Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-02-09T11:09:32Z No. of bitstreams: 1 soniaportelladeabreu_dissert.pdf: 1009667 bytes, checksum: 53cd218115ffeeb3cff853c2ea525cd2 (MD5) / Made available in DSpace on 2017-02-09T11:09:32Z (GMT). No. of bitstreams: 1 soniaportelladeabreu_dissert.pdf: 1009667 bytes, checksum: 53cd218115ffeeb3cff853c2ea525cd2 (MD5) Previous issue date: 2014-09-25 / The aim of the present study is to analyze the production of knowledge about the use of patient classification instruments in care and managerial nursing practice in Brazil. We conducted an integrative literature review, using the Latin American and Caribbean Center on Health Sciences Information (LILACS), Medical Literature Analysis and Retrieval Sistem on-line (MEDLINE) Cummulative Index to Nursing and Allied Health Literature (CINAHL) data bases for articles from January 2002 to December 2013. Data extracted from the articles were organized, categorized, and summarized using the Matrix method of literature review. The Research Appraisal Checklist (RAC) was used in order to evaluate the quality of the articles. Of the 1129 publications found, 31 met the selection criteria. The articles retrieved were classified into three categories according to the purpose of application: Assessment of Psychometric Properties, Patient Care Profile and Identification of Workload, and Planning Assistance. We found a higher number of articles in the category “patient care profile and workload” (n = 15) followed by the category “assessment of psychometric properties” (n = 14). According to RAC, 21 studies were appraised as superior studies and 10 studies were appraised as medium studies. We concluded that the Brazilian scientific production has not yet explored some purposes of using patient classification instruments in professional nursing practice. The identification of yet unexplored areas can guide future research on the topic. / Este estudo teve por objetivo analisar a produção do conhecimento sobre a utilização de instrumentos de classificação de pacientes na prática assistencial e gerencial no Brasil. Consiste em uma revisão integrativa da literatura com consulta na base de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval Sistem on-line (MEDLINE) e Cummulative Index to Nursing and Allied Health Literature (CINAHL) relativa ao período de janeiro de 2002 a dezembro de 2013. Os dados extraídos dos artigos foram organizados, categorizados e sumarizados utilizando-se o método Matrix. Para avaliação da qualidade dos artigos foi utilizado o Research Appraisal Checklist (RAC). Das 1129 publicações encontradas 31 atenderam aos critérios de seleção. Os artigos foram classificados em três categorias de acordo com a finalidade de aplicação: Avaliação das Propriedades Psicométricas, Perfil Assistencial dos Pacientes e Identificação da Carga de Trabalho e Planejamento da Assistência. Observou-se maior número de artigos na categoria perfil assistencial e carga de trabalho (n=15) seguidos da categoria avaliação das propriedades psicométricas (n=14). De acordo com a RAC, 21 artigos foram considerados como superiores e 10 como médios. Concluiu-se que a produção nacional ainda não explorou algumas finalidades de utilização de instrumentos de classificação de pacientes na prática profissional do enfermeiro. A identificação de áreas ainda inexploradas poderá nortear futuras investigações sobre a temática.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-03-10T15:24:14Z No. of bitstreams: 1 mariliasilveirafaeda_dissert.pdf: 1644595 bytes, checksum: 938a2984ef496d1821eba633bca8f0a8 (MD5) / Made available in DSpace on 2017-03-10T15:24:14Z (GMT). No. of bitstreams: 1 mariliasilveirafaeda_dissert.pdf: 1644595 bytes, checksum: 938a2984ef496d1821eba633bca8f0a8 (MD5) Previous issue date: 2016-01-15 / Objectives: Analyze the correlation between nursing prescriptions recorded in the files and patient care needs; investigate the correlation between the professional profile of nurses and agreement of requirements; and investigate the conception of nurses about the nursing prescription for hospitalized patients care needs and factors associated with this conformity. Methods: Descriptive study with quantitative and documentary approach performed in 20 inpatient units and two medical clinics, two surgical clinics and 16 specialized units of teaching hospital in a city of São Paulo State. Data collection was performed