Abstract: Due to the rise of aging population, effective utilization
of healthcare resources has become an important issue. With the
advance of ICT technology, the application of tele-healthcare service
has received more attention than ever. The main purpose of this
research is to investigate how to conduct innovative design for
tele-healthcare service based on user-s perspectives. First, the
healthcare service blueprint was used to describe the processes
of tele-healthcare service delivery, and then construct PZB service
quality gap model based on the literature and practitioners-
interviews. Next, TRIZ theory is applied to implement service
innovation. We found the proposed service innovation procedures can
effectively improve the quality of service design.
Abstract: Nowadays pharmaceutical care departments located in
hospitals are amongst the important pillars of the healthcare system.
The aim of this study was to evaluate quality of hospital drugstores
affiliated with Kermanshah University of Medical Sciences.
In this cross-sectional study a validated questionnaire was used.
The questionnaire was filled in by the one of the researchers in all
seventeen hospital drugstores located in the teaching and nonteaching
hospitals affiliated with Kermanshah University of Medical
Sciences. The results shows that in observed hospitals,24% of
pharmacy environments, 25% of pharmacy store and storage
conditions, 49% of storage procedure, 25% of ordering drugs and
supplies, 73% of receiving supplies (proper procedure are fallowed
for receiving supplies), 35% of receiving supplies (prompt action
taken if deterioration of drugs received is suspected), 23.35% of
drugs delivery to patients and finally 0% of stock cards are used for
proper inventory control have full compliance with standards.
Abstract: With the advent of new technologies, factors related to
mental health in e-workspaces are taken into consideration more than
ever. Studies have revealed that one of the factors affecting the
productivity of employees in an organization is occupational stress.
Another influential factor is quality of work life which is important in
the improvement of work environment conditions and organizational
efficiency. In order to uncover the quality of work life level and to
investigate the impact of occupational stress on quality of work life
among information technology employees in Iran, a cross-sectional
study design was applied and data were gathered using a
questionnaire validated by a group of experts. The results of the study
showed that information technology staffs have average level of both
occupational stress and quality of work life. Furthermore, it was
found that occupational stress has a negative impact on quality of
work life. In addition, the same results were observed for role
ambiguity, role conflict, role under-load, work-pace, work
repetitiveness and tension toward quality of work life. No significant
relation was found between role overload and quality of work life.
Finally, directions for future research are proposed and discussed.
Abstract: Today-s healthcare industries had become more
patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may
be detrimental to the patient-s life, and thus is one of the major indexes
of patient safety and healthcare quality. A high UE rate not only
defeated the healthcare quality as well as the patient safety policy but
also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the
healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular
project that was organized to reduce the UE rate from the current 2.3%
to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st,
2011 and August 31st, 2011. Based on the error information gathered
from varied units of the hospital, the team analyzed the root causes
with possible solutions proposed to the meetings. Four solutions were
then concluded with consensus and launched to the units in question.
The UE rate was now reduced to a level of 0.17%. Experience from
this project, the procedure and the tools adopted would be good reference to other hospitals.
Abstract: In managing healthcare logistics, cost is not the only
factor to be considered. The level of items- criticality used in patient
care services plays an important role as well. A stock-out incident of
a high critical item could threaten a patient's life. In this paper, the
DMAIC (Define-Measure-Analyze-Improve-Control) methodology is
used to drive improvement projects based on customer driven critical
to quality characteristics at a Jordanian hospital. This paper shows
how the application of Six Sigma improves the performance of the
case hospital logistics system by reducing the number of stock-out
incidents.
Abstract: There is inadequate information on the practice of
female genital mutilation (FGM) in the UK, and there are often
myths and perceptions within communities that influence the
effectiveness of prevention programmes. This means it is difficult to
address the trends and changes in the practice in the UK.
To this end, FORWARD undertook novel and innovative research
using the Participatory Ethnographic and Evaluative Research
(PEER) method to explore the views of women from Eritrea, Sudan,
Somalia and Ethiopia that live in London and Bristol (two UK cities).
