No description available.

The objective of this study was to determine whether 11 independent variables or combinations of variables help to predict a diabetes-related hospital readmission for patients with diabetes within 60 days from discharge. The variables were categorized into four main groups: (a) patient characteristics, (b) lifestyle, (c) biomarkers, and (d) disease management aspects. A convenience sample of 389 historical medical records of patients who were admitted to a rural hospital in northeastern North Carolina with a diagnosis of, or relating to, diabetes was studied. After comparing predictive discriminant analysis (PDA) and logistic regression (LR), PDA performed better and was chosen to analyze a convenience sample of patients admitted to the hospital for a diabetes-related diagnosis from January, 2004 to December, 2006. The best overall subset accurately classified 27 cases with six predictors that included (a) systolic blood pressure, (b) smoking status, (c) blood glucose range, (d) ethnicity, (e) diabetes education, and (f) diastolic blood pressure. In an effort to simplify the prediction process, the subsets of two predictors were examined. The results of the analysis returned four subsets of 2-predictor variable combinations that correctly classified cases for readmission. Each of the four subsets has two predictors that are statistically and practically significant for predicting readmissions for a diabetes-related problem within fewer than 60 days. These combinations are the predictor subsets of (a) smoking status and being treated by a specialist or non-specialist physician, (b) a religious affiliation or a lack thereof and smoking status, (c) gender and smoking status, and (d) smoking status and ethnicity. / by Darwin E. Asper. / Vita. / Thesis (Ph.D.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

Although strategic planning is widely used in industry and has been adopted by many not-for-profit organisations, the Department of Health has been slow to realise the relevance of a strategic approach. This thesis uses a strategic planning approach to assess the Department of Health by examining the three interacting factors which influence organisational outcome, namely the external environment, the internal structure of the organisation and the planning process itself. A composite model or template which incorporates several well-known strategic instruments is proposed as well as an overview of the Australian national health system and these are then used as part of the strategic assessment of the Department's vision and mission. The results and recommendations of the assessment are presented in the thesis. / Thesis (MBA)-University of KwaZulu-Natal, 2005.

Michael E. Borus, C. Gregory Buntz, William R. Tash. / Bibliography: p. 129-147.

Thesis (MTech (Emergency Medical Care))--Cape Peninsula University of Technology, 2016. / Background - As emergency medical care students approach the exit level of their four-year qualification, additional focus get placed on assessment of their ability provide patient care in the real world pre-hospital emergency care environment. Upon graduation, there is no opportunity for newly graduated emergency care practitioners to complete an internship programme. The assessment of clinical competence is therefore regarded as a critically important and invaluable activity within the academic unit. Academic staff within the Emergency Medical Care department at UJ recognised the need for the development of a standardised assessment instrument to purposefully assess pre-hospital clinical performance and developed an assessment instrument referred to as the University of Johannesburg Clinical Performance Assessment Instrument (UJ CPAI). Having developed the UJ CPAI it became necessary and important to scientifically investigate and evaluate the extent to which the CPAI (as a newly developed instrument) meets the requirements of what is considered to be a "good assessment instrument". For this reason investigation of the validity, reliability and end-user support for the implementation of the UJ CPAI became the central aim and focus of this study.

No description available.

This work explores the development and use of patient satisfaction evaluation system in a family practice setting. The goal was to develop a system that would minimally interfere with the delivery of care while simultaneously disclosing sources of patient satisfaction and dissatisfaction. The information would then be used to improve aspects of patient care and service delivery.

Annually, hypertension is responsible for over 10 million deaths. During the span of a decade, low-middle income countries (LMICs) have experienced the most negative change in progress towards decreasing hypertension prevalence. It is estimated that 46% of the adult population in Sub-Saharan Africa (SSA) is hypertensive. When looking at solutions to address hypertension management in SSA, finding effective medication adherence interventions is the way forward. The purpose of this study was to promote the implementation of evidence-based interventions for successful treatment and improved life quality of hypertensive adults in Sub-Saharan Africa, with the input of healthcare stakeholders. The specific aims were to: 1) determine what interventions for antihypertension medication adherence have been successfully implemented in SSA and assess their implementation outcomes, and 2) conduct a focus group with health practitioners to evaluate what interventions and implementation practices were supported. The methods used to complete this study were a systematic review and focus group sessions. The systematic review was able to identify measurable implementation outcomes for the evidence based interventions found in the literature. The implementation outcomes identified in each of the included studies were categorized according to definitions derived from Proctor, et al.’s Outcomes for Implementation Research and Gyamfi, et al.’s Assessment of Descriptors of Scalability. The systematic review findings revealed that to establish antihypertensive medication adherence in SSA, the appropriateness of an intervention and the inclusion of health education are essential. Additionally, in order to have successful implementation of an intervention, stakeholders need to commit to addressing systematic challenges emphasized in the literature. The focus group sessions helped to identify tangible actions that can be implemented in order to improve antihypertensive medication adherence in the region. Thematic analysis was used to organize themes found across the focus group transcriptions. During the focus group sessions, health practitioners addressed the practicality of implementing evidence-based interventions found in the literature within their communities. The focus group findings reveal key recommendations including increasing government participation and addressing barriers to implementation. Overall, the data gathered across the studies shows that implementation is not easy to achieve. In addressing antihypertensive medication adherence, stakeholders must take into consideration how healthcare systems function as a whole. Although international and national guidelines provide excellent guidance for implementing evidence-based care, adjustments are needed in order to address population needs and scale interventions.

