The theoretical part of the Thesis is aimed at explanation of certain terms of the sphere of institutional and protected upbringing. It also tries to map the situation among the young adults leaving institutional or protected upbringing. The work is aimedat assessment whether clients of children's homes are interested in halfway living and to elaborate a halfway house project for the town of Jinřichův Hradec. A model project of a halfway house specific for the town of Jindřichův Hradec was developed upon the data observed, in which the project risks are considered and exaples of good practice included.

No description available.

Problématique : Au Québec, le Processus de soins en nutrition (PSN) est peu utilisé, les organisations appréhendent que l’implantation sera ardue mais sont motivées à procéder. Objectif : Accompagner deux services de nutrition clinique d’établissements de santé de la grande région de Montréal dans le déploiement du PSN et documenter les barrières et facteurs facilitants. Méthodologie : L’Hôpital du Sacré-Cœur de Montréal et le CSSS Champlain–Charles-Le Moyne ont été recrutés. La collecte de données fut réalisée via des séances d’accompagnement tout au long du déploiement du PSN. Une rencontre de bilan fut effectuée dans chaque milieu, avec les nutritionnistes et les chefs de service. Les données colligées sont qualitatives. Les échanges furent enregistrés et un cahier de bord complété. La synthèse a été rédigée selon un modèle de gestion de changement. Résultats : Au total, 18 séances d’accompagnement eurent lieu et cinq rencontres de bilan. Les principaux obstacles à la mise en œuvre du PSN sont en grande partie liés à l'engagement des nutritionnistes, à la formation et aux contraintes de temps. Les principaux facteurs facilitants sont les présentations d’histoires de cas accompagnées de discussion et le manuel de la Terminologie internationale de diététique et de nutrition (TIDN). Discussion : Notre système de santé est de plus en plus sujet à des changements et les dirigeants devront optimiser les ressources. L’International Confederation of Dietetic Associations a suggéré d’adopter, à l’échelle internationale, le PSN en tant que cadre pour la profession. Les stratégies d’implantation portant sur des principes de gestion du changement organisationnel faciliteront l’intégration de ces changements importants. L’expérience des deux milieux documentés sera éclairante pour les autres organisations désirant implanter le PSN. / Problem: In Quebec, the use of the Nutrition Care Process (NCP) is limited, organizations apprehend its implantation will be arduous but are motivated to proceed. Objective: To accompany two clinical nutrition services of health facilities in the greater Montreal area in the deployment of the NCP and document the barriers and facilitating factors. Methodology: The Hôpital du Sacré-Cœur de Montréal and the CSSS Champlain–Charles-Le Moyne were recruited. Data collection was accomplished through accompanying sessions throughout the deployment of the NCP. An end of project meeting was held in each area, with nutritionists and heads of departments. The data collected is qualitative. The exchanges were recorded and a logbook was completed. The synthesis was written using a change management model. Results: A total of 18 accompanying sessions were held and five end of project meetings were held. The main obstacles to the implementation of the NCP are largely related to the commitment of nutritionists, training and time constraints. The main facilitating factors are the presentations of case studies with discussion and the manual of the International Dietetics and Nutrition Terminology (IDNT). Discussion: Our health system is increasingly subject to change and leaders will need to optimize resources. The International Confederation of Dietetic Associations suggested adopting the NCP as an international framework for the profession. Implementation strategies for organizational change management principles will facilitate the integration of these important changes. The experience of the two documented environments will be enlightening for other organizations wishing to implement the NCP.

Care process monitoring is important in healthcare domains to provide precise and detailed analytics on patients, providers, and resources participating in a care process and their status. These analytics are used to keep track of whether the quality of care goals set by healthcare organizations are satisfied and ensure that legislative and organizational guidelines are followed. The complexity of care process monitoring can vary depending on whether the care process takes place in a hospital or out in the community, and it can vary depending on the complexity of the information technology infrastructure that is in place to support the care process. A Care Process Monitoring Application (CPMA) is a software application which collects and integrates data from various sources while a care process is being provided, in order to provide performance reporting of metrics that are used to measure how well the performance goals and guidelines for the care process are being met. In our research, we have studied how CPMAs are built in order to improve the quality of their engineering. The significant challenge in this context is how to engineer a CPMA so that the engineering process is repeatable, produces a CPMA of consistent high quality, and requires less time, less effort and less complexity. This thesis proposes an application framework for care process monitoring that collects and integrates events from event sources, maintains the individual and aggregate states of the care process and populates a metrics data mart to support performance reporting. Our contributions are the following: a state-based application meta-model of care process monitoring, a care process monitoring architectural pattern, and finally, a behavior driven development methodology for CPMAs based on our meta-model and architectural pattern. Our results are validated through three different case studies in which we collaborated with two different health care organizations to build and deploy CPMAs for two different care processes (one hospital-based, the other community-based) in collaboration with healthcare clinicians and researchers.

No description available.