in the period from September 2013 to January 2014 and from February to June 2015. On the first stage was applied the new version of validated patient classification instrument and, investigated 380 nursing prescriptions at admission and hospital discharge. Later, the participants (N = 139) answered a semi-structured questionnaire. Results: It was found that 75% of items of nursing prescriptions were consistent with the actual care needs of patients and 35% of the needs identified at admission and 32.3% at hospital discharge were not related prescriptions. It was found a low correlation between the compatibility of the nursing prescription and professional profile. For 43 (30.9%) of nurses the nursing prescriptions are always aligned to care needs of patients. Eliminations and Body Care, Skin Care and Mucous membranes and Research and Monitoring areas were the most discussed. Conclusion: The nursing prescriptions are not being carried out, if at all, in line with the needs of patients. It is recommended the implementation of strategies aimed at improving the quality of prescriptions, among others, continued qualification programs and the systematic use of instruments for evaluating the patient's attention demand in relation to nursing. / Objetivos: Analisar a concordância entre prescrições de enfermagem registradas nos prontuários e as necessidades de cuidados dos pacientes; investigar a correlação entre o perfil profissional dos enfermeiros e a concordância das prescrições; e, investigar a concepção de enfermeiros sobre a conformidade da prescrição de enfermagem às necessidades de cuidados de pacientes hospitalizados e fatores associados a esta conformidade. Método: Estudo descritivo com abordagem quantitativa e documental realizado em 20 unidades de internação sendo duas clínicas médicas, duas clinicas cirúrgicas e 16 especializadas de um hospital de ensino no interior do Estado de São Paulo. A coleta de dados foi realizada nos períodos de setembro de 2013 a janeiro de 2014 e fevereiro a junho de 2015. Na primeira etapa foi aplicada a nova versão validada do Instrumento de Classificação de Pacientes e, investigadas 380 prescrições de enfermagem no momento da admissão e alta hospitalar. Posteriormente, os participantes (N=139) responderam a um questionário semiestruturado. Resultados: Identificou-se que 75% dos itens das prescrições de enfermagem estavam compatíveis com as reais necessidades cuidativas dos pacientes e que 35% das necessidades identificadas na admissão e 32,3% no momento da alta hospitalar não tiveram prescrições relacionadas. Encontrou-se baixa correlação entre a compatibilidade da prescrição de enfermagem e o perfil profissional. Para 43(30,9%) dos enfermeiros as prescrições de enfermagem encontram-se, sempre, alinhadas às necessidades cuidativas dos pacientes. As áreas de Cuidado Corporal e Eliminações, Cuidados com Pele e Mucosas e Investigação e Monitoramento foram as mais abordadas. Conclusão: As prescrições de enfermagem não estão sendo realizadas, em sua totalidade, em consonância com as necessidades dos pacientes. Recomenda-se a implementação de estratégias objetivando aprimorar a qualidade das prescrições, dentre outras, programas de qualificação contínua e a utilização sistemática de instrumentos para avaliação da demanda de atenção do paciente em relação a enfermagem.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-03-14T14:06:22Z No. of bitstreams: 1 priscilafernandesmartins_dissert.pdf: 2117046 bytes, checksum: 0ff2d44cd2cefbf706851395befc6c5e (MD5) / Made available in DSpace on 2017-03-14T14:06:22Z (GMT). No. of bitstreams: 1 priscilafernandesmartins_dissert.pdf: 2117046 bytes, checksum: 0ff2d44cd2cefbf706851395befc6c5e (MD5) Previous issue date: 2016-02-26 / Objectives: To access the patients´ perception and their level of satisfaction as well as their companions according to the care needs during hospitalization period; to observe the association of this level with sociodemographic variables and characteristics of hospitalization and the unity; to compare the care needs as realized by the patient and the Nursing team and investigate the sociodemographic factors associated with these perceptions. Methods: In the first stage, a descriptive exploratory study was performed in hospitals in the interior of São Paulo state, from March to May 2014; 411 patients and their companions participated. Afterwards, a comparative study in units