Timeliness Of Services Research Articles

Kinerja Pelayanan Publik Studi Kasus Pada Dinas Kependudukan dan Catatan Sipil (Disdukcapil) Kota Jambi

The purpose of this study is to determine the performance of public services in the Dinas Kependudukan dan Catatan Sipil Kota Jambi. This study uses the concept of performance measurement with five indicators of productivity, quality of service, responsiveness, r esponsibility and accountability. These indica tors are used to measure the efficiency and effectiveness of services, quality of service received by the public. The method used in this research is quantitative method. The research location is determined by the method of purposive, are determined by deliberate that the study was conducted in the Depar tment of P opulation and Civil Registry. Data collection techniques used in this study include interviews, observations, and literature. Based on the research findings that the productivity of public services in terms of the ability of officers and service performance can be summed been efficient with an average result value of 70% of respondents said either. The quality of service in terms of satisfaction of the performance of services, timeliness of service, comfortable environment and good infrastructure which is an average result of 41% while the measured responsiveness of service delivery performance , kedesiplinan, service procedur es and speed of service. The final result that stands out from the responsiveness can be judged good quality with an average of 51% of good quality, the next responsibility is measured on the suitability of cost and fairness of service delivery is good is seen from the average value of responsibility is 45% and the accountability of public service in the Department of Popula-tion and Jambi City Civil Registry, is good for 70% of respondents said that responsibility.

Kinerja Pelayanan Publik Studi Kasus Pada Dinas Kependudukan dan Catatan Sipil (Disdukcapil) Kota Jambi

The purpose of this study is to determine the performance of public services in the Dinas Kependudukan dan Catatan Sipil Kota Jambi. This study uses the concept of performance measurement with five indicators of productivity, quality of service, responsiveness, r esponsibility and accountability. These indica tors are used to measure the efficiency and effectiveness of services, quality of service received by the public. The method used in this research is quantitative method. The research location is determined by the method of purposive, are determined by deliberate that the study was conducted in the Depar tment of P opulation and Civil Registry. Data collection techniques used in this study include interviews, observations, and literature. Based on the research findings that the productivity of public services in terms of the ability of officers and service performance can be summed been efficient with an average result value of 70% of respondents said either. The quality of service in terms of satisfaction of the performance of services, timeliness of service, comfortable environment and good infrastructure which is an average result of 41% while the measured responsiveness of service delivery performance , kedesiplinan, service procedur es and speed of service. The final result that stands out from the responsiveness can be judged good quality with an average of 51% of good quality, the next responsibility is measured on the suitability of cost and fairness of service delivery is good is seen from the average value of responsibility is 45% and the accountability of public service in the Department of Popula-tion and Jambi City Civil Registry, is good for 70% of respondents said that responsibility.

The better model to predict and improve pediatric health care quality

The perpetual search for ways to improve pediatric health care quality has resulted in a multitude of assessments and strategies; however, there is little research evidence as to their conditions for maximum effectiveness. A major reason for the lack of evaluation research and successful quality improvement initiatives is the methodological challenge of measuring quality from the parent perspective. Comparison of performance-only and importance-performance models was done to determine the better predictor of pediatric health care quality and more successful method for improving the quality of care provided to children. Fourteen pediatric health care centers serving approximately 250,000 patients in 70,000 households in three West Central Florida counties were studied. A cross-sectional design was used to determine the importance and performance of 50 pediatric health care attributes and four global assessments of pediatric health care quality. Exploratory factor analysis revealed five dimensions of care (physician care, access, customer service, timeliness of services, and health care facility). Hierarchical multiple regression compared the performance-only and the importance-performance models. In-depth interviews, participant observations, and a direct cognitive structural analysis identified 50 health care attributes included in a mailed survey to parents(n = 1,030). The tailored design method guided survey development and data collection. The importance-performance multiplicative additive model was a better predictor of pediatric health care quality. Attribute importance moderates performance and quality, making the importance-performance model superior for measuring and providing a deeper understanding of pediatric health care quality and a better method for improving the quality of care provided to children. Regardless of attribute performance, if the level of attribute importance is not taken into consideration, health care organizations may spend valuable resources targeting the wrong areas for improvement. Consequently, this finding aids in health care quality research and policy decisions on organizational improvement strategies.

