Improvement Of Hospital Services Research Articles

Strengthening health system through outsourcing of non-clinical services: inputs for improving management

Background: Public-Private Partnership (PPP) as a strategic management policy to improve hospital health services standards to the Indian Public Health Standards level, specially the non-clinical services. The studies on the qualitative as well quantitative aspects of services by identifying components that are suitable for execution Public Private partnerships for improving hospital services specially for non-clinical services are needed. There is also a need to identify probable modalities for the sustainability of the same. Objectives: The aim was to propose management inputs in improving non-clinical services of cleaning, security, diet, driver, and laundry in the hospitals under Public Health Department Maharashtra. The objectives were to assess the scope and feasibility of specific managerial inputs to promote the Public-Private Partnership under the National Rural Health Mission in emphasizing the qualitative aspect of service. To identify components where Public-Private Partnership can be evolved for hospital services, develop probable modalities for sustainability. Material and methods: The study adopted an experimental, epidemiological study design involving a study and control group. The study group of six sub-districts hospitals received an intervention package, and the control group of 14 sub-district hospitals did not receive an intervention package. Which included interventions to improve performance of clinical quality indicators, training, monitoring, and corrections. The author randomly selected the hospitals from betterperforming hospitals. The focus was mainly on “outsourcing'' components such as non-clinical services and their impact on the quality of services. In the evaluation of non-clinical services, the focus was on the quality of performance and cost-saving, compared to expenditure if regularly appointed employees would have delivered the services. Results and impact: Only 25% of patients were satisfied with non-clinical services. The contractors did not pay as per Minimum Wages Act 1948. The department accepted the checklist for monitoring cleaning and security services and disseminated it across the state as a circular.

Application of Rough Set Theory to Improve Outpatient Medical Service Quality in Public Hospitals Based on the Patient Perspective.

Purpose: To analyze the key factors and decision-making behaviors affecting overall satisfaction based on perceptual data of outpatients.Methods: The official satisfaction questionnaire developed by the National Health Commission of the People's Republic of China was used. Rough set theory was used to identify the perception patterns between condition attributes (i.e., service factors) and a decision attribute (i.e., overall service level) and to express them in rule form (i.e., if-then).Results: The four minimal-coverage rules, with strength exceeding 10% in the good class, and six crucial condition attributes were obtained: “Ease of registration (C1),” “Respected by registered staff (C2),” “Registered staff's listening (C3),” “Respected by doctor (C9),” “Signpost (C12),” and “Privacy (C16).” In addition, the average hit rate for 5-fold cross-validation was 90.86%.Conclusions: A series of decision rules could help decision-makers easily understand outpatients' situations and propose more suitable programs for improving hospital service quality because these decision rules are based on actual outpatient experiences.

Study on Services of Chattogram Maa-O-Shishu Hospital

Background: Hospital services are the amenities provided by a hospital both for the patients and the workforces. Periodical assessment of hospital service quality discovers the demands and needs thus ensuring the development of the institution. The aim of the study to find out the problems regarding hospital services and its solution.
 Materials and methods: This observational study was conducted among the health personnel of Chattogram Maa-O-Shishu Hospital from 01 July to 30 August 2019 and 01 January to 29 February 2020. Purposive sampling technique was followed to collect data from 100 randomly selected samples. They were interviewed with pretested questionnaire and data were managed manually.
 Results: Different findings were drawn. These are: Lack of work dedication, responsibility, loyalty and internal co-operation among the staff (60%). Lack of manpower including doctors, nursing staff, cleaners and few recruitments are not so experienced as to fulfill the demands of their duty (56%). The number of beds is less compared to the number of patients who need them e.g. ICU, CCU, NICU, Paediatric ICU Adult medicine ward, etc. Hence patients are referred outside (46%). Patient visiting hours and number of visitors not properly maintained. Visitors make noise, take food on patient’s bed and sometime physically assault employees when they are asked to obey rules (40%). However, overall job satisfaction of the respondents was 78%.
 Conclusion: Ascertaining the issues regarding the improvement of hospital services is mandatory. Quick detection and early solution would gain confidence by employees and beneficiary which would ultimately boost up the reputation of the hospital.
 Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 41-44