and hospitalization was carried out in an extra–large capacity hospital in the state of São Paulo from April to July 2015. The subjects were 100 professionals (50 nurses and 50 technicians and nursing assistants) and 50 patients. A questionnaire was created and validated (for each stage) about care needs filled up by the participants. Results: The patients/companions ´ score of satisfaction ranged from 3.6 (0.4) to 4.6 (0.4). Emotional and spiritual needs (81 and 82%), security (83 and 67%) and attention (87 and 61%) were the most satisfied. An association was found between satisfaction and some sociodemographic variables and hospitalization characteristics. Considering the four areas investigated regarding the process of caring, the following variations were found: kw 0.32 (0.07 - 0.46) to kw 0.93 (0 - 0.40) for Planning and Care Organization; kw 0.56 (0 - 0.35) to 0.92 kw (0 - 0.39) for the Environmental Care; Kw 0.55 (0 - 0.32) to 0.96 kW (0 - 0.35) for Communication and Information and also kw 0.50 (0-0.20) to 0.93 (0.23 -0.64 for Basic Care. The domains of Environmental Care and Information and Communication received the highest percentage of kw values ≥ 0.61. Conclusions: Patients and their companions were satisfied with the service of care needs, however, some important areas showed a deficit of satisfaction. In general, it was observed alignment in meeting the care needs according to the patients´own view and nursing staff. However, the average satisfaction was found to be far below the desirable, underlying the need for much knowledge by the team on the caring needs of patients and participation of the patient and companion in decision-making. Information on the quality of received care can improve changes on the practice for the patient / family centered care. / Objetivos: Examinar a percepção e o nível de satisfação de pacientes e acompanhantes quanto ao atendimento das necessidades de cuidados durante o período de hospitalização; verificar a associação deste nível com variáveis sociodemográficas e características da hospitalização e da unidade; comparar as necessidades de cuidados como percebidas pelo paciente e equipe de enfermagem e investigar os fatores sociodemográficos associados a estas percepções. Métodos: Na primeira etapa foi realizado um estudo descritivo-exploratório em instituições hospitalares no interior do Estado de São Paulo, no período de março a maio de 2014 onde participaram 411 pacientes e seus acompanhantes. Posteriormente, conduziu-se estudo comparativo em unidades e internação de uma instituição hospitalar de capacidade extra do interior do Estado de São Paulo no período de abril a julho de 2015. Os sujeitos foram 100 profissionais (50 enfermeiros e 50 técnicos e auxiliares de enfermagem) e 50 pacientes. Construiu-se e validou-se um questionário (para cada etapa) sobre necessidades de cuidados preenchido pelos participantes. Resultados: O escore de satisfação dos pacientes/acompanhantes variou de 3,6(0,4) a 4,6(0,4). As necessidades emocionais e espirituais (81 e 82%), segurança (83 e 67%) e atenção (87 e 61%) foram as mais atendidas. Encontrou-se associação entre satisfação e algumas variáveis sociodemográficas e características da hospitalização. Considerando os quatro domínios investigados em relação ao processo do cuidar obteve-se as seguintes variações: kw 0,32(0,07-0,46) a kw 0,93(0-0,40) para Planejamento e Organização do Cuidado; kw de 0,56(0-0,35) a kw 0,92(0-0,39) para O Ambiente do Cuidado; Kw 0,55(0-0,32) a Kw 0,96(0-0,35) para Comunicação e Informação e, ainda, kw 0,50(0-0,20) a 0,93(0,23-0,64 para Cuidados Básicos. Os domínios O Ambiente do Cuidado e Comunicação e Informação receberam o maior percentual de valores kw ≥ 0,61. Conclusões: Os pacientes e seus acompanhantes mostraram-se satisfeitos com o atendimento das necessidades de cuidados, porém, algumas áreas importantes apresentaram déficit de satisfação. De maneira geral, observou-se alinhamento no atendimento das necessidades de cuidados no olhar do próprio pacientes e da equipe de enfermagem. No entanto, a média de satisfação mostrou-se muito abaixo do desejável evidenciando a necessidade de maior conhecimento pela equipe das necessidades cuidativas dos pacientes e participação do paciente e acompanhante na tomada de decisão. Informações sobre a qualidade da atenção recebida possibilitam implementação de mudanças na prática para o cuidado centrado no paciente/família.

