Coordinated Support System Research Articles

Strategy to Improve Electronic Medical Certification of Cause of Death at Rumah Sakit Persahabatan, Jakarta, Indonesia

Proper death certification has broad medical and public health benefits. Therefore, death certificates should be completed accurately according to the medical certification of cause of death (MCCD) scheme. To improve the data quality of MCCD, Rumah Sakit Persahabatan (RSP) has implemented an electronic form (e-SMPK) since 2023. Although equipped with a user manual and coordination support system, incomplete and inaccurate e-SMPKs are still found. This study aims to identify interventions that can improve the quality (completeness and accuracy) of e-SMPK in RSP using one action research cycle consisting of 4 stages, i.e., diagnosing, planning, taking, and evaluating action. Qualitative data was collected through focused group discussions and field observations. Quantitative data was collected by comparing the completeness and accuracy of e-SMPKs before and after the intervention agreed upon with the participants. Triangulation of the data was carried out to maintain the credibility of the research. This study found that obstacles to e-SMPK consist of system and regulatory factors, skills, practical tools, and processes. Interventions are implemented by adjusting regulations, providing guidance and training, revising electronic forms, improving coordination, and facilitating consultation and verification to overcome obstacles. An increase in the completeness and accuracy of filling in the e-SMPK elements was obtained, most of which were statistically significant.

The Burden of Drug-Resistant Tuberculosis among Kenya's Devolved Health Units and Associated Treatment Outcomes

Background: A devolution is a form of decentralisation or the transfer of authority and responsibility from central to lower levels of government for a range of public functions. The drafters of the 2010 Kenyan constitution chose to devolve functions to 47 newly created counties. In Kenya, health is a devolved function that county governments run. Tuberculosis is managed at the county level in coordination with the National Leprosy Tuberculosis and Lung Disease Program (NLTP) with a mission of End TB Strategy to achieve a 95% decline in deaths due to tuberculosis compared with the 2015 baseline and reach an equivalent 90% reduction in tuberculosis incidence rate. Methods: This was a retrospective cohort study that collected data from health facilities accredited by the NLTP for drug-resistant tuberculosis treatment. The study population included patients who tested positive for drug-resistant tuberculosis from 2014 to 2019. Data was sourced from NLTP Electronic Medical Records (TIBU-System). After abstraction, the data was entered into Excel and analysed through STATA software version 13. Results: Of the 2674 enrolled patients in total, there were more males affected with DRTB at 64 % compared to the female patients. The public facilities carried the immense burden of diagnosis and treatment of the patient, having a cumulative number of 83 %, while the prison sector had the lowest number. For the resistance pattern, the new, relapse, and failure of first-line drugs accounted for most drug-resistant cases at 80 %, with only 65 % of the total cases having been done a gene-expert test at the point of screening. Conclusion: With a devolved health unit in Kenya, there needs to be a more coordinated support system from the national government to the county health units in terms of surveillance of TB disease. Regional centralised laboratories for diagnosis and monitoring of TB would reduce the time it takes for samples to come to Nairobi for testing, which takes time before patents are initiated on treatment.

Facilitators and barriers to return to work and meet financial needs in parents of children with cancer.

The aim of this study was to explore what facilitators and barriers parents of children with cancer identify for their ability to return to work and meet financial needs. Nine focus groups (21 mothers; 11 fathers) were performed across Sweden in 2015 and 2019. A deductive content analysis approach was used. A preconstructed matrix consisting of 12 codes based on previous literature was used to organize the data. The codes were grouped into subcategories, which were abstracted to four generic categories. Facilitators for a return to work were covered in the category "Flexibility and understanding from employers and social services," and barriers in the category "Pressure to return without consideration of the consequences." Facilitators to meeting financial needs were covered in the category "Available public, private, and employer support," and barriers in the category "Lack of organized and efficient support from employers and social services." The identified barriers suggest that there is room for improvement in the provision of psychosocial support, which relates to a perceived lack of organized support regarding practical, financial, and occupational matters. The results show a need for a coordinated support system that includes major stakeholders, such as the health care, welfare agencies, and employers. Moreover, employers should consider how to implement more workplace flexibility and involvement of occupational health services. Importantly, to be able to return to work and achieve a sustainable financial situation, it is necessary for all stakeholders to recognize the long-term impact of parenting a child with cancer.

