The pressure on the healthcare sector is increasing all over the world. The amount of treatable diseases increases and the time spent with each patient decreases. As a reaction towards the way the healthcare works today, patient-centred healthcare has become increasingly popular. Bringing the patient into the centre also needs changes in the staffs’ way of working. One way of making these changes is by implementing Lean healthcare. This thesis uses a systematic review approach to find out what organisational changes have been made at hospitals where they have implemented Lean healthcare and how the implementations were done. The results showed that the most important thing was to engage the staff at an early point. Those hospitals that had representatives from all the different categories of the staff were the ones who managed to make the modifications with less effort and they also had an easier way of maintaining them. The most obvious similarities in the organisational changes the hospitals had made were that they clearly defined who were supposed to do what and that they changed the work into multi-disciplinary teams. By that the hospitals saved a lot of time both for the staff and for the patients. Lean thinking has similarities theories of cognitive science, like distributed cognition and safety barriers and it could get inspiration from these areas to enhance the implementations. There are few articles concerning the organisational changes that have been made at hospitals when implementing Lean healthcare. However the results of this thesis was that the most important thing when implementing Lean healthcare is to involve everyone at an early stage and the only way to get Lean healthcare to really work is by changing the attitude and making people realise that improvement is a never ending process. The changes that were most common among the hospitals were to clearly define and document who was supposed to do what and to change the structure to multi-disciplinary teams working together.
The impacts of adopting large touch screens and tablets with access to electronic healthcare recordsAl-Omaishe, Allaa January 2015 (has links)
In the last decade modern information technology systems have been introduced to healthcare in order to improve it. The aim of this study is to present the impact of such information system’s adoption on patient safety and efficiency within healthcare. Interviews, observations along with literature study were conducted in order to study the impact of the adoption on patient safety and efficiency at hospital’s wards where a new information system is implemented. The conclusion of this study is that such information technology systems can improve patient safety. However it is believed that the information technology system can improve efficiency in some aspects such as the communication among medical care personnel while other aspects within efficiency can be achieved if some improvements are made. Moreover the ability to access Electronic Healthcare Records is considered to be important to improve the medical care, which can increase patient safety.
08 September 2009
There is not sufficient information in the market of medical service. Whether the public has adequate information is the key to the choice of healthcare seeking. Due to the shift of medical environment, rise of consumer¡¦s awareness and respect to patient¡¦s right, the public is concerned about their health and right. Becoming customer-oriented, the industries of medical service start to emphasize the management of customer¡¦s needs and provide appropriate products and service in order to achieve hospital¡¦s sustainable operation and development. This research aims to explore people¡¦s needs of medical seeking from the health news offered by medical institutes and to probe into the influence of health news on choice of medical seeking. Furthermore, the difference of people¡¦s medical seeking behavior of different demographic characteristics and health condition would also be discussed. This research adopts the quantitative survey method of questionnaire to collect data of outpatients in the over 15 age group on a regional hospital in Kaohsiung City. We received 381 valid questionnaires totally and 352 surveys are usable. The valid sample returns-ratio is 92.3%. The results for statistical analysis show that the rank order of demands on issues of news for people¡¦s seeking medical care are listed as follows according to the assisting extent of healthcare provider: ¡§The new trend of health and diseases¡¨, ¡§novel treatments or technique,¡¨ ¡§information of healthcare and hygienic education,¡¨ ¡§introduction of new equipment and facility,¡¨ ¡§medical discovery,¡¨ and ¡§doctor introduction or profession¡¨. The average mean of the required level marks above 4¡§satisfaction¡¨. (The score 5 is the highest.) By excluding other factors, it achieves levels of significance in aspects of health news path and health news issues on explanation of each dimension of people¡¦s medical seeking behavior. Health news shows significant effect on people¡¦s medical seeking behavior. The standardized coefficient is analyzed for further check that health news path and health news issues are positive predictable variables in each dimensions of people¡¦s medical seeking behavior. It implies that for people¡¦s medical seeking behavior, the higher the health news path uses and the higher the demand of health news requires, the stronger the influence on people¡¦s medical seeking behavior. In the discussion of the difference of people¡¦s medical seeking behavior of different demographic characteristics and health condition, it shows that gender, age, level of education, occupation, medical seeking under discomfort, commercial medical insurance, health condition and frequency of medical seeking in recent month would intervene how health news influence people¡¦s medical seeking behavior. By logistic regression analysis, it is found that level of education, coverage on newspapers, hospital handouts, introduction of new equipment and facility and medical discovery are possible predictors of the purpose of medical seeking. On the other hand, easy to choose of healthcare seeking , critical illness, frequency of medical seeking in recent month, coverage on newspapers and medical discovery are possible predictors of the site of medical seeking. In addition, age, level of education, medical seeking under discomfort, health condition, hospital website, community healthcare service and public relationship activity are possible predictors of the frequency of medical seeking. The conclusion of this research could be adopted by the hospital manager and the public relations practitioner for reference as they intend to release health news.