自從二次世界大戰以後，人力資源發展的重要性已受到許多專家學者的肯定，隨著人力管理哲學的改變，組織常會投資大量的人力資源與金錢來從事人力資源發展的工作，例如教育、訓練計畫的推行。雖然教育、訓練工作已日漸受到組織的重視，但是卻常因未以系統性的方法來辦理訓練，而導致訓練的成果不如預期，徒然花費許多不必要的人力與金錢。為了使各種訓練方案能確實有效地執行，並符合原先的預期目標，組織在進行訓練工作方案時，必須以系統性的方法來辦理；其中訓練需求評估則處於系統性訓練過程的第一階段。行政機關常受限於行政程序、資源、財務等因素而與一般企業組織進行訓練需求評估的方式有所差異；再加上例行性的訓練計畫容易因缺乏定期的評估而導致設計出不合時宜的訓練方案，所以訓練單位應以整體系的前瞻眼光，配合外在環境的變遷與組織內部人員的需求，才能設計出符合組織與個人需求的訓練活動，不僅培養員工應有的知識與技能，更進而提升組織效能。一般而言，需求評估可從三方面進行分析，分別是組織分析、工作分析、以及人員分析，找出組織問題所在，並就可經由訓練方案來改進的部分，進行更深層的分析，以確知那一部門的那些人必須接受何種內容的學習活動。由於社會型態的變遷與服務型組織需求的增加，當今的行政組織不應只以滿足民眾目前需求為服務目標，而更應採行策略性分析的途徑，進行訓練需求評估，以求能探知現有需求，並預測未來需求樣態，使訓練的進行能掌握時代環境的脈動。本文旨在研究訓練需求評估與組織效能間的關係，並以中央銀行暨所屬中央印製、造幣廠作為本文個案分析的研究對象。

Målet med denna uppsats är att bidra till kvalitetsutveckling gällande behovsbedömning och beslutsformulering vid handläggning enligt socialtjänstlagen. Syftet med uppsatsen är att granska handläggningsprocessen gällande boendestödsbeslut. Med utgångspunkt i denna granskning vill vi komma fram till förslag på förbättringsområden. Förslagen ska vara förenliga med krav från och behov hos lagstiftaren, den enskilde, socialtjänsten/kommunen och biståndshandläggaren. Beslut om boendestöd är idag tidsbegränsade, oftast till ett år, utan att den enskilde egentligen ansökt om det. För den enskilde stödmottagaren innebär detta bristande rättssäkerhet, otrygghet och brist på kontinuitet. Vi har i denna uppsats försökt kartlägga skälen till att besluten ser ut på detta sätt genom att tillämpa en hermeneutisk metod. Av vår genomgång framgår att det inte finns stöd för rutinmässig tidsbegränsning av beslut i lagstiftningen. I vissa fall, där det kan förutses att behovet förändras över tid, kan det dock vara motiverat. Målgruppen för boendestöd har ofta långvariga funktionsnedsättningar och stödbehov som kan antas kvarstå över längre tid än ett år. Enligt de kommunala riktlinjer som vi har granskat är boendestöd en insats som ska tidsbegränsas. De biståndshandläggare som vi har tillfrågat tidsbegränsar i 80 procent av fallen beslut om boendestöd till en giltighetstid på upp till ett år. Det huvudsakliga skälet till detta är att biståndshandläggarna anser att det underlättar uppföljning av besluten. Resultatet av vår studie pekar på att ett antal åtgärder skulle kunna öka kvaliteten på behovsbedömning och beslut om boendestöd. Dessa innebär främst implikationer för kommun, socialtjänst och biståndshandläggare att arbeta vidare med i syfte att skapa en mer rättssäker och evidensbaserad biståndshandläggning. / The intention of this study is to contribute to quality enhancement regarding needs assessment and shaping of decisions of the social service called living support (i.e. boendestöd) according to the law of social service. The aim of this study is to review the process of needs assessment concerning living support. Based on this review we want to give suggestions to possible improvements. Our suggestions must be compatible with demands and requirements from the lawmaker, the individual, the social service/the municipality and the process officer. Today, decision of living support is time limited, usually to a year, without the individual actually having applied for it. This leads to a lack of legal security, personal security and continuity for the individual. In this study, we have tried to locate the reasons for why the decisions are constructed in this way by using a hermeneutical method. Our study shows no support for perfunctory time limiting of decisions according to the law. In some cases where there can be forecasted that the need changes over time, it can though be motivated. The target group for living support often have prolonged impairments and needs of support highly estimated to last more than a year. According to municipal guidelines, reviewed by us, living support is an inset to be time limited. The process officers we have asked in 80 per cent of all cases time limits the decisions up to one year. The main reason for this is that the process officers regard time limiting as making follow-ups of the decisions easier. The result of our study points to a number of measures for increasing the quality of needs assessment and decisions of living support. These measures have implications for the municipality, the social services and the process officers with the purpose of creating a more legally secure and evidence based process of needs assessment.

