Efficiency Of Healthcare Services Research Articles

Utilising VSM insights to address health system disconnects: introducing three novel organisational pathologies

PurposeHealth systems worldwide are hampered by disconnects between governance, management, and operations, which negatively impact on their ability to deliver efficient, effective, and safe healthcare services. This paper shows how insights from the Viable System Model (VSM) can help us to conceptualise health system disconnects impacting specialist clinical services and develop solutions to address organisational fragmentation.Design/methodology/approachA case study of a specialist clinical service was undertaken, where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and analysis of findings.FindingsThe VSM provides a coherent way to conceptualise the disconnects and identify their structural underpinnings. Three novel organisational pathologies emerged from the study.Research limitations/implicationsThis New Zealand-based study was undertaken during the COVID-19 pandemic and a period of major health system reform, introducing uncertainty into service provision that may have impacted stakeholders’ views.Practical implicationsThe three novel pathologies affect how health systems define their services, their understanding of the management function, and the importance of coordination. The resulting clarity of functioning could improve service quality, staff and patient satisfaction, and the effectiveness and efficiency of healthcare service delivery.Originality/valueThis study contributes to the VSM literature on organisational pathologies by providing three novel pathologies for a perspective that may be useful beyond healthcare and invites consideration of health system disconnects as a coherent field of study.

An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System

Background and Objectives: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability. Materials and Methods: We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world. Results: We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement–importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram. Conclusions: Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability.

Symptom experiences and influencing factors in patients undergoing chemotherapy for gastrointestinal cancers: a qualitative study

ObjectiveTo explore the symptom experiences and influencing factors of gastrointestinal (GI) cancer patients on chemotherapy (CTX) in China.MethodsSemi-structured interviews were conducted with 13 GI cancer patients undergoing CTX. Following the Colaizzi 7-step analysis method, the interview data were read carefully, meaningful statements related to the research questions were extracted, coded, collected, and described in detail, and the authenticity of the theme was verified.ResultsNine themes were grouped into two main areas including the characteristics of symptom experiences and influences on symptom experiences.ConclusionThe symptom experiences of patients undergoing CTX for GI cancer is poor and influenced by multiple factors. Nurses need to pay attention to the assessment and monitoring of CTX-related symptoms, improve symptom recognition, enhance doctor-patient communication and social support, explore intelligent management methods, and increase the efficiency of healthcare services to improve patients’ symptom experience.

Shaping the Future of Healthcare: Integrating Ecology and Digital Innovation

The concept of sustainable healthcare is the subject of an increasingly intense, captivating, forward-looking, yet sometimes still overly theoretical debate. The aim of this contribution is to analyze the current scenarios of ecological and digital transition in the healthcare sector, considering its high energy consumption. In particular, we adopt a holistic and convergent vision of the energy mix and its infrastructure, moving beyond the ideological dichotomy of energy sources. Renewable sources, digital innovations, and the circular economy are seen as playing key roles in the future of the energy sector. In this research, a mixed methodology was employed, combining a questionnaire consisting of 31 questions with semi-structured interviews conducted with the top management of a major player in the private healthcare sector located in southern Italy in 2023. Consequently, we examine the main macro-guidelines of technological development, encompassing enabling technologies, new business models, roles, and professional skills. Based on the analyses conducted, we provide some insights to inform governmental policies and industrial strategies in the near future. Digitalization represents an opportunity to enhance the efficiency of healthcare services, reducing waste and ensuring quality. For instance, digital healthcare solutions enable personalized care on a global scale and offer decision support systems that can enhance overall healthcare performance. However, to maximize the benefits of digital transformation, it is essential to integrate new technologies effectively and sustainably into the existing healthcare ecosystem. A promising example is telemedicine, which can help reduce carbon emissions by decreasing healthcare workers’ travel.

