World-class Health Care Research Articles

Commitment to Excellence, Innovation in Health Care: Journey to Enhance Healthcare Quality and Patient Safety at Shuang Ho Hospital

<p>雙和醫院自2008年開院以來一直秉持以病人及員工為中心的服務理念，持續提升醫療品質和病人安全。醫療品質部結合醫院理念，推動卓越服務，包括健全品質與安全管理、人才培育、競賽活動以及創新特色發展。在醫療品質推動方面，醫院重視病人安全，鼓勵異常事件通報文化，並進行指標管理以及人才培育。此外，醫院積極參與各項競賽活動，鼓勵全院參與品質改善，並提供完善獎勵。在創新特色發展方面，推動智慧醫療、醫病共享決策和明智選擇等服務，以提供更加有效的醫療照護。未來，醫院將持續與其他醫療機構合作，建立共享交流平台，推動醫療品質和病人安全，以提供高品質的國際一流醫療服務為目標。</p> <p> </p><p>Since its opening in 2008, Shuang Ho Hospital has upheld the concept of patient- and staff- centered service to continuously enhance health-care quality and patient safety. The Department of Healthcare Quality promotes service excellence in alignment with the hospital’s philosophy, which encompasses robust quality and safety management, talent cultivation, competition activities, and the development of innovative features. In promoting health-care quality, the hospital emphasizes patient safety, encourages a culture of reporting abnormal events, conducts benchmarking tests, and fosters talent development. In addition, Shuang Ho Hospital actively participates in various competitions, encourages hospital-wide participation in quality improvement, and provides comprehensive rewards. Regarding innovative feature development, the hospital promotes intelligent health care, shared decision-making, and Choosing Wisely initiatives to enhance the effectiveness of health-care services. In the future, Shuang Ho Hospital will continue to collaborate with other health- care organizations to establish a platform for sharing and exchanging ideas to promote health-care quality and patient safety, with the goal of providing high-quality, world-class health care services.</p> <p> </p>

‘Your CV looks amazing but I am sorry, you didn’t get the job’: analysing experiences of global majority physiotherapists aspiring to and working at consultant level practice in the UK

IntroductionEffective leadership shapes organisational culture to deliver world class healthcare. Racially minoritised individuals rarely access opportunities leading to leadership positions. This paper expands on themes from qualitative research which explored...

Blackness and the Pandemic: Critiquing the Mathematics Curriculum in a Large Urban City

ABSTRACT The COVID-19 pandemic brought booming economies, seemingly world-class health care systems, educational infrastructures, and the lives and well-being of nations to a complete standstill. Georgia was one of the few states that released their Shelter-in-Place order early, while reports suggest that Black communities have disproportionally higher rates of deaths and hospitalizations. What mathematics would allow students to critically examine the data shared and other data reported about the COVID-19 pandemic? In this essay, we apply a culturally relevant pedagogical (CRP) lens to examine the mathematics curriculum taught in K-12 schools before and during the COVID-19 pandemic. Specifically, we consider the shortcomings of the curriculum given the impact of the pandemic on Black communities in Atlanta, Georgia, and the barrage of statistics used to inform their lives. We consider how to look at mathematics curriculum through a CRP lens and what that means in terms of the scope of standards that are being addressed and the flexibility for teachers to have autonomy to go beyond the prescribed curriculum. Two concentration areas are addressed, and they highlight how to use a CRP lens for secondary and elementary mathematics relevant to our local context in ways that envision how mathematics curriculum can support Black children moving forward.