The purpose of this study was to identify the information needs and information seeking behaviour of international students at the University of KwaZulu-Natal, Pietermaritzburg Campus (UKZNP). The study assisted in identifying different information services offered by the International Student Office (ISO). It also determined various information seeking situations involved in relation to academic needs and personal issues of international students. The approach that the researcher undertook was a triangulation approach where both quantitative and qualitative data were collected. Instruments used for data collection were a self-administered questionnaire and semi-structured interview. A sample size of 150 international students was surveyed, with 137 students responding, giving a response rate of 91.3%. The Head of the International Student Office (HISO) was also interviewed. The validity and reliability of the instrument were established by pre-testing the questionnaire with four international students enrolled at UKZNP. The quantitative data was analysed using SPSS and the qualitative data was analysed using thematic content analysis. The international students’ information seeking behaviour was identified using Wilson’s (1999) model of information behaviour which suited the group under study. The outcome of the study revealed that more than half, 62.7%, of academic needs were characterized by two situations, namely, the registration process (32.2%) and issues around lectures (30.5%). Other main issues discussed were based on information literacy skills and English language problems experienced by international students enrolled at UKZNP. In terms of personal issues, a majority (60.2%) of respondents mentioned either accommodation (34.9%) or health issues (25.3%). A minority, just on 30%, of the respondents resided on campus and for the majority of the respondents who lived off campus, accessing the Library and computer LANs after hours was not possible as transport at night was not always available. Thus the accommodation need was regarded as a very significant problem. The study indicated that two main sources used in relation to academic needs were library resources and information from the Faculty offices, while the most used source by international students for their personal issues was the consultation of colleagues. Based on the results and conclusions of the study, recommendations for action and further research were made. Recommendations included the need to consider a temporary registration period during which the complex requirements of the registration process could be pursued and satisfied by the students and, in response to the accommodation crisis experienced by students, consideration be given to the Student Housing Office giving priority to first year international students in particular when allocating rooms. / Thesis (M.I.S.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

Syftet med studien var att analysera biståndsutredningar utifrån ett genusperspektiv för att undersöka om det finns några skillnader både språkligt och innehållsmässigt utifrån kön. Vårt gemensamma intresse för genusfrågor och socialt arbete för individer med funktionsnedsättningar är anledningen till valet av studiens inriktning. Karin Barrons teori om att kvinnor och män med funktionsnedsättningar inte tilldelas kön har inspirerat till studien. Med hjälp av socialkonstruktivism och ett genusperspektiv har empirin analyserats med en kvalitativ innehållsanalys. Studiens empiri består av biståndsutredningar enligt Lagen om stöd och service för vissa funktionshindrade (SFS 1993:387) angående ansökan om personlig assistans. Utredningarna kommer ifrån en relativt stor kommun. Resultatet visar att språket i biståndsutredningarna synliggör kön och skapar olika bilder av kvinnor och män med funktionsnedsättningar. Utredningarna porträtterar mannen som drabbad av sin funktionsnedsättning, drabbad men fortfarande stark och kompetent. I samma sorts texter skildras kvinnan som att hon är, har eller har utvecklat sin funktionsnedsättning och som beroende av hjälpmedel och annat stöd / The purpose was to analyze needs assessment investigation to explore if there are differences in the linguistic and content regarding gender. We have common interest in both gender perspective and disability care. Therefore these areas were chosen for the study. Karin Barron and her theory about disabled people being declined their gender was the inspiration to the study.  A social constructionist and a gender perspective were used throughout this research and a qualitative content analyze were used to analyze and process the documents. The documents consisted by needs assessment investigation regarding applications about personal assistance. The applications are regulated by the Swedish law, Lagen om stöd och service för vissa funktionshindrade (SFS 1993:387). The data was collected from a relatively large municipality. The results show that in these documents gender is visible and creates different images of disabled men and women. The documents presented the men as victims of their disability, victims but still strong and abled and the women were presented as accountable of their disability and dependent of means

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 4 uppsatser.

