This thesis is a descriptive analysis of a milieu programme, giving specific attention to its groupwork methods and contributions which is in operation at Warrendale, a residential treatment home for emotionally disturbed girls situated in Newmarket, Ontario. Against a brief history of the institution, it gives the theoretical basis of the work done with children, using the milieu concept as pioneered by Fritz Redl and Bruno Bettleheim. The institution uses caseworkers and groupworkers as residential staff, dealing directly with the children, but only the group work aspects of the programme are considered here. Three aspects of the total milieu are considered; (a) routines and rules; (b) leisure-time activities and the community; (c) discipline and problem-handling. Parts of the life of the institution are illustrated and analyzed in relation to the various therapeutic goals of the institution; (a) tension reduction; (b) individuality; (c) gaining relationships; (d) expression and release of feelings. The value of these three aspects are also considered for their diagnostic value. The contribution and use of group skills in the milieu setting are considered in the light of the therapeutic goals mentioned above. The group session is the principal technique considered, and the interpretive and goal setting values of group sessions are brought out. The significance of celebrating social festivities and the special uses of group sessions as expressive media are also exemplified as a part of group skills. The overall contributions, and possibilities of improvement, are summarized in a concluding chapter. / Arts, Faculty of / Social Work, School of / Graduate

This study attempts to improve the delivery of health services by applying operations research techniques to hospital admission systems. Although this study applies to hospital admissions systems in general, the admission system of one ward of one hospital was chosen to be the central object in the study. A computer simulation model was formulated to examine the -results of various policies. In the model, the admission of patients is determined primarily by the scheduling of the operating theatre and secondarily by the availability of beds. The three standard priorities for hospital admissions (elective, urgent and emergent) are given separate considerations as would be the case in real life; because scheduling can be much more flexible for elective patients, while time must be set aside for emergent patients although the hospital has no advance information about them. The general results of this study led to two suggestions that would improve most existing admission systems. The first requires that the hospital set up a special class of patients, the "quickcall patients," who would be willing to be admitted for surgery on short notice. It was shown that this procedure significantly reduced the waiting time for elective surgery. The second requires that the hospital limit each physician to a fixed number of requests for elective surgery at any given time, so that the hospital need not keep extensive files. The model could be extended to examine (1) the sensitivity of the schedule to referral patients, (2) the higher utilization of the operating theatre and (3) waiting priority based on patient need and/or utility. In conclusion the simulation study indicated that these policies if implemented would significantly reduce the waiting time (29% in the model), and increase the hospital's effectiveness in assessing the order of admission for patients. / Business, Sauder School of / Graduate

Thesis (MBA (Business Management))--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: Given the increase in the cost of health care, economic considerations have drawn more and more interest over the last decade. Facilities are faced with the challenge to reduce costs while maintaining productivity. The Operating Room (OR) represents a significant opportunity to reduce expenses and improve efficiency. With the development of ambulatory or day surgery, minimally invasive procedures and the decline in admissions to hospitals the management of the OR suite needs re-evaluation. The Battlefords Union Hospital has a four room OR suite that performs a mixture of both inhospital and day surgeries. The current OR suite efficiency is determined by its adherence to the annual budget. A literature study was conducted with the focus on OR efficiency and in particular Patient Outcome and OR Management. Other issues included Perioperative Information systems and OR design. A survey was conducted in the OR suite and responses obtained from OR staff were evaluated. The survey included questions on patient experiences, procedural times, case scheduling, support, communication, quality measures and OR efficiency. The goals of this project was not to do an extensive statistical analysis of OR data. A limited study of OR suite data was presented to highlight relevant OR efficiency indicators. A summary of the findings and recommendations for improvement of the Battlefords Union Hospital OR suite’s efficiency, concludes the report. / AFIKAANSE OPSOMMING: Na aanleiding van die verhoging in koste van gesondheidsorg die laaste dekade, is ekonomiese aspekte meer op die voorgrond. Inrigtings word deur uitdagings in die gesig gestaar om kostes te verminder, terwyl produktiwiteit gehandhaaf moet word. Die operasie suite bied ‘n aansienlike geleentheid om kostes te verminder en effektiwiteit te verhoog. Met die ontwikkeling van dagchirurgie, “minimal invasive” prosedures en die afname in hospitaal opnames, behoort die bestuur van operasie suites herevalueer te word. Die Battlefords Union Hospitaal het ‘n vier teater operasie suite waar ‘n verskeidenheid van dagchirurgie en in-hospitaal prosedures uitgevoer word. Die operasie suite se effektiwiteit word huidiglik slegs gemeet aan die mate van hoe dit binne die jaarlikse begroting bly. ‘n Literatuurstudie is uitgevoer met die fokus op operasie suite effektiwiteit, met die klem op pasient uitkoms en operasie suite bestuur. Ander items wat ook ondersoek is, sluit in perioperatiewe informasie stelsels en teater ontwerp. ‘n Empiriese studie, gebaseer op ‘n vraelys, is uitgevoer onder die staflede van die operasie suite by die Battlefords Union Hopitaal. Die vraelys het vrae ingesluit oor pasient ervarings, prosedure tye, geval skedulering, kommunikasie, kwaliteitsversekering en operasie suite effektiwiteit. Die doel van die projek was nie om ‘n uitgebreide statistiese analise van die operasie suite data te doen nie. 'n Beperkte studie van die beskikbare data is gedoen en relevante effektiwiteits indikators is uitgewys. Die verslag word afgeëindig deur bevindinge, gevolgtrekkings en aanbevelings oor hoe die Battlefords Union Hospitaal die operasie suite se effektiwiteit moontlik kan verhoog.