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This study was undertaken to determine the present and potential contribution of dietitians to health care in Australia. Data were collected from three separate surveys conducted over a 15 month period from September 1984 to December 1985. The first survey, a National Workforce survey, provided a profile of the demographic and employment characteristics of the dietetic profession in Australia. The second survey was undertaken to determine the role of the dietitian as perceived by dietitians themselves and in the third survey a group of general practitioners was surveyed to determine what they perceived to be the role of the dietitian and to what extent they utilised the services of dietitians.Results of the surveys suggest that dietitians in Australia are not realising their full potential contribution to health care. Firstly, there are too few dietitians in Australia and it is unlikely, despite the best intentions, that the profession will be able to meet consumer need and demand for nutritional care and education. There was considerable disparity between what dietitians considered to be their ideal role versus their actual role. Role disparity among dietitians was highest for professional development, education and research activities and low or moderate for nutritional care activities. A lack of time was most frequently cited as the major deterrent preventing dietitians performing activities which they perceived to be part of their ideal role.The results of the third survey indicated that in general, the doctors surveyed had favourable opinions of dietitians but that they held rather traditional views of the role of the dietitian, expecting them to be more involved in food preparation and service than dietitians expected to be. This general lack of awareness of the role and expertise of dietitians and their potential contribution to health care is likely to lead ++ / to an under- utilisation of the full range of services provided by dietitians as evidenced by this study.

Thesis (M.S.)--University of Missouri--Columbia, 2000. / "May 2000." Typescript. Includes bibliographical references (leaves [32]-35). Also available on the Internet.

Thesis (M.Public Health) -- University of the Western Cape, 2009. / Includes bibliographic references (leaves 118-126).

Thesis (doctoral)--Rijksuniversiteit te Utrecht.

<p>Average compensation of a CEO of publicly-traded hospitals was about $4 million a year for the period 2011 to 2016. Their compensation is growing while people have a hard time to pay the medical bills. The passage of the Affordable Care Act of 2010 has a significant effect on the healthcare system specifically on hospital operations. Hospitals account for 32% of the total healthcare costs. Through the passage of the ACA, lawmakers intended to reduce costs and increase the quality of care. Publicly-traded entities because of the separation of the management (agent) and ownership (principal) have conflicts of interest that lead to agency problems and costs such as the cost of monitoring and low return to shareholders. The publicly-traded hospitals are no exception. Hospitals provide incentives to the CEOs to reduce these costs and align their and shareholders? objectives. The purpose of the quantitative study was to examine the following question. What correlation, if any, existed between CEO compensation and financial performance of the U.S. hospitals post the ACA Act of 2010 for 2011-2016? The following metrics, operating margin, return on assets, return on equity, occupancy rate, length of stay, and profit per discharge, were used to perform multiple regression analysis. Initially, seven hospitals were selected, but one hospital was excluded because of missing data. Spearman?s rho correlation was used because data violated some of the parametric assumptions. The Operating margin, occupancy rate, and profit per discharge variables were statistically significant in explaining the CEO compensation. Other variables affected the CEO compensation but were not statistically significant. Finally, including all six variables explained less than 30% of CEO compensation, which would indicate agency problems exist in the hospitals. Future studies should identify what other variables explain the change in CEO compensations

<p> With the push for national EHR adoption and the subsequent increase in meaningful use of HIT applications, the healthcare industry has sought to realize reduced cost, increased safety, and improved patient outcomes. In an effort to evaluate the goal of improved patient outcomes, this study examines the effect of HIT adoption stage on the length of stay (LOS) for children admitted with an asthma diagnosis. Asthma is a chronic disease affecting millions of children each year, and has significant health, monetary, and emotional costs. As asthma is in the top three of most common conditions requiring hospital admissions for children and that nearly 50% of inpatient pediatric patients are covered by Medicaid, improving quality outcomes for this condition has large implications across the healthcare delivery system. </p><p> Using comparisons from the KID 2009 and 2012 datasets, the differences between mean LOS for pediatric asthma patients between stages of adoption of Health IT as measured by the EMRAM scale are statistically significant at the p &lt; .05 level, demonstrating that increased use of Health IT has lowered the mean length of stay for this population. Thus, the utilization of a medical best practice, here the adoption of Health IT, resulted in shorter hospital stays and thus cost savings, in this defined pediatric patient population. While further studies examining Health IT implementation in other patient populations are necessary, these results demonstrate that the implementation of Health IT can lead to both better standards of care and lower healthcare costs, which should be of significant interest to those charting the future course of healthcare and healthcare reimbursement in this country.</p><p>

