditions of 2014 crisis. We have defined the “best in class” enterprises and “potential bankrupts” in 2014 which has allowed us to calculate average values and median value for ferrous metallurgy enterprises, to identify position of each enterprise and to assess the gap of integral efficiency indicators of basic functional strategies and corporate strategy implementation.

Cancer disparities represent a significant public health problem in the United States. Inequity in cancer screening, incidence, treatment, prognosis, and mortality is a hallmark of many common cancers ([1][1]). These disparities exist across groups defined by race, ethnicity, gender, age, and

To establish reference intervals for major haematological and biochemical parameters in Gabonese infants and children. The reference sample population consisted of 226 healthy infants (4-9 weeks of age) and 185 healthy children (18-60 months of age). Basic red cell parameters as well as total and differential white blood cell counts were performed. Clinical chemistry parameters consisted of glutamate-pyruvic transaminase and creatinine, and total bilirubin was measured in children. Statistical analysis was based on the guidelines of the Clinical and Laboratory Standards Institute. Nonparametric methods were used to determine 95% reference limits and their 90% confidence intervals. Compared to European populations, values for several red cell parameters (haemoglobin, haematocrit, red blood cell count, mean corpuscular volume) were lower and platelet counts were higher. Eosinophils were higher in the older age group, most likely caused by intestinal helminths. The study confirms the importance of establishing reference limits for local populations. The reference ranges could be used as a benchmark for similar populations in Central Africa.

The linked open data (LOD) initiative – an initiative taken by governments around the world to open up and link the vast repositories of data they hold across agencies and departments – features particular potential in the health care sector. The real value of linked open data comes from its interpretation, analysis and linking up which, in the healthcare sector, is expected to result in improved quality of care and lower healthcare costs. In particular, emergency healthcare quality is expected to improve by making healthcare data, which is related to emergency healthcare, available to authorized users at the point of care (suitably anonymized for security reasons) and by providing researchers with access to large volumes of data. In addition, the analysis of emergency healthcare LOD can provide insights on a variety of factors contributing to emergency medical services (EMS) usage and to EMS failures so that to formulate sustained emergency healthcare policies and enable effective and efficient decision making that results in improving emergency case morbidity and mortality indices. This paper addresses the general problem of LOD usage in emergency healthcare delivery and describes a LOD-based cloud service that seeks to automatically export appropriate emergency healthcare data of interest from a variety of sources, semantically annotate this data and enriching it through the creation of links with other, relevant, data. To this end the service is designed to interact with EMS information systems, electronic medical records (EMRs) and personal health records (PHRs).

Healthy brain aging and delayed dementia in Texas rural elderly.

Basics of Quality Improvement in Health Care

Addressing issues of asthma in inner-city children

Despite the increasing demand for artificial intelligence research in medicine, the functionalities of his methods in health emergency remain unclear. Therefore, the authors have conducted this systematic review and a global overview study which aims to identify, analyse, and evaluate the research available on different platforms, and its implementations in healthcare emergencies. The methodology applied for the identification and selection of the scientific studies and the different applications consist of two methods. On the one hand, the PRISMA methodology was carried out in Google Scholar, IEEE Xplore, PubMed ScienceDirect, and Scopus. On the other hand, a review of commercial applications found in the best-known commercial platforms (Android and iOS). A total of 20 studies were included in this review. Most of the included studies were of clinical decisions (n = 4, 20%) or medical services or emergency services (n = 4, 20%). Only 2 were focused on m-health (n = 2, 10%). On the other hand, 12 apps were chosen for full testing on different devices. These apps dealt with pre-hospital medical care (n = 3, 25%) or clinical decision support (n = 3, 25%). In total, half of these apps are based on machine learning based on natural language processing. Machine learning is increasingly applicable to healthcare and offers solutions to improve the efficiency and quality of healthcare. With the emergence of mobile health devices and applications that can use data and assess a patient's real-time health, machine learning is a growing trend in the healthcare industry.