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1	Simulace provozu nemocničního oddělení / Simulation of the operation of the hospital department Olejár, Filip January 2011 (has links) This diploma thesis deals with the solution to a real situation that occurred at Nemocnice Na Františku in Prague. The problem is solved by using a computer simulation in SIMUL8 simulation program. At the beginning I describe the theoretical foundations that are afterwards used as a basis for the main practical part. The main subject of the work is a simulation of an operation of the hospital outpatient department. The hospital management decided to change the system for handling patients operations. I have created simulation models for particular workday and weekend means of patients serving operations. The created simulation models and their outputs are evaluated in the final part of the thesis and will serve as a basis for making reorganization decisions in the hospital. The provided advice for hospital management fulfills the goal of this thesis.
2	Paslaugų kokybės vertinimas pacienčių ir medikų požiūriu universitetinės ligoninės moterų konsultacijoje / The assessment of outpatient service quality in the university clinic: views of patients and physicians Aniulienė, Rosita 15 June 2006 (has links) The aim of the study – to assess the consultation service quality provided for patients in the maternity academic clinic. Methods. The anonymous poll has been proceeded in September, 2005. It included all physicians of the university clinic such as obstetricians and gynecologists (N=68, response rate - 94.4 %) and all patients visited in the clinic during the research period (N=334, response rate 81.1 %). The consultation service quality was assessed with the structured questionnaire by Ferguson et all. Data of respondents was analyzed and statistically justified by using the „SPSS 10.03“. Results. The study showed that majority of patients positively assessed the technical aspect of service quality. The patients were satisfied with clear indoor signs and references as well as with comprehended and obvious oral instructions. The majority of patients were also complied to the statements that the clothing and appearance and of clinic staff was clean and ordered, that health care means, methods and regulations are secured and appropriate for patients, that medical equipment is advanced and modern, that all physicians of the clinic are competent and qualified. We have also determined that 53.7 % of clinical workers accepted and 28.4 % rejected the statement that the equipment and indoor rooms were sterile and aseptic. The majority of patients and clinic staff members assessed positively the functional service quality in clinic: enough information about necessity and aims of... [to full text] Public Health Pacientų požiūris Paslaugų kokybė
3	Multidimenzionální pohled na práci dětské sestry v ambulantní sféře dětského oddělení / Multidimensional view on the work of children's nurse in the emergency room of children's ward PŘÍPLATOVÁ, Iveta January 2019 (has links) The work of nurses in the outpatient department belongs between discussed topics. The interplay and cooperation of all members of the medical team are especially important. Correct communication between all team members and communication with children and their accompaniment are also a matter of course. The aim of this diploma thesis is to map the work of a nurse in a comprehensive view in the outpatient area of the children's ward, the satisfaction of children and parents in the outpatient area of the children's ward and to suggest possible improvements for the outpatient sphere of the children's ward of České Budějovice a.s. The diploma thesis is processed by qualitatively quantitative investigation using semi-structured interviews, questionnaires and observations. The research group consisted of nurses, doctors, paediatric patients and their accompaniment at the children's ward, paramedics and the general public as well. The interviews were categorized and processed by the method of pencil and paper. Questionnaires were processed statistically. The hidden participating observation was focused on the collaboration and communication of nurses from outpatient department with other nurses, doctors, paramedics, children and their accompaniment; and it was also focused on the satisfaction of the children or their accompaniment at the outpatient department. The results of the work showed that the view of the work of the paediatric nurse is distorted both from the health care professionals and the general public, which means that the nurse is seen mainly as a nursing care provider. The results also showed the necessity of proper communication and knowledge of foreign languages. At the same time, the thesis was used to identify shortcomings or suggestions for changes in the paediatric outpatient department of the České Budějovice Hospital, including the satisfaction of patients and their accompaniment during visiting the department that depends on the time spent in the waiting room. Suggestions for improvement were drawn up, drafted and handed over to the children's ward management.
4	Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital Lucas, D. Pulane 24 April 2013 (has links) Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs. Disruptive Disruptive Innovation Theory Disruptive Transformations Disruptive Innovation Innovation Technology Technological Innovation Medical Innovation Medical Technology Medical Advancement Laparoscopy Laparoscopic Surgery open surgery appendectomy cholecystectomy bariatric surgery weight loss surgery appendectomies cholecystectomies inpatient outpatient ambulatory ambulatory surgery ambulatory surgery center acute care general hospital hospital acute care hospital general hospital health care healthcare hospital industry health care industry Clayton Christensen Clayton M Christensen Michael Porter Harvard Business School Virginia Commonwealth University CMS Health policy public policy public administration organizational theory organization theory Population Ecology Theory Competitive Strategy policy analysis John Kimberly Organization Size Structural Inertia liability of smallness health spending health care cost specialty medical facility open system niche width dynamic outpatient department technology shift surgical setting surgical setting shift medical facility shift substitution threat health system system level analysis Ecological Approach hospital trends ambulatory surgery trends reimbursement rate Medicare CMS coverage decision P J DiMaggio DiMaggio and Powell w w Powell Hannan and Freeman M T Hannan Organizational change minimally invasive surgery less invasive surgery Prospective Payment System Outpatient Prospective Payment System entreprenuerial physician health care organization health care management Roice Luke Carl Ameringer new technology surgical utilization elective surgery Medicare Payment Advisory Commission MedPAC coverage decision trends in surgery abdominal surgery surgical variation physician-owned physician ownership physician autonomy outpatient clinic utilization trends unnecessary surgery Pfeffer Salancik technology diffusion redefining health care interdisciplinary research health care delivery panel design diffusion of hospital technology state variation regional variation local health care market government intervention medical facility health care capacity focused factory advances in health care physician organization relationship hospital competition medical specialization hospital expansion medical arms race integrated care integrated health system J E Wennberg health care transformation reimbursement scheme surgical volume Florida Wisconsin policy making health policy analysis competitive dynamics center of excellence intervening factor service line competition service-line competition surgical reimbursement innovative business model innovative technology environmental influence established firm new market entrant patient safety sophisticated technology Harvard Divinity School Social and Behavioral Sciences

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