Thesis (Ph.D.)--Mississippi State University. Department of Human Sciences. / Title from title screen. Includes bibliographical references.

Thesis (MScEng)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The various applications of Information and Communication Technologies (ICTs) in healthcare are increasingly effective to improve the cost-effectiveness and quality of healthcare service delivery. Telemedicine is such an application, using ICTs to provide health services over a distance. Since 1997, the South African Department of Health has invested large amounts of capital to implement telemedicine systems in South Africa. Unfortunately, telemedicine programs have had little success since, leading to many workstations standing dormant. Telemedicine implementation decision making that is based on insufficient evidence is identified as one of the underlying problems that cause telemedicine programs to fail. It is proposed that implementation decisions should be based on quantifiable evidence regarding the potential benefits of telemedicine. A decision support system is developed that can be used to quantify potential benefits and plan telemedicine implementation programs accordingly. The decision support system is modelled and demonstrated using data from the Eastern Cape public health sector. The first phase of the system guides decision makers to identify potential telemedicine benefits as well as data sources that can be used to measure these benefits. The system is scoped to focus on the application of telemedicine to support patient referrals between hospitals. Data sources are considered accordingly, with electronic health record (EHR) data proving to be a feasible primary source for needs assessments, however limiting the benefits that can be quantified. The analysis of the needs assessment is included in the second phase of the decision support system. Data are extracted, transformed and loaded into a data warehouse from where it can be analysed. The system includes three analysis steps to: map referral patterns, analyse potential benefits of telemedicine programs and determine cost-effective telemedicine solutions by allocating equipment at different hospitals. Analysis techniques used in the system include Pareto analysis, economic analysis, linear programming and the use of a genetic algorithm. It is proposed that the potential benefit results and equipment allocation algorithm be used to plan telemedicine programs for continuous evaluation. The final phase of the system therefore guides decision makers to use the results for implementation planning as well as evaluability assessments, for future management and evaluation of telemedicine programs. The decision support system is validated using patient referral data from the Western Cape public health sector. The case study proved that the system is applicable to the real-world and could be a valuable tool for decision makers to base telemedicine implementation planning on quantifiable evidence. The limitation on size and quality of both the Eastern Cape and Western Cape data sets, caused that the full potential of the system could not be demonstrated and validated. It is recommended that the quality standards of EHR referral reports be improved, to ensure more accurate benefit results. Future work is recommended to include qualitative needs assessments in the scope of the decision support system, hereby increasing the amount of benefits to be assessed. Although it is expected that the developed system is capable to support even better resolution decisions with more detailed data sets, the system developed in this study proved already adequate for improved implementation decision making. This could lead to higher success rates of telemedicine programs and ultimately better quality healthcare for all. / AFRIKAANSE OPSOMMING: Die verskillende toepassings van Informasie en Kommunikasie Tegnologie (IKT) in