The Impact of the COVID-19 Pandemic on Multidisciplinary Clinics: A High-Volume Pancreatic Cancer Center Experience

The unprecedented impact of the Sars-CoV-2 pandemic (COVID-19) has strained the healthcare system worldwide. The impact is even more profound on diseases requiring timely complex multidisciplinary care such as pancreatic cancer. Multidisciplinary care teams have been affected significantly in multiple ways as healthcare teams collectively acclimate to significant space limitations and shortages of personnel and supplies. As a result, many patients are now receiving suboptimal remote imaging for diagnosis, staging, and surgical planning for pancreatic cancer. In addition, the lack of face-to-face interactions between the physician and patient and between multidisciplinary teams has challenged patient safety, research investigations, and house staff education. In this study, we discuss how the COVID-19 pandemic has transformed our high-volume pancreatic multidisciplinary clinic, the unique challenges faced, as well as the potential benefits that have arisen out of this situation. We also reflect on its implications for the future during and beyond the pandemic as we anticipate a hybrid model that includes a component of virtual multidisciplinary clinics as a means to provide accessible world-class healthcare for patients who require complex oncologic management.

ANALYSIS OF INTERNATIONAL EXPERIENCE IN FINANCING EDUCATION

Everyone knows that education is the foundation of a nation. Countries that have implemented this motto and have long invested heavily in the sustainable development of the country's education sector are now leaders in innovation, global influence, employment, innovative thinking, world-class healthcare, technology, ideological influence and even in the military. They diversified investment in education, which spurred progress across all sectors. On the contrary, there are many countries that rely on some specific advanced countries for creativity, education and even making important decisions. These countries cannot support their own sustainable development because they rely on others. In addition, some countries are highly dependent on natural resources, which currently face constraints due to the sharp fall in the prices of these assets due to the global economic depression or the invention of alternatives. The world's best educated countries have more researchers, a diversified world-class education system, and the creativity to cope with changing global circumstances. Thus, funding for education opens up many employment opportunities, which leads to a decrease in the crime rate in the country and, as a result, leads to the sustainable economic development of the nation.

Awareness and Enrolment of Chief Minister Comprehensive Health Insurance Scheme in Poor Cancer Patients in Coimbatore

The Government of India has started several healthcare schemes to provide best-in-class healthcare facilities to several low-income families in the country. Chief Minister’s (CM’s) Comprehensive Health Insurance Scheme (CMCHIS), additionally recognized as Amma Health Insurance, presents low-income households in Tamil Nadu get the right of entry to world-class healthcare services via cashless economic assistance.That way, these people do not have to suffer any financial burden when seeking medical backup. The research states that the government scheme succeeds in Tamil Nadu, particularly in poor cancer patients who took treatment from the government hospital in Coimbatore district and are aware of other life and general insurance companies.

Talent management strategies of a public UAE hospital in the Industry 4.0 era: A qualitative analysis

Talents play a critical role in achieving organizational strategic goals and a higher level of performance in the healthcare industry. Therefore, the UAE government, which strives to provide world-class healthcare services, encouraged the adoption of talent management strategies and creation of essential capabilities for talent recruitment, development, and retaining. This study explores the talent management strategies, policies, and practices in multiple departments of a public UAE hospital. Moreover, it investigates required skills, competencies, and programs for those departments in the context of Industry 4.0. The study adopted a case study approach and qualitatively surveyed a purposive sample of 13 departmental managers, section heads, and supervisors who are experienced in employee management. The study found that talent management at the studied hospital is undefined and unclear in terms of strategies, policies, and practices. Furthermore, the study highlighted the need for employee encouragement, motivation, and engagement, as well as confirmed the critical role of management and leadership in facilitating talent management in the hospital. Accordingly, a UAE hospital could benefit from this study to develop its talent management policy and strategies that will guide managers in the Industry 4.0 era. Acknowledgment The nursing administration, nursing research committee at Tawam hospital and managers who responded to the study survey are acknowledged for the extension of support for the study.

Primary care mental health services in Qatar.

