Thesis (M.H.A.)--University of Michigan, 1972.

Thesis (M.H.A.)--University of Michigan, 1972.

No description available.

Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 16-17). / vi, 17 leaves, bound 29 cm

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

No description available.

Emergency department overcrowding is a growing problem worldwide including Rwanda. Literature shows that this problem has an impact on the functioning of the health care system and the quality of care provided. Research Methodology. This study aimed at exploring the phenomenon of overcrowding in ED/CHUK. Fifty one self-administered questionnaires were distributed to 40 ED nurses; these comprised three questions related to demographic data and 48 questions related to overcrowding. Correlation between overcrowding and causes and overcrowding with outcomes was explored and the pearson's test demonstrated that there is no linear correlation between these variables. Results. Findings from the demographic data demonstrated that the majority (92%) of ED nurse's were young (aged between 20 to 35 years). The majority (74%) of ED nurses had less than one to three years of experience in ED. With regard to overcrowding characteristics; nurses reported that the patient's waiting time for a physician varied between less than 30 min to more than 180 min; ED beds occupancy varied between 1 hour to more than 24 hours; patients were placed in the ED hallways for 1 hour to more than 24 hours; waiting room occupancy varied between less than 1 hour to more than 24 hours. Nurses attributed overcrowding to a variety of causes, including; a lack of inpatients beds (95%), large volume of trauma patients (87%), patients with no urgent condition (66), inappropriate referral of chronic cases (61 %), space limitation in emergency department (76%) and insufficient acuity ED beds (74%). Perceived outcomes (impact) were also multiples including, boarding patient in ED (92%), increased stress among nurses (79%), stress among physicians (60%), and risk of poor outcomes (60%), staff dissatisfaction (58%), violence between health care providers and patients (60%) and increased patient waiting time (58%). Regarding the undertaken interventions to reduce ED overcrowding, 100% of respondent asserted that there was some sporadic interventions, but not consistent. Recommendations: Like in other countries ED/CHUK overcrowding is a complex problem that needs to be addressed by all stakeholders: CHUK managers, hospital staff, ED staff, Rwandan district hospitals and Ministry of health. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2008.

Background Patient satisfaction is an important assessment of hospital’s service quality. Patients from emergency department (ED) usually have high expectation on receiving timely and high quality medical service. They generally have low patient satisfaction. Patient satisfaction has been identified to be associated with willingness to return and recommendation of the medical service to others. Therefore, to identify the factors associated with patient satisfaction in ED is important. Factors associated with patient satisfaction could vary by different ED systems. This project aimed at synthesizing factors associated with patient satisfaction in ED in Mainland China, Hong Kong and Taiwan, and comparing the different factors associated with patient satisfaction among the three areas and make recommendations on interventions to improve patient satisfaction in ED. Methods This review retrieved published literatures from PubMed, CNKI, and Taiwan electronic periodical services (TEPS). There is no restriction on study design, study population and measurements of patient satisfaction. Studies reporting factors associated with patient satisfaction in ED, and studies reporting effective interventions of improving patient satisfaction in ED were included. A total of 20 including 12 studies about Mainland China, two studies about Hong Kong and six studies about Taiwan were included. Results Common factors associated with patient satisfaction in emergency services have been identified in Mainland China, Hong Kong and Taiwan as well as other countries. These common factors included patients' characteristics, technical skills of medical staff, service attitudes, communication skills, professional ethics, provision of sufficient information, waiting time, allocation of resources and physical environment of ED. Different health systems can explain some unique factors identified in different areas. Satisfaction with medical expenses has been identified as a factor associated with overall patient satisfaction of ED in Mainland China, which could be due to that patients in Mainland have higher out-of-pocket share. Hong Kong has a gate keeper system which results in a large number of inappropriate ED users and thereby increases the waiting time and causes the ED crowding. Conclusion On the basis of the identified factors, potential interventions such as providing patients with sufficient information and improving medical staff’s technical skills, service attitude and communication skills can be implemented to increase patient satisfaction. Future studies should focus more on the evaluation of specific interventions. / published_or_final_version / Medicine / Master / Master of Public Health

Battery is a major health care issue that, despite increased recognition, fails to be detected in health care institutions. Without adequate detection, referral to social and community services are less likely to occur, rendering women victims vulnerable to continued risk physically, psychologically and medically. This study seeks to describe actual detection and referral practices in an emergency department at a large teaching hospital in Quebec, as well as explore health care professionals' knowledge about and practices regarding the detection and referral of battered women. Its aim is to better understand the pathways and barriers to detection and referral of abused women in order to enhance current practice responses in emergency departments. To examine detection and referral rates and predictors of battery, 200 medical charts from the emergency department were reviewed. Supplementing analyses of the charts were in depth interviews with ten health care professionals working in the emergency department. From these sources of data, it became apparent that neither detection nor referral occur in any systematic fashion. Whereas health care professionals seem to know a great deal about battery, their actual practice appears to be contradictory. Gynecological problems and woman's age were not found to be related to detail in charts but physical injuries were. Whereas a positive relationship was found between detection and referral in the chart reviews, everyday practice showed inadequacy in both areas. Implications for social work contributions to health care practice related to battery are offered.

Thesis (MTech (Business Administration))--Cape Technikon, Cape Town, 2000 / The current rationalisation of health care in the Western Cape may result in a decrease in the number of patients attending the Trauma Unit at Groote Schuur Hospital (GSH), one of the two large tertiary care hospitals in the Western Cape. This in turn may result in cuts in staff allocations to this unit. The nursing staff need to be proactive in preventing potential cuts which may compromise the services that they offer. Current statistics collected by nursing managers in the trauma unit at GSH provide an indication of the volume of work handled, but do not necessarily capture the intensity of that work. The purpose of this research project will determine the extent to which nursing care required by patients attending the trauma unit at GSH has increased and to establish appropriate staff workload scheduling. The existing classification systems available for assessing patient acuity levels are no longer suitable as they use patient numbers to describe workload. By using a classification system specifically developed for the use by nurse managers in high care units (trauma units), the appropriate staffing norms based on the acuity level of patients can be determined. Finally, this research project will determine a suitable model for measuring the intensity of workload specific to a trauma unit environment for the effective and efficient allocation of staff.