Framing Improvement of Emergency Services RSKJ Soeprapto Hospital with Lean and WAM Modification

The present study reports the first comprehensive research on covid19 emergency services model. Healthcare services inside hospitals during pandemic can apply the Lean Hospital and Waste Assessment Model (WAM) modification, which is a new method that can be used to identify waste in the hospital service process flow and operational of emergency service. The purpose of this study is to provide recommendations for improving emergency services in the covid19 era. The method used in this research is a descriptive qualitative analysis carried out through observing the service flow of patients who will be hospitalized from the emergency, confirming the service flow by in-depth interviews and looking at secondary data and giving a questionnaire on a modification of eight waste relationship at 15 persons expert who understands the emergency service process. The results showed that the critical waste of emergency services at RSKJ Soeprapto hospital is a waste of human skills of 17.5%. The reasons for the emergence above are because the covid19 team has not yet been formed, the absence of special officers to conduct primary triage before the patient enters the emergency unit, and many officers who do not understand the flow of emergency services in the covid19 pandemic era. In order to improve hospital services in the future, it is necessary to form a covid19 team, to develop a standard emergency service guide, to conduct continuous socialization to all the hospital staff through education and training programs, which are recommendations for improving emergency services at RSKJ Soeprapto Hospital Bengkulu in the pandemic era and new normal preparation.

Measuring hospital performances of regional referral hospitals in Tanzania

In Tanzania, regional referral hospitals (RRHs) play a major role in providing curative and diagnostic services and influence the performance of the entire health system. The results of a baseline survey conducted in 2015 to determine the status of RRHs in Tanzania indicated that there were many supportive supervisory and assessment tools for RRHs but none of them specifically focused on the performance of hospitals. In an endeavor to enhance the performance of RRHs, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and the President Office – Regional Administration and Local Government (PO-RALG) developed an external hospital performance assessment (EHPA) tool to analyze all aspects of the performance of RRHs. EHPA was started in 2017 to assess the performance of 28 RRHs in the country. This study examines the changes to the performance of the RRHs based on the introduction of the EHPA and the supportive interventions by the Ministry of Health. It is also studying the factors that influence the assessment of EHPA. As the results of this study, there is a great indication of the overall performance of RRHs being improved as observed from an upward gradient of average EHPA scores from 2017 to 2019 in all RRHs. This improvement is exemplified by the decrease in the standard deviation gap amongst RRHs. The three years (2017–2019) of consecutive assessment has also observed implicit competition in improving hospital services among Regional Referral Hospital Management Teams (RRHMTs) using the findings from the EHPA.

Integrity Assessment of Medical Devices for Improving Hospital Services

The present study examines the various techniques being used to maintain the integrity of the medical devices, and develops a quantitative framework to list these in the sequence of priority. To achieve the intended objective, the study employs the combined procedure of Fuzzy Analytic Network Process (ANP) and Fuzzy Technical for Order Preference by Similarities to Ideal Solution (TOPSIS). We selected fuzzy based decision making techniques for assessing the integrity of medical devices. The suggested methodology was then used for classifying the suitable techniques used to evaluate the integrity of medical devices. Different techniques or the procedures of integrity assessment were ranked according to their satisfaction weights. The rating of the options determined the order of priority for the procedures. As per the findings of the study, among all the options, A1 was assessed to be the most likely option. This means that the integrity of medical devices of A2 is the highest amongst all the chosen alternatives. This analysis will be a corroborative guideline for manufacturers and developers to quantitatively test the integrity of medical devices in order to engineer efficacious devices. The evaluations undertaken with the assistance of the planned procedure are accurate and conclusive. Hence instead of conducting a manual valuation, this experimental study is a better and reliable option for assessing the integrity of the medical devices.

ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN PENGGUNAAN EARLY WARNING SYSTEM PADA PERUBAHAN KLINIS PASIEN DI RUMAH SAKIT X

Early Warning System (EWS) is an information system on patient care that needed to support decision making of patient’s clinical change. The impact of EWS usage on patient’s clinical change still varies therefore a question raised whether EWS usage will improve hospital service quality. The lack of information on factors related to EWS usage effectivity became the reason to conduct this study. The study aimed to understand the factors that relates to EWS usage. The study was a cross sectional approach. Population in the study was 297 EWS healthcare users in X Hospital. Sample taken in the study was 168 healthcare users with proportionate stratified random sampling method. EWS usage data were collected from medical records audit. Factors related to EWS usage data was taken from questionnaire. Relationship between factors and EWS usage were analyzed by using Chi square test and logistic regression test. Proper EWS usage on patient’s clinical change in X Hospital general ward was very low. System quality, user satisfaction and organization structure independently were significant related to EWS usage. Organization structure and user satisfaction have an impact as 12.374 times and 4.671 times to the use of EWS system. Keywords: EWS; General ward; Service qualitiy

Analisis SIMRS Dengan Metode PIECES Di RSU Dr. H. Koesnadi Bondowoso

Hospital Information System (HIS) is an important component to improve hospital service quality. HIS at General Hospital Dr. H. Koesnadi Bondowoso has been running for about 5 years since 2015. HIS implementation is not optimal because there are still various problems in its implementation. The problem such as errors in printing reports so users must create reports manually. This research was aimed to analyze the application of hospital information systems using the PIECES method. This type of research is qualitative. It showed that the information Hospital Information System (HIS) performance results based on aspects of performance Hospital Information System (HIS) performance goes according to user needs, information aspects of information generated accurately, aspects of economics have produced economic value, running control aspects related to control and system security, efficiency aspects have provided efficiencies in its application, service aspect has made it easy for system users. Based on aspects of Performance, Information, Economic, Control, Efficiency, and Service Hospital Information System (HIS) performance has been running according to user needs, but it is not free from various problems, so there needs a efforts to improvement and development of Hospital Information System (HIS) through the recommendation of researchers so that Hospital Information System (HIS) can maintain quality and improve service quality to patients.

The application of the fast method needed in improving hospital services

Using the FAST method of designing hospital management information systems in hospitals. Constraints on the application of SIM in the hospital. Generate effective strategies that can optimize the implementation of management information systems in hospitals. The qualitative approach in this study is used to assist the identification process in the methodology for developing hospital management information systems in supporting service management decisions. The results showed that the FAST method could improve the quality of information through the application of management information systems in hospitals. The obstacle to applying SIM in hospitals is the high cost of building management information systems, the effective strategies for implementing management information systems in hospitals strengthen the commitment of hospital management that the system management information will run. With the FAST method, it can improve the quality of information through the SIM RS application at the hospital. An effective strategy for implementing hospital MIS in hospitals is to strengthen hospital management's commitment that management information systems will work.

Evaluasi Sistem Pendaftaran Online dengan Metode Technology Acceptance Model di Rumah Sakit Umum Daerah K.R.M.T Wongsonegoro Kota Semarang

The online registration system is important component to improve hospital service quality. Regional GeneralHospital K.R.M.T. Wongsonegoro City of Semarang has implemented online registration system since 2017and never been evaluated. An online registration system that is often used by patients is via the MYRSWNapplication, can be downloaded at the play store and app store. Online registration system users in 2019totaling 15,437 users from 199,188 patients. Based on data, it can be seen that users of the online registrationsystem are only 8% of the total number of patients. This shows the user's interest in using the onlineregistration system is very lacking. This research was aimed to analyze the acceptance of an onlineregistration system. The research showed that overview of the online registration system based on aspects ofperceived ease of use can be assessed as easy to learn, quite flexible and easy to use, aspects of perceivedusefulness is considered to have considerable benefits in increasing productivity, making work effective andfast, last aspects of behavioural intention to use tend to be satisfied using the online registration system.Based on aspects of perceived ease of use, perceived usefulness,and behavioural intention to use applicationof an online registration system has been running according to user needs, but it is not free from variousproblems, so there needs a efforts to improvement and development of online registration system through therecommendation of researchers so that online registration system can maintain quality and improve servicequality to patients.

