Typescript (photocopy). / Digitized by Kansas Correctional Industries

Typescript (photocopy). / Digitized by Kansas Correctional Industries / Department: Computer Science.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Typescript (photocopy). / Digitized by Kansas Correctional Industries / Department: Computer Science.

Os serviços de emergências hospitalares (EH) desempenham um papel fundamental no sistema de saúde, servindo de porta de entrada para hospitais e fornecendo cuidados para pacientes com lesões e doenças graves. No entanto, as EH em todo o mundo sofrem com o aumento da demanda e superlotação. Múltiplos fatores convergem simultaneamente para resultar nessa superlotação, porém a otimização do gerenciamento do fluxo dos pacientes pode auxiliar na redução do problema. Nesse contexto, o tempo de permanência dos pacientes na EH (TPEH) é consolidado na literatura como indicador de qualidade do fluxo de pacientes. O tema desta dissertação é a previsão e gestão da demanda em EH com alto grau de congestionamento, que é abordado através de três artigos científicos. O objeto de estudo é o Hospital de Clínicas de Porto Alegre (HCPA). No primeiro artigo, são aplicados quatro modelos de previsão da procura por atendimento na EH, avaliando-se a influência de fatores climáticos e de calendário. O segundo artigo utiliza a técnica de regressão por mínimos quadrados parciais (PLS – partial least squares) para previsão de quatro indicadores relacionados ao TPEH para hospitais com alto grau de congestionamento. O tempo médio de permanência (TM) na EH resultou em um modelo preditivo com melhor ajuste, com erro médio absoluto percentual (MAPE - mean absolute percent error) de 5,68%. O terceiro artigo apresenta um estudo de simulação para identificação dos fatores internos do hospital que influenciam o TPEH. O número de exames de tomografias e a taxa de ocupação nas enfermarias clínicas e cirúrgicas (ECC) foram as que mais influenciaram. / Emergency departments (ED) play a key role in the health system, serving as gateway to hospitals and providing care for patients with injuries and serious illnesses. However, EDs worldwide suffer from increased demand and overcrowding. Multiple factors simultaneously converge to result in such overcrowding, and the optimization of patient flow management can help reduce the problem. In this context, the length of stay of patients in ED (LSED) is consolidated in the literature as a patient flow quality indicator. This thesis deals with forecast and demand management in EDs with a high degree of congestion. The subject is covered in three scientific papers, all analyzing data from the Hospital de Clínicas de Porto Alegre’s ED. In the first paper we apply four demand forecasting models to predict demand for service in the ED, evaluating the influence of climatic and calendar factors. The second article uses partial least squares (PLS) regression to predict four indicators related to LSED. The mean length of stay in the ED resulted in a model with the best fit, with mean percent absolute error (MAPE) of 5.68%. The third article presents a simulation study to identify the internal hospital factors influencing LSED. The number of CT exams and the occupancy rate in the clinical and surgical wards were the most influential factors.

Thesis. 1977. M.S.--Massachusetts Institute of Technology. Dept. of Electrical Engineering and Computer Science. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING. / Bibliography : leaves 131-139. / M.S.

This document is submitted in partial fulfilment for the degree Master of Architecture (Professional) at the University of the Witwatersrand, Johannesburg, South Africa , in the year 2015. / Shack fires in townships have been a prevalent issue within Johannesburg, especially as the Emergency Management Services are under strain due to a lack of fi re service amenities. A significant cause of these fires includes utilizing paraffin stoves for cooking in a high dense population. This is specifically relevant to the Soweto Township in Johannesburg and results in a large number of vulnerable residents. Research aims and objectives include uncovering a new typology for Johannesburg fire stations. This typology will aim to successfully integrate the community in order to simultaneously support the community in the event of shack fires as well as educate the community in terms of safe cooking, fire prevention and fire management. This typology might become a step in the right direc on in order for fire stations to evolve into non-bureaucratic architecture which blurs with functions that will create a 24-hour opera onal mixed-use building. Furthermore this will provide a sense of security to the surrounding community. Numerous fire stations in Johannesburg were visited in order to investigate how the current and conventional fire station typology integrates into the Johannesburg context, if at all. These visits included interviewing firefighters and volunteers who are employed at the stations by means of semi-structured informal interviews. It was discovered that the architectural typology of a fire station is in essence fluid and not fixed, it evolves with society. This is evident as the various fire stations studied in Johannesburg as well as international precedents have been blurred with educational, commercial, hospitality, cultural and even private upmarket residential programmes. In Soweto it was discovered that the three existing fire stations are all small and isolated from the community. Furthermore there is no centralized or main fire station in Soweto. This is needed for training facilities but more importantly to have a centralized control room which in turn will optimize response mes to all emergencies in the en re Soweto. Fire sta ons which created a sense of awareness and belonging to the community generally had lower fi re incident rates as ci zens were aware of the dangers of fi re (CSIR & DPSA, 2012). Fire policy initiatives within Soweto and the City of Johannesburg should thus engage all stakeholders. This especially includes educating and training community members in order to potentially have a network within the community which will fight fires in conjunction with the Johannesburg fire brigade. The proposed fi re sta on in Orlando West in Soweto thus includes a public market in a public park which sells equipment and fuel for safe cooking at discounted rates should you a end the educa onal seminars in the outdoor amphitheater which doubles up as a mul -functional space. Other areas of the park will be a food market. This will result in the inversion of the current bureaucratic architecture that we often encounter with fire stations. / EM2017