Modeling daily patient arrivals at Emergency Department and quantifying the relative importance of contributing variables using artificial neural network

Emergency Department (ED) plays a critical role in healthcare systems by providing emergency care to patients in need. The quality of ED services, measured by waiting time and length of stay, is significantly affected by patient arrivals. Increased patient arrivals could undermine service timeliness, thus putting patients in severe conditions at risk. These factors lead to the following research questions that have rarely been studied before: What are the variables directly associated with patient arrivals in the ED? What is the nature of association between these variables and patient arrivals? Which variable is the most influential and why? To address the above questions, we proposed a three-stage method in this paper. First, a data-driven method is used to identify contributing variables directly correlated with the daily arrivals of Categories 3 and 4 patients (i.e., non-critical patients). Second, the association between contributing variables and daily patient arrival is modeled by using artificial neural network (ANN), and the modeling ability is compared with that of nonlinear least square regression (NLLSR) and multiple linear regression (MLR) in terms of mean average percentage error (MAPE). Third, four types of relative importance (RI) of input variables based on ANN are compared, and their statistical reliability is tested by the MLR-based RI. We applied this three-stage method to one year of data of patient arrivals at a local ED. The contribution of this paper is twofold. Theoretically, this paper emphasizes the importance of using data-driven selection of variables for complex system modeling, and then provides a comprehensive comparison of RI using different computational methods. Practically, this work is a novel attempt of applying ANN to model patient arrivals, and the result can be used to aid in strategic decision-making on ED resource planning in response to predictable arrival variations.

Timeliness of adjuvant chemotherapy (AT) for stage III adenocarcinoma of colon (CC): A measure of quality of care.

282 Background: In the past three decades multiple clinical trials have proven the benefit of AT for CC, establishing combination chemotherapy after recovery from surgery as a quality measure in stage III CC. The majority of clinical trials require enrollment for AT within eight weeks from surgery nonetheless there is no established standard time for delivery of AT. Timeliness of service is defined as one of the domains of quality care by Institute of Medicine. We explore the timing of AT as a quality measure in patients (pts) with CC. Methods: We conducted a retrospective analysis of pts with CC who underwent surgery in Los Angeles County Hospital between January 2005 through December of 2009, with at least six months of follow up after surgery. Pt, disease and treatment characteristics were recorded. Disease free survival (DFS) was measured as the time from surgery to the last follow up or recurrence. Results: 52 pts, median age 58 years (28 – 86), 62% female, 65% Hispanics, 21% Asian, 6% black and 6% white, with CC were included all of whom received adjuvant FOLFOX. 24 pts had right and 26 left-sided cancers. Median start day for AT was 60 days after surgery (12-145 days), with 60% waiting more than 8 and 19% more than 12 weeks. 4 pts received 6, 1 pt 10, 2 pts 11 and 45 pts 12 cycles of therapy. 17 pts had recurrence, 3 local and 14 systemic. Median DFS was 25.3 month (range 8-70). In univariable analysis only age was a predictor of recurrence (HR 0.96 95% CI 0.92-0.99). Time from surgery to adjuvant chemotherapy was not a predictor of recurrence (systemic, local and combined), or DFS. Conclusions: In several meta-analyses time form surgery to AT is identified as an independent risk factor for death from colon cancer. In this study there was no association between time from surgery to AT and DFS. Delivery of AT depends on several factors including recovery from surgery, medical oncology visit, placement of a central line, and initiation of the treatment. Quality measures to assess each of these processes can improve the adherence to available data and improve enrollment on clinical trials. The major limitation of our study is the limited sample size and lack of power to detect a small effect.

Improving access to health care for malaria in Africa: a review of literature on what attracts patients

Increasing access to health care services is considered central to improving the health of populations. Existing reviews to understand factors affecting access to health care have focused on attributes of patients and their communities that act as 'barriers' to access, such as education level, financial and cultural factors. This review addresses the need to learn about provider characteristics that encourage patients to attend their health services. This literature review aims to describe research that has identified characteristics that clients are looking for in the providers they approach for their health care needs, specifically for malaria in Africa. Keywords of 'malaria' and 'treatment seek*' or 'health seek*' and 'Africa' were searched for in the following databases: Web of Science, IBSS and Medline. Reviews of each paper were undertaken by two members of the team. Factors attracting patients according to each paper were listed and the strength of evidence was assessed by evaluating the methods used and the richness of descriptions of findings. A total of 97 papers fulfilled the inclusion criteria and were included in the review. The review of these papers identified several characteristics that were reported to attract patients to providers of all types, including lower cost of services, close proximity to patients, positive manner of providers, medicines that patients believe will cure them, and timeliness of services. Additional categories of factors were noted to attract patients to either higher or lower-level providers. The strength of evidence reviewed varied, with limitations observed in the use of methods utilizing pre-defined questions and the uncritical use of concepts such as 'quality', 'costs' and 'access'. Although most papers (90%) were published since the year 2000, most categories of attributes had been described in earlier papers. This paper argues that improving access to services requires attention to factors that will attract patients, and recommends that public services are improved in the specific aspects identified in this review. It also argues that research into access should expand its lens to consider provider characteristics more broadly, especially using methods that enable open responses. Access must be reconceptualized beyond the notion of barriers to consider attributes of attraction if patients are to receive quality care quickly.