MANAGEMENT TECHNIQUE, GOVERNANCE, AND MANAGEMENTSTRATEGY FOR PERFORMANCE AND BUSINESS ETHICS OF PUBLIC SERVICE HOSPITALS

Abstract The purpose of this paper is to test management technique, governance, and strategy choices affect the performance of government hospitals assigned as public service agencies.Indonesian’s well aware of opting for medical treatments in hospital are basically underlined by higher level education, prolonged life expectancy, and more information disclosure. This awareness leads to significant increases in number of inpatients and outpatients treated in public health services.This research belongs to quantitative research which implements validity test, reliability test, normality test, multicollinearity test, and heteroskedasticity test. Quantitative research is required to examine whether the instruments used in this study are valid, consistent, and normally distributed. This study consist of one dependend variabel namely performance, three independent variables, namely management technique, GCG, and management strategies. Supplemented by one moderation variable, business ethics. This research employs an explanatory design, comprising an elucidation of events in present conditions (explanation) and events that will occur (prediction). The sampling technique used was purposive sampling with sampling criteria that are at the level of administrative staff up to the directors and have worked for at least one year. Based on predetermined criteria, there were 260 research respondents. Data was collected using a questionnaire and measured on a Likert scale of 1-5 with a value of 1 for answers that strongly disagree and a value of 5 for answers strongly agree. The data analysis technique used is multiple regression analysis with the help of SPSS 22. Based on the above findings and discussions, the limitations for future research are elaborated as follows: the level of understandings possessed by respondents regarding the concept of hospitals as public service agencies varies and cannot be controlled or specified. Stakeholders from different occupational positions may have different experiences and educational backgrounds which may affect their understanding of public service agency, particularly the hospital. For this reason, mapping specific respondents might be required for future research. Categorized and specified respondents could optimize the research process by providing more focused answer from and more thorough discussion with stakeholders with the same understanding level. This research can be developed by extending the coverage of hospitals granted with the BLU authorization throughout Indonesia. Besides, alternative research object can also developed by examining non-BLU hospitals. This research concludes Corporate Governance is positive influencer for and significant to Performance; in contrast, Management Strategy is insignificant to Performance. Besides, Ethics itself indirectly influences performance. This study is useful for regulators as policy makers to improve professionalism and improve hospital services. It is also hoped that the results of this study will benefit other stakeholders, change business-oriented mindset without neglecting services and human values. Keywords: Management Technique, Governance, Management Strategy, Performance, Business Ethics, Public Service Hospitals.

Development on Meso Ergonomics in Manufacturing Based on Research Trends in The Last Twenty Years

Meso ergonomics continues to develop, research journals on meso ergonomics continue to increase in number, meso ergonomic discussions are carried out ranging from the scope of studies to the application of meso ergonomics in various fields. Macro, meso and micro ergonomics do not yet have clear scope limits, this makes the researchers continue to conduct studies on the limits of meso ergonomic studies. The application of ergonomic science continues to be developed by researchers, during the span of 1997 to 2017 a total of 51 studies on ergonomic meso were carried out, the main focus of the research was carried out in the fields of health, services, manufacturing and other fields. Meso ergonomic research in the field of health as many as 20 studies, 6 services and 12 fields of manufacturing and 13 other fields of research. Most research occurred in the health sector with the most research in 2005 as many as 5 studies, research in the field of health, especially in hospitals consisting of, managerial design and improvement, improvement of hospital services and the impact of managerial policies on nurses. In the field of services, the focus of his research is the managerial system and improvement of the customer’s perspective on services. In manufacturing the focus of the research is to maximize output by taking into account worker fatigue. All fields of ergonomic meso studies will be evaluated because they still have shortcomings and are not credible

Pharmacy professionals\u2019 experiences and perceptions of providing NHS patient medicines helpline services: a qualitative study