With rapid growth and development in recent decades, the State of Qatar has been redefining strategies and policies towards building a world-class healthcare system. Mental health has emerged as a priority area for development. As a result, mental health services in the region are being redefined and expanded, and this was realised with the launching of the ambitious National Mental Health Strategy in 2013. Traditionally, mental healthcare in Qatar had been considered to be the remit of psychiatrists within secondary care. The new strategy supported the transition towards community-based care. It outlined a plan to design and build a comprehensive and integrated mental health system, offering treatment in a range of settings. In this article, we provide an overview of the advent of primary care mental health services in Qatar. We discuss the historical aspects of psychiatric care and development of primary care mental health services in Qatar.

Doctor Finder: Find doctors on the Go

Currently most people don’t have access to world-class health care. People tend to go to their local doctors and get their treatment delayed in case of serious diseases. These cases require a specialist to tend to the needs of the patients. A system is created that helps a person find a doctor based on the symptoms the user is facing. The system helps the user to get redirected to the nearest specialist that is appropriate to the special case of each user. This article discusses how the system was designed and implemented and what exactly was the need to implement such a system.

The experiences of diploma registered nurses returning to undergraduate study in Qatar: A descriptive qualitative study

BackgroundQatar aspires to provide world-class healthcare comparable with Western countries. Compelling evidence demonstrating the positive effects of bachelor of nursing (BN) educated nurses on patient outcomes is creating a global demand for these graduates, particularly in contexts such as Qatar where historically RN-to-BN programs were unavailable. ObjectiveThe aim of this study was to examine the return to education experiences of diploma educated registered nurses (RNs) undertaking a bachelor program. MethodsThis descriptive qualitative study included 19 diploma educated registered nurses enrolled in a BN program in a Qatar campus of a Canadian university. Focus groups and thematic analysis were used. ResultsThree major themes described RNs' experiences of returning to education: the right time, balancing act and rewards. The convergence of timing, BN program availability and employer sponsorship were significant levers. Returning to education was challenging and required balancing competing demands of work, home, and study. The exposure to enquiry-based learning required rapid development of study skills to enable learning. Previous education was often seen as incongruent with requirements for academic success. A notable omission from accounts was reference to professional identity. Undertaking the program brought returns such as increased self-esteem, enhanced knowledge and potential for career progression. Organizational culture and commitment appeared to impact on students' experience. ConclusionsCompleting a BN program was reward for the challenges engendered by returning to education. Effective partnerships and structural support between academic and service providers are required to ensure the benefits of BN attainment become embedded and impact on professional identity.

A modified-Delphi study of a framework to support the potential implementation of pharmacist prescribing.

There is an extensive evidence base of the effectiveness and safety of pharmacist prescribing around the globe. There is therefore potential to develop a framework to support the implementation in Qatar to achieve the National Vision 2030 of establishing a comprehensive world-class healthcare system by better utilisation of its healthcare workforce. To determine the levels of agreement amongst key stakeholders regarding a framework for the potential development and implementation of pharmacist prescribing in Qatar. A quantitative, consensus-based modified Delphi study involving stakeholders in Qatar with key strategic positions of health policy influence (directors of medicine/nursing/pharmacy, lead administrators, health-related academics, patient safety leads, professional regulators) was conducted. Delphi statements were developed from extensive literature reviews, semi-structured interviews, pharmacist prescribing frameworks implemented in other countries, and based on the Consolidated Framework for Implementation Research. The scope of the statements included definitions and scope of prescribing, education and training, and governance, were validated with eight specialists from UK and Qatar, and presented as an online Delphi. Consensus was set at 70% or higher agreement and less than 15% disagreement for each statement. Thirty-three experts agreed to participate in the Delphi, with a response rate of 94% for Round 1 and 91% for Round 2, at which point the Delphi stopped. Consensus was achieved for 38 out of 47 statements indicating that a collaborative prescribing model was preferred, and that experience and additional training were required along with robust governance. Consensus was not reached in relation to independent prescribing, prescribing controlled drugs, and ordering certain diagnostic/monitoring investigations (e.g. ECG, X-ray). High levels of agreement were attained for statements, which can constitute a framework for the development and implementation of pharmacist prescribing in Qatar. Further work is required to translate this framework into healthcare policy and practice.