Improving access to health care for malaria in Africa: a review of literature on what attracts patients

BackgroundIncreasing access to health care services is considered central to improving the health of populations. Existing reviews to understand factors affecting access to health care have focused on attributes of patients and their communities that act as 'barriers' to access, such as education level, financial and cultural factors. This review addresses the need to learn about provider characteristics that encourage patients to attend their health services.MethodsThis literature review aims to describe research that has identified characteristics that clients are looking for in the providers they approach for their health care needs, specifically for malaria in Africa. Keywords of 'malaria' and 'treatment seek*' or 'health seek*' and 'Africa' were searched for in the following databases: Web of Science, IBSS and Medline. Reviews of each paper were undertaken by two members of the team. Factors attracting patients according to each paper were listed and the strength of evidence was assessed by evaluating the methods used and the richness of descriptions of findings.ResultsA total of 97 papers fulfilled the inclusion criteria and were included in the review. The review of these papers identified several characteristics that were reported to attract patients to providers of all types, including lower cost of services, close proximity to patients, positive manner of providers, medicines that patients believe will cure them, and timeliness of services. Additional categories of factors were noted to attract patients to either higher or lower-level providers. The strength of evidence reviewed varied, with limitations observed in the use of methods utilizing pre-defined questions and the uncritical use of concepts such as 'quality', 'costs' and 'access'. Although most papers (90%) were published since the year 2000, most categories of attributes had been described in earlier papers.ConclusionThis paper argues that improving access to services requires attention to factors that will attract patients, and recommends that public services are improved in the specific aspects identified in this review. It also argues that research into access should expand its lens to consider provider characteristics more broadly, especially using methods that enable open responses. Access must be reconceptualized beyond the notion of barriers to consider attributes of attraction if patients are to receive quality care quickly.

Orthopaedic podiatry triage: process outcomes of a skill mix initiative

The Orthopaedic Podiatry Triage Clinic (OPodTC) is a 'skill mix' model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. This study highlights the potential of screening and triage functions in the skill mix debate. In this example, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service.

Impact of Disaster Drills on Caregiver Perception and Satisfaction in the Pediatric Emergency Department

The objective of this study was to assess caregiver perception and satisfaction of a regional disaster drill in a pediatric emergency department (ED). Caregivers of children receiving care during a 2-hour disaster drill were given a survey regarding perceived importance of the drill, waiting time to see a physician, service timeliness, impact on comfort, and overall recommendation of the ED. As a control, the survey was also given to caregivers a week before and after the drill. Caregivers on the drill date were more likely to consider drill conduction to be highly important (100% vs 82.9%, P < 0.045). Compared with the drill date, there were no significant differences in the perceived duration of waiting, impact on care, or likelihood to recommend the ED to others. In a single regional disaster drill, we found that caregivers feel that disaster drills are important and unlikely to impact care of children negatively. These findings can help support decision making by hospital administrators to commit personnel and resources to conduct necessary disaster drills involving children.

Patients’ perceptions of services and preferences for care in amyotrophic lateral sclerosis: A review

Service providers and service users often have different perspectives on health and social care services. We have undertaken a systematic review of empirical data between 1988 and March 2011 relating to ALS service users' perspectives on health and social care services. Forty-seven texts were extracted and a narrative synthesis conducted. Few studies have explored ALS patients' experiences in relation to their satisfaction with services. Our review showed that ALS patients expect dignified care but they are often dissatisfied with health care services and have unmet expectations of their care. Most studies of decision-making and preferences for care have focused on end-of-life intervention. Various factors influence preferences for care from the service user perspective and people with ALS may adjust their use of services as they negotiate change. In conclusion, further research on the timeliness of services to meet changing needs of service users is required. The service user experience of allied health care services prior to end-of-life care also warrants investigation. Service providers need to support people with ALS as they negotiate feelings of acceptance and independence. Research to identify the key parameters of the ALS patient experience of services is required.

Factors affecting delays in first trimester pregnancy termination services in New Zealand

To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand. Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%). Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay. Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve.