BackgroundPatient medicines helpline services (PMHS) have been established at some National Health Service (NHS) Trusts in England, with the aim of providing medicines-related support to patients after they have been discharged. Addressing an important knowledge gap, this qualitative study sought to examine pharmacy professionals’ experiences and perceptions of their PMHS, including perceived benefits of the services, and areas for improvement.MethodsInvitations to participate were sent to all NHS Trusts within England that were known to provide a PMHS (n = 117). Semi-structured interviews were conducted via telephone with 34 pharmacy professionals who provide a PMHS (female = 76%, male = 24%; predominantly from Acute NHS Trusts, 76%). Interviews were audio-recorded and transcribed verbatim. The RE-AIM framework for evaluating interventions (RE-AIM: Reach, Effectiveness, Adoption, Implementation, Maintenance) informed the development of the interview schedule and the analysis of the data using framework analysis.ResultsTwo themes were generated from the analysis: Resources, and Perceived benefits. Findings illustrate how providing a PMHS with limited resources (e.g., no specific funding, understaffed) negatively impacts the implementation, maintenance and reach of PMHS, and the ability to evidence their effectiveness. Despite operating with limited resources, PMHS are considered to have many benefits for patients and healthcare organisations (e.g., providing a ‘safety net’ to patients during the transfer of care period, providing reassurance to patients, helping to optimise patients’ medicines, resolving medicines-related errors, reducing the burden upon other services, and providing the potential to improve hospital services based upon the content of enquiries). However, actually establishing the effectiveness and cost-effectiveness of PMHS is challenging due to perceived logistical difficulties of collecting data, and the difficulty measuring hard outcomes (e.g., prevention of readmissions).ConclusionsPMHS are typically perceived to be under-resourced, although they are considered by pharmacy professionals to have several benefits for service users and NHS Trusts. For those sites that provide a PMHS, we recommend using enquiry data to improve hospital services, and to share ideas for implementing and maintaining a PMHS within a resource-limited context. High-quality research is needed to evidence the effectiveness and cost-effectiveness of PMHS, which may help to secure adequate resources for this service in the future.

The Application of The Fast Method Needed in Improving Hospital Services

The Application of The Fast Method Needed in Improving Hospital Services

Testing the Task Scheduling in Healthcare with Cloud Sun Tool using Emergency Resource Allocation

In recent years cloud computing impact all fields such an IT, industries etc...Hence researchers, organizations focus the cloud computing implementation in different sectors. The number of cloud-based services has amplified hastily and shaped desired outcome in the past years. The cloud computing also impact health care side because of its availability, security, portability, efficiency, and convenient low cost, dissimilar health care services (pay-as-you-go). Health care is vital part in human life so peoples must provide high priority for that. The cloud computing take care the health care carefully and gives the medical assistance whenever the peoples need that. Patients can get quality of health care services such a medical assistance anywhere and anytime with help of PC and other portable devices. Efforts are being made to shrink these costs, improving hospital service and quality outcomes for patients without any inconvenience. The ultimate aim of this paper is to testing the task scheduling in healthcare with help of our CloudSun tool. The emergency resource allocation policy is first process the critical patient’s medical data and send the alert SMS to hospital uses and patient’s care takers.

Improving Hospital Service Quality Strategy with Servqual and Kano Methods

In daily activities, human beings cannot be separated from the services offered by a particular organization, such as the use of public transportation, education, food, health and much more related to daily life. Therefore competition between services is inevitable. Quality is related to customer satisfaction. Customers will be a benchmark for the good or not the quality given by a particular company. Companies can increase customer satisfaction by providing good service of course. Hospital is one of the companies engaged in public health services. To get what the customer wants, the hospital is required to give maximum satisfaction to its customers, but the reality is still often encountered customer dissatisfaction while using hospital services. In addition, based on the results of previous studies, it was found that some attributes of service attributes were still at the level that needed improvement. In addition, based on the results of previous studies, it was found that some attributes of service attributes were still at the level that needed improvement. Corrective actions can be done by the Kano method. The Kano method categorizes the attributes of products or services based on how well the product or service can satisfy customer needs, with service attributes can be divided into several categories.

Implementasi Clinical Pathway Tahun 2018 dalam Upaya Meningkatkan Mutu Pelayanan di Rumah Sakit Umum Daerah Koja

