Search results for: standardized questionnaire

Authors: Anjula Negi, Sanjay Gupta

Abstract:

Paradigms studied inform inadequacies of financial resources, be it to finance metro rails for construction or to meet operational revenues or to derive profits in the long term. Funding sustainability is far and wide for much-needed public transport modes, like urban rail or metro rails, to be successfully operated. India embarks upon a sustainable transport journey and has proposed metro rail systems countrywide. As an emerging economic leader, its fiscal constraints are paramount, and the land value capture (LVC) mechanism provides necessary support and innovation toward development. India’s metro rail policy promotes multiple methods of financing, including private-sector investments and public-private-partnership. The critical question that remains to be addressed is what factors can make such mechanisms work. Globally, urban rail is a revolution noted by many researchers as future mobility. Researchers in this study deep dive by way of literature review and empirical assessments into factors that can lead to the adoption of LVC mechanisms. It is understood that the adoption of LVC methods is in the nascent stages in India. Research posits numerous challenges being faced by metro rail agencies in raising funding and for incremental value capture. A few issues pertaining to land-based financing, inter alia: are long-term financing, inter-institutional coordination, economic/ market suitability, dedicated metro funds, land ownership issues, piecemeal approach to real estate development, property development legal frameworks, etc. The question under probe is what are the parameters that can lead to success in the adoption of land value capture (LVC) as a financing mechanism. This research provides insights into key parameters crucial to the adoption of LVC in the context of Indian metro rails. Researchers have studied current forms of LVC mechanisms at various metro rails of the country. This study is significant as little research is available on the adoption of LVC, which is applicable to the Indian context. Transit agencies, State Government, Urban Local Bodies, Policy makers and think tanks, Academia, Developers, Funders, Researchers and Multi-lateral agencies may benefit from this research to take ahead LVC mechanisms in practice. The study deems it imperative to explore and understand key parameters that impact the adoption of LVC. Extensive literature review and ratification by experts working in the metro rails arena were undertaken to arrive at parameters for the study. Stakeholder consultations in the exploratory factor analysis (EFA) process were undertaken for principal component extraction. 43 seasoned and specialized experts participated in a semi-structured questionnaire to scale the maximum likelihood on each parameter, represented by various types of stakeholders. Empirical data was collected on chosen eighteen parameters, and significant correlation was extracted for output descriptives and inferential statistics. Study findings reveal these principal components as institutional governance framework, spatial planning features, legal frameworks, funding sustainability features and fiscal policy measures. In particular, funding sustainability features highlight sub-variables of beneficiaries to pay and use of multiple revenue options towards success in LVC adoption. Researchers recommend incorporation of these variables during early stage in design and project structuring for success in adoption of LVC. In turn leading to improvements in revenue sustainability of a public transport asset and help in undertaking informed transport policy decisions.

Keywords: Exploratory factor analysis, land value capture mechanism, financing metro rails, revenue sustainability, transport policy

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Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

Abstract:

Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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Authors: Veenapani Rajeev Verma

Abstract:

Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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Authors: Krystian Szczepanski, Sylwia Łaba

Abstract:

