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A randomised comparison of practice pharmacist-managed hypertension providing Level 3 Medication Review versus usual care in general practiceJamieson, L.H., Scally, Andy J., Chrystyn, Henry January 2010 (has links)
No description available.
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Assessing Implementation Outcomes To Address Antihypertensive Medication Adherence In Sub-Saharan Africa: A Systematic Review And Focus Group StudyEgekeze, Chioma Ogechi January 2024 (has links)
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.
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The changing political economy of hospitals: the emergence of the "business model" hospitalAustin, Raymond Edwin January 1989 (has links)
The hospital industry is now in a major transitional phase which is substantially changing its operational values and organizational forms. This transition was triggered primarily by a crisis brought on by rapidly escalating costs. Many forces centering on the cost containment theme are now forging new political and economic operating rules for health care providers. Collectively these forces are bringing about decisive changes in the quality, quantity and structure of health care delivery systems. The result has been the emergence of a new pattern of hospital organization and administration, described here as the <i>business model hospital</i>. This model is driven by incentives and performance criteria wholly different from those of traditional community hospitals. This research describes this new political economy of health care and identifies, via analysis of field interviews, the crucial issues faced by hospital administrators today and specific actions they are taking to adapt to their new environment. The emergence of the business model hospital has many positive attributes but could have adverse consequences for the broader public interest. Emerging public policy issues are discussed and recommendations are made as to how public policy makers may deal with these issues. These recommendations focus on retaining the major benefits of the business hospital model while preserving useful aspects of the community hospital framework. / Ph. D.
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Emergency department utilization by insured users : a study of motivation factorsOetjen, Reid M. 01 January 2004 (has links)
No description available.
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The rural and urban poor of Honduras: a descriptive analysis of their health care needs and living conditionsKuhn, Deanna Matuska 01 January 2001 (has links)
Since Hurricane Mitch there have been many humanitarian efforts to provide health care to the poor and needy of Honduras. Unfortunately there is little information available regarding the specific health needs in this country. The purpose of this project was to analyze data collected during a recent mission trip to Honduras for trends in health symptoms, diagnoses and health care practices to assist in the planning of future trips. Health Intake forms were created by Drs. Holcomb and Crigger and were filled out by 500 patients at the time of their visit to both rural and urban clinics. The forms included information on the patient's health history, current symptoms, diagnosis and treatment as well as their health habits and living conditions that might affect their health. Descriptive statistics revealed the clinic population to be primarily women and children. The most common presenting symptoms were gastrointestinal, non specific (i.e. fever, malaise . .. ) and pulmonary. Common diagnoses included intestinal parasites, arthritis and upper respiratory infections. The most frequently prescribed medications were over the counter medications (i.e. vitamins, and Tylenol) as well as antibiotics. Chi-square analysis revealed few differences between the urban and rural populations. It was discovered that many of the population continue to drink unpurified tap water, which may contribute to their gastrointestinal complaints and the frequent occurrence of intestinal parasites.
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Utilisation of mobile health in ZimbabweMarufu, Chester 10 February 2015 (has links)
MHealth is an upcoming area promising to contribute benefits to health service delivery. The purpose of this study was to identify and describe the rate of mHealth utilisation as well as opportunities for mHealth and the barriers to use at one central hospital in Zimbabwe. A quantitative, descriptive, cross-sectional study was undertaken at the central hospital. Data collection was done using structured questionnaires. The entire population of medical doctors at the hospital (N=42) were the respondents of the research. The 18 mHealth activities were chosen from a possible of 101 available. The most used as well as the least used mHealth activities were identified and the reasons for use or lack of use were identified.
The study revealed that 75% of the activities were currently being used and 95% had the potential of future use by medical doctors. This study highlights the potential of mHealth from medical doctors’ perspective. / Health Studies / M. A. (Public Health)
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Experiences of homosexuals' access to primary health care services in Umlazi, KwaZulu-NatalCele, Nokulunga Harmorny 03 1900 (has links)
Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015. / Introduction
Access to effective health care is at the heart of the discourse on how to achieve the health related Millennium Development Goals. Lesbian and gay persons are affected by a range of social and structural factors in their environment, and as a result have unique health needs that might not be met by existing health care services. Sexual stigma remains a barrier to seeking appropriate health care. Lesbians and gays might delay seeking health care when needed or avoid it all together, because of past discrimination or perceived homophobia within the health care system.
Aim of the study
The aim of the study was explore and describe the accessibility of primary health care services to lesbians and gays in Umlazi in the province of KwaZulu-Natal.
Methodology
A qualitative, exploratory, descriptive study was conducted which was contextual in nature. Aday and Andersons’ theoretical framework of access was chosen to guide this study. Semi-structured interviews were conducted with 12 lesbian and gay participants. The findings of this study were analysed using content analysis.
Results
Four major themes that emerged from the data analysis were discrimination of homosexual men and women by health care providers and community members in PHC facilities; attitudes of homosexual men and women towards health care providers; homophobic behaviour and equality of PHC services. Few participants were satisfied with the primary health care services they received. Intervention by the Department of Health, Department of Education, curriculum planners and Health Professionals Councils is recommended wherein homosexuality education should be addressed during pre-service and in-service education sessions so as to familiarise health care providers with such clients’ health care needs and to decreased homophobic attitudes.