Thesis (MCur)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Nationally and internationally emphasis is placed on quality care in health services. The researcher identified a need to evaluate a component of primary health care service in the Northern province. A study based on the combination of qualitative and quantitative methods was conducted to formulate and evaluate structure, process and outcome standards for selected clinics in the Northern Province. The most important results are: • The standard relating to the structure was suboptimal. Physical and human resources are of critical importance to the rendering of quality patient care. However this did not comply with the pre-set standard norm of 80%. • Process standards focused on physical examination of patients taking into account the age of the client and the systems involved. Substandard care was found in all these aspects. • Outcome standards determined by the patient questionnaire also revealed negative findings. Recommendations include the development of a quality improvement model for the Northern Province Health Services, formulation of standards for all disciplines of health care, annual evaluation of patient care and the institution of a formal staff development programme. Key words: quality care, formulation of standards, structure, process, outcome / AFRIKAANSE OPSOMMING: Nasionaal en internasionaal word die belang van gehaltesorg in gesondheidsdienste beklemtoon. Die navorser het enbehoefte ge'identifiseer om en component van prirnerre gesondheidsorgdienste in die Noordelike provinsie te evalueer. en Kombinasie van kwalitatiewe en kwantitatiewe metodes is gebruik om struktuur-, proses en uitkomsstandaarde in geselekteerde klinieke in die Noordelike provinsie te formuleer en evalueer. Die belangrikste resultate was: • Die standard ten opsigte van die standard was suboptimal. Fisiese en menslike hulpbronne is van kritiese belang vir gesondheidsdienslewering. Die standaard hiervan het nie voldoen aan die voorafbepaalde norm van 80% wat gestel is nie. • Prosesstandaarde het op fisiese ondersoek van die pasiente gefokus met inagneming van die ouderdom van die klient en die simptome waarmee pasiente presenter. Sub-standaardsorg is ten opsigte van al hierdie aspekte gevind. • Uitkomsstandaarde is deur middel van en pasientevraelys gemeet en he took negatiewe bevindinge opgelewer. Aanbevelings sluit in die ontwikkeling van engehalteversekeringsmodel vir die Noordelike Provinsie se gesondheidsdienste, die formulering van standaarde vir aile dissiplines van gesondheidsorg, jaarlikse evaluering van pasientesorq en die instelling van enformele personeelontwikkelingsprogram. Kernwoorde: Gehaltesorg, formulering van standaarde, struktuur, proses, uitkomsstandaarde.

The demand for human services has grown exponentially in recent years. Self-help groups now fill the gap between consumer needs and the reach of traditional health care. This study examines the perception of the members of these groups toward the professional community. Four self-help groups, all based on principles of Alcoholics Anonymous (AA) and all primarily concerned with the control of excessive behavior were examined: (1) Parents Anonymous (PA), (2) Overeaters Anonymous (OA), (3) Alcoholics Anonymous (AA) and (4) Narcotics Anonymous (NA). A 60 item questionnaire was designed to obtain the following information: (1) demographic, (2) membership participation, (3) professional contact, and (4) attitude expression regarding respondents' perception of their particular self-help group, perceptions of health care professionals and perceptions of society's beliefs regarding their behavior. Among the 110 respondents from the four groups responding to the questionnaire, (overall return rate of 52%), there was strong support of the methods and conduct of the self-help groups. Criticism of the self-help groups was negligible. Criticism of the health care community was consistently strong, although respondents indicated relatively high usage of health care providers. The respondents from all four groups appeared to support any individual member's decision to pursue whatever assistance that individual might deem necessary, but maintained firm delineation between the individual's freedom to choose alternative or adjunctive assistance and the group's decision to remain "forever nonprofessional". Despite a common theoretical background, the groups have developed in different directions. PA, which has included health care professionals as group sponsors since its inception, was more open to professional involvement in group affairs than the others and cited a higher rate of professional referral to the group. OA, with less mental health contact and with more medical involvement, expressed greater reluctance to involve professionals in any aspect of the group's activities. AA and NA tended to take more intermediate positions, however, both groups were firmly against professional involvement in group activities. Information of this nature may assist professionals and self-help groups in developing a collaborative and respectful working relationship.