Effectiveness of a coordinated support system linking public hospitals to a health coaching service compared with usual care at discharge for patients with chronic low back pain: protocol for a randomised controlled trial

BackgroundAlthough many people with chronic low back pain (LBP) improve following conservative treatment, one in five will experience worsening symptoms after discharge from treatment and seek health care again. The current LBP clinical care pathway in many health services lacks a well-integrated, systematic approach to support patients to remain physically active and self-manage their symptoms following discharge from treatment. Health coaching can support people to improve physical activity levels and may potentially reduce health care utilisation for LBP. The primary aim of this study is to evaluate the effect of introducing a coordinated support system (linking hospital outpatient physiotherapy services to a public health coaching service) at discharge from LBP treatment, on the future use of hospital, medical, and health services for LBP, compared with usual care provided at discharge.MethodsThree hundred and seventy-four adults with chronic non-specific LBP will be recruited from the outpatient physiotherapy departments of public hospitals in New South Wales, Australia. Participants will be individually randomised to a support system (n = 187) or usual care group (n = 187). All participants will receive usual care provided at discharge from treatment. Participants allocated to the support system will also receive up to 10 telephone-based health coaching sessions, delivered by the Get Healthy Service®, over a 6-month period. Health coaches will monitor and support participants to improve physical activity levels and achieve personal health-related goals. The primary outcome is the total number of encounters with hospital, medical, and health services for LBP, at 12 months from baseline. A within-trial economic evaluation will quantify the incremental costs and benefits of the support system from a health system perspective, to support reimbursement decision making.DiscussionThis study will establish the effect of a coordinated support system, introduced at discharge from treatment, on the future use of hospital, medical, and health services for LBP and various health outcomes.ConclusionInnovative community-driven solutions to support people with chronic LBP after discharge from treatment are urgently needed. Study findings will help inform health care policy and clinical practice in Australia.Trial RegistrationProspectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12620000889954) on 10/09/2020.

A BIM-Based Coordination Support System for Emergency Response

In fire emergencies, timely communication with on-site coordinators and accurate localization of first responders facilitates effective task assignment and resource allocation in harsh, low-visibility environments. Building information modeling (BIM) is widely accepted in the architecture, engineering, and construction industries as a central repository of building information. It could provide both the geometric building data and semantic information; however, the convenient linkage and integration with indoor location technologies for emergency purposes have not been addressed according to the authors’ knowledge. A stand-alone BIM-based indoor location (BIMIL) framework and portal were designed and tested to enable the automatic extraction, transformation, and visualization of BIM-related data for public safety purposes in this study. Based on current information technology, this research reduces the gap in cross-application by supporting indoor location to overcome the primary shortcoming of existing indoor building models. Eliminating the need for specific software and skill in data processing, this portal will support on-site coordinators’ importation of BIM files, allowing them to convert those files into processed and visualized indoor information containing key yet simplified geometric building data and essential emergency-related information such as fire rating hours, egresses, and hazardous materials. Additionally, the indoor location data can be integrated into a generalized 3D building model to support decision-making activities and management tasks in the field.

Precariousness, access to care and home support, a coordination support system

In their daily practice, professionals are called upon to meet older people who are more in distress than others. In order to best meet their needs, it is necessary first to define these difficulties and then to consider the mechanisms that can provide assistance adapted to the requirements and needs of the people. Access to hospital health care services and coordination support mechanisms, as defined by the law of 26 July 2019, can contribute to this assistance, without criteria limiting access to care. Examples of prevention and coordination actions carried out by the Access to Health Care, Rights and Education Network.

Supporting dyslexic Scottish university hospitality students: positive actions for the future?