<p> Patient falls present challenges in acute care settings. It was unknown if hourly patient rounding using an electronic whiteboard system (EWS) impacted fall rates on a 16-bed surgical unit in a community hospital in Philadelphia, PA. The clinical questions for this project were what impact does the EWS have on hourly patient rounding and fall rates, and what impact does patient rounding logs have on hourly patient rounding and fall rates. Roy&rsquo;s adaptation model, capacity building, and Kurt Lewin&rsquo;s change theory were the theoretical and conceptual frameworks used in this project. Descriptive analyses were used to interpret data from the EWS and patient rounding logs completed on 220 randomly selected patients, in two nursing units, totaling 7,689 patient rounds. A quantitative correlational design determined the impact of the EWS on hourly patient rounding. A chi-square (&chi;²) test of independence determined the expected and actual numbers of missed and completed patient rounds. The results indicated a statistically significant relationship between the EWS and hourly patient rounding, <i>X²</i> = (1, <i>N</i> = 7,689) = 371.3; <i>p</i> = &lt; 0.05. A statistically significant relationship was found between hourly patient rounding completed on dayshift compared to nightshift, <i>X²</i> = (1, <i>N</i> = 7,689) = 38.7, <i>p</i> = &lt; 0.05. However, using the EWS did not reduce fall rates on the control unit (<i>n</i> = 7.04). The findings of this project support the use of an EWS to enhance hourly patient rounding and is being considered as a standard of care for the future. </p><p>

<p> Mitigating ED crowding will not be solved by working harder and faster, and is not a one-solution problem. There are tactics the ED can implement, tactics the inpatient units can implement, and tactics that should be implemented to support the transitioning of patients from the ED to the inpatient units. This DNP project focuses on implementing a pilot to evaluate the use of hall beds in the inpatient units for ED patients awaiting placement. This will be a significant change for the inpatient caregivers, and time and attention must be committed to the initial phase to promote cultural readiness in order to achieve success. Crowding in the ED is a facility problem, not an ED problem. A multipronged approach when mitigating ED crowding must emphasize safe, efficient patient care that leads to the best possible outcomes without delays in treatment, while still maintaining standards of care, respect for privacy, and clear communication with the patient. This project focuses on both providing care to adult general medical-surgical patients admitted to a Midwestern level-1 trauma center through the ED and reducing the volume of patients who leave before treatment complete or without being seen. In the end, this practice change will benefit patients seeking care in addition to capturing the lost patients and reimbursement that accompanies the care. </p><p>

This thesis is concerned with current debates as to the value of patient satisfaction research. The thesis reports two surveys by means of which the scope of patient satisfaction research is considered. Conceptual and methodological problems in this field of research and alternative theories of the social process whereby patients evaluate health care are reviewed. The two surveys are presented in terms of an introduction to the particular field of medicine involved, the methods of enquiry used, survey responses and discussion of results. The first survey is of patients attending outpatient neurological clinics presenting with headache. This study was conducted with intensive interviews, one before the neurological consultation and a second at home, one month later. The problems of making sense of patients' accounts in terms of 'expectations' and 'satisfaction' are outlined. Instead different perceptions of the value of clinic visits are related to four different concerns felt by patients in relation to their headaches, concerns for reassurance, explanation, prevention and symptomatic treatment. The second survey is of patient satisfaction with outpatient care in a department of genito-urinary medicine. This survey was conducted with two questionnaires: one completed whilst patients waited in the clinic for theirconsultation, and a second which was mailed to patients one month later. Survey results are used to examine an interactionist model of patient satisfaction developed by Ben Sira. The data is examined by various methods to suggest limitations of and modifications to the original model. Finally the thesis assesses the contribution of the two surveys to an understanding of how patients evaluate medical care. Alternative models of patient satisfaction are reexamined. It is argued that some perspectives have too restricted a view of patients' abilities. The implications of the two surveys are reviewed in terms of the different interests researchers may have in surveying patients' views.