Shrinking health care resources, especially the lack of health care staffs is an important public health challenge in the 21st century. One of the good practical solutions is to use volunteers as free supplementary human resources in healthcare settings. This literature review purposes to identify benefits of healthcare volunteerism, which covers three levels related to the benefits of healthcare volunteerism in terms of economic value analyses, patients’ satisfaction and safety, as well as benefits to volunteers and healthcare staff. Furthermore, this review aims to draw out the key health care policy issues and implications that healthcare organizers should take into consideration when setting up and implementing an effective, efficient and economical volunteering initiative. PubMed and Medline were searched using Medical Subject Heading (MeSH) and inclusion and exclusion criteria were applied, finally, sixteen studies were retrieved. Limitations of this literature review were also mentioned. / published_or_final_version / Public Health / Master / Master of Public Health

BACKGROUND: Health Information Technology (HIT) enhances patient safety, which can also help to reduce health care costs. When it is used to replace the paper-based records, it will alter the workflow of front line workers and facilitate the management of care. The data captured can be shared in a seamless manner throughout the whole patient care journey. Since a significant upfront investment is required in the implementation and the use of the Electronic Health Record (EHR), it is still recognized as one of the major barriers. Despite these factors, governments and private health care provider organizations are all moving to implement a myriad of HITs. Therefore, meaningful use (MU) is an important criterion when assessing HIT utilization. This study focuses on the review and synthesis of evidence relating to the cost and effectiveness of health informatics adoption for health care delivery. Taking these findings into account may increase the likelihood of successful and cost-effective HIT implementation. METHODS: Literature searches of BMJ, Science Direct, and PubMed as well as a manual search for grey literature via Google scholar were performed. The inclusion criteria were any studies, both quantitative and qualitative, that describe the cost-effectiveness of informatics via any type of HIT used during the provision of health care services. English publications from 2003 to 2013 with any type of study setting were included. Through this search, nine articles were chosen for the final analysis. RESULTS: Among the nine selected studies, eight of them concluded that the adoption of HIT may-be-cost-effective to health care delivery. One study found the adoption of HIT not effective. The studies did not provide sufficient and concrete evidence to prove cost-effectiveness of HIT adoption. DISCUSSION: There is insufficient evidence to support the cost-effectiveness of HIT adoption. The cost data from these studies are not available. Data quality, system design, and physician behavior are other concern for MU of health informatics. Health care organization and governments should engage with the end-users (e.g. medical & paramedical personnel and patients) during system design (or selection), adaptation and implementation. CONCLUSION: Stakeholders should be aware of the tradeoffs throughout the implementation process. HIT scope, design, development, implementation, and performance monitoring should be well planned right from the start. In the foreseeable future, formal economics evaluation reports of Cost-Effectiveness Analysis (CEA) should be compulsory for stakeholders investing in Health Information Technologies. / published_or_final_version / Public Health / Master / Master of Public Health

This thesis explores the quality of health care delivery in rural Ghana. In Ghana, the Ministry of Health has been concerned about the quality of health care for sometime, but improvements in quality have been slow to develop and become noticeable: there continue to be complaints about the quality of care given by health workers and received by clients. For their part, health workers have reported the challenges to delivering quality services, while patients describe difficulties of accessibility and technical competence of health workers. It was envisaged that an exploration of the quality of care at the district level would reveal the range of constraints to provision and receipt of quality care, providing an evidence-based analysis incorporating the views of the important stakeholder groups, that could help to contribute to quality improvement in rural Ghanaian health care, especially in primary health care delivery at the local level. The study reported here was carried out in rural Amansie West district in the Ashanti region of Ghana. Using the administrative district as a case study allowed for “multiple sources of evidence gathering”, thus ensuring that the findings are more likely to reflect reality if based on several different sources of information and types of data. The study design was qualitative and involved qualitative data collection methods, including: semi-structured interviews with 66 patients, 25 health workers from seven primary health care facilities and six core members of the district health management team; and focus groups that involved discussions with members from seven communities. These data collection methods explored study participants‟ ideas about the definition of quality of health care, perceptions about the quality of actual health care delivery and feelings about the quality improvement strategy adopted in the primary care facilities studied. Interviews were tape recorded with consent, and translated into English as they were transcribed. Data were analysed manually, using iteration and thematic analysis. Data collection and analysis were guided by a phenomenological approach intended to capture the essence of statements and their meaning to participants. Thematic qualitative analysis of the data suggested that the different provider, recipient and administrative level groups had similar views on what constituted quality of care. In their perceived definitions, all groups tended to emphasise the importance of interpersonal relations, accessibility, technical competence and effectiveness, but these dimensions variously „ranked‟ in importance by stakeholder groups. Perceptions of the quality of actual health care received and the quality improvement process being deployed in Amansie West revealed that many of the obstacles to high quality health care were described as residing within the structure of health care delivery. This study provides new knowledge about perceptions of quality, experience of quality and quality improvement in a rural area of a developing country. It has improved understanding of the differing views held by the different stakeholders. It shows the dimension of understanding about quality added when the views of patients and community members are considered in addition to providers and administrators. Findings suggest improvements could be made to structural aspects of health care provision that could improve quality: for example, appropriate equipment, trained health workers and sufficient numbers of trained workers.