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The Old Mutual Healthcare Call Centre Project : applying world class manufacturing techniques in a non-production environmentKapp, H. A. (Heronemus Albertus) 03 1900 (has links)
Thesis (MBA)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: This thesis researches World Class Manufacturing Techniques (WCMT) and their
applicability in a Non-Production Environment such as an inbound call centre in the
financial services sector.
These WCMT involve a set of innovative techniques and principles, which are
applied by foremost manufacturing companies. These techniques however, are not
sacred and one always needs to refer back to the objectives of World Class
Manufacturing, namely to (a) Eliminate waste, (b) Improve quality, (c) Shorten lead
times, (d) Reduce costs, and (e) Improve morale and seek other improvements. The
importance lies in attaining the objectives in the context of the necessary
manufacturing tasks. Companies applying these techniques demonstrate significant
productivity gains, production synergies, reduced rework and more reliable on-time
delivery. In the highly competitive global market, these offer a competitive advantage
for such companies.
A critical and essential element of a company's strategic vision is a clearly defined
and healthy competitive advantage. It is imperative that a company's vision is clearly
aligned to its business objectives and goals. The WCMT is a tool that aligns the
business vision and strategic objectives to realize its competitive advantage. By
aligning the vision to its competitive advantage, it is crucial that the company
challenge its existing production processes and the way in which it operates. Existing
production processes need to be continuously reviewed and adjusted where
necessary to sustain the competitive advantage.
This paper is a practical example of how a non-production organisation can apply
these WCMT to sustain its competitive advantage. The WCMT such as Theory of
Constraints (TOC), Just in Time (JIT) and Total Quality Management (TQM) are
discussed and applied in the inbound call centre of a medical aid administration
company.
In a relatively short time span, some remarkable sustainable productivity
improvements were achieved. This would imply that these WCMT could be applied in
traditional non-production environments. / AFRIKAANSE OPSOMMING: Hierdie navorsings werkstuk ondersoek Wêreld Klas Vervaardigings Tegnieke
(WCMT) en die moontlike toepassing daarvan in 'n nie-vervaardigings omgewing,
soos 'n inbeldienssentrum in die finansiële dienste sektor.
Hierdie WCMT omsluit 'n groep innoverende tegnieke wat huidiglik aangewend en
toegepas word in die meeste vervaardigings ondernemings.
Hierdie tegnieke is nie beperk nie en verwys altyd terug na die doelstellings van
WCMT naamlik (a) Vermindering van afval, (b) Verbetering van kwaliteit,
(c) Verkorting van wag periodes, (d) Verlaging van kostes, en (e) Verbeterende
personeel moraal en die voortdurende soeke na ander verbeteringe.
Die belangrikheid van WCMT lê in die bereiking van hierdie bogenoemde doelwitte
binne die konteks van die noodsaaklike vervaardigings metodes. Ondernemings wat
hierdie tegnieke toepas vind groot produksiekapasiteit verbeteringe, produksie
sinergie, 'n verlaging in die oordoen van foutiewe werk en ondervind ook grotendeels
meer gereelde op-tyd aflewering. In die hoogs kompeterende globale mark bied die
WCMT die broodnodige mededingende voordeel aan hierdie ondernemings.
Die kritieke en belangrike bestanddeel van 'n onderneming se strategie en visie is die
onderneming se vermoë om 'n deeglike en gesonde mededingende voordeel bo sy
mededingers te hê. Dit is van kardinale belang dat die onderneming se visie
behoorlik in lyn is met die onderneming se strategiese doelwitte. Hierdie WCMT is 'n
instrument wat die onderneming kan aanwend ten einde sy visie en strategiese
doelwitte, asook sy kompeterende voordeel, te bereik.
Dit is krities belangrik dat 'n onderneming se visie en sy kompeterende doelwitte
gesinkroniseer en gelykgestel is en verder dat die onderneming ook sy huidige
produksie prosesse herevalueer, asook die manier waarop die onderneming opereer.
Huidige produksie prosesse moet voortdurend geherevalueer en aangepas word
waar nodig, ten einde die onderneming se voortdurende kompeterende voordeel te
behou. Hierdie navorsings stuk is 'n voorbeeld van die praktiese toepassing van WGMT en
hoe hierdie tegnieke 'n onderneming behulpsaam kan wees ten einde sy
kompeterende voordeel te behou.
Die WGMT soos die Teorie van Beperkings (TOC), Net Betyds (JIT) en Totale
Kwaliteit Beheer (TQM) word deeglik ondersoek en bespreek. Die navorser
ondersoek voorts die moontlikheid om hierdie tegnieke toe te pas in 'n in beldienssentrum by 'n administrateur van mediese fondse.