Improving the quality of patient services in hospitals is an important program implemented in hospitals. One indicator of improving hospital quality is the application of Clinical Pathway (CP) as an evaluation of hospital accreditation. Benefits of CP as a means of quality control and costs in improving hospital services. The general objective of this research is the preparation of a Clinical Pathway implementation plan in improving the quality of hospital services.This research method is qualitative with data collection techniques conducting in-depth interviews, observation and document review. The selection of informants in qualitative research, based on suitability and adequacy as many as 17 people. Analysis of CP implementation consists of inputs; which constitute human resources, processes; implementation of monitoring and evaluation, output; service quality after CP. The results of the study are based on inputs, processes and outputs that indicate implementation has been implemented in accordance with hospital accreditation, but needs optimization. Input factors analyzed will support the implementation of CP but need to uniformize the Clinical Pathway format, the evaluation monitoring process has not run optimally while the quality of service output is in accordance with the Clinical Pathway. Suggestions for Hospital Director to carry out Clinical Pathway understanding by holding workshops for all related parties and increasing the guidance and supervision of the implementation of Clinical Pathway, all units involved to coordinate with each other and implement Standard Operating Procedures (SPO) of CP for patient safety.

Understanding the Psychosocial Impact of Oral Cancer on the Family Caregivers and Their Coping up Mechanism: A Qualitative Study in Rural Wardha, Central India.

Background:A family caregiver is the one who provides care to their near and dear one who is suffering from some debilitating disease like oral cancer. Apart from providing physical care, they also provide emotional and financial support to their close relatives. They can be the patient's spouse, children, and siblings. This study was, hence, designed to understand the psychosocial impact of caregivers of oral cancer patients.Methodology:This was a qualitative study using in-depth interviews of 24 purposively chosen family caregivers irrespective of age, sex, and relationship with patients, who provided deep insight into the psychosocial impact of the disease on themselves during caregiving of their loved ones and how they coped with it. Interviews were taken in Hindi, in the houses of caregivers. Care was taken to maintain utmost privacy while taking the interviews, which were either audio recorded or noted down. Informed written consent was obtained from participants before the start of the study. Themes were evolved from the interviews and content analysis was performed using ATLAS.ti.Results:Six themes emerged after data analysis. Those were the impact on physical health and lifestyle, emotional impact, impact on family and social relationship, impact on financial and work status, improvement of hospital services, spiritual concern, and acceptance of the disease. A concept map was made to provide a vivid explanation of how oral cancer caused these impacts on caregivers and their interrelationship.Conclusion:Caregiving is not an easy job. This study recommends extra care to be taken in preparing them for caregiving to the oral cancer patients with adequate knowledge of the disease process and its consequences along with counseling facilities in the hospital to address the different psychosocial needs of the patients.

The Meaning of Breast Cancer Patients’ Experience in Hospital X: a Viewpoint From Patient Centered Care

Patient experience is a significant factor in improving hospital service quality. This study aims to determine the meaning of treatment received by breast cancer patients during the treatment period. In the treatment of breast cancer, the patients require a personalized service or patient-centered care. This research is a qualitative analysis with phenomenology approach. Informants in this study were breast cancer patients who underwent chemotherapy treatment and had a mastectomy. Data were obtained through in-depth interviews in patients with breast cancer. The results of the study revealed there are 10 themes, namely worrying about something uncomfortable in the body, resigning to the doctor's recommendations, feeling comfortable and uncomfortable in the service received, feeling stress after recognizing the disease suffered, feeling fearful to the disease, experiencing pain before and after treatment, obtaining encouragement, refraining from thinking that slows down the healing, feeling of having no choice over the disease, and feeling of not obtaining explanation. There is relevance between theme and patient-centered care.

Komunikasi Bisnis dalam Perspektif Islam di Rumah Sakit Muhammadiyah Bandung (Studi Pada Divisi Bimbingan Rohani Rumah Sakit Muhammadiyah Bandung Dalam Peningkatan Kualitas Pelayanan Pasien)

Communication is one of the dimensions that affect the quality of services by providing information to customers. The hospital also needs to improve the quality of service in terms of communication. This research aimed to to describe and analyze business communication in Islamic perspective (study on the spiritual guidance division of Rumah Sakit Muhammadiyah Bandung in improving services quality). This research is descriptive qualitative research. This research collects data through interview, observation, and literature study. The results of this study indicate that one of the forms of communication is communication in spiritual guidance activities as commitment of Rumah Sakit Muhammadiyah Bandung as an Islamic hospital. And as a strategy for improving hospital services in Rumah Sakit Muhammadiyah Bndung 
 
 Keywords: Public Relations, Corporate Social Responsibility, Corporate Image.