Bakgrund: Hot och våld är ett växande problem på akutmottagningar. Vad som upplevs som hot och våld är individuellt. Sjuksköterskor utsätts för hot och våld från dels patienter, anhöriga, andra sjuksköterskor och läkare. Patienter som var våldsamma kände sig ofta missförstådda eller kränkta. De sjuksköterskor som inte vårdade med patientperspektiv blev mer utsatta. Syfte: Syftet med uppsatsen är att beskriva sjuksköterskors upplevelser och erfarenheter av hot och våld på akutmottagningar. Metod: Detta är en litteraturöversikt med kvalitativa och kvantitativa artiklar som följer. Resultat: litteraturöversikten resulterar i tre huvudteman och nio relaterade subteman. Dessa teman är upplevda känslor, behov av stöd och negativ påverkan. Konklusion: Det skulle behöva vidtas åtgärder mot hot och våld för att förbättra sjuksköterskornas arbetsplats. Denna studie visar att HOV påverkar såväl sjuksköterskor som patienter och hela vårdkulturen. Det har negativa konsekvenser som på sikt leder till att sjuksköterskor inte vill arbeta kvar på arbetsplatsen / Background: Threats and violence are a growing problem in emergency departments. What is perceived as threat and violence is individual. Nurses are exposed to threats and violence coming from patients, relatives, other nurses and doctors and more. Patients who were violent often felt misunderstood or offended. The nurses who did not care with the patient perspective became more vulnerable. Aim: The aim of this study is to describe nurse’s experiences of threats and violence in the emergency departments. Method: This is a literature review with qualitative and quantitative articles that follow Friberg (2017) Results: The literature review results in three main themes and nine related sub-themes. These themes are perceived emotions, need for support and negative impact. Conclusion: Action against threats and violence would have to be taken to improve the nurses' workplace. This study shows that HOV affects both nurses and patients and the entire care culture. This has negative consequences that eventually lead to nurses not wanting to work in the workplace.

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use of LHDs. LHDs and their system partners (hospitals, federally qualified health centers, and primary care providers) that utilize HIT as part of their QI decision making may have an easier time of using data to support evidence-based decision making and implementing the provisions of the Patient Protection and Affordable Care Act of 2010 in order to achieve population health for all.

Thesis (MPA.) -- University of Limpopo, 2012 / The main aim or purpose of this study was to examine the impact of the supply chain management on service delivery on the Limpopo Department of Economic, Development, Environment and Tourism (LEDET). The field survey was conducted in LEDET in the supply chain management directorate after gaining permission from the Head of Department of LEDET. The study was qualitative in design. Semi-structured interviews and questionnaires were used. The questionnaire has both open ended and closed ended questionnaires. The supply chain management directorate plays an important role in all the departments in South Africa as a whole. Supply chain management in South Africa was created to improve the lives of the communities such as historically disadvantaged individuals, disabled and women, but it is no longer serving its purpose because nowadays it is serving the few politicians, public officials and the friends and relatives of the public officials. One of the findings of this study is that the supply chain management directorate cannot function properly if the public officials who are appointed does not have relevant qualifications, training and experience towards supply chain management. There should always have uniformity of supply chain management in the three spheres of government to prevent corruption. Supply chain management must be centralised. This means that all the tender contract of the three spheres of government must be done in one centralised unit. Linking of the databases in the three spheres of government can also help the supply chain management not to appoint the same service providers in the tender contract. Appointment of service providers must be done electronically to minimize all forms of corruption. To improve service delivery the public officials must know how to interpret the acts, rules, regulations and policies governing supply chain management. They must also monitor and evaluate the entire contract from the start to the end of the contract The public officials working in the supply chain management must be paid competitive salaries, because they are compelled by the low salaries to corruption such as bribery, fraud, nepotism, extortion, embezzlement and conflict of interest become common in place. It is further recommended that the officials working in the supply chain management, who are getting lower salaries must also be evaluated and upgraded to the higher salary, depending on their qualification, experience and training.