Care process monitoring is important in healthcare domains to provide precise and detailed analytics on patients, providers, and resources participating in a care process and their status. These analytics are used to keep track of whether the quality of care goals set by healthcare organizations are satisfied and ensure that legislative and organizational guidelines are followed. The complexity of care process monitoring can vary depending on whether the care process takes place in a hospital or out in the community, and it can vary depending on the complexity of the information technology infrastructure that is in place to support the care process. A Care Process Monitoring Application (CPMA) is a software application which collects and integrates data from various sources while a care process is being provided, in order to provide performance reporting of metrics that are used to measure how well the performance goals and guidelines for the care process are being met. In our research, we have studied how CPMAs are built in order to improve the quality of their engineering. The significant challenge in this context is how to engineer a CPMA so that the engineering process is repeatable, produces a CPMA of consistent high quality, and requires less time, less effort and less complexity. This thesis proposes an application framework for care process monitoring that collects and integrates events from event sources, maintains the individual and aggregate states of the care process and populates a metrics data mart to support performance reporting. Our contributions are the following: a state-based application meta-model of care process monitoring, a care process monitoring architectural pattern, and finally, a behavior driven development methodology for CPMAs based on our meta-model and architectural pattern. Our results are validated through three different case studies in which we collaborated with two different health care organizations to build and deploy CPMAs for two different care processes (one hospital-based, the other community-based) in collaboration with healthcare clinicians and researchers.

Um den Kostendruck in medizinischen Versorgungseinrichtungen, getrieben von den Forderungen aus SGB V und DRG, bei gleichzeitiger Patientenzufriedenheit und Behandlungsqualität im komplexen Rahmen gerecht zu werden, ist die Identifizierung von Optimierungspotentialen und deren Realisierung ein wesentlicher Hebel für das Überleben von Krankenhäusern am medizinischen Markt. Der Patientenpfad, der den Kernprozess der Wertschöpfung der medizinischen Dienstleistung im Krankenhaus darstellt, bildet gleichzeitig die "Logistische Kette an medizinische und sozialen Dienstleistungen". Zur Darstellung der komplexen Struktur des Zusammenwirkens von Prozessen und Schnittstellen entwickelt der Autor das Phasenmodell "Gesundheitsversorgungsprozess" (GVP), bestehend aus seinen drei Hauptprozessen prästationärer-, stationärer- und poststationärer Prozess, die durch deren medizinische, logistische, ökonomische und humansoziale Interdisziplinarität charakterisiert werden. Dieses Modell erweist sich als ein tragfähiger Ansatz für die Analyse zur Optimierung von Behandlungspfaden im klinischen Bereich der Mund-, Kiefer- und Gesichtschirurgie (MKG). Im Ergebnis wird ein Vorschlag erarbeitet, der 7 elektive Krankheitsbilder und deren heterogene Prozessstrukturen in einen standardisierten Behandlungspfad MKG überführt. Ausgehend von der Herleitung standardisierter Behandlungspfade und der Definition sogenannter "Standard Operating Procedures" (SOP´s) wird ein Baukastensystem für die medizinische Behandlung bereitgestellt, welches eine konfigurierbare Individualisierung des Behandlungsprozesses für den Patienten garantiert. Mit der detaillierten Analyse und Ableitung der Sollstrukturen klinischer Behandlungspfade am Beispiel der MKG am Uniklinikum Dresden und dern Verknüpfung zu Interdisziplinaritäten unter dem prozessualen Aspekt liefert die Arbeit einen Beitrag zur Prozessoptimierung im Krankenhaus und bildet gleichzeitig einen Beitrag zur Modellierung für ein modellgestütztes, evidenzbasiertes Prozessmanagement. / To meet the cost pressures in medical care facillities, driven by the demands of the volume V of the German Social Code and DRG, while patient satisfaction and quality of care in complex organizational requirements, the identification of optimization potentials and its realization is an essential lever for the survival of hospitals on the medical market. The patient pathway, which is the core process of the value added chain of medical services at the hospital, froms the "Logistical chain for medical and social services" at the same time. To illustrate the complexity of the interaction of processes and interfacesthe author develops the phase madel "Health Care Process" (HCP) consisting of its three madical and care main processes pre-clinical; clinical and post-clinical process, characterized by their medical, logistical, economic and human social interdisciplinary. This model proves to be a viable approach for the analysis for the optimization of tretment pathways in the clinical field of oral and maxillofacial surgery (OMS). As a result a proposal is being developed which converts 7 elective medical pattern and the heterogeneous processstructures in a standardized treatment pathway OMS. Based on the derivation of standardized treatment pathways and the definition of so-called "Standard Operating Procedures" (SOPs) a modular system for medical treatment is provided which guarantees a configurable individualization of the treatmet process for the patient. Based on the detailed analysis and derivation of target structures for clinical pathways on the example of OMS at the University Medical Center Dresden and their linkage to interdisciplinarities under the procedural aspect this bachelor graduation paper-work makes a contribution to process optimization in the hospital and at the same time forms a contribution to the modeling of a model-aided, evidence-based process management.