Women-s views, taken from PEER interviews, reflected reasons for
continued practice of FGM: marriageability, the harnessing and
control of female sexuality, and upholding traditions from their
countries of origin. It was also clear that the main supporters of the
practice were believed to be older women within families and
communities.
Women described the impact FGM was having on their lives as
isolating. And although it was clearly considered a private and
personal matter, they developed a real sense of connection with their
peers within the research process.
The women were overwhelmingly positive about combating the
practice, although they believed it would probably take a while
before it ends completely. They also made concrete
recommendations on how to improve support services for women
affected by FGM: Training for professionals (particularly in
healthcare), increased engagement with, and outreach to,
communities, culturally appropriate materials and information made
available and accessible to communities, and more consequent
implementation of legislation.
Finally, the women asked for more empathy and understanding,
particularly from health professionals. Rather than presenting FGM
as a completely alien and inconceivable practice, it may help for
those looking into these women-s lives and working with them to
understand the social and economic context in which the practice
takes place.
Abstract: Background, measuring an individual-s Health
Literacy is gaining attention, yet no appropriate instrument is available
in Taiwan. Measurement tools that were developed and used in
western countries may not be appropriate for use in Taiwan due to a
different language system. Purpose of this research was to develop a
Health Literacy measurement instrument specific for Taiwan adults.
Methods, several experts of clinic physicians; healthcare
administrators and scholars identified 125 common used health related
Chinese phrases from major medical knowledge sources that easy
accessible to the public. A five-point Likert scale is used to measure
the understanding level of the target population. Such measurement is
then used to compare with the correctness of their answers to a health
knowledge test for validation. Samples, samples under study were
purposefully taken from four groups of people in the northern
Pingtung, OPD patients, university students, community residents,
and casual visitors to the central park. A set of health knowledge index
with 10 questions is used to screen those false responses. A sample
size of 686 valid cases out of 776 was then included to construct this
scale. An independent t-test was used to examine each individual
phrase. The phrases with the highest significance are then identified
and retained to compose this scale. Result, a Taiwan Health Literacy
Scale (THLS) was finalized with 66 health-related phrases under nine
divisions. Cronbach-s alpha of each division is at a satisfactory level
of 89% and above. Conclusions, factors significantly differentiate the
levels of health literacy are education, female gender, age, family
members of stroke victims, experience with patient care, and
healthcare professionals in the initial application in this study..
Abstract: In this paper, a Bayesian Network (BN) based system
is presented for providing clinical decision support to healthcare
practitioners in rural or remote areas of India for young infants or
children up to the age of 5 years. The government is unable to
appoint child specialists in rural areas because of inadequate number
of available pediatricians. It leads to a high Infant Mortality Rate
(IMR). In such a scenario, Intelligent Pediatric System provides a
realistic solution. The prototype of an intelligent system has been
developed that involves a knowledge component called an Intelligent
Pediatric Assistant (IPA); and User Agents (UA) along with their
Graphical User Interfaces (GUI). The GUI of UA provides the
interface to the healthcare practitioner for submitting sign-symptoms
and displaying the expert opinion as suggested by IPA. Depending
upon the observations, the IPA decides the diagnosis and the
treatment plan. The UA and IPA form client-server architecture for
knowledge sharing.
Abstract: Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.
Abstract: The menace of counterfeiting pharmaceuticals/drugs has become a major threat to consumers, healthcare providers, drug manufacturers and governments. It is a source of public health concern both in the developed and developing nations. Several solutions for detecting and authenticating counterfeit drugs have been adopted by different nations of the world. In this article, a dialogue system-based drug counterfeiting detection system was developed and the results of the user satisfaction and acceptability of the system are presented. The results show that the users were satisfied with the system and the system was widely accepted as a means of fighting counterfeited drugs.