gesondheidsorg, speel ʼn rol in toenemende doeltreffendheid om die koste-effektiwiteit en kwaliteit van gesondheidsorg dienslewering te verbeter. Tele-geneeskunde is een van hierdie toepassings, wat IKT gebruik om gesondheidsdienste oor ʼn afstand te kan voorsien. Die Suid-Afrikaanse Departement van Gesondheid belê sedert 1997, groot bedrae kapitaal in die implementering van tele-geneeskunde stelsels, in Suid-Afrika. Ongelukkig het tele-geneeskunde programme min sukses behaal sedertdien, wat veroorsaak dat vele werkstasies dormant is. Die basering van implementeringsbesluite op onvoldoende getuienis, is geïdentifiseer as een van die onderliggende probleme wat veroorsaak dat tele-geneeskunde programme misluk. Daar word voorgestel dat implementeringsbesluite gebaseer moet word op kwantifiseerbare getuienis ten opsigte van die potensiële voordele van telemedisyne. ʼn Besluitnemingsondersteuning stelsel is ontwikkel wat gebruik kan word om die potensiële voordele te kwantifiseer en dienooreenkomstig implementering van tele-geneeskunde programme te beplan. Die stelsel is gemodelleer en gedemonstreer aan die hand van data uit die Oos-Kaap publieke gesondheidsektor. Die eerste fase van die stelsel begelei besluitnemers om potensiële voordele van telegeneeskunde, sowel as data-bronne wat gebruik kan word om hierdie voordele te meet, te identifiseer. Die stelsel is beperk tot ʼn fokus op die ondersteuning wat tele-geneeskunde aan hospitaal pasiënt verwysingstelsels, kan bied. Data bronne is dienooreenkomstig oorweeg: elektroniese mediese rekords (EMR) word erken as ʼn gunstige primêre databron, maar veroorsaak egter beperkings op die aantal voordele wat gekwantifiseer kan word. Die behoeftebepaling word uitgevoer in die tweede fase van die besluitnemingsondersteuning stelsel. Data is onttrek, getransformeer is en gelaai in 'n data stoor, vanwaar dit ontleed kan word. Die stelsel sluit drie analisestappe in: verwysingspatroon analise, berekening van potensiële voordele vir tele-geneeskunde programme en die bepaling van koste-effektiewe oplossings deur toekenning van toerusting by verskillende hospitale. Die analise tegnieke wat in die stelsel gebruik word, sluit die volgende in: Pareto analise, ekonomiese analise, lineêre programmering en 'n genetiese algoritme. Die gebruik van potensiële voordeel resultate en die toerusting toekenning algoritme word voorgestel vir die beplanning vir deurlopende evaluering in tele-geneeskunde programme. Die finale fase van die stelsel is gestruktureer, om besluitnemers te begelei in die gebruik van analise resultate, vir implementering beplanning sowel as evalueerbaarheid studies, wat sodoende deurlopende evaluering en bestuur van tele-geneeskunde programme sal verbeter.Die besluitnemingsondersteuning stelsel is gevalideer deur pasiënt verwysings data van die Wes-Kaap publieke gesondheidsektor, te gebruik. Die gevallestudie het bewys dat die stelsel toepaslik is in die werklike wêreld en kan as ʼn waardevolle hulpmiddel vir besluitnemers dien om tele-geneeskunde implementering beplanning op kwantifiseerbare bewyse te baseer. Die beperkings op die grootte en gehalte van beide die Oos-Kaap en Wes-Kaap datastelle het veroorsaak dat die stelsel nie tot sy volle reg gedemonstreer en gevalideer kon word nie. Verbeterings in kwaliteit standaarde van EMR verwysing data word aanbeveel om meer akkurate resultate te bekom. Verdere studies wat die byvoeg van kwalitatiewe meetings in die stelsel ondersoek, sal die omvang van potensiële voordele verbeter en dus die algehele waarde van die stelsel verbeter. Alhoewel die ontwikkelde stelsel in staat is om beter resolusie besluite te kan ondersteun met meer gedetailleerde data, is dit bewys dat die huidige stelsel reeds voldoende is om besluitneming te verbeter. Beter besluitneming gevolglik lei tot hoër sukseskoerse van tele-geneeskunde programme en uiteindelik verbeterde gehalte gesondheidsorg vir almal.