PurposeThe purpose of the paper is to explore the issues of dyslexia and the management of learning support within two Scottish suppliers of premier HE hospitality education: Napier and QMU universities of Edinburgh.Design/methodology/approachThis exploratory, qualitative fieldwork outlines course managers', teachers' and disabilities support staff perceptions of dyslexia support. Students' views are noted, not interviewed. The paper describes the views of 12 of a sample of (eight female and four male) staff interviewees. Napier University and Queen Margaret University are post‐1990 “new” universities; Napier has a larger student/staff population than QMU.FindingsThe emergent findings in this paper highlight the fact that managers, teachers and support staff operate an under‐resourced and largely ad hoc system of dyslexic support, although Napier, with greater central funding, shows signs of more strategic insight with the appointment of a full‐time dyslexia coordinator with strategic potential. The findings pinpoint the strengths (personal attention) of decentralised support with ambiguity problems and the need for a generic centrally coordinated support system capable of codifying tacit experience into customised support packages for hospitality students.Research limitations/implicationsThe paper is a small exploratory study of the views and perceptions of dyslexia of course managers', hospitality teachers' and support staff from two of Edinburgh's new universities. Both have decades of internationally respected work in hospitality education and elsewhere in higher education.Practical implicationsThe fieldwork draws attention to this situation and suggests ways to make concepts of dyslexia and disability more relevant to academic hospitality managers teaching in higher education and to those practising in the field.Originality/valueThe paper examines the proposition that, while dyslexia is a condition open to support and improvement, it is for many practitioners a vague concept. What emerges from the interviews is that disability and what to do about it seems to be an attitude of mind, a question of perceptions, frames of references, intangible properties: that the essence of enhanced dyslexic support is how to do things better. Napier and QMU give valuable ad hoc examples here on which to design future practice. What is needed is a systematic approach to design, implementation and sustainability, and an understanding of the tacitly held knowledge that underpins experience‐generated systems of knowledge. Bringing out such tacit and explicit notions of the complexity of perceptions of knowledge lies in future studies.

Enterprise resource planning (ERP) operations support system for maintaining process integration

A successfully adopted and implemented enterprise resource planning (ERP) system does not automatically guarantee full benefits. It is important that ERP is operated as planned and thus provides the real-time information with a desired level of process integration. Any ERP system pushes a company toward full process integration and solves the fragmentation of information. However, the tight process integration involves operational issues that must be carefully managed. Thus, a conjecture can be made that a centrally coordinated support system is required to assist ERP users and administrators find problems, perform tedious validation and verification, and maintain the process integration of ERP with great consistency. This paper proposes an ERP operations support system (EOSS) that aims to achieve and maintain the process integration of ERP. EOSS monitors the operational status of process integration, prevents anomalies as early as possible and conducts repairs as soon as possible.

The Walden House Young Adult HIV project: Meeting the needs of multidiagnosed youth

Walden House, Inc.’s Young Adult Human Immunodeficiency Virus (HIV) (YAH) project is supported by the Special Projects of National Significance Program of the Health Resources and Services Administration (SPNS-HRSA). This project has served 512 high-risk young people (ages 13–25 years), 101 of them living with HIV/acquired immunodeficiency syndrome (AIDS). The YAH project offers treatment services and a coordinated support system to adolescents and young adults who are in need of HIV/AIDS services as well as behavioral health care; all clients suffer from multiple diagnoses. This system includes medical and psychological assessment, referral and coordination; therapy and counseling services; transportation; peer education and counseling; legal information and referral; and case management for long-term options. YAH provides HIV testing access, pretest and posttest counseling, HIV and sexually transmitted disease education, HIV-positive speakers as role models, and community-based outreach. YAH also serves as a resource within Walden House to spur enhancement of service provision for HIV care as well as programming for young people. The emphasis is on providing a comprehensive continuum of services, with the case manager and peer staff coordinating services to try to meet the diverse needs of each client. The complexity and intensity of the target population’s needs challenge the traditional models of care. This project provided almost 4 h daily of cost-effective rehabilitation programming to each client, increased participants’ self-reported measures of well-being, and increased staff’s ability to deal with HIV issues.

A prototype of an integrated coordination support system

UTUCS is a system for supporting a group of people (an office, a team, etc.) interconnected through a communication network in handling conversations carried on through different communication media. It has been developed with the aim of providing a good coordination support system that pairs the best computer-based tool a group may have in any situation (dispersed versus non dispersed, synchronous versus non synchronous) with the ability to switch from one to another, maintaining integrated and linked the information it creates. As UTUCS is a general system devoted to integrating conversations independently of the communication media exploited, it has been designed in such a way that it can be enhanced by developing a module for any communication medium that can be effectively supported by a computer network. Up to now the Electronic Mail module, the Face to Face Couple Colloquies module, and the Face to Face Group Meetings module have been implemented.

The role of the pediatrician with young exceptional children and their families.

The pediatrician's role in early intervention with handicapped children and their families is discussed primarily from the perspective of a subspecialist in handicapped children. Although the needs of the handicapped child and family are so extensive and ongoing that a host of professionals are required throughout the child's life, the pediatrician has a primary responsibility for guiding parents through the early diagnostic phase and helping them cope with the multiplicity of ongoing and emerging medical problems that tend to arise. In addition, pediatricians can be effective in assisting parents in the process of becoming more confident and competent in relating to their handicapped child and, through collaboration with other disciplines and community agencies, can provide a consistent and coordinated support system.