Exploring Iot Embedded Systems Along the Line of Identity Access Management for Enhanced Health Data Security

A. Overview of IoT Embedded Systems The pervasiveness of Internet of Things (IoT) embedded systems in the digital era has significantly transformed numerous industries, including healthcare. These interconnected devices, capable of collecting, transmitting, and analyzing data, offer immense potential to improve healthcare service efficiency, accessibility, and quality. However, the escalating volume of sensitive health data being generated and exchanged necessitates the implementation of robust security measures. A critical element in this regard is Identity and Access Management (IAM), which governs the control of user identities and their access privileges within a specific system [1].

Management Information Systems Towards Improving the Quality of Nursing Care Services: A Literature Review

Background: Many developing countries are striving to further develop health information technology at the healthcare service level, particularly through the implementation of electronic health records (EHR). Objectives: This research aims to evaluate the quality and impact of implementing electronic health records in healthcare services from various perspectives. Methods: The research design employed in this study is a literature review, involving the collection of articles from selected databases, including PubMed and Cochrane. The article search started from the year 2014, and the Boolean operators used were "Electronic Health Record" OR "Electronic Medical Record" OR "EHR" AND "Quality" OR "Documentation" OR "Quality Documentation" OR "Quality Care" AND "Nurs*". The research design incorporated into this study is observational. Results: The use of Electronic Health Records (EHR) has a significantly positive impact on various healthcare service sectors. Hospitals that have fully implemented EHR show a significant improvement in the quality of patient medical records, a decrease in information delivery delays, and a reduction in patient admission costs. Conclusion: Investment in EHR technology can be considered a crucial step in enhancing the quality and efficiency of healthcare services while reducing operational costs. However, it is important to note that EHR implementation is not a straightforward task and requires consideration of various factors mentioned above to achieve optimal results in health information management.

IJCM_376A: Time motion study in Anti Rabies Vaccination OPD in tertiary care Hospital of Central India

Background: Outpatient department is considered a doorway to health services. The outpatient department thus requires a systematic study of its services for its efficient management and functioning. Time-motion study in ARV OPD provides information on how much time it takes for management of animal bite patients at each step. Such a study could prove useful to improve efficiency of health care services. Objective: To assess the average time spent in different service delivery points in ARV OPD Methodology: A hospital based cross0sectional study was conducted in ARV OPD from July 2022 to June 2023 on Patients coming to ARV OPD. A total of 960 patients were included in the study using Systematic Random sampling technique. Data was collected using a pre-designed and pre-tested questionnaire for socio-demographic details and case history of patients and time required for each step in management of animal bite. Stopwatch of smartphone was used to record time at each step of patient management. All the collected data was entered in SPSS software (version 20.0) and was analyzed accordingly. Results: Study results showed that out of 960 patients 613 (63.85%) were male and 347(36.15%) were female. 509 (53.02%) were from urban and 451(46.98%) were from rural area. Out of 960 patients 816 (85 %) were of category III bite and 144 (15%) of category II bite. The most common site for animal bite was lower limb 556 (57.9%) followed by 288 (30%) on upper limb, on trunk 38 (3.96 %) and 78 (8.14%) on head and neck region. Total time required for management of animal bite was 35.15+/- 17.92 minutes. Conclusion: The time spent in transit could be reduced with proper management of logistics. Also reframing of strategies at various steps could help reduced average time needed to attend a patients at ARV OPD.