An assessment of client satisfaction wirh services at a model primary health care centre in Ogun State, Nigeria

Assessing patient satisfaction with health care is increasingly becoming an integral component of quality monitoring in health care systems. However, studies that have been conducted in this environment often show that clients' perceptions of quality of care from public sector providers are generally low. Timeliness, which refers to obtaining needed care and minimizing unnecessary delays in getting that care, may impact considerably on patients' satisfaction. This study w as designed toexamine how the consumers of services at a model primary health centre in Ogun State, Nigeria, viewed their health-seeking experience, relating this to the level of organization.and timeliness of health services provision. This study sought to assess the satisfaction of clients with services at a model PHC centre at Pakoto, Ogun State, Nigeria. The Pakoto model primary health care centre is an outstation of the Lagos University Teaching Hospital (LUTH) Idi-Araba, Lagos State. The study was carried out on weekday mornings at the model PHC clinic during the month of June, 2006. Methods of data collection employed were a general observation of clinic activities, and the administration of a modified client flow analysis chart to clients as they exited the health facility. The peak time of arrival of clients was between 9.00 and 11.00 a.m. when the majority (58.5%) of clients arrived; the majority of clients (84%) exited the facility oetween 11:00 a.m. and 1:00 p.m. The highest proportion of clients (33.1%) spent 3-4 hours accessing services at the model PHC facility. Good staff attitude topped the list of aspects of service liked most by clients (36%), while the aspect of service liked least by respondents was lack of timeliness of services (43%). Suggestions for improvement of services included increase in the number of staff and staff training (30%) and early arrival of staff to work (13%). The study concludes that timeliness of services at the primary health care level impacts positively upon the perception of quality of services rendered to clients.

Supply chain visibility a servizio del cliente. Un metodo per identificare aree di opportunitÀ e di rischio

- In a world of high complexity and dependency from external factors and where timeliness of service is key for customer service, visibility has become a powerful weapon to better manage company operations and supply chain. The technology can help for that and also it is now more available than before. Companies shall act upon these opportunities and value their advantage. They have to look at their operations, understand which of the "visibility" sense is most relevant for them and evaluate which of the technology-process combination would better satisfies their needs. In that research we tried to develop a method to understand opportunities and risk areas across the supply chain to improve customers service, using also technologies. Keywords: marketing &amp; logistics, supply chain, visibility, logistics technologies, customer service.

Design, Implementation, and Assessment of a Radiology Workflow Management System

The objective of this article is to describe the development, launch, and outcomes studies of a paperless workflow management system (WMS) that improves radiology workflow in a filmless and speech-recognition environment. The WMS prioritizes cases automatically on the basis of medical and operational acuity factors, automatically facilitates communication of critical radiology results, and provides permanent documentation of these results and communications. It runs in parallel with an integrated radiology information system (RIS)-PACS and speech-recognition system. Its effects on operations, staff stress and satisfaction, and patient satisfaction were studied. Despite an increase in caseload volume after the launch of the WMS, case turnaround times, defined as the time between case availability on PACS and signing of the final radiology staff interpretation, decreased for all case types. Median case turnaround time decreased by 33 minutes (22%) for emergency department, 47 minutes (37%) for inpatient, and 22 minutes (38%) for outpatient radiology cases. All reductions were significant at a p value of < 0.05. Interruptions were reduced, consuming an estimated 28% less radiology staff time, after implementation. Patient perceptions of radiology service timeliness showed modest improvement after the WMS was implemented. Staff satisfaction showed no significant change. There is room for improvement in radiology workflow even in departments with integrated RIS-PACS and speech-recognition systems. This study has shown that software tools that coordinate decentralized workflow and dynamically balance workloads can increase the efficiency and efficacy of radiologists. Operational benefits, such as reduced reading times, improvements in the timeliness of care (both actual and as perceived by patients), and reduced interruptions to radiologists, further reinforce the benefits of such a system. Secondary benefits, such as documenting communication about a case and facilitating review of results, can also promote more timely and effective care. Although use of the system did not result in a substantial improvement in staff perceptions, neither did it reduce their satisfaction, suggesting that these operational improvements were not achieved as a trade-off against the quality of the work environment.

Assessing uncertainty in outsourcing clinical services at tertiary health centers

When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract.