Development and Implementation of Maternity Dashboard in Regional Hospital for Quality Improvement at Ground Level: A Pilot Study.

ObjectivesWe sought to develop and implement a Maternity Dashboard to improve the quality of health care at the ground level.MethodsWe conducted a prospective, descriptive cross-sectional study, involving patients with high-risk pregnancies who had been referred to Nizwa Hospital, Oman. The selection of quality indicators was based on the prototype of clinical outcomes from the Royal College of Obstetricians and Gynecologists. The Maternity Dashboard team adapted local parameters and used preselected general parameters, based on clinical observations, to develop the dashboard.ResultsThe issues posing a threat to Nizwa Hospital in becoming a world-class healthcare facility were: overbooked outpatient department, insufficient staff, and more junior doctors compared to senior doctors and consultants. Additionally, being pioneers, naturally, the dashboard development team faced difficulties while handling adverse situations. More time, guidance, and standardization of quality indicators are desirable.ConclusionsFollowing the approval for a Maternity Dashboard in Nizwa Hospital, the data compiled in an Excel sheet are transmitted manually every month for display on the dashboard in the delivery suite. It is intended to make data collected and dissemination completely automated in the future with the help of the Al-Shifa Healthcare Information System. Expansion of the idea of a Maternity Dashboard to other hospitals and specialties at the regional and tertiary level of the health care system in Oman and a comparison of the standard of health care provided between hospitals based on similar quality indicators would be the next milestone.

How do we strengthen the health workforce in a rapidly developing high-income country? A case study of Abu Dhabi's health system in the United Arab Emirates

BackgroundThe United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971. The UAE has experienced unprecedented population growth coupled with increased rates of chronic diseases over the past few decades. Healthcare workers are the core foundation of the health system, especially for chronic care conditions, and the UAE health workforce needs to be fully prepared for the increased rates of chronic diseases in the adult population. Abu Dhabi is the largest emirate in terms of land mass and population size, and the purpose of this paper was to assess how the health system has been using the Chronic Care Model to improve its capacity to reach out to all patients in the population.Case presentationThe Abu Dhabi health workforce has twice the number of doctors (52.4 vs. 23.2 per 10 000 population) and nurses (134.7 vs. 50.4 per 10 000 population) compared to the entire UAE health workforce. In addition to an overreliance on expatriate workers, there is an excess of some specializations such as general medicine and gynecology and a severe undersupply of other specialties including trauma and injury, and medical oncology. The digital infrastructure and skills of the health workforce need to be improved to minimize the proportion of the appointment time required to complete administrative tasks for a health insurance system and maximize the doctor-patient face-to-face interaction time for consultation and lifestyle counseling.ConclusionsA greater emphasis needs to be placed on developing self-management support strategies using a combination of nurse health educators and community-based patient-led health programs. The UAE Vision 2021 includes developing a world-class healthcare system, and full implementation of the Chronic Care Model seems to facilitate the detailed planning and preparation of healthcare services and workers required to achieve this goal.

Fourth Industrial Revolution for Development: The Relevance of Cloud Federation in Healthcare Support