A Study on Automated Hospital Management System in Nigeria

This thesis underscores the critical importance of effective data management in the operational and survival aspects of contemporary hospitals. Acknowledging the imperative for continuous enhancements in this domain, the study recommends a proactive approach to explore and advance the existing hospital data management project by transitioning it to an online platform. This strategic move includes the implementation of robust security measures, particularly a secure access code system, to fortify the protection of sensitive information. The proposed transition aims not only to modernize the hospital's data management capabilities but also to establish a secure online infrastructure, guarding against unauthorized access and ensuring the integrity and confidentiality of critical healthcare data. The thesis concludes with a comprehensive overview of the development process for the computerized system. A detailed survey of the existing system laid the groundwork for the meticulous design of a database application focused on facilitating the search and retrieval of patient folders. The anticipated automated hospital management system is poised to significantly enhance the overall efficiency of healthcare services for both nurses and doctors, introducing notable improvements such as reduced time spent on locating patient folders, increased accuracy, and timely record preparation. Throughout the implementation phase, substantial efforts were dedicated to eliminating data redundancy and inconsistency, with a specific emphasis on enhancing the integrity of the stored data. The chosen software model, the waterfall model, provided a systematic and sequential approach to software development. Additionally, a structured design methodology was employed during the design stage to ensure clarity and efficiency. Recognizing the sensitivity of healthcare data, the thesis rigorously addresses security concerns by incorporating robust measures into the computerized system. These measures are designed to prevent unauthorized access, safeguarding the confidentiality and privacy of stored data. This multi-faceted approach to system development underscores the commitment to delivering a robust, efficient, and secure automated hospital management system aligned with the evolving needs of healthcare professionals, guaranteeing top-tier levels of data integrity and security.

BENEFITS OF USING TELEMEDICINE IN THE HEALTH CARE SYSTEM

Health systems in all countries are facing a variety of challenges in providing universal access to health services or the public’s growing demands for quality care. The COVID-19 pandemic, which began in early 2020, has significantly accelerated the previously of digital development. The use of telemedicine solutions is increasingly recognized as essential in coordinating complex activities that respond to emerging issues in the healthcare system. The implementation of telemedicine solutions aims to promote efficiency in healthcare services and improve healthcare infrastructure. In particular, the rising costs of healthcare systems, as well as rapid technological advances in medicine or demographic changes, justify the use of telemedicine in the area of health.The aim of the article is to assess the benefits of using the potential of telemedicine for the health care system, doctors and patients. The article uses the analysis of the literature on the subject and the results of own research on the use of telemedicine solutions in hospitals on the example of the Łódź Voivodeship.

Mindfulness-based empathy training supported by Obese Simulation Suit: Randomized Controlled Trial

AbstractNursing serves as the foundation of patient-centered healthcare services, and the empathetic connections formed between nurses and patients are integral to delivering quality care. In this context, the mental well-being and empathy levels of nurses significantly impact the efficiency of healthcare services and patient contentment. This study investigates the impact of mindfulness-based empathy training and obese simulation suits on nursing students' attitudes and empathy levels towards obese patients. The research, conducted as a randomized controlled trial, encompassed 84 nursing students and employed the "Attitude Scale Towards Obese Patients," "Jefferson Empathy Scale for Nursing Students," and "Descriptive Information Form." Data analysis involved two-factor ANOVA for mixed measurements. The study revealed significant interaction effects between group and time concerning nursing students' attitudes towards obese individuals [F(1,70) = 43.281, p < 0.05] as well as their empathy levels towards obese individuals [F(1,70) = 15.657, p < 0.05]. The experimental group exhibited a noteworthy increase in both attitudes and empathy levels compared to the control group. Furthermore, Single Factor ANOVA for Repeated Measures revealed a statistically significant difference in the experimental group's attitudes and empathy scores across pretest, posttest, and follow-up assessments [p < 0.01, partial η2 = 0.492 and 0.186, respectively]. These findings underscore the effectiveness of these interventions in enhancing essential nursing competencies necessary for providing comprehensive patient care. Thus, integrating these methods into the curriculum is recommended to cultivate more positive attitudes and heightened empathy among nursing students, particularly concerning obese patients, throughout their educational journey.