Abstract: Leave of absence is important in maintaining a good
status of human resource quality. Allowing the employees temporarily
free from the routine assignments can vitalize the workers- morality
and productivity. This is particularly critical to secure a satisfactory
service quality for healthcare professionals of which were typically
featured with labor intensive and complicated works to perform. As
one of the veteran hospitals that were found and operated by the
Veteran Department of Taiwan, the nursing staff of the case hospital
was squeezed to an extreme minimum level under the pressure of a
tight budgeting. Leave of absence on schedule became extremely
difficult, especially for the intensive care units (ICU), in which
required close monitoring over the cared patients, and that had more
easily driven the ICU nurses nervous. Even worse, the deferred leaves
were more than 10 days at any time in the ICU because of a fluctuating
occupancy. As a result, these had brought a bad setback to this
particular nursing team, and consequently defeated the job
performance and service quality. To solve this problem and
accordingly to strengthen their morality, a project team was organized
across different departments specific for this. Sufficient information
regarding jobs and positions requirements, labor resources, and actual
working hours in detail were collected and analyzed in the team
meetings. Several alternatives were finalized. These included job
rotating, job combination, leave on impromptu and cross-departmental
redeployment. Consequently, the deferred leave days sharply reduced
70% to a level of 3 or less days. This improvement had not only
provided good shelter for the ICU nurses that improved their job
performance and patient safety but also encouraged the nurses active
participating of a project and learned the skills of solving problems
with colleagues.
Abstract: Medical services are usually provided in hospitals; however, in developing country, some rural residences have fewer opportunities to access in healthcare services due to the limitation of transportation communication. Therefore, in Thailand, there are charitable organizations operating to provide medical treatments to these people by shifting the medical services to operation sites; this is commonly known as mobile medical service. Operation routing is important for the organization to reduce its transportation cost in order to focus more on other important activities; for instance, the development of medical apparatus. VRP is applied to solve the problem of high transportation cost of the studied organization with the searching techniques of saving algorithm to find the minimum total distance of operation route and satisfy available time constraints of voluntary medical staffs.
Abstract: Understanding how airborne pathogens are
transported through hospital wards is essential for determining the
infection risk to patients and healthcare workers. This study utilizes
Computational Fluid Dynamics (CFD) simulations to explore
possible pathogen transport within a six-bed partitioned Nightingalestyle
hospital ward.
Grid independence of a ward model was addressed using the Grid
Convergence Index (GCI) from solutions obtained using three fullystructured
grids. Pathogens were simulated using source terms in
conjunction with a scalar transport equation and a RANS turbulence
model. Errors were found to be less than 4% in the calculation of air
velocities but an average of 13% was seen in the scalar field.
A parametric study of variations in the pathogen release point
illustrated that its distribution is strongly influenced by the local
velocity field and the degree of air mixing present.
Abstract: Business scenario is an important technique that may be used at various stages of the enterprise architecture to derive its characteristics based on the high-level requirements of the business. In terms of wireless deployments, they are used to help identify and understand business needs involving wireless services, and thereby to derive the business requirements that the architecture development has to address by taking into account of various wireless challenges. This study assesses the deployment of Wireless Local Area Network (WLAN) and Broadband Wireless Access (BWA) solutions for several business scenarios in Asia Pacific region. This paper focuses on the overview of the business and technology environments, whereby examples of existing (or suggested) wireless solutions (to be) adopted in Asia Pacific region will be discussed. Interactions of several players, enabling technologies, and key processes in the wireless environments are studied. The analysis and discussions associated to this study are divided into two divisions: healthcare and education, where the merits of wireless solutions in improving living quality are highlighted.
Abstract: The health record in the Electronic Health Record
(EHR) system is more sensitive than demographic. It raises the
important issue for the EHR requirement in privacy, security, audit
trail, patient access, and archiving and data retention. The studies
about the EHR system security are deficient. The aim of this study is to
build a security environment for the EHR system by Integrating the
Healthcare Enterprise (IHE) Audit Trail and Node Authentication
Security (ATNA) profile. The CDAs can be access in a secure EHR
environment.