In 'n relatiewe kort periode het die navorser noemenswaardige en voortdurende
produksie verbetering teweeg gebring deur die toepassing van WGMT. Die navorser
het afgelei dat hierdie WGMT nie net beperk is tot die vervaardigings sektor nie,
maar dat dit ook in die nie-vervaardigings sektor doeltreffend aangewend kan word.
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Die bepaling van standaarde vir 'n omvattende opvolgdiens aan onkologiepasiente op die Wes-Kaapse plattelandBimray, Portia Benita 12 1900 (has links)
Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Against the background of the approach to make the follow up care to oncology
patients more accessible and with the emphasis on quality care, it was indicated
that this service needs to be evaluated.
A study based on a combination of qualitative and quantitative methods (also
called triangulation) was conducted to formulate structure, process and outcome
standards for a comprehensive follow up care for the oncology patients and to
evaluate this service according these standards.
The most important results are:
• The quality of care relating to the structure standards was optimal
regarding the organization of the patient's visits, follow up treatment and
referrals. A suboptimal standard was found regarding the general
management system.
• In the process standards focusing on the physical and psychosocial needs
of the patient, a suboptimal standard was found regarding all aspects.
Nursing practice leading to subobtimal care of patients is a major cause
for concern.
• With the outcome standards reflecting in patient satisfaction, positive as
well as negative opinions and perceptions were found.
Recommendations include:
• Upgrading of management systems
• Empowerment of the nurses with knowledge and scientific competencies
• Attention to the opinions and perceptions of the patients to completely
involve the patient in the service and treatment process.
Keywords: Oncology follow up service I formulation of structure, process and
outcome standards. / AFRIKAANSE OPSOMMING: Teen die agtergrond van die benadering om opvolgdienste meer
toegangklik te maak vir onkologiese pasiënte, met die beklemtoning van
gehaltesorg, is dit aangedui dat hierdie diens geëvalueer moes word.
'n Studie gebaseer op 'n kombinasie van kwalitatiewe en kwantitatiewe
metodes (genoem triangulasie) is uitgevoer om struktuur, proses en
uitkomsstandaarde vir 'n omvattende opvolgdiens aan onkologiepasiënte
te formuleer en die diens aan die hand daarvan te evalueer.
Die belangrikste resultate is:
• Die gehalte van sorg wat verband hou met die struktuurstandaarde
was net optimaal ten opsigte van die organisasie van die pasiënt se
besoeke, opvolgbehandeling en verwysings. 'n Suboptimale
standaard is gevind ten opsigte van die algemene bestuurstelsel.
• In die prosesstandaarde wat fokus op die fisiese en psigososiale
behoeftes van die pasiënt, is 'n suboptimale standaard in alle
aspekte gevind. Verpleegpraktyk wat lei tot suboptimale sorg van
pasiënte is 'n groot bron van kommer.
• Met die uitkomsstandaarde wat reflekteer in pasiënttevredenheid is
positiewe maar ook negatiewe opinies en persepsies gevind.
Aanbevelings sluit in:
• Verbetering van bestuurstelsels
• Bemagtiging van die verpleegkundige met kennis en wetenskaplike
vaardighede
• Aandag aan pasiënte se opinies en persepsies ten einde die pasiënt
ten volle te betrek by die hele diens en behandelingsproses.
Sleutelwoorde : Onkologiese opvolgdiens / formulering van
struktuurproses en uitkomsstandaarde.
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Looking for harm in healthcare : can Patient Safety Leadership Walk Rounds help to detect and prevent harm in NHS hospitals? : a case study of NHS TaysideO'Connor, Patricia January 2012 (has links)
Today, in 21st century healthcare at least 10% of hospitalised patients are subjected to some degree of unintended harm as a result of the treatment they receive. Despite the growing patient safety agenda there is little empirical evidence to demonstrate that patient safety is improving. Patient Safety Leadership Walk Rounds (PSLWR) were introduced to the UK, in March 2005, as a component of the Safer Patients Initiative (SPI), the first dedicated, hospital wide programme to reduce harm in hospital care. PSLWR are designed, to create a dedicated ‘conversation’ about patient safety, between frontline staff, middle level managers and senior executives. This thesis, explored the use of PSLWR, as a proactive mechanism to engage staff in patient safety discussion and detect patient harm within a Scottish healthcare system- NHS Tayside. From May 2005 to June 2006, PSLWR were held on a weekly basis within the hospital departments. A purposive sample, (n=38) of PSLWR discussions were analysed to determine: staff engagement in the process, patient safety issues disclosed; recognition of unsafe systems (latent conditions) and actions agreed for improvement. As a follow-up, 42 semi-structured interviews were undertaken to determine staff perceptions of the PSLWR system. A wide range of clinical and non-clinical staff took part (n=218) including medical staff, staff in training, porters and cleaners, nurses, ward assistants and pharmacists. Participants shared new information, not formally recorded within the hospital incident system. From the participants perspectives, PSLWR, were non threatening; were easy to take part in; demonstrated a team commitment, from the Board to the ward for patient safety and action was taken quickly as a result of the ‘conversations’. Although detecting all patient harm remains a challenge, this study demonstrates PSLWR can be a useful tool in the patient safety arsenal for NHS healthcare organisations.
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