Designing a model for implementing diagnosis‐related groups in Iran: An action plan approach

AbstractBackground and AimsImplementing diagnosis‐related groups (DRGs) in different countries increases the efficiency of healthcare services, improves treatment quality, and reduces treatment costs. Due to the lack of a coherent model for its implementation, the present study aimed to develop a DRGs‐based implementation action plan Model for Iran.MethodsThe present study was an applied, descriptive cross‐sectional study conducted in three stages. In the first stage, a review of studies conducted in different countries was carried out. In the second stage, a model was designed for an action plan to implement the DRGs in Iran. In the third stage, the model was validated based on the Delphi technique.ResultsThe DRGs‐based implementation action plan model in Iran was designed in three primary axes, including the strategic approach of the DRGs‐based implementation action plan, technical dimensions, and executive institutions involved in the DRGs‐based implementation action plan. Validation of the designed model showed the agreement of experts (94%) for the mentioned axes.ConclusionThe significance of tailoring a DRGs‐based implementation action plan to each country's unique context is well‐established. Given the intricacies of the Iranian healthcare system, we recommend an initial pilot implementation of DRGs at the hospital level, followed by a gradual national rollout.

Analysis of The Impact of Hardware And Software System Develop-ments And Inte-gration On The Domestic Healthcare Market

This article examines the profound impact of advanced hardware and software system developments and their integration in transforming the domestic healthcare sector. It explores how these technological advancements are reshaping healthcare delivery, improving patient outcomes, and contributing to the efficiency of healthcare services.

Evaluation of logistics management information system and availability of non-program tracer drugs in public health facilities in Bahir Dar City, Northwest Ethiopia.

The logistics management information system (LMIS) plays a crucial role in effective record-keeping and reporting, ensuring efficient management of stock status and consumption data. A proficient LMIS improves accountability and supports informed logistic decisions in healthcare. Conversely, a subpar LMIS negatively affects essential medicine availability, compromising overall healthcare service efficiency. This study aimed to evaluate the status of the logistics management information system and the availability of non-program tracer drugs (NPTDs) in public health facilities within Bahir Dar City. This study employed an institutional-based cross-sectional study. Data were collected from February 20 to April 30, 2022 in 12 public health facilities located in Bahir Dar City. Structured questionnaire and data abstraction formats were used to gather pertinent data. After checking for completeness, the data were analyzed using Microsoft Excel and SPSS version 23. The primary analytical outcomes involved descriptive statistics, encompassing frequencies, averages, and percentages, which were subsequently presented in tables and figures. Bin card and Internal Facility Report and Resupply Form were the only blank LMIS tools available in all health facilities, while stock-record card was the least available, present in only 2(16.7%) facilities. Nine health facilities (75%) used self-prepared forms to request NPTDs from the Ethiopian Pharmaceutical Supply Agency (EPSA) at the end of the review period, whereas 7(58.3%) used official letters for emergency orders. Additionally, seven health facilities (58.3%) used the Health Commodities Management Information System On the day of the visit, 78.68% of NPTDs were available. Tetracycline eye ointment 1% had the longest stock-out duration, lasting for a mean 69.64 days. Rather than using the RRF, most of facilities opted for their own forms to request NPTDs from EPSA. While it is advisable for all health facilities to maintain continuous availability of tracer drugs, this study revealed that the current state of non-program tracer drug availability falls short of meeting this expectation.

A novel mathematical model for emergency transfer point and facility location

The significance of emergency transfer point and facility location lies in its potential to save lives, optimize resource allocation, and enhance the efficiency of healthcare services during emergencies. It ensures timely patient access and cost-effective care. So, this study introduces a novel Mixed Integer Programming Model (MIP) for addressing the Multi-Facility and Multi-Transfer Point Location Problem (MFMTPLP). The problem involves determining the optimal locations for q facilities and p transfer points to facilitate direct customer access to facilities or through transfer points. The objective is to minimize the maximum expected weight distance for all the required points via transfer points. The study focuses on identifying the required points that carry weight and proposes a viable solution for solving the associated mathematical problems. An important contribution of this study, which has been overlooked in previous research, is the exploration of relevant costs associated with not transferring patients from demand points and hospitalizing them at transfer points. Additionally, the study emphasizes the significance of prioritizing different points and considering the costs associated with not transferring injured individuals from demand points and admitting them to transfer points. Previous models for locating facility and transfer points did not account for these factors. The study concludes by presenting the computed results, which validate the feasibility and effectiveness of the proposed model.