Abstract: This study used Item Analysis, Exploratory Factor
Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to
exam the Questions which selected by the Delphi method based on the
issue of “Socio-technical system (STS)" and user-centered
perspective. A structure questionnaire with seventy-four questions
which could be categorized into nine dimensions (healthcare
environment, organization behaviour, system quality, medical data
quality, service quality, safety quality, user usage, user satisfaction,
and organization net benefits) was provided to evaluate EMR of the
Taiwanese healthcare environment.
Abstract: The Taiwan Health Literacy Scale (THLS) was developed to cope with the need of measuring heath literacy of Chinese-speaking adults in Taiwan. Although the scale was proven having good reliability and validity, it was not popularly adopted by the practitioners due to the length, and the time required completing. Based on the THLS, this research further invited healthcare professionals to review the original scale for a possible shorten work. Under the logic of THLS, the research adopted an analytic hierarchy process technique to consolidate the healthcare experts- assessments to shorten the original scale. There are fifteen items out of the original 66 items were identified having higher loadings. Confirmed by the experts and passed a pilot test with 40 undergraduate students, a short form of THLS is then introduced. This research then used 839 samples from the major cities of the Hua-lien county in the eastern part of Taiwan to test the reliability and validity of this new scale. The reliability of the scale is high and acceptable. The current scale is also highly correlated with the original, of which provide evidence for the validity of the scale.
Abstract: Healthcare providers sometimes use the power of
humor as a treatment and therapy for buffering mental health or easing
mental disorders because humor can provide relief from distress and
conflict. Humor is also very suitable for advertising because of similar
benefits. This study carefully examines humor's widespread use in
advertising and identifies relationships among humor mechanisms,
female depictions, and product types. The purpose is to conceptualize
how humor theories can be used not only to successfully define a
product as fitting within one of four color categories of the product
color matrix, but also to identify compelling contemporary female
depictions through humor in ads. The results can offer an idealization
for marketing managers and consumers to help them understand how
female role depictions can be effectively used with humor in ads. The
four propositions developed herein are derived from related literature,
through the identification of marketing strategy formulations that
achieve product memory enhancement by adopting humor
mechanisms properly matched with female role depictions.
Abstract: Increased physical fitness participation has been
paralleled by increasedoveruse injuries such as insertional Achilles
tendinosis (AT). Treatment has provided inconsistentresults. The use
of extracorporeal shockwave therapy (ECSWT) offers a new
treatment consideration.The purpose of this study was to assess the
effects of ECSWTon pain, function, range of motion (ROM), joint
mobility and strength in patients with AT. Thirty subjects were
treated with ECSWT and measures were takenbefore and three
months after treatment. There was significant differences in visual
analog scale (VAS) scores for pain at rest (p=0.002); after activity
(p= 0.0001); overall improvement(p=0.0001); Lower Extremity
Functional Scale (LEFS) scores (p=0.002); dorsiflexion range of
motion (ROM) (p=0.0001); plantarflexion strength (p=0.025);
talocrural joint anterior glide (p=0.046); and subtalar joint medial and
lateral glide (p=0.025).ECSWT offers a new intervention that may
limit the progression of the disorder and the long term healthcare
costs associated with AT.
Abstract: Healthcare issues continue to pose huge problems and incur massive costs. As a result there are many challenging problems still unresolved. In this paper, we will carry out an extensive scientific survey of different areas of management and planning in an attempt to identify where there has already been a substantial contribution from management science methods to healthcare problems and where there is a clear potential for more work to be done. The focus will be on the read-across to the healthcare domain from such approaches applied generally to management and planning and how the methods can be used to improvement patient care. We conclude that, since the healthcare domain significantly differs from traditional areas of management and planning, in some cases there is a need to modify the approaches so as to incorporate the complexities of healthcare, and fully exploit the potential for improvement.