Smartphones are used by incredibly many people, and in 2011 there where a total of 491.4 million units soled worldwide. This makes it a relevant technique for performing dietary studies when the test patients are on the move. This thesis shows how to create a back end environment for an Android application with existing techniques linked together, using MSSQL database, Visual Studio Web Service, web pages and C# classes and ASP.NET security. The back end development is used in a dietary study on Gothenburg University, butcould be applied on many similar back end projects using databases and server development.Techniques used in this thesis are: REST (Representational State Transfer) -client implementation and development inside the Android application, using HTTP methods to set and get information from the server and database, and JSON-format to read and transferinformation in an easy and understandable way, both from the Android application and from the database. FileMaker is also used in this project as a third part programme tovisualise the information in the database.
A Middleware of Wireless sensor networks for Home healthcare monitoring application : Design and implementation based on multiple module of data acquisitionTang, Jun January 2013 (has links)
With the continued increases in the global population, a serious problem will occur in relation to an ageing population. The reason for this is that a significant number of elderly people may suffer from serial chronic diseases making it difficult for them to live independently and thus they pose a significant economic burden for both themselves and for their government. In order to solve this problem, more and more E-healthcare applications are being designed. In addition, a wide range of medical sensors exist, which can monitor almost all the important physiological parameters of the human body. However, different sensors may use different communication protocols, data units and formats. Additionally, the elderly may use more than one E-healthcare application at the same time and this can lead to problems if there is more than one data source. The project “A Middleware of Wireless sensor networks for Home healthcare monitoring application” is designed to solve these problems. The focus of this report is on the design and implementation based on multiple modules of data acquisition. There are four data acquisition modules which include the ZigBee module, 6LowPAN module, Wi-Fi module and a Bluetooth module. Thus, multiple data acquisition module middleware supports the sensor by means of ZigBee, 6LowPAN, Wi-Fi and Bluetooth. The tasks of the middleware are to collect packets from sensors, perform data processing and mapping and then displaying as real-time data and finally transmitting the data to the remote server.
Sadler, Daniel J.
This thesis focuses on provincial reactions to the Supreme Court decision on 5 June 2005, Chaoulli v. Quebec (Attorney General). In this decision, the Court struck down the government of Québec’s ban on private insurance for publicly-insured services, on the grounds it violated the Québec Charter of Human Rights and Freedoms, while the decision on the Canadian Charter ended in a 3:3 tie with one abstention. It is the purpose of this research to examine the reactions of each provincial government to the decision in an attempt to understand why each province responded in its chosen manner. In order to make this determination, four hypotheses were constructed in order to test four separate variables: court interference, current law, ideology, and political calculation. These hypotheses were tested against provincial reactions in the media, legislatures, court documents, and E-mail administered questionnaires. This research finds that each hypothesis had some success in predicting provincial reactions to the decision, with a government’s current law and ideology proving to be the most accurate predictors. Based on the evidence gathered, three conclusions were arrived at: first, a government’s law and its ideology will often predict how a government will behave; second, that governments are open to Supreme Court decisions in the area of health care, and, finally, that if provincial governments were to make the decision to increase the role of the private sector in health care, political leaders would require public opinion be in support of such a decision rather than act solely on an ideological predisposition to greater private sector involvement.
Radio Frequency Identification (RFID) technology has been widely adopted by different industries for various purposes. While implementing a RFID system for personnel tracking in an industrial environment, such as a hospital, the tracking accuracy is not always satisfactory due to incorrect placement of RFID hardware, coarse system configuration or environment. This thesis proposes comprehensive optimization methods for improving the tracking accuracy of a RFID system for personnel tracking. The improvement is achieved from four perspectives including RFID data cleaning, experimental design, data fusion and simulation modeling. This research is based on a case study carried out in a local community hospital where a RFID system for personnel tracking has been implemented. Through applying the optimization methods, the tracking accuracy of the RFID system has been improved to 87.33%. The thesis provides a guideline for the hospital and other similar application environment to implement improvement methods on a RFID tracking system.