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published_or_final_version / Public Administration / Master / Master of Social Sciences

No description available.

Currently, mental handicap nursing reflects a scenario whereby major advances have occurred within a relatively short time scale. Sophistication not previously recognised has created an educational requirement for a clear relationship between knowledge, skills and assessment. Student nurses are expected to develop their skills through reflective practice, and it is the intention of this study to analyse the place of practical skills assessment in the educational and professional growth of students as they progress through their programme of training.

This thesis considers quality in the National Health Service (NHS), the theories of dialogue, critical systems thinking, and quality - and how these domains can be related together to produce a new concept of quality called critical quality.A quality gap is identified between what the NHS produces and what the public requires of it. It is argued that this gap is unfair because of the generally unequal access of stakeholders to decisions about quality in the NHS. It is suggested that only through dialogue can the gap be reduced in size in a non-oppressive way.Principles of dialogue are derived from Habermas's (1991a,b) theory of communicative action and applied to interest group relationships using Grant's (1989) insider/outsider model. It is argued that critical systems thinking can be enhanced by embedding interventions within processes of dialogue, and that the analysis of insider/outsider relationships in situations can guide the use of critical systems thinking in creating dialogues.Three modes of quality management are identified (strategic, normative and critical). It is argued that the requirements and needs of the public cannot be met by an NHS that is dominated by strategic and normative quality. Instead critical quality, defined as the specification of services by mediation through dialogue between stakeholders, is advocated as a fairer mode of quality management for the NHS.An NHS quality dialogue (the Trent Quality Initiative) is evaluated. Dialogue is found to have occurred both within and between meetings. Two modes of peer group participation are identified (main dialogue vs meta-dialogue) and two general approaches to the implementation of critical quality in the NHS (incremental vs radical). Finally critical quality in public welfare services is discussed and a research agenda outlined for dialogue, quality and critical systems thinking.

The purpose of the study was to 'examine the idea that the processes of normal grieving can be impaired or complicated by virtue of an individual being a nurse or midwife'. A mixed methodology was utilised to allow data to be collected at both exploratory and descriptive levels, and to provide reinforcement via the triangulation of data relating to key concepts, derived from a variety of methods. At the exploratory level, the study examined the incidence of factors said to predispose towards complicated grief (Murray-Parkes 1972), within a population of nurses and midwives. This alongside consideration of factors within the socialising environment of hospital nurse/midwifery, which might engender or reinforce certain personality traits. The study also investigated the respondents' views on their role within their family. Interviews with bereaved nurses and midwives, then explored the implications of these traits and norms of behaviour, for those who had actually experienced the death of a loved one. This provided data at the level of description, as relationships between identified concepts were examined.In the event, the data suggested that certain predisposing factors to complicated grief: a 'coper' self-concept; a strong sense of personal independence from others; and a perceived lack of functional social support, both at home and at work, were prevalent within the group studied. They also indicated a range of difficulties which may arise when nurses and midwives become consumers of the services they usually provide, and the related problem(s) of being the 'family nurse'. Interviews with bereaved nurses and midwives, then identified how one or more of these issues can impact upon the experience of family hospitalisation, and ensuing bereavement, to the detriment of individual nurses and midwives - particularly by predisposing them to delayed onset of their grief, perhaps for months or even years.

No description available.