The object of this study was to survey large Canadian organizations in order to: 1) determine the extent to which these organizations have established a separate Data Administration function, 2) empirically test Nolan's Stage Model of EDP Growth as a predictor of a separate Data Administration function, and 3) survey the characteristics of the Data Administration function in those organizations that have formally established such a speciality. A survey package containing two questionnaires was sent to 555 large Canadian organizations in the private and public sectors. The "EDP Profile Questionnaire" was directed to the Manager of the EDP Activity in the surveyed organizations. This questionnaire is concerned with the EDP growth process and the existence of a Data Administrator. The "Data Administration Questionnaire" was directed to the Data Administrator in the surveyed organizations. This questionnaire is concerned with the characteristics and responsibilities of the Data Administration function. Analysis was performed on 254 EDP functions and 69 Data Administration functions. The results obtained indicate that the Data Administration function is not prevalent in large Canadian organizations; where the function does exist its role is a fairly minor one within the EDP activity. This study found that organizations with very large EDP activities and many years of experience with computers were more likely to have established a Data Administration function than-smaller and less experienced ones. Certain organizational types (those with discretionary funds available) were more likely, to have a Data Administration function than other types. The "maturity" of the organization's EDP activity was not found to be- a good predictor of the existence of a Data Administrator. The sampled Data Administration functions exhibited a wide dispersion in both the activities performed and the amount of time spent on each. Few policy setting activities were performed by the Data Administrators. The Data Administration function appeared to be focused on those "data bases" using a Data Base Management System. Organizational conflicts and a general misunderstanding of the function by EDP Management have likely held back the development of the function beyond one involved primarily with the support of DBMS application systems. Future research should be directed at- understanding these conflicts and misperceptions through an analysis of the decision process involved in establishing the Data Administration function. An attempt- should be made to more fully understand the data resource and how it might differ among organizational types. Before further use is made of Nolan's Stage Growth model, serious thought should be given to determining in more precise terms what the EDP growth process variables are and how they might best be measured. / Business, Sauder School of / Graduate

No abstract available. / Dissertation (MCom)--University of Pretoria, 2013. / gm2014 / Auditing / unrestricted

This research examined the impact of ED process complexity on hospital quality outcomes. Nine emergency department nurse managers from hospitals in Mississippi, Alabama, and Louisiana were interviewed regarding processes of registration, laboratory testing, medication administration, radiology, and discharge. Interview data was coded according to variables in proposed equations for patientocused, providerocused, and overall process complexity. Hospital quality was measured using existing process of care, outcome of care, and patient satisfaction standards. Results showed a strong negative correlation between process complexity and overall quality, suggesting that hospitals with lower process complexity experience higher quality outcomes. Regression analysis showed that the average number of patient steps in a process and the overall complexity the registration process were significant predictors of overall quality. Methods of reducing patient steps and registration process complexity are discussed.

Introduction: Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers to providing end-of-life (EOL) care. This study was completed to discover what the size, frequency, and magnitude of obstacles were in providing EOL care in rural emergency departments as perceived by rural emergency nurses. Methods: A 58-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived barriers to providing EOL care in rural emergency departments. Results were compared with results from two previous emergency nurses' studies to determine if rural nurses had different barriers to providing EOL care. Results: The top three perceived obstacles by rural emergency nurses were: 1) family and friends who continually call the nurse wanting an update on the patient's condition rather than calling the designated family member; 2) knowing the patient or family members personally, and 3) the poor design of emergency departments which do not allow for privacy of dying patients or grieving family members. The results of this study differed from the other two previous studies of emergency nurses. Discussion: Nurses in rural emergency settings often work in an environment without many support personnel. Answering numerous phone calls removes the nurse from the bedside of the dying patient and is seen as a large and frequent obstacle. Personally knowing either the patient or members of the family is a common obstacle to providing EOL care in rural communities. Rural nurses often describe their patients as family members or friends. Caring for a dying friend or family member can be intensely rewarding, but can all so be very distressing. Conclusion: Rural emergency nurses live and work on the frontier. Little EOL research has been conducted using the perceptions of rural emergency nurses possibly because of the difficulty in accurately accessing this special population of nurses. Rural emergency nurses report experiencing both similar and different obstacles as compared to their counterparts working in predominately urban emergency departments. By understanding the obstacles faced by emergency nurses in the rural setting, changes can be implemented to help decrease the largest barriers to EOL care which will improve care of the dying patient in rural emergency departments. Further research is also required in the area of rural emergency nursing and in EOL care for rural patients.

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When an emergency department (ED) decides that it is not going to be able to serve any more newly arriving patients, it declares "diversion". When an ED is on diversion, it suspends arrivals that can be controlled by forcing some or all of the incoming emergency medical system (EMS) transport units to search for alternate treatment facilities for their patients. This search causes both patients and EMS crew to loose valuable time. Contrary to the general belief that suggests diversions are not very common, the results of the American Hospital Association survey present an example where one third of the studied hospitals were on diversion more than 20% of the three-day study period. Past research indicates that the lack of critical care beds in the hospital is the primary contributor to ambulance diversion. When patients need to be transferred from the ED to the hospital with no available beds in the hospital, they continue occupying their beds (i.e. the patient is boarding). While they are boarding in the ED, the associated staff is idle, and their bed cannot be used to treat other patients. Boarders in the ED lead to gridlock, which is defined as the situation when no new patient can be accepted to the ED until a hospital bed becomes available. In this research, we developed a predictive model to provide probabilities of entering gridlock within a time horizon, given the current state of the system. These real-time predictions are provided for a relatively short time horizon, and in order to be useful, they need to be used in conjunction with effective preventive measures that can be applied quickly. The predictive model is based on a queueing theoretic approach and encapsulated in a user-friendly Visual Basic program in order to calculate and provide gridlock probabilities. Two systems, one with low (24% - System 1), and one with high (81% - System 2) gridlock probability were simulated in conjunction with our predictive model and preventive measures. When a gridlock was found imminent, the number of ED beds was temporarily increased, attempting to prevent gridlock. With only 3 additional beds, the probability of gridlock decreased to 6% in System 1 and 58% in System 2. With 5 additional beds, gridlocks in System 1 were almost eliminated while System 2 entered gridlock only 34% of the time. Our results indicate that by temporarily increasing the number of ED beds in the event of an imminent gridlock, the proportion of time that system enters gridlock can be significantly reduced. / Master of Science

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Thesis (M.B.A.)--University of Hong Kong, 1995. / Includes bibliographical references (leaves 95-97).