Smart city healthcare delivery innovations: a systematic review of essential technologies and indicators for developing nations

BackgroundIn recent times, the concept of smart cities has gained remarkable traction globally, driven by the increasing interest in employing technology to address various urban challenges, particularly in the healthcare domain. Smart cities are proving to be transformative, utilizing an extensive array of technological tools and processes to improve healthcare accessibility, optimize patient outcomes, reduce costs, and enhance overall efficiency.MethodsThis article delves into the profound impact of smart cities on the healthcare landscape and discusses its potential implications for the future of healthcare delivery. Moreover, the study explores the necessary infrastructure required for developing countries to establish smart cities capable of providing intelligent health and care services. To ensure a comprehensive analysis, we employed a well-structured search strategy across esteemed databases, including PubMed, OVID, EMBASE, Web of Science, and Scopus. The search scope encompassed articles published up to November 2022, resulting in a meticulous review of 22 relevant articles.ResultsOur findings provide compelling evidence of the pivotal role that smart city technology plays in elevating healthcare delivery, forging a path towards improved accessibility, efficiency, and quality of care for communities worldwide. By harnessing the power of data analytics, Internet of Things (IoT) sensors, and mobile applications, smart cities are driving real-time health monitoring, early disease detection, and personalized treatment approaches.ConclusionSmart cities possess the transformative potential to reshape healthcare practices, providing developing nations with invaluable opportunities to establish intelligent and adaptable healthcare systems customized to their distinct requirements and limitations. Moreover, the implementation of smart healthcare systems in developing nations can lead to enhanced healthcare accessibility and affordability, as the integration of technology can optimize resource allocation and improve the overall efficiency of healthcare services. It also may help alleviate the burden on overburdened healthcare facilities by streamlining patient care processes and reducing wait times, ensuring that medical attention reaches those in need more swiftly.

Healthcare services efficiency and its intrinsic drivers in China: based on the three-stage super-efficiency SBM model

BackgroundThe purpose of this study is to examine the development of healthcare services efficiency in China since the reform of the healthcare system. By examining the development environment of healthcare services in China and examining the driving factors affecting the efficiency of healthcare services, we provide a reference for the future high-quality development of healthcare services in China.MethodsA three-stage super-efficient slack-based measure (SBM) model with undesirable outputs was used to measure the efficiency of healthcae services in 31 Chinese provinces from 2009 to 2021, and a global Malmquist-Luenberger (GML) index was used to assess their spatiotemporal evolution characteristics and internal influencing mechanisms of healthcare services efficiency.ResultsThe empirical results showed that the efficiency of China's healthcare services changed significantly from 2009–2014 and then remained stable. During the study period, the efficiency of healthcare services in the eastern region was higher than the national level, while it was lower in the western region. The results of the analysis of environmental factors indicated that an increase in population density reduced the redundancy of healthcare input resources and that economic development as well as an increase in government subsidies, contributed to an increase in the redundancy of healthcare input resources. The main contribution to the growth of healthcare sercices efficiency in China came from the technological innovation effect, and the growth was most significant in the western region.ConclusionFrom 2009 to 2021, the efficiency of national healthcare services generally showed a slow upward trend, and the efficiency of healthcare services varied widely among regions. Under the existing environmental constraints, relevant departments in each region should strengthen technological innovation in healthcare services, completely focus on the regional catch-up effect, and promote the balanced development of regional health.

Implementing a Joint Operational Plan in Medical Sciences Universities: A Qualitative Policy Analysis in Iran