The Impact of Third-Party Logistics Performance on the Logistics and Export Performance of Users: An Empirical Study

Third-party logistics (3PL) denotes ‘a relationship between a shipper and third party which, compared with basic services, has more customised offerings, encompasses a broader number of service functions and is characterised by a longer-term, more mutually beneficial relationship’. Previous studies on 3PL generally fall into two categories. The first group examines the willingness of shippers (users), and the respective benefits and costs to them, of using 3PL services, whereas the second group concentrates on devising winning strategies for 3PL providers to better fulfil the requirements of users. This paper attempts to provide new insights on the relationship between 3PL providers and shippers by examining the impact of the performance of 3PL service providers on the user logistics and export performance of manufacturers and traders in Hong Kong. The results reveal that the timeliness of the service; pricing; and the quality of delivery of 3PL service providers are positively related to the users’ logistics and/or export performance. However, performance in customised supplementary services is not related to any aspect of the users’ logistics or export performance. The overall findings suggest that users should focus primarily on the timeliness of 3PL services, followed by the quality of delivery and pricing when selecting service providers. On the other hand, 3PL service providers are advised to focus primarily on core logistics activities, that is timely deliveries and quality handling at reasonable prices, and to downplay offerings of customised supplementary services unless they are engaged in long-term relationships with the users.

Functional Outcomes and Consumer Satisfaction in the Independent Living Program for Older Individuals who are Blind

This study of a national sample of elders served by the Independent Living Program for Older Individuals Who Are Blind found that, overall, they were highly satisfied with the quality and timeliness of services and help in achieving independent living goals. A slight improvement was found in their perceptions of functional outcomes from 1999 to 2004.

ATTRIBUTES OF SMALL-SCALE SUGARCANE CONTRACTORS THAT INFLUENCE THEIR SERVICE QUALITY IN KWAZULU-NATAL

The productivity of small-scale sugarcane contractors affects not only their own profitability and sustainability, but that of other stakeholders as well, such as the small-scale sugarcane farmers they contract to and the sugar mills they supply with sugarcane. This study examines the attributes of small-scale sugarcane contractors that affect their quality of service as perceived by small-scale sugarcane growers (SSGs). Information was obtained through interviews conducted with 114 contractors sampled in ten mill group areas in KwaZulu-Natal between September 2002 and July 2003. Further interviews were conducted in the same time period with SSGs for information on contractor service quality (transport and general service timeliness, meeting of daily rateable delivery requirements, low downtimes, good staff management, and minimal disagreements on service terms). Results show that factors affecting a contractor's perceived service quality include gender, training, the quality of information used (industry focused information sources such as the South African Sugar Association Experiment Station (SASEX)3 and the Ingede magazine, or general sources such as the radio), and sugarcane tonnage transported (size of business). Being a male contractor and having a larger business positively influence service rating as perceived by SSGs. The importance of the quality of information used and increased training levels highlights the need for the continual provision of relevant information and training for sugarcane contractors by extension services (government, SASEX and milling companies).

Pengaruh alat penyajian disposable terhadap sisa makanan pasien di ruang rawat inap RSUP Dr. Kariadi Semarang

Background: Food service success relates to patient plate waste. Patient plate waste in Indonesia Hospitals could be more than 25%. Cause of patient plate waste in Hospital is lack of food and equipment quality. Almost of 32.8% patients in 10 hospitals model in Indonesia clarify that appearance, cleanliness, and equipment are good.Objective: The aim of theses research was to identify the effect of serving utensils and the other factors to the plate waste.Methods: This was a Quasi Experiment study using pre posttest with control. Study subject consisted of 45 patients in the treatment group and 45 patients in the control group. Data were analyzed descriptively and whereas t-test, Fisher Exact test, Chi-Square were performed to differentiate the proportions and means in two groups. The effect of several variables on plate waste was calculated using logistic regression on analysis.Results: This study showed that no significant difference of taste, appearance, attitude of the staff who serve meals, service timeliness, kind of food, kind of diseases and environment to patient plate waste (p&gt;0.05). There was no significant effected of the serving disposable utensils on patient plate waste (p&gt;0.05).Conclusion: The type of serving disposable utensils was no a significant factor effected the plate waste.

Computerized physician order entry of diagnostic tests in an intensive care unit is associated with improved timeliness of service.

To measure the effect of computerized physician order entry on timeliness of urgent laboratory and imaging tests. Before-after. Eleven-bed medical-surgical intensive care unit in a tertiary teaching hospital. All patients who had "stat" laboratory or imaging tests ordered during each of two 1-month periods 10 months before and 2 months after introducing computerized physician order entry. Introduction of computerized physician order entry. After computerized physician order entry was introduced, median time from ordering to obtaining laboratory specimens decreased from 77 to 21.5 mins, median time from ordering to laboratory result being reported decreased from 148 to 74 mins, and median time from ordering to imaging completed decreased from 96.5 to 29.5 mins. Introduction of computerized physician order entry for ordering "stat" tests in an intensive care unit is associated with improved timeliness of these tests.