Inefficient healthcare is a major concern among many African nations and can be mitigated by building world-class infrastructure connecting different medical facilities for collaboration and resource sharing. Such infrastructure should support collection and exchange of medical data for the purpose of accessing expertise not available locally. It should be equipped with modern technologies of the fourth industrial revolution, providing decision support to doctors thereby enabling African nations leapfrog from poorly equipped to medically prepared. Sadly, world-class healthcare infrastructure are a missing piece in the African public health ecosystem. Medical facilities are either non-existent or prohibitively expensive when they exist. Federated cloud computing can provide a solution to this challenge. Being a model that allows collaboration between multiple Cloud service providers through resources pooling; it allows for the execution of tasks on computing resources flexibly and cost efficiently. This paper aims to connect unconnected medical facilities in Africa by proposing a Cloud federation for healthcare using cooperative and competitive collaboration models. Simulations were carried out to test the efficacy of these models using five different workload allocation schemes: First-Fit-Descending (FFD), Best-Fit-Descending (BFD), Binary-Search-Best-Fit (BSBF); Genetic Algorithm meta-heuristic and Stable Roommate Allocation economic model for both light and heavy workloads. Results of simulations revealed that the cooperative model resulted in lower delays but higher resource utilisation; while the competitive provided faster service delivery and better quality of service. BSBF and BFD resulted in the best resources utilisation and energy conservation. Finally, deployment considerations and potential business models for federated Cloud for African healthcare were presented.

Assessment of hospital service quality parameters from patient, doctor and employees’ perspectives

The Indian healthcare industry has been growing at a tremendous pace and contributing a great deal towards the employment and revenue generation for the country. Recently, medical tourism has also gained a huge impetus as people from all over the globe visiting India for availing affordable and worldclass healthcare services. Hence, delivering effective healthcare service quality and understanding the perceptions of all stakeholders – i.e. patients, doctors and employees – has become very critical for the success of any healthcare centre. Over a period of time, service providers have been defining service quality parameters based on their own judgment and trying to deliver services as per their assumptions. However, patient satisfaction requires a proper synchronisation between what the patient expects and what the management perceives. For addressing this issue, six new dimensions were identified using SERVQUAL and termed it as ‘HealQual’ tool keeping in mind the needs of current Scenario. The paper would identify those healthcare service quality parameters which improve patient satisfaction and also generate priority weights from the perspectives of both service reviewer, i.e. patients and the service provider, i.e. doctors and employees.

A pushing chronic care forward in Abu Dhabi by identifying priorities and addressing barriers: a modified Delphi technique

ObjectiveThis study aimed to elucidate the top five key priorities and barriers to chronic care in the health system of Abu Dhabi, United Arab Emirates (UAE).DesignA modified Delphi study was...

An innovative integrated model for improving oral health in the Australian context

Background: Australia has a world-class health care system. Yet the prevalence of tooth decay among 5 year olds (50%), and untreated tooth decay among adults (30%) remains high. 23% of Australian adults have moderate to severe periodontitis (gum disease) and with a rapidly increasing prevalence of type 2 diabetes, the bidirectional association of periodontitis and unstable diabetes is predominantly ignored. Dental treatment addressing the result of the disease process is costly, and does not address the actual causes of disease, or the risk factors associated with these diseases. Objectives: To present an innovative population based preventive approach to primary oral health care that is client and family centred, targeted and co-ordinated, and integrates oral and general health. Methods: North Richmond Community Health (NRCH), an inner urban community health service, in Victoria, Australia, has developed a preventive and risk based innovative model of oral-health care. NRCH serves vulnerable groups, including refugees and asylum seekers, homeless, people living with mental illness, elderly, substance users, Aborigines and Torres Strait Islanders. The team includes the full range of oral health professionals (dental assistants, oral health educators, dental and oral health therapists, dental hygienists, prosthetists) and general health professionals, including general medical practitioners, diabetes nurse educators (DNE) and practice nurses. Employing outreach and education methods, minimally invasive and preventive oral health clinical procedures such as the Hall Technique and Silver Diamine Fluoride are incorporated into the program. Results: A health literacy approach for consumers from first contact ensures preparation for this program. The NRCH model of oral health care and its links with other community services will be presented, highlighting a shift in types of services provided, referrals made and consumer engagement in oral health care. In particular the NRCH developing collaborative model of diabetes and oral health management will be presented. In this model the DNE routinely include the ‘mouth’ as a risk factor to be addressed and enquire about daily oral health routines, last oral health review or oral problems. In addition clients seen in the oral health program are assessed for diabetes risk. Those with a high risk score or established diabetes are referred to the DNE. Conclusion: Through re-orienting workforce, utilising health professionals from different disciplines, and a risk based, person-centred care approach to a population health issue, it is possible to find potentially cost-effective ways of delivering primary preventive integrated health care that includes oral health. Collaboration and consistency of care is enhanced through professionals from different disciplines working together and most importantly, in partnership with the client.