31 January 2015
This study builds on the theory of planned behavior, institutional and innovation diffusion theories to investigate physicians' responses to introduction of electronic medical records (EMR) in large healthcare organizations. Using a case study methodology, we show that physicians' attitudes towards using EMR are influenced by their perceptions of EMR complexity, relative advantage, compatibility with professional beliefs and individual predisposition to change. Specifically, we found that EMR usability characteristics such as system interface, "navigation," "search" and "speed" are major dimensions underlying physicians' perceptions of EMR complexity. To the extent that navigating and searching for clinical results are seen as difficult, physicians' perceptions of the complexity of using EMR are enhanced, with the result of physicians forming more negative attitudes towards EMR and using EMR less. Accessibility to EMR (i.e. logging in) and availability of hardware are two emergent constructs. These factors are immediate barriers for physicians not using EMR or using EMR minimally. At the same time, these barriers contribute to impacting physicians' perceptions that EMR is difficult to use and disadvantageous (i.e. time inefficient) compared to the paper chart. Results also show that most EMR usage at Alpha is rather "shallow." Physicians tend to use data-retrieval EMR minimally, mainly to supplement the paper chart. The availability of this "competing artifact," that is much easier to use and conveniently located near a patient's room limits the extent to which physicians use EMR at Alpha. Use of an imaging EMR system (EMR3) is more committed. EMR3 is used to replace the "old way" of accessing films. Lack of accessibility and hardware barriers, the relative advantage of EMR3 and other system usability considerations contribute to physicians using this system more faithfully. As regards the question "what do physicians want?" it seems that physicians want a system that that is easy to access and simple to use but most importantly, a system that they can directly identify with, an EMR that is personally relevant. In order to promote a "deeper" level of EMR usage, the benefits of EMR need to be emphasized to physicians while any potential costs or barriers reduced or eliminated. / Ph.D. / Department of Management Information Systems / Business Administration
Pope, Brandon 1984-
16 December 2013
U.S. healthcare costs have experienced unsustainable growth, with expenditures of $2.5 trillion in 2009, and are rising at a rate faster than that of the U.S. economy. A major factor in the cost of the U.S. healthcare system is related to the strategic behavior of system participants based on their incentives. This dissertation addresses the challenge of designing incentives to solve problems in healthcare systems. Principal agent theory and Markov decision processes are the primary methods used to construct incentives. The first problem considered is how to design contracts in order to align consumer and provider incentives with respect to preventive efforts. The model consists of an insurer contracting with two agents, a consumer and a provider, and focuses on the trade off between ex ante moral hazard and insurance. Two classes of efforts on behalf of the provider are studied: those which complement consumer efforts, and those which substitute with consumer efforts. The results show that the provider must be given incentives when the consumer is healthy to induce effort, and that inducing provider effort allows an insurer to save on incentives given to the consumer. The insurer can save on the cost of incentives by using a multilateral contract compared to the bilateral benchmark. These savings are illustrated by an example showing which model features affect the savings achieved. The second problem addresses the decision to provide knowledge to consumers regarding the consequences of health behaviors. The model developed to address this second problem extends the literature on incentives in healthcare systems to consider dynamic environments and includes a behavioral model of healthcare consumers. By using a learning model of consumer behavior, a policy maker's knowledge provision problem is transformed into a Markov decision process. This framework is used to solve for optimal knowledge provision policies regarding behaviors affecting coronary health. Sensitivity analysis shows robust threshold features of optimal policies. The results show that knowledge about smoking should be provided at most health and behavior states. As the cost of providing knowledge increases or aptitude for behavioral change decreases, fewer states are in the optimal knowledge provision policy, with healthy consumers dropping out first. Knowledge about diet and physical activity is provided more selectively due to the to uncertainty in the health benefits, and the time delay in accrued rewards.
Implicit or Explicit: : Understanding the role of Information Technology in Co- Creational Workshop ResultsHolmlund, Jeanette, Schimmer, Robyn January 2014 (has links)
The demand for increased efficiency and patient-centered care has been influencing the development of healthcare in Sweden, and information technology has an important role in that process. Developing and implementing systems for public healthcare have proven to be a great challenge. One way to address this challenge is open innovation and co-creation. While there are a lot of studies focusing on innovation processes, there is little research regarding how technology is presented in the results. We have studied a co-creational workshop that focused on putting new perspectives on the use of information technology in healthcare. The workshop resulted in eight concepts which have been analyzed in terms of how technology is expressed. The results were categorized into implicit and explicit use of technology and this categorization indicates that the implicit use of technology is of the bricolage kind. By being both implicit and bricolage-like, the concepts hold qualities that make them more likely to be integrated into existing workplaces.
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