Production of fruit and vegetables, food cereals or oilseeds affects the natural environment via intake of nutrients being contained in the soil, use of the resources of water, fertilizers and food protection products, and energy. The limitation of the mentioned effects requires the introduction of techniques and methods for cultivation being friendly to the environment and counteracting losses and waste of agricultural raw materials as well as the appropriate management of food waste in every stage of the agri-food supply chain. The link to basic production includes obtaining a vegetal raw material and its storage in agricultural farm and transport to a collecting point. When the plants are ready to be harvested is the initial point; the stage before harvesting is not considered in the system of measuring and monitoring the food losses. The moment at which the raw material enters the stage of processing, i.e., its receipt at the gate of the processing plant, is considered as a final point of basic production. According to the Regulation (EC) No 178/2002 of the European Parliament and of the Council of 28 January 2002, Art. 2, “food” means any substance or product, intended to be, or reasonably expected to be consumed by humans. For the needs of the studies and their analysis, it was determined when raw material is considered as food – the plants (fruit, vegetables, cereals, oilseeds), after being harvested, arrive at storehouses. The aim of the studies was to determine the reasons for loss generation and to analyze the directions of their management in basic vegetal production in Poland in the years 2017 and 2018. The studies on food losses and waste in basic vegetal production were carried out in three sectors – fruit and vegetables, cereals and oilseeds. The studies of the basic production were conducted during the period of March-May 2019 at the territory of the whole country on a representative trail of 250 farms in each sector. The surveys were carried out using the questionnaires by the PAP method; the pollsters conducted the direct questionnaire interviews. From the conducted studies, it is followed that in 19% of the examined farms, any losses were not recorded during preparation, loading, and transport of the raw material to the manufacturing plant. In the farms, where the losses were indicated, the main reason in production of fruit and vegetables was rotting and it constituted more than 20% of the reported reasons, while in the case of cereals and oilseeds’ production, the respondents identified damages, moisture and pests as the most frequent reason. The losses and waste, generated in vegetal production as well as in processing and trade of fruit and vegetables, or cereal products should be appropriately managed or recovered. The respondents indicated composting (more than 60%) as the main direction of waste management in all categories. Animal feed and landfill sites were the other indicated directions of management. Prevention and minimization of loss generation are important in every stage of production as well as in basic production. When possessing the knowledge on the reasons for loss generation, we may introduce the preventive measures, mainly connected with the appropriate conditions and methods of the storage. Production of fruit and vegetables, food cereals or oilseeds affects the natural environment via intake of nutrients being contained in the soil, use of the resources of water, fertilizers and food protection products, and energy. The limitation of the mentioned effects requires the introduction of techniques and methods for cultivation being friendly to the environment and counteracting losses and waste of agricultural raw materials as well as the appropriate management of food waste in every stage of the agri-food supply chain. The link to basic production includes obtaining a vegetal raw material and its storage in agricultural farm and transport to a collecting point. The starting point is when the plants are ready to be harvested; the stage before harvesting is not considered in the system of measuring and monitoring the food losses. The successive stage is the transport of the collected crops to the collecting point or its storage and transport. The moment, at which the raw material enters the stage of processing, i.e. its receipt at the gate of the processing plant, is considered as a final point of basic production. Processing is understood as the change of the raw material into food products. According to the Regulation (EC) No 178/2002 of the European Parliament and of the Council of 28 January 2002, Art. 2, “food” means any substance or product, intended to be, or reasonably expected to be consumed by humans. It was determined (for the needs of the present studies) when raw material is considered as a food; it is the moment when the plants (fruit, vegetables, cereals, oilseeds), after being harvested, arrive at storehouses. The aim of the studies was to determine the reasons for loss generation and to analyze the directions of their management in basic vegetal production in Poland in the years 2017 and 2018. The studies on food losses and waste in basic vegetal production were carried out in three sectors – fruit and vegetables, cereals and oilseeds. The studies of the basic production were conducted during the period of March-May 2019 at the territory of the whole country on a representative trail of 250 farms in each sector. The surveys were carried out using the questionnaires by the PAPI (Paper & Pen Personal Interview) method; the pollsters conducted the direct questionnaire interviews. From the conducted studies, it is followed that in 19% of the examined farms, any losses were not recorded during preparation, loading, and transport of the raw material to the manufacturing plant. In the farms, where the losses were indicated, the main reason in production of fruit and vegetables was rotting and it constituted more than 20% of the reported reasons, while in the case of cereals and oilseeds’ production, the respondents identified damages, moisture, and pests as the most frequent reason. The losses and waste, generated in vegetal production as well as in processing and trade of fruit and vegetables, or cereal products should be appropriately managed or recovered. The respondents indicated composting (more than 60%) as the main direction of waste management in all categories. Animal feed and landfill sites were the other indicated directions of management. Prevention and minimization of loss generation are important in every stage of production as well as in basic production. When possessing the knowledge on the reasons for loss generation, we may introduce the preventive measures, mainly connected with the appropriate conditions and methods of the storage. ACKNOWLEDGEMENT The article was prepared within the project: "Development of a waste food monitoring system and an effective program to rationalize losses and reduce food waste", acronym PROM implemented under the STRATEGIC SCIENTIFIC AND LEARNING PROGRAM - GOSPOSTRATEG financed by the National Center for Research and Development in accordance with the provisions of Gospostrateg1 / 385753/1/2018

Keywords: food losses, food waste, PAP method, vegetal production

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Authors: Zhi-Zhong Chen, Jun-Hao Lu, Jr., Shih-Ying Chueh

Abstract:

Based on Unified Theory of Acceptance and Use of Technology (UTAUT), the study investigates people’s intention on using smart phones. The study additionally incorporates two new variables: 'self-efficacy' and 'attitude toward using'. Samples are collected by questionnaire survey, in which 240 are valid. After Correlation Analysis, Reliability Test, ANOVA, t-test and Multiple Regression Analysis, the study finds that social impact and self-efficacy have positive effect on use intentions, and the use intentions also have positive effect on use behavior.

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