The Journey of 10,000 Miles Begins With 1 Step

The journey to providing world-class health care can be gauged by various metrics: some are more tangible and concrete, such as patient satisfaction scores, whereas others aren't necessarily readily seen or felt. Nursing identity, role clarification, and owning nursing practice are all less measurable, yet immeasurably vital elements of a journey to excellence. In our world of immediate gratification with instant everything from messaging to downloads to show me the results…now, the world of professional nursing practice challenges the perceptive norms of our health care world. Things that take time, such as cultural change related to how nurses see themselves as professionals, elbow to elbow with their interdisciplinary colleagues as well as their peers, doesn't happen overnight. Developing and nurturing professionalism in nursing takes time, authentic presence of leaders, engagement of colleagues, and somehow creating a feeling of value in the contribution of each nurse from the bedside to the boardroom. So how does that happen? Not an easy answer, but the professional practice team at WellStar Cobb is on a mission to make it happen. This is the story of a team's vision to define themselves and become owners of their practice.

Lean Six Sigma in Health Operations

The hospitals over the last few years have been facing major issues and challenges; the patients aspire world-class health care quality delivery while state and health insurance companies demand the delivery at the lowest price. Lean which eliminates the waste and Six Sigma which decreases the variation in hospital processes are complementary quality improvement tools that can help to achieve these goals. The lean principles have been now successfully applied to the delivery of health care over the last few years. Lean management primary begins with underlying principle of eliminating waste. In order for lean methodology to be successful and able to enhance the operations the hospital must first work to create an organizational culture that is receptive to lean thinking. The commitment to start lean must start from the top management, and the junior staff must be involved. Whether manufacturing a car or delivering health care to a patient, the industry worker or health personal relies on multiple, disorganized, chaotic and complex in-built system and processes to accomplish the goal to deliver value to the customer or patient. It is a widely held dictum that once the lean principles are applied rigorously and throughout an entire organization, it can have a positive impact on productivity, cost, quality and timely delivery in a resource limited settings of Indian subcontinent. In hospital industry, the operational efficiency means rapid access to care, minimum waiting time while at the same time delivering defect free quality care at the minimum cost. We believe the Lean Six Sigma (LSS) is a panacea management philosophy to overcome the burgeoning health and hospital industry challenges.

The Impact of Joint Commission International Healthcare Accreditation on Infection Control Performance: A Study in Dubai Hospital

Objective - The United Arab Emirates (UAE) Vision 2021 aims to achieve a world-class healthcare system and the national agenda has set multiple Key Performance Indicators (KPIs) to accomplish accreditation by all healthcare facilities in the country by 2021. The purpose of this study was to assess the impact of Joint Commission International (JCI) accreditation on Infection Control (IC) KPIs in Dubai Hospital (DH). Methodology/Technique - A longitudinal case study covering 2007 to 2013 was conducted to examine this impact based on secondary data of the KPIs during this period and semi-structured interviews with senior health officials. Findings - The study reveals that the healthcare accreditation acts as a catalyst for implementing and monitoring changes but it also underscores some challenges. It proposes recommendations such as improving surveillance systems, ensuring proper resources allocation, and undertaking further research. Novelty - The study recommends improving the surveillance and reporting systems at the national level through frequent internal surveys. Type of Paper - Empirical Keywords: Dubai; Infection Control; Joint Commission International Accreditation; Key Performance Indicators; United Arab Emirates. JEL Classification: H51, I11, P46