Background: The joint operational plan was introduced by Iran’s Ministry of Health and Medical Education in 2015 as a way to improve the quality and efficiency of healthcare services by promoting collaboration and coordination among medical sciences universities. The plan aimed to address issues related to overlapping responsibilities, duplication of efforts, and resource constraints among universities. Objectives: This study was conducted to analyze this policy intervention and explore its challenges and opportunities. Methods: Using a qualitative policy analysis approach, this study collected data through documentary analysis and semi-structured interviews with stakeholders at various health system levels. Research participants were selected using purposive and snowball sampling methods. The collected data were analyzed using the framework analysis approach, supported by the policy triangle framework and heuristic model. Results: The policy analysis results yielded 14 categories and 29 sub-categories grouped into four overarching themes: Content, context, process, and actors/stakeholders. The content theme included categories such as the plan’s goals, the linkage between the plan’s goals and upstream policy documents, and the consistency between the plan’s goals and the visions and missions of medical universities. The context theme included structural characteristics, economic and financial factors, and social and cultural situations. The process theme included the issue’s priority, service delivery, policy design and formulation, implementation approach, and assessment and evaluation. The actors/stakeholders theme included categories such as the owner and leader of the policy, political support, and ambiguity in assigning responsibilities. Conclusions: While enforcing a joint operational plan in medical universities can boost performance and foster competition, it may also hinder universities’ ability to pursue innovative interventions and activities outside the plan. To address this issue, stakeholders from various health system levels should work together to modify the plan’s development and implementation process. Effective use of planning tools is crucial for ensuring that medical universities and the health system achieve their goals.

Healthcare Service Efficiency: An Empirical Study on Healthcare Capacity in Various Counties and Cities in Taiwan.

As human lifespan increases and the need for elderly care grows, the demand for healthcare services and its associated costs have surged, causing a decline in the operational efficiency of universal healthcare. This has created an imbalance in medical services across different regions, posing a long-standing challenge for the public. To address this issue, strategies to enhance the capacity, efficiency, and quality of healthcare services in various regions must be developed. The appropriate allocation of medical resources is a fundamental requirement for countries to establish a robust healthcare system. This empirical study utilized data envelopment analysis (DEA) to evaluate the efficiency of medical service capacity and identify potential improvement strategies for counties and cities in Taiwan during the period from 2015 to 2020. The results of this study show that (1) the annual average efficiency of medical service capacity in Taiwan is approximately 90%, indicating that there is still room for a 10% improvement; (2) among the six municipalities, only Taipei City has sufficient healthcare capacity, whereas the efficiency of the remaining municipalities needs improvement; and (3) most counties and cities demonstrated increasing returns to scale, indicating a need to scale up the capacity of medical services as appropriate. Based on the findings of this study, it is recommended that medical personnel be increased accordingly to balance the workload, a favorable working environment be provided to stabilize the medical workforce, and urban-rural medical disparities be balanced to improve service quality and reduce cross-regional health services. These recommendations are expected to provide a reference for society as a whole to promote and enhance public health policies, leading to a continual improvement of the quality of medical services.

Diagnostic performance of deep learning in infectious keratitis: a systematic review and meta-analysis protocol

IntroductionInfectious keratitis (IK) represents the fifth-leading cause of blindness worldwide. A delay in diagnosis is often a major factor in progression to irreversible visual impairment and/or blindness from IK. The...

Lightweight Authentication Scheme for Data Dissemination in Cloud-Assisted Healthcare IoT

Recent advancements in the Internet of Things (IoT) and cloud computing technologies have accelerated the development of various practical applications, including healthcare systems. Adequately revealing the collected healthcare data in a cloud-assisted healthcare IoT system brings a huge potential for improving the safety, quality, and efficiency of healthcare services. However, often the data collected in a healthcare IoT system is vital and sensitive. The dissemination of such data is also vulnerable to malicious attacks such as tampering, eavesdropping, and forgery. Thus, disseminated data's integrity, authenticity, and privacy are elementary security demands to end-users and owners. Also, the resource-constrained nature of healthcare IoT devices invalidates the existing solutions. To address the above challenges, we propose a lightweight and secure redactable signature scheme with coarse-grained additional redaction control (CRS) for secure dissemination of healthcare data in a cloud-assisted healthcare IoT system. The security analysis indicates our CRS is secure against signature forgery, additional redaction attacks, and redacted version linkability. Compared to other existing solutions, our scheme can achieve some level